Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

Second semester / Chapter one

Physics of cardiovascular system
Heart

A double pump as shown in (figure 1), it provides the force needed to circulate the
blood through two major circulatory systems:

- Pulmonary circulation 20% of the blood (right side pump):

Right Ventricle (RV) 25 mmHg pulmonary artery pulmonary capillary
pulmonary vein Left Atrium (LA) 7 ~ 8 mmHg  Left Ventricle (LV)
-Systemic circulation 80% of the blood (left side pump): Left Ventricle (LV) 125
mmHg arteries  arterioles capillary bed (for a few seconds) venules
veins  superior vena cava and inferior vena cava Right Atrium (RA) 5 ~ 6
mmHg Right Ventricle (RV)

Figure (1): anatomy of heart

Work done by heart

In a typical adult each contraction of the heart muscles forces about 80 ml of blood
through the lungs from RV and similar volume to the systematic circulation from
LV. In the process the heart does work.

1|Page
 Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

The work done by the heart (W)

W = PV
Where P = pressure, V = volume pumped
- The pressures in two pumps of the heart are not the same (fig, 2); in the pulmonary
system the pressure is very low due to the low resistance of the blood vessels in the
Lungs, typically about 25mm Hg. In the systemic circulation the pressure produced
by the left side of heart at the peak (systole) is about 120 mmHg, during the resting
phase (diastole) of the cardiac cycle the pressure in the systemic circulation is
typically about 80mmHg.

Figure (2): The pressure varies throughout the circulatory system

- Note the greater thickness of muscles on the left side of the heart. The muscle
driving the left ventricle is about three times thicker than that the right ventricle. In
addition, the circular shape of the left ventricle is more efficient for producing high
pressure than the elliptical shape of the right ventricle (fig, 3).

2|Page
 Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

Figure (3): The cross section shows the circular of the left ventricle and the elliptical shape of the
right ventricle.

Example 1:
- If the average pressure is 100 mmHg (100 mmHg=10388 dynes /cm2) and 80 mL of
blood is pumped each second (pulse rate of 60/min) what is the (W) of the heart.
W per second = P V = 10388x 80
W= 830.040 ergs
W= 0.830 J/sec = 0.830 Watt

- During strenuous work or exercise the blood pressure my rise by 50% and the blood
volume pumped per minute may increase by a factor of 5, leading to an increase of
7.5 times in the work done by the heart per minute

Blood pressure and its measurement

- During surgery and in intensive care, a direct measurement of blood pressure

is performed, Hollow needle is inserted in the blood vessel and a catheter (hollow
plastic tube) is threated through the needle. The catheter transmits the blood pressure
to the pressure transducer. The pressure deflects the diaphragm causing a change of
resistance in the four strain gauge wires. The T wires undergo tension and C wires
undergo compression.

3|Page
 Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

Figure (4): direct blood pressure measurement

- Indirect blood pressure measurements by using the sphygmomanometer.

The sphygmomanometer consists of a pressure cuff, gauge on the upper arm and a
stethoscope placed over the brachial artery at the elbow (fig, 5). The pressure cuff is
inflated to a pressure sufficient to stop the blood flow and then the air is released
gradually. As the pressure in the cuff becomes lower than the systolic pressure, the
turbulent blood flow can be heard in the stethoscope as so called Korotkoff sounds.
The pressure shown by the gauge at which Korotkoff sounds start indicates the
systolic pressure. The pressure at which Korotkoff sound die out points the diastolic
pressure.

Figure (5): blood pressure measurements by using the sphygmomanometer.

4|Page
Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

Pressure across the blood vessel wall

The greatest pressure drop in the cardiovascular system occurs in the region of the
arterioles and capillaries. The capillaries have very thin walls (1µm) that permit easy
diffusion of O2 and CO2. In order to understand why they do not burst we must
discuss how the tension in the wall of a tube is related to the radius of the tube and
the pressure inside the tube.
T = RP
Consider along tube of radius R carrying blood at pressure P. We calculate the
tension T in the wall. We can divide the tube in half as shown in (fig, 7). The force
per unit length pushing upward is 2RP. There is a tension force T per unit length at
each edge that holds the top half of the tube to bottom half. Since the wall is in
equilibrium the force pushing the two halves a part is equal to the tension forces
holding them together or 2T =2RP or T =RP. For very small radius the tension is
also very small.

Figure (7): for a long tube of radius R with blood at pressure P. The tension is very small for very
small vessels.

5|Page
Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

Bernoulli’s principle applied to the cardiovascular system:

Bernoulli's principle is based on the law of conservation of energy. Pressure in
fluid is a form of potential energy PE since it has ability to perform useful work. In a
moving fluid is kinetic energy KE due to motion.
If fluid is flowing through the frictionless tube shown in (fig, 8), the velocity
increases in the narrow section and increased in kinetic energy KE of the fluid is
obtained by a reduction of the potential energy of the pressure in the tube. As the
velocity reduces again on the far side of the restriction the kinetic energy is
converted back into potential energy and the pressure increases again.
The sum of the static pressure p, the dynamic pressure (kinetic energy per unit
volume) and the hydrostatic pressure (the potential energy per unit volume) has
the same value at all points along a streamline.
1
p  2  gh  a constant
2

Figure (8): As the velocity of the fluid increases in the narrow section of the tube.

The work done on the any system W

W = KE + PE
M
W = P V = P

1
KE = Kinetic energy = MV2
2
PE = Potential energy = Mgh

6|Page
Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

M 1
P = MV2 + Mgh
 2
1
P=  V2 + gh
2
1
(P1 – P2) = ( V22 -  V12 ) + g ( h2 – h1 )
2

1 1
P1 + gh1 +  V12 = P2 +gh2 +  V22
2 2

How fast dose your blood flow?

The blood goes from the aorta into the smaller arteries and arterioles with greater
total-cross sectional areas the velocity of the blood decreases.

The velocity =

The blood leaves the heart at speed of about 30 m/s through the aorta of the cross-
sectional area of 3cm2. Total cross-sectional area of capillaries is about 900cm2, the
speed through capillaries is:
A1 1 = A2 2
30cm/s 3cm2= 900cm2 2= 0.1cm/s. or 1mm/s
This low velocity allows time for diffusion of O2 and CO2 to occur.

Figure (8): The dashed curved shows the change in cross sectional area. The velocity of blood
flow (solid line) decreases as the total cross sectional area increases.

7|Page
 Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

- Continuity of flow equation tells us this: when the area decreases, the velocity
increases in order to maintain a constant flow rate.

- Bernoulli’s equation tells us that when velocity increases, the pressure (that the fluid
exerts on its walls) decreases.

- When you have cholesterol buildup (fig, 9) and arterosclerosis, then the arteries
decrease in area since the radius is smaller. From the continuity of flow equation, the
velocity of the blood must increase to maintain the same flow rate Q. This increase
in velocity results in a lower pressure at that area.

Figure (9): the cholesterol buildup in vessels

From continuity and Bernoulli’s equations

From the continuity equation, A1v1 = A2v2.
Due to cholesterol deposits, A1 > A2 —-> v1 < v2.

From Bernoulli’s equation, ½ ρv2+ ρgh + P = constant.

Thus, since v1↓ —-> P1↑

8|Page
 Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

The factors affect the flows of blood in the vessel are.

The flow rate = ΔP (𝜋/8) (1/𝜂) (𝑅4/𝐿)

1-viscosity (η), the cgs unit used to measure viscosity is Poise, the SI unit for
viscosity is Pascal second (Pas), which equals 10 poises. The viscosity of blood is
typically 3x10-3 to 4x10-4 pas.
Viscosity of blood depends on:-
 Hematocrit (the percent of red blood cells in the blood) – as the hematocrit increases,
the viscosity also increases. Persons with the disease polycythemia vera with an
over-production of erythrocytes have a high hematocrit and circulatory problems.

 Temperature – as blood gets colder, the viscosity increases and this can reduce the
blood supply to cold hands and feet.

2- Pressure difference (ΔP), If ΔP is doubled, the flow rate also doubles.

3- The length (L), the flow varies inversely with the length.
4-The radius (R), if the radius is doubled the flow rate increases by 24 or factor 16
(fig, 10).

Figure (10): poiseulle's law, the flow rate through a tube.

9|Page
Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

Blood flow- Laminar and Turbulent:

1. Laminar flow:-

It is a slow, smooth and quietly flows of blood in most blood vessels.

The properties of Laminar flow:

- The layers of blood in contact with the walls of the blood vessels are
essentially stationary.

- The next to the outside layer is moving slowly and the layer in center of the
vessel is moving more rapidly.

- The effect of Laminar flow on the distribution of red blood cells in the
circulatory system is not uniform. There are more in the center than at the edges,
and this produces two effects:

1. When blood enters a small blood vessel from the side of a main vessel the
percentage of red blood cells will be slightly less than in the blood in the main
vessel due to the skimming effect.

2. Because the plasma along the vessel walls is moving more slowly than the red
blood cell, the blood in the extremities has a greater percentage of red blood cells
than when it left the heart.

2. Turbulent flow:-

It is rapid and noisy flow of blood, for example, where the blood is flowing rapidly
past the heart valves. The heart sounds heard with a stethoscope are caused by
turbulent flow, measurement of blood pressure, the constriction produced by the
pressure cuff on the arm produces turbulent flow and the resulting vibrations can be
detected by stethoscope on the brachial artery.

10 | P a g e
Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

3. Critical flow:-

The velocity of blood increase by reducing the radius of the tube, it will reach a
critical velocity (Vc) when Laminar flow changes into turbulent flow (fig, 11).

Figure (11): if fluid is flowing in a long tapering tube, the velocity will gradually increase to the
point where it exceeds the critical velocity Vc, producing turbulent flow.

- The critical velocity (c) depends upon the viscosity  of the fluid, the density  of
the fluid and the radius R of the tube:

Vc = K
Reynolds number (K) = 1000 (fluid, blood), but if there is bend or obstruction, K <
1000  Vc is lower

Example-2:
Find the critical velocity of blood in the aorta of radius 1 cm (adult)?

Vc = K

 37 C = 4 x 10-3 pas, of blood = 1.04 g cm-3 103 Kg m-3, R=1cm, K=103
o

103 x 4 x103 pas

 Vc = 3
10 Kgm 3 x10 2 m

11 | P a g e
Uruk University Medical Physics

College of Dentistry Assist lect. Zahraa Abass

Vc = 0.4 m/sec, the range of velocity of blood in Aorta (0 – 0.5 m s-1) and thus the
flow is turbulent during part of the systole.

The physics of some cardiovascular diseases

Heart diseases often have physical component. Many of these diseases, for
example, increase the work load of the heart or reduce its ability to work at a normal
rate.
W = P ΔV equation of work done •
T = P R Laplace equation •
The work done by the heart is roughly the tension of the heart muscle times how
long it acts. Anything that increase the work load of the heart. For example:

1- Hypertension
Causes the muscle tension to increase in proportion to the pressure, due to Laplace
law T = PR so the high blood pressure causes to increase the work done by equation
W = PΔV.

2-Tachycardia
A fast heart rate increases the work load since the amount of time the heart muscle
spend contracting increases.

3-Enlargement of the heart and reduction in the ability of the heart to

provide adequate circulation.
If the radius of the heart is doubled, the tension of the heart muscle must also be
doubled if the same blood pressure is too maintained. Since the heart muscle is
stretched, it may not be able to produce sufficient force to maintain normal
circulation; the stretched heart muscle is also much less efficient than normal heart
muscle.

12 | P a g e