CHAPTER ONE be seen at the edge of your field of view (but not at the centre) but you
cannot tell their colour. Rods contain rhodopsin, also known as visual
MEDICAL PHYSICS
INTRODUCTION
In this book, you have learned many important ideas from physics. You
may have noticed that the same big ideas keep reappearing–for
example, the idea of a field of force (magnetic, electric, gravitational),
or the idea of energy transmitted as waves, or the idea that matter is
made of particles with forces acting between them. This is an important
characteristic of physics; ideas that are used in one area prove to be
useful in another. Hopefully, you will see many of these connections
now that you are approaching the end of your course. Physics is also
useful. It is applied in many areas of life. In this chapter, we look at one
of these areas: Medical Physics.
PHYSICS OF THE EYE AND SEEING
The eye is an optical instrument that can focus automatically on objects
over a wide range of distances, adjust automatically to a wide range of
light intensities and is sensitive to a continuous range of
electromagnetic waves from less than 400 nm to about 650 nm in
wavelength and can perceive objects which emit or reflect radiation in
this range. Fig. O4.1 shows the diagram of the human eye.
cillary muscle
sclera
choroid
cornea retina
fovea
iris
lens visual axis
pupil blind spot
aqueous vitreous humour
humour
suspensory
ligament
optic nerve
conjunctiva
rectus muscle (takes signal
(swivel the eyeball to the brain)
in its socket)
Fig.O4.1
The main optical parts of the eye and their principal features are:
The cornea is a protective transparent layer at the front of the eye. It has
a fixed convex curvature and therefore acts as a „fixed focus‟ lens.
The eye lens is flexible and attached to the ciliary muscles. These
muscles change the thickness of the eye lens which alters its optical
power. This enables it to form an image on the retina of the eye of any
object within a range of distances.
The ciliary muscle fibres lie along concentric circles round the rim of
the eye lens.
• To view a near object, the eye muscles must become taut so that the
muscle fibres shorten and make the eye lens thicker and more powerful.
• To view a distant object, the eye muscles must relax so that the muscle
fibres lengthen, allowing the eye lens to become thin and less powerful
The iris controls the amount of light entering the eye. It consists of
concentric and radial muscle fibres.
• In bright light, the concentric fibres contract and the radial fibres relax
so the iris expands, making the eye pupil narrower so less light passes
through it.
• In dim light, the concentric fibres relax and the radial fibres contract
so the iris contracts, dilating (i.e. widening) the eye pupil so more light
passes into the eye.
The range of the eye pupil‟s diameter is typically from less than 1 mm
up to 10 mm. The area of the pupil determines the amount of light
entering the eye which therefore increases by a factor of 100 when the
diameter of the eye pupil increases from 1 mm to 10 mm.
Sensitivity of the eye
The retina is a layer of light-sensitive cells at the back of the eye. There
are two types of retinal cells, rods and cones, when exposed to very
bright light automatically become less sensitive; in dim light, the cones
„switch off‟ and the rods become more sensitive. The retinal cells are
most dense at the fovea which is the region of the retina near the
principal axis of the eye lens. The fovea consists mostly of cones
whereas rods predominate near the periphery of the retina.
Rods are sensitive to low levels of light intensity but cannot
distinguish between colours. Because rods predominate at the
periphery of the retina, dim objects viewed in dark conditions can often
543
purple, which consists of complex molecules that each can be split in
two by light photons. This causes a change in the cell potential which
helps to „trigger‟ the nerve fibre to which the cell is connected. Up to
ten photons need to be absorbed to trigger a rod. Several rods connected
to the same nerve fibre need to be triggered to send an electrical
impulse to the brain. The rhodopsin molecules regenerate slowly. In
very bright light, the molecules are unable to regenerate so the rods
have reduced sensitivity. Adaptation to dark conditions takes over 30
minutes as the rhodopsin molecules slowly re-form.
Light
Nerve fibres
Bipolar nerves
Cone
Rod
Pigment cells
Fig. O4.2: rods and cones
Cones are of three types, each sensitive to a different range of
wavelengths. These ranges correspond broadly to the primary colours
white light (red, green or blue). Cones do not respond to very low levels
of light intensity and automatically become less sensitive at very high
intensities. The after-image seen after a very bright image disappears is
because the cones take up to a second or so to regain normal sensitivity.
This is known as persistence of vision. If the original image is coloured,
the after-image will be the complementary colour. This is because the
type of coloured cones stimulated by the original image does not
respond effectively until they regain their normal sensitivity. During
this time, the other cones operate normally and hence form a temporary
after-image in the complementary colour. Television viewers rely on
persistence of vision as the TV picture is „renewed‟ at least 25 times
every second. The viewer sees a continuous sequence of „frames‟
because of persistence of vision. If the frame rate was significantly
lower, the pictures would flicker noticeably.
Therefore rods and cones are two types of photoreceptors in the human
retina; rods are responsible for vision at low light levels, while cones
are active at higher light levels
Colour Vision
Electromagnetic radiation of wavelength approximately 380 nm to 650
nm is detected by the eye as different colours. All these colours can be
produced using mixtures of the primary colours, red, green and blue,
and so in principle the retina need only be sensitive to these three
colours. Modern ideas concerning colour vision suggest that cones
contain three types of light sensitive material, each able to detect one of
the primary colours. When light falls on the retina, each of these
materials will be affected to an extent depending on the intensity of the
primary colour present in the incident light, and each will produce a
corresponding stimulus which is passed on to the brain. Simplified
theory of colour vision states that there are three primary colours, which
correspond to the three types of cones.
Resolution
The resolution of the eye is determined by the size and closeness of the
retinal cells. Light passing through the eye pupil of width 4 mm from a
point object would form a diffracted image about 3 μm in diameter,
covering two or three retinal cells.
retina cell nerve fibre
separation >2 retinal cell
diameters
diffracted light
from each object nerve fibre
Fig. O4.3
For two nearby point objects, because a single nerve fibre is usually
connected to a number of rods or cones, the two diffracted images on
the retina need to be separated by at least two retinal cells to be resolved
(seen separately), as shown in Fig. O4.3
 For two point objects at separation d and at distance u from the eye as To locate the tip of the image, three key „construction‟ rays from the tip
shown in Fig.O4.4 of the object are drawn through the lens. The tip of the image is formed
where these three rays meet. The image is real and inverted as shown in
u v Fig.O4.6.
A
Converging lens
da θ θ y
B Object
eye lens F 2F
2F F
Fig.O4.4 Image
d
• their angular separation,  
u Fig.O4.7
• the separation of their image centres, y = θv, where v is the distance  Ray 1 is drawn parallel to the lens axis before the lens so it is refracted
from the eye lens to the retina (image distance). by the lens through F.
If the retinal cells where the image is formed are 1.5 μm in diameter, the  Ray 2 is drawn through the lens at its centre without change of
two images must be separated by a distance of at least 3 μm (= 2 retinal direction. This is because the lens is thin and its surfaces are parallel
cell diameters) to be resolved. to each other at the axis.
 Ray 3 is drawn through F before the lens so it is refracted by the lens
Converging and diverging lenses parallel to the axis.
Lenses are used in optical devices such as the camera, the telescope and In Fig.O4.7, the image is smaller than the object. This is because the
the eye. A lens works by changing the direction of light at each of its object is beyond 2F.
two surfaces.
Fig. O4.5 shows the effect of a converging lens and of a diverging lens Formation of virtual image by a converging lens
on a beam of parallel light rays. The object must be between the lens and its principal focus as shown in
A converging lens makes parallel rays converge to a focus. The point Fig. O4.8. The image is formed on the same side of the lens as the
where parallel rays are focused to is called the principal focus or the object.
focal point of the lens.
Optical centre Convex lens
Principal VirtualOptical
imagecentre
focus (magnified)
Principal L F L Principal
axis F axis F F
Object
Principal focus

Focal length Focal length

observer
cal centre Fig. O4.8
Principal Optical centre
focus The diagram shows that the image is virtual, upright and larger than the
F L Principal
object. The image is on the same side of the lens as the object and can
F axis
only be seen by looking at it through the lens. This is how a magnifying
Principal focus glass works.
l length Focal length
If the object is placed in the focal plane, light rays from any point on the
object are refracted by the lens to form a parallel beam. A viewer
Fig. O4.5 looking at the object through the lens would therefore see a virtual
A diverging lens makes parallel rays diverge (spread out). The point image of the object at infinity.
where the rays appear to come from is the principal focus or focal point
of this type of lens. Formation of a virtual image by a diverging lens
In both cases, the distance from the lens to the principal focus is the
focal length of the lens. The lens makes light rays from a point object diverge. The image is
formed on the same side of the lens as the object, as shown in Fig. O4.9.
Note To locate the tip of the image, three key „construction‟ rays from the tip
The principal axis of a lens is the straight line that passes normally of the object are drawn, as described below, through the lens. The tip of
through both surfaces at their centres. The plane on each side of the lens the image is formed where these three rays appear to come from.
perpendicular to the principal axis containing the principal focus is
called the focal plane.

Ray Diagrams
object F image F
The position and nature of the image formed by a lens depends on the
focal length of the lens and the distance from the object to the lens. Image form is virtual, erect
If we know the focal length, f, and the object distance, u, we can find and smaller than the object
the position and nature of the image by drawing a ray diagram, to scale,
Fig. O4.9
in which:
• Ray 1 is drawn parallel to the lens axis before the lens so it is refracted
• the lens is assumed to be thin so it can represented by a single line at
as if it passed through F before the lens,
which refraction takes place,
• Ray 2 is drawn through the lens at its centre without change of
• the principal focus F is marked on the principal axis at the same direction. This is because the lens is thin and its surfaces are parallel to
distance from the lens on each side of the lens each other at the axis.
• the object is represented by an „upright‟ arrow as in form three. • The image position can be checked by drawing a third ray (shown in
Note that the „horizontal‟ scale of the diagram must be chosen to enable grey) from the tip of the object towards F on the other side of the lens so
you to fit the object, the image and the lens on the diagram. it is refracted by the lens parallel to the axis.

Formation of a real image by a converging lens Note

To form a real image, the object must be beyond the principal focus, F, height of the image
of the lens as shown in Fig. O4.6. The image is formed on the other side The linear magnification, m =
height of the object
of the lens to the object.
the image distance, v
2 It can be shown that this ratio =
Object 1 the object distance, u
L F 2F
/ / 3
The image is said to be magnified if the image height is greater than the
2F F Image
object height and diminished if it is smaller

Fig. O4.6
544
 THE LENS FORMULA (a) Short-sighted defect image formed
For an object on the principal axis of a thin lens of focal length f at before the retina
„fat‟ lens
distance u from the lens, the distance from the image to the lens, v, is
given by: nearly parallel image not
1 1 1 rays from point focused on
  retina
f u v on distant object
Notes
 Proof of the lens formula is not required in the option specification. (b) Short-sighted correction
 When numerical values are substituted into the formula, the sign image is
convention „real is positive; virtual is negative’ is used for the object focused on
and image distances. The focal length, f, of a converging lens is retina
always assigned a positive value. A diverging lens is always assigned virtual image of distant
appear near concave lens
a negative value.
Fig.O4.12
Lens power Therefore, the correcting lens for myopia must:
1 • be a diverging lens
The power of a lens = • have a focal length equal to the distance from the eye to the
its focal length in metres
uncorrected far point
The unit of power is the dioptre (D). For example, for:
• the correcting lens forms a virtual image of the distant point object at
 a converging lens with a focal length of 0.20 m (f = + 0.20 m), its
the uncorrected far point
lens power = +5.0 D
• the cornea and eye lens see the object as if it was at the uncorrected
 a diverging lens with a focal length of 0.25 m (f = −0.25 m), its lens
far point and form a real image of the object on the retina.
power = −4.0 D.
The eye is capable of focusing objects at different distances on to the
Note
retina. This process is called accommodation and is achieved by
The correcting lens effectively moves the far point of the uncorrected
automatic adjustment of the thickness of the eye lens.
eye to infinity. It also „moves‟ the near point away. The correcting lens
makes the image of an object placed at the least distance of distinct
The Normal Eye
vision (i.e. „new‟ near point) appear at the „unaided‟ near point.
The near point is the closest distance at which an object can be clearly
Therefore, the image is virtual and nearer the lens than the object as
focused by the eye on to the retina. In the „normal eye‟ this distance is
shown. If the object is at distance u and the image is at distance v,
about 25 cm. The far point is the farthest distance at which an object
applying the lens formula gives
can be clearly focused. In the „normal eye‟ this is infinity.
1 1 1
◊ For near objects, the eye lens must be thicker and hence more powerful  
v f u
than for distant objects. Fig. O4.10 shows the light rays from a nearby
object brought to a focus on the retina. Since f is negative (as the correcting lens is a diverging lens), 1v is more
25 cm
negative than  u1 so the distance to the „unaided‟ near-point (i.e. image
distance v) is smaller than the „new‟ near-point distance (i.e. object
Point object at
the near point distance u).

normal eye
Fig. O4.10 Near object
◊ For distant objects, the eye lens must be thinner and hence less
powerful than for distant objects. Fig. O4.11 shows the light rays from
a distant object brought to a focus on the retina.
light ray from object placed at infinity
Hypermetropia (far-sighted)
Hypermetropia or long-sight occurs when an eye cannot focus images
of nearby objects on to the retina. The uncorrected near point of the
defective eye is further away than 25 cm. This is because the eye
muscles cannot make the eye lens thick enough to focus an image on
the retina of an object 25 cm away. The eye can focus distant objects
hence the defect is referred to as „long-sight‟.
This happen because the eyeball is too short or the cornea is not curved
enough, and the image of an infinitely distant object is behind the retina
The cause of hypermetropia is that light, after passing through the eye
lens, does not converge enough to form an image on the retina, as
shown in Fig. O4.13.

normal eye (a) Long-sighted defect

Fig. O4.11: Distant (far) object „thin‟ lens
image is
focused
after retina
Eye defects and corrections point on nearby object
retina
Myopia (near-sighted)
Near sightedness or myopia refers to an eye that can only focus on (b) Long-sighted correction
objects that are close. Distant objects are not seen clearly (i.e. the far virtual rays from
point is not infinity). That is near objects are seen clearly but distance image is
an apparent focused
object seen blurred. The uncorrected far point of the defective eye is „far‟ object on retina
nearer than infinity. This is because the eye muscles cannot make the nearby object
convex lens
eye lens thin enough to focus an image on the retina of an object at
infinity. Fig. O4.13
Here, the eyeball is too long from front to back in comparison with the This happens if the eye lens cannot become thick enough to focus light
radius of curvature of the cornea (or the cornea is too sharply curved), onto the retina or if the eyeball is too short.
and rays from an object at infinity are focused in front of the retina. The To correct hypermetropia using a lens, a converging lens of a suitable
most distant object for which an image can be formed on the retina is focal length must be placed in front of the eye as shown in the figure
then nearer than infinity. Fig.O4.12 (a) show what happens if the eye below. The correcting lens makes the rays from an object 25 cm away
lens cannot become thin enough to focus light onto the retina or if the diverge less so they appear to come from the uncorrected near point.
eyeball is too long. Therefore, the correcting lens for hypermetropia must:
To correct myopia using a lens, a diverging lens of a suitable focal  be a converging lens
length must be placed in front of the eye as shown. The correcting lens  have a focal length which makes an object placed 25 cm from the eye
makes parallel rays from a distant object diverge so they appear to come appear as if it is at the uncorrected near point.
from the uncorrected far point.  the correcting lens forms a virtual image of the point object at the
uncorrected near point

545
 the cornea and eye lens see the object as if it was at the uncorrected hardens. Normally, the lens of the eye changes with age in ways that
near point and form a real image of the object on the retina. tend to preserve the ability to see distant objects clearly but do not allow
the eye to accommodate for close vision, a condition called presbyopia
Note (literally, elder eye or „old-age vision‟). To correct this vision defect, we
The correcting lens effectively moves the near point of the uncorrected place a converging, positive power lens in front of the eye, such as
eye nearer the lens to 25 cm away (the near point of a normal eye). It found in reading glasses. Commonly available reading glasses are rated
also „moves‟ the far point from infinity nearer to the eye as shown. The by their power in diopters, typically ranging from 1.0 to 3.5 D. Hence,
correcting lens makes the image of an object at the „new‟ far point presbyopia is a condition in which the lens of the eye becomes
appear to be at infinity. The object must be at the focal point of the progressively unable to focus on the retina objects close to the viewer.
converging lens for the rays to become parallel after the lens to make
the image appear to be at infinity. Therefore, the new far point is at Worked Example
distance f from the lens, where f is the focal length of the lens. 1) An object is placed on the principal axis of a convex lens of focal
The myopic eye produces too much convergence in a parallel bundle of length 150 mm at a distance of 200 mm from the centre of the lens.
rays for an image to be formed on the retina; the hyperopic eye, not a) Calculate the image distance.
enough convergence. b) State whether the image is real or virtual.
Solution
Astigmatism 1 1 1 1 1
a)      1.67
Astigmatism is a sight defect in which objects are seen to be sharper in v f u 0.150 0.200
focus in one direction than in other directions. Corneas are not spherical  v  0.600 m
in shape. They have different curvatures, and so different refracting b) The image is real (because v is positive).
powers, in different directions. When this difference in curvature is 2) A short-sighted eye has a far point of 5.00 m and a near point of 0.25
large, or there are irregularities in the cornea, the image formed on the m.
retina can be unevenly focused, a condition known as astigmatism a) State the type of lens needed to correct this defect and calculate the
(Fig.O4.14 (a)). power of the correcting lens.
focal point of b) Calculate the distance from the lens to the near point of the eye with
cornea of varying horizontal plane the correcting lens in front of the eye.
focal length
Solution
focal point of
vertical plane
a) A diverging lens is needed. Its focal length is − 5.00 m (= the
object
distance to its far point).
1 1
The power of a lens =   0.20 D
(a) Astigmatism defect f  5.00 m
cylindrical lens b) Let u = least distance of distinct vision to an object with the
focal point of correcting lens in place. The image of this object is a virtual image
object all the rays formed at 0.25 m from the eye. Hence v = − 0.25 m
1 1 1 1 1
     3.80
(b) Astigmatism u f v 5.00 0.25
correction This cylindrical lens diverges light in
tthe horizontal plane, so that the image  u  0.26 m
is correctly focused on the retina 3) A long-sighted eye has the far point at infinity and a near point
Fig.O4.14 which is 40 cm from the eye.
The cause of astigmatism is uneven curvature of the cornea. If the a) State the type of lens needed to correct this defect and calculate the
curvature is different in different directions, straight lines at different power of the correcting lens.
orientations cannot be focused on the retina at the same time. The more b) Calculate the distance from the lens to the far point of the eye with
prominent line(s) will be in focus on the retina; the other lines will be the correcting lens in front of the eye.
out of focus. Solution
Astigmatism is corrected by using a cylindrical lens, as shown in a) A converging lens is needed.
Fig.O4.14 (b). A cylindrical lens has curved faces that are sections of a For an object at 25 cm from the eye, the object distance u = +25 cm
geometric cylinder. It thus has differing radii along perpendicular axes = + 0.25 m
and focuses parallel light rays to a line. The lens must form a virtual image of the object at the uncorrected
An optician‟s prescription for a lens to rectify astigmatism needs to give near point of the eye.
the power of the lens, in dioptre, and the required direction of the Hence the image distance v = −40 cm
cylindrical axis. The table below shows an example of prescription for a 1 1 1 1 1
      1.50
person who has astigmatism. f u v 0.25 0.40
1 1
SPH CYL AXI Hence, the power of the correcting lens =   1.50 D
Right eye +0.25 –1.25 75 f 1.50 m
Left eye +0.25 –1.25 100 1
b) Distance from lens to „new‟ far point = f   0.67 m
1.50
In the table, the „Sphere (SPH)‟ refers to the spherical portion of the 4) a) Explain what is meant by astigmatism. How can it be corrected?
prescription, which is the correction in dioptre needed for short- b) An optician prescription for man is as shown in the table below.
sightedness (a negative correction) or long-sightedness (a positive SPH CYL AXI
correction). Right eye – 2.00 +1.50 180
The „Cylinder (CYL)‟ refers to the cylindrical correction, which Left eye +3.50 +3.00 45
depends on the degree of astigmatism, and can be a negative or a Explain what the prescription tells the optician about man‟s:
positive number in dioptre. If nothing appears in this column i) right eye.
on a prescription, there is no astigmatism that needs to be corrected. ii) left eye.
The „Axis (AXI)‟ is a number of degrees of angle between 1° and 180°. Solution
This specifies in what direction the difference in curvature is, and so a) A defect of the eye in which the cornea has different degrees of
where in the spectacle lens the cylindrical axis should be. The angle is curvature in different directions, which results to the formation of
measured using an imaginary semicircle with a horizontal base line that distorted images on the retina. It is corrected with a cylindrical lens.
starts with 0° in the b) i) He has 2.00 D of short-sightedness in his right eye, with 1.50 D of
3 o‟clock direction (as viewed by the optician who is taking the astigmatism and an axis of 180°.
measurement) and increases to 180° in an anticlockwise direction. It ii) He has 3.50 D of long-sightedness in his left eye, with 3.00 D of
represents the angle at which the spectacle lens is set into the frame. astigmatism and an axis of 45°.
5) a) State the changes which occur in a normal eye when
Presbyopia i) the eye changes from focussing on a distant object to focussing on a
Beginning in middle age, most people lose some of their near object, both objects being viewed in bright light
accommodation ability as the ciliary muscle weakens and the lens
546
ii) the eye changes from viewing an object in very dim light to viewing
the same object in bright light.
b) State two differences in the perceived image of a coloured object
viewed in bright white light compared to the perceived image of the
same object viewed in very dim white light.
c) i) A patient‟s eye is astigmatic. State the effect of astigmatism on
the image produced by the defective eye.
ii) State the usual cause of astigmatism.
iii) State the shape of lens used to correct astigmatism.
Solution
a)i) The ciliary muscles contracts while suspensory ligaments relaxes.
This produces a lens of greater power and shorter focal length
ii)The iris circular muscles contract and the radial muscles relax
producing a constricted (smaller) pupil. The cones „turn on‟ and rods
become inactive.
b) Bright white light the colours of an object is seen, but black and
white in very dim light. Good detail of an object in bright light, but
much less detail in very dim light.
c)i) Image is focussed in a given plane and out of focus in
perpendicular plane.
ii) non-spherical cornea
iii) cylindrical lens
6) a) How does the range of wavelengths that the eye can detect change
as the intensity of light decreases to a very low value?
b) What effect does this have on our ability to differentiate colours in
very dim light?
c) Why is the eye able to see more detail in the centre of the field of
view than at the edges?
Solution
a) At low levels of illumination, the cones will not be stimulated.
Scotopic vision using rod cells will dominate and the wavelength
range of detected light will shift towards the blue end of the visible
spectrum, with maximum sensitivity at about 500 nm and no response
above about 670 nm.
b) The response of rods does not allow the brain to distinguish colours,
so in very dim light colours are „washed out‟.
c) The density of cones in this region is very high and so the visual
angle that can be resolved is very small. Also there are no large
blood vessels present, giving an unobstructed view.
7) In the eye, rods and cones are used to detect light incident on the
retina.
a) i) Describe how the rods and cones are distributed over the surface
of the retina.
ii) On the same axes, sketch three curves to show how the response of
each of the three types of cone found in the retina varies with the
wavelength of light and relative absorption. Indicate the sketch of
the rod. Label each of the three curves with the cone colour to
which it refers. Mark approximate values on both axes.
b) i) State the condition that must be satisfied for two objects to be
resolved as individual images on the retina.
ii) Explain how the resolution of the image of an object seen in very
dim white light compares to that of the image of the same object
seen in bright white light.
c) Give the similarities between an eye and a camera.
Solution
a) i) Only the cones are found at fovea. As you move away from fovea
fewer cones present and more rods.
ii)The three colours of cones are blue, green and red. See Fig. O4.15
Relative absorption
- amount of light entering eye and camera can be controlled
8) (a) For the eye defect astigmatism, complete each of the following.
(i) Astigmatism is caused
(ii) The image seen by a person with astigmatism is
(iii) Astigmatism is corrected using
(b) A person has a myopic eye with a range of clear vision at distances
from his eye of 0.15 m to 0.80 m.
(i) Calculate the power of the correcting lens which would allow this
eye to produce focused images of distant objects.
(ii) Calculate the new near point position for the eye when using the
correcting lens.
Solution
(a) (i) Astigmatism usually caused by an irregularity in the curvature of
the cornea
(ii) A person with astigmatism would see an image which was less
well-focussed in one particular plane
(iii) Defect is corrected using a (correctly orientated) cylindrical lens
1 1 1 1 1
b) i) P       1.25 dioptre
f u v  0.8
1 1 1 1
ii)    1.25   5.42
u f v 0.15
 u  0.18 m
9) (a) A lens is used as shown in Fig. O4.16 is to enable a person with
an eye defect to see distant objects clearly.
Fig. O4.16
(i) Name the defect corrected by this lens.
(ii) Determine the power of the lens.
(iii) Draw a ray diagram to show the path through the eye of rays from
a distant object when a correcting lens is not being used.
(iv) Draw a ray diagram to show the path through the eye of rays from
an object positioned at the uncorrected far-point.
(v) State one cause of the defect you have named in part (i).
(b) When a camera is focused on a near object at a point P, the
distance from lens to film is 36.4 mm. In order to refocus on a very
distant object, the lens has to be moved a distance of 1.2 mm.
(i) State the direction in which the lens must be moved.
(ii) Calculate the focal length of the lens.
(iii) Calculate the distance from the lens to P.
(iv) One frame of the film in the camera has a height of 24mm.
Determine whether or not the image of an object of height 0.60 m
placed at P will fit into this frame.
c) A photographic plate can be used with an astronomical telescope in
order to photograph the night sky. State where the plate should be
positioned in the telescope and give one advantage which
photography has over direct observation when using telescopes.
Solution
(a) (i) short sight (myopia)
ii) Lens produces virtual image at uncorrected far point
1 1
P   2.0 D
f 0.5

1 rod
all cone iii) Diagram with rays cross in front of retina from parallel incident
rays
„green‟ cone
(iv) Diagram with image on retina, object at uncorrected far point
„blue‟ „red‟ cone
(v) Long eyeball (or strong lens or eye insufficiently relaxed)
cone (b) (i) towards film
(ii) f = 36.4 – 1.2 = 35.2 mm
1 1 1
400 500 600 700
(iii)    u  1.1 m
wavelength / nm 35.2 u 36.4
Fig. O4.15 36.4
(iv) Image height = 0.60   0.020
b) i) The two images fall on receptors with at least one un-stimulated 1068
receptor between them. That is, they are separated by at least two Since, 0.020 is less than 0.024, therefore, yes
cell diameters. c) At focal point of objective long exposure allows more detail to be
ii) The cones used in bright light while the rods used in dim light for observed
resolution. Resolution in bright light better because the size of 10) (a) Sketch the response curves for the colour cones of the eye. Label
cones are smaller than the size of rod while resolution in dim light the wavelength axis with a scale appropriate for your curves.
worse because several rods are connected to one nerve far away b) In terms of receptors,
from the fovea (i) give the condition for two different images to be resolved by the
c) - both use a converging lens eye,
- image formed is real (ii) explain why finer detail can be seen in bright light than in dim
- image is inverted light.
- image in eye formed on retina, image in camera formed on film (c) (i) State what is meant by persistence of vision.
547
 (ii) Give an example of a practical situation where persistence of ii) Calculate the power of the correcting lens needed to allow the person
vision is used to advantage. to see distant objects clearly.
Solution iii) The person has an unaided near point at 0.22 m. Calculate the aided
a) The three overlapping colour curves labelled blue, green and red near point of the person when using the correcting lens. (
 unit and scale on wavelength axis peaks at approximately 430 Solution
(blue), 520 (green), 570 (red) (  30 for each) ranges approximately (a) In bright light, the cones are stimulated the colour and detailed of the
400 - 520 (blue), 430 - 670 (green), 480 - 730 (red) (  30) object is focus on the optical axis. In dim light, the rods are
intensity activated and black and white image with little detail is for at the
Green
periphery of fovea.
(b) (i) short sight
Red 1
Blue (ii) P   0.5 D =  0.4 D
2.0
1 1
(iii)   0.5
u 0.22
400 500 600 700 800  u  0.25 m
wavelength / nm 14) The eye is capable of adjustment to different environmental
In Fig.O4.17 conditions.
b) i) Two stimulated receptors must be separated by at least one a) (i) Explain what is meant by accommodation.
unstimulated receptor ii) Describe how accommodation is achieved in the human eye.
(ii) In bright light, cones activated. The cones smaller than rods, hence b) The eye can adjust to light intensities ranging from bright sunlight to
angular separation thus smaller moonlight. By making reference to the diameter of the pupil of the
(c) (i) lights flashing at greater than or equal to 20 Hz appear steady (or eye, suggest why the iris cannot be responsible for all of this
image appears steady although stimulus is flashing) adjustment.
(ii) any correct example e.g. cine films, television Solution
11) A defective eye has an unaided far point of 2.5 m and an unaided a) i) This is process by which objects at different distances from the eye
near point of 0.20 m. A correcting lens is used to produce an aided are brought to a focus on the retina.
far point at infinity. (ii) The ciliary muscles alter shape of lens and this alters the focal
a) (i) Name the defect of vision affecting the eye. length of the lens
(ii) State one possible cause of this defect of vision. b) This is done by varying the diameter pupil. The light intensity
b) Draw ray diagrams to show this defective eye and correction. admitted into the eye is proportional to diameter square. When the
(c) (i) Calculate the power of the correcting lens. variation of light intensity is large, the factor is large.
(ii) Calculate the aided near point when wearing the correcting lens. 15) A person discovers that the power of the lens used to correct the
Solution defect of one of his eyes is +2.5D.
(a) (i) myopia or short sight a) For this corrective lens,
(ii) eyeball too long i) name the type of lens,
(b) 1st diagram: rays focused on retina ii) calculate the focal length in cm.
2nd diagram: rays focussed before retina b) i) Name the defect of this eye.
3rd diagram: rays diverging from lens and appear to come from point ii) Make calculations to estimate the distance of the far point and the
2.5m away rays (after diverging) focused on retina distance of the near point from this unaided eye.
1 1 Solution
(c) i) P   =  0.4 D
f 2.5 a) i) Converging lens since the power is positive 
1 1
1 1 1 ii) f =   0.4 m = 40 cm
ii)   power 2.5
u 0.2 2.5
b) i) Long sight (hypermetropia)
 u  0.22 m
ii) The far point is at infinity.
12) (a) Fig. O4.18 represents a simplified version of a normal eye, with
Normal near point is distance 25 cm from eye
no sight defects, looking at a distant point object. Copy and complete
1 1 1 1
the paths of the two rays.   
v 25 40 67
eye lens
Therefore, the near point is 67 cm in front of the eye
rays from a 16) a) With reference to the eye, explain what is meant by
optic
distant point axis accommodation.
fovea b) Estimate the change in power of the optical system of an eye when
cornea viewing a star and then when reading a book.
Fig. O4.18 Solution
(b) Describe the distribution of receptors over the retina. a) This is the ability of the eye to form focused images of objects at
(c) (i) State the purpose of the iris. different distances from the eye.
1 1 1
(ii) Describe how this purpose is achieved when the eye is exposed to b) Power of star =  
bright light.  L L
(d) (i) State what is meant by accommodation. 1 1
Power of book = 
(ii) Describe how accommodation is achieved. 0.25 L
Solution 1 1 1
(a) Diagram to show: rays reflected inwards at cornea rays reflected at Change in power =    4.0 D
0.25 L L
lens rays focused at optic axis on retina 17) An eye test shows that a person suffers from astigmatism.
(b) Only the cones are found at fovea moving away from fovea, more i) Give the main cause of astigmatism.
rods, less cones ii) State the effect of astigmatism on the image seen.
(c) (i) to control the intensity of light reaching retina iii) State the type of lens needed to correct this defect of vision.
(ii) forms a small pupil iv) Give two quantities which must be known in order to manufacture
(d) (i) accommodation is the ability of the eye lens to change and focus the correcting lens.
on different object distances ( or adjustment of the eye lens to form a Solution
clearly focused image on the retina) (i) non-spherical cornea
(ii) Changing the shape of the lens (or using the cillary muscles) (ii) image in one plane is focused, but image in plane at right angles is
13) (a) A detailed, coloured object is illuminated by white light. out of focus
Compare what is seen under high intensity light with that seen under (iii) cylindrical lens
low intensity light by an observer with normal eyesight. Your (iv) power of the lens angle of correction
explanation should refer to rods and cones. 18) a) For slight hypermetropia and slight astigmatism, describe the
(b) A person suffering from a defect of vision has an unaided far point sharpness of the image formed of an object placed at a distance of 25
of 2.0 m. cm from the eye.
i) Name this defect of vision b) A converging lens is used to view an object placed 36 cm from it. A
548
 virtual image is formed which is 2.5 times larger than the object. State speaker leaving a reduced pressure further out. Each time the
the defect of vision that this lens would be used to correct and calculate diaphragm moves forward, it compresses the surrounding air slightly,
the power of the lens. pushing the surrounding air molecules into molecules further away
Solution which push into other molecules further away again so the compression
a) For hypermetropia, the image is blurred and for astigmatism, the (C) travels through the air away from the loudspeaker.
image is focus in a plane, but out of the perpendicular plane. When the diaphragm moves backwards, it expands the air slightly so
b) u = 0.36 m creating a low-density region, referred to as a rarefaction (R), which
v  mu   2.5  0.36  0.90 m nearby air molecules move into so vacating space which molecules
1 1 1 1 1 further way move into. In this way, the change of pressure propagates.
P      1.7 D
f u v 0.36 0.90
19) „Bad light stopped play‟. Cricket games are often abandoned if the .Notes and Noise
weather gets gloomy. Explain why? A note of sound consists of a sound wave that varies smoothly and
Solution rhythmically which makes them easy to listen to. In contrast, noise
Low light levels produce poorer visual acuity because the rods which generally consists of sound waves that change abruptly and randomly.
are sensitive to low light levels are around the yellow spot and several In effect, noise is unwanted sound.
rods might be connected to one nerve cell. So cricketers may not see
the small, dark, and fast moving ball. Diagram of the Ear
20) a) Explain how the eye changes the depth of field The normal human ear can hear sound waves that can range in
b) Explain why yellow is a good colour for a high-visibility jacket amplitude by a factor of about 1012 and in frequency from about 20 Hz
Solution to 18 000 Hz. It is largely maintenance free and it filters out unwanted
a) If the aperture of the iris is wide in low light depth of field is limited. body noises such as from the blood system and the digestive system.
If the light is bright, the iris has a constricted aperture, increasing the Fig.O4.21 is a diagrammatic representation of the human ear. The ear is
depth of field. divided into three regions, the outer ear, the middle ear and the inner
b) Yellow light is the sum of red light and green light. The sensitivity ear.
of the green cones and the red cones add up to a maximum
sensitivity.
21) The far point of a patient is 60 cm. If the distance from the lens to
the retina is 0.02 cm.
a) What is the power of the eye?
b) What is the power of the eye with a corrective lens?
c) What is the power of the corrective lens? What kind of lens is it and
what is its focal length?
Solution
1 1 1 1 1
a) P       51.67 D
f v u 0.6 0.02
1 1 Fig.O4.21
b) P    50 D The pinna serves in „catching‟ the sound waves. It also helps to
 0.02 determine the direction of a sound. The brain determines the horizontal
c) Power of the corrective lens = Power of the corrected eye - power of position of a sound by comparing the information coming from the two
the uncorrected eye ears. Once the sound waves travel into the ear canal, they vibrate the
 P  50  51.67  1.67 D tympanic membrane or eardrum. This is a thin, cone-shaped piece of
Since the power is negative, the lens must be concave (diverging) skin, about 10 mm wide. It is positioned between the ear canal and the
with focal length 60 cm. middle ear.
22) A patient has a near point of 3.0 m. Assuming that the distance from Air from the atmosphere flows in from the outer ear onto one side, and
the front of the eye to the retina is 2 cm. from the mouth on the other side, via the eustachian tube connecting the
a) What is the power of her eye unaided? middle ear to the throat; so that the air pressure on both sides of the
b) What power of eye will she need to read a book at 25 cm? eardrum remains equal. This pressure balance lets the eardrum move
c) What power should the lens be and what kind of lens is it? freely back and forth with even there is a slightest air-pressure
Solution fluctuation. Higher-pitch sound waves move the drum more rapidly
1 1 1 1 1 (higher frequency), and louder sound moves the drum a greater distance
a) P       50.33 D
f v u 3 0.02 (bigger amplitude). The eardrum is the entire sensory element in the ear.
1 1 The rest of the ear serves only to pass along the information gathered at
b) P    54 D the eardrum.
0.25 0.02
c) P  P  P  54  50.33  3.67 D
Since the power is positive, the lens must be convex with focal The Outer Ear
length 0.27 ( 1 3.67 ) m. The outer ear consists of the pinna, the external auditory canal and the
ear-drum. Sound waves reaching the ear are collected by the pinna (ear
flap). It has a spatial focussing role in hearing. Once the sound is
PHYSICS OF THE EAR AND HEARING picked, it is directed down an external auditory canal, about 2.5 cm long
Sound waves and 7 mm wide. It is closed at one end by the eardrum. The wall of the
Sound waves are longitudinal waves that pass through any solid, liquid auditory canal contains wax glands whose secretion helps to protect the
or gas. Sound is produced by a vibrating object, such as a loudspeaker tympanic membrane and keep it workable.
cone as show in Fig.O4.20. The eardrum acts as an interface between the external and middle ear.
loudspeaker diaphragm vibrations As sound travels down the auditory canal it intensity is increased. When
RR C
R
C C the sound reaches this eardrum, the pressure of the air next to the
CC RR C eardrum will change as illustrated in Fig.O4.22. This change in pressure
results to an unbalanced force that causes the eardrum to move inwards.
longitudinal
displacement of A
Pressure invisible air F
change air molecule
molecules
Max. pressure P + ΔP P
a
Undisturbed
air pressure Fig.O4.22
Min. pressure Force pushing eardrum inward = (P + ΔP)A
C R C R C R Force pushing eardrum outward = PA
Fig. O4.20 Unbalanced force = (P + ΔP)A – PA = ΔPA.
As the cone moves back, the pressure of the layer of air in front of the The unbalance force towards the inner side of the eardrum is balance
speaker is reduced; this causes air in the next layer to flow towards the with the help of the eustachian tube. The changes in the air pressure due
549
to sound waves are extremely small. They don't apply much force on sound waves vestibular
the eardrum, but the eardrum is so sensitive that this minimal force membrane vestibular
moves it a good distance. However, the cochlea in the inner ear oval window channels
conducts sound through a fluid, instead of through air. This fluid has a
much higher inertia than air so the small force felt at the eardrum is not hair cells in organ
strong enough to move this fluid. Therefore before the sound passes on of corti
to the inner ear, the total pressure (force per unit of volume) must be tympanic
amplified. round window channel
Basilar membrane
cochlear channel
The Middle Ear Fig.O4.24
The middle ear consists of a small, irregular, air-filled cavity in which, When these hair cells are moved, they send an electrical impulse
suspended by ligaments, are the ossicles. Ossicles is made up a chain of through the cochlear nerve. The cochlear nerve sends these impulses on
three bones: - malleus, incus and stapes, more commonly known as the to the cerebral cortex, where the brain interprets them. The brain
hammer, anvil and stirrup respectively. They are connected as shown in determines the pitch of the sound based on the position of the cells
Fig.O4.23. sending electrical impulses. Louder sounds release more energy at the
resonant point along the membrane and so move a greater number of
hair cells in that area. The brain knows a sound is louder because more
hair cells are activated in an area.
Hence, the cochlea contains hair cells along the basilar membrane.
Different regions of the membrane respond to sound waves of different
frequencies.

Amplification of Sound in the Ear

They are two main amplification mechanisms: - size difference between
the eardrum and oval window, and the configuration of the ossicles.

i) Surface area difference

The surface area of window to the cochlea (oval window) is far smaller
than surface area of the eardrum. A given force on the eardrum will be
transmitted to the oval window as illustrated in Fig.O4.26.
Fig.O4.23
oval window
The ossicles amplify the force from the eardrum, with the main
amplification coming from the surface area difference between the A1 F = ΔP2A1
ΔP1
eardrum and oval window, and the configuration of the malleus, incus ossicles ΔP2 = F/A2
A2
and stapes.
The malleus is connected to the center of the eardrum, on the inner side. eardrum
When the eardrum vibrates, it moves the malleus from side to side like a Fig.O4.26
lever. The other end of the malleus is connected to the incus, which is A pressure ΔP1 causes a force F = ΔP1A1 on the eardrum.
attached to the stapes. The other end of the stapes rests against the This force is passed onto the cochlea via the ossicles. At the cochlea the
cochlea, through the oval window. force (ΔP1A1) is applied to the oval window of area A2 so the increase in
When air-pressure compression pushes in on the eardrum, the ossicles pressure is
move so that the stapes pushes in on the cochlear fluid through the oval
F P1 A1
window. When air-pressure rarefaction pulls out on the eardrum, the P2  
ossicles move so that the stapes pulls in on the fluid. Essentially, the A2 A2
stapes acts as a piston, creating waves in the inner-ear fluid to represent A 
the air-pressure fluctuations of the sound wave.  P2   1  P1
 A2 
The Inner Ear Since A1 is larger than A2, there is an increased in pressure acting on the
The cochlea structure consists of three adjacent tubes separated from cochlea. This is greater than it was in the air. Therefore,
each other by sensitive membranes. These tubes are coiled in the shape A
Amplification factor  1
of a snail shell. The membrane between these tubes is so thin that sound A2
waves travel as if the tubes weren't separated at all. The stapes moves
The eardrum has a surface area of approximately 60 mm2, while oval
back and forth, on the oval window creating pressure waves in the
window has a surface area of about 3.0 mm2. Hence
entire cochlea. The cochlea fluid moves out when the stapes pushes in
A 60
and moves in when the stapes pulls out. amplification factor  1   20
As the stapes moves in and out, it pushes and pulls on the part of the A2 3.0
basilar membrane just below the oval window. This force starts a wave
moving along the surface of the membrane. The wave travels something ii) Configuration of the ossicles
like ripples along the surface of a pond, moving from the oval window The configuration of ossicles provides additional amplification. The
down to the other end of the cochlea. The basilar membrane has reed- malleus is longer than the incus, forming a basic lever between the
like fibers that extend across the width of the cochlea. eardrum and the stapes. The malleus moves a greater distance, and the
Near the oval window, the fibers are short and stiff. As they move incus moves with greater force (energy = force × distance). The way the
toward the other end of the tubes, they get longer and less rigid. This ossicles move is rather complicated but the principle involved is that of
gives the fibers different resonant frequencies. A specific wave a simple lever. This is illustrated in Fig.O4.27. The work done by F1 =
frequency will resonate perfectly with the fibers at a certain point, F1d1 and work done by F2  F2 d 2
causing them to vibrate with a big amplitude. Because of the increasing F1
length and decreasing rigidity of the fibers, higher-frequency waves F2
vibrate the fibers closer to the oval window, and lower frequency waves
vibrate the fibers at the other end of the membrane.
The organ of corti is a structure containing thousands of tiny hair cells d1 d2
shown in Fig.O4.25. It lies on the surface of the basilar membrane and
extends across the length of the cochlea.
Until a wave reaches the fibers with a resonant frequency, it doesn't L1 L2
move the basilar membrane very much at all. But when the wave finally Fig.O4.27
does reach the resonant point, the membrane suddenly releases a burst Since energy is conserved, F1d1 = F2d2
of energy in that area. This energy is strong enough to move the organ F d
of corti hair cells at that point. So, 1  2
F2 d1

550
Since d2 is smaller than d1 then F2 must be bigger than F1. In this way For example, the threshold of hearing for human ranges from 2 to 3 kHz
d at an intensity of 10 –12 W m-2 and at 90 Hz, the threshold of hearing is
the force is made bigger. The amplification factor is equal to 2 . about 10–8 W m-2.
d1
Psychologists also say that the sense of hearing is roughly logarithmic.
d2 L1 In other words, they think that to increase the sound intensity by the
Since the triangles are similar,  .
d1 L2 same factor is to have the same increase in loudness.
The dB(A) scale is an adapted dB scale - it gives relative
L1
amplification factor 
. measurements. There are also dB(B), and dB(C) weightings. These
L2 symbols are often used to denote the use of different frequency
This amplification factor can easily observed using the principle of weightings used to approximate the human ear's response to sound,
mechanical advantage. This amplification factor is about 1.5. although the measurement is still in dB. Other variations that may be
seen are dBA or dBA.
Physics Mechanism of Hearing The dB scale just measures pure sound intensity levels. The ability of
the ear to distinguish different frequencies is called frequency
The pinna collects the sound waves into the ear canal which increases
discrimination.
the intensity of the sound by reducing the area. The sound wave is
impinged on the tympanic membrane which causes it to vibrate. This
vibrates the ossicles (the three small bones). The ossicles amplify the Loudness
sound by increasing the movement through a system of levers (hammer, The loudness of a note is a subjective quantity. It is not a measure of
anvil, and stirrup). intensity level. Although loudness takes into account the logarithmic
Oval window measure of the ear‟s response to intensity dB, it does not take into
account the hearing of the listener or the frequency response of the
Cochlea fluid
Hammer motion listener‟s ear to different frequencies. Therefore, loudness is
(Malleus)
determined by the intensity and the frequency of a sound. Loudness is
Stapes measured in phons. A change in the observed loudness of a sound is the
Ear drum (Stirrup) response of the ear to a change in intensity.
Ear drum Just as an audible frequency is dependent on the sound level intensity,
motion Anvil (Incus) so too is loudness intensity. However, it is also dependent on the
Fig.O4.28 energy transfer mechanisms of the ear. The basilar membrane and the
The stapes (stirrup) in turn strike the oval window of the cochlea where hair cells are affected, and as the sound intensity is increased the nerve
the sound is further amplified due to the fact that the ear drum fibres become more stimulated and this creates a greater impulse
(tympanic membrane) is far larger than the oval window. As the fluid frequency to the brain. The brain registers this as an increase in
filled cochlea vibrates, the nerve cells found on the wall of the cochlea loudness. A graph of loudness perception is shown in Fig. O4.31.
detect the sound, converts it into electrical impulses and sent through
sound intensity / W m–2

102 120 phon

the auditory nerves to the brain for processing. The lever mechanism of
100
the ossicles is shown in Fig.O4.28. 80 phon
10–2
In short, the ossicles of the middle ear (anvil, malleus and stirrup) –4
10 40 phon
transfer vibrations from the eardrum to the oval window. The bones act
–6
as a lever, producing an increase in force. The area of the oval window 10
is much smaller than that of the eardrum, and since pressure = 10–8
force/area, the pressure at the eardrum is amplified at the oval window. 10–10 20 phon
10–12 0 phon
Range of audible frequencies for humans 0 10 100 1000 10000 Frequency/Hz
The range of frequency audible to the human ear varies considerably Fig. O4.31
from individual to individual, but the average range is from 20 Hz to 20 Equal changes in sound intensity are not perceived as equal changes in
kHz. The upper limit but it is around 20 kHz for a young, normal loudness. Each curve is of equal loudness perception and is measured in
individual but it decreases with age. Sound waves below 20 Hz are units called phons. The relationship between sound intensity and
termed subsonic or infrasonic. Below this frequency, sounds waves in loudness is logarithmic. A hundredfold increase in intensity is perceived
the cochlea merely move the perilymph fluid in the helicotrema but they to be a twentyfold increase in loudness. So a ten times increase in
do not disturb the basilar membrane and the fibres of the organ of Corti. intensity would raise the loudness by a factor of two. It can be shown
Sound waves of frequencies greater than 20 kHz are called ultrasonic that:
and the characteristics of ultrasound will be examined later this chapter Loudness increase (dL)
in the section concerning medical imaging. the intensity increase  dI 

initial intensity  I 
Logarithmic Scale
dI
The human perception of loudness at different frequencies is not  dL  k
constant and varies considerably over the audible frequency range as the I
intensity-logarithmic frequency diagram shown in Fig. O4.30. The ratio If we integrate this expression we get
of the sound pressure that causes permanent damage from short L  k ln I  C
exposure to the limit that an undamaged ears can hear is more than a where C is a constant. When I = Io, L = 0.
million. To deal with such a range, logarithmic units are useful: the  C   k ln I 0
logarithm of a million is 6, so this ratio represents a difference of 120
 L  k ln I  k ln I 0
dB.
The intensity of a sound wave is defined as the energy per second per  I
unit area incident normally on a surface. The unit of intensity is J s−1  L  k ln 
m−2 or W m−2. The minimum detectable intensity for a given frequency
 I 0 
is called the threshold intensity of hearing and it is the envelope of the This is further evidence of the logarithmic response to a change in
curve in Fig.O4.30. intensity.

Sound intensity and intensity level

intensity level / dB
sound intensity / W m–2

102 140 Jet talking off

0 120
10 The ear and the brain in combination produce a very sensitive
10–2 100 instrument that can detect properties such as pitch and loudness. Pitch is
Thunder storm
10–4 80 a measure of frequency. Loudness is a measure of the power carried in a
Shouting
10–6 60 longitudinal sound wave. Sound waves travel in a three-dimensional
10–8 40 Quiet talking medium such as air (gas) or bone (solid) but these travelling sound
10–10 20 Whispers waves form two-dimensional fronts that are perpendicular to the
10–12 0 direction of the wave propagation. Therefore, it is more appropriate to
define the transport of sound energy as the average power per unit area
0 10 100 1000 10000 Frequency/Hz rather than as the total power in the wave because of the two-
Fig. O4.30 dimensional wavefronts that are detected in the air-brain combination.
551
The average power per unit area of a sound wave that is incident
perpendicular to the direction of propagation is called the sound
intensity. The units of sound intensity are watts per square metre, W m-
2
.
P Short-term and long-term exposure to noise
I  av
A As already mentioned, the decibel is a logarithmic scale whose sound
As the sound intensity spreads out from its source, the intensity I is
reduced as the inverse square of the distance d from the source.
Therefore,
1 established ranges of the sound intensity level of the degree of a hearing
I 2
d
For example, doubling the distance from a sound source would cause
the sound intensity to become one-quarter that at the original distance.
In a sound wave, the medium particles such as air molecules, vibrate in
simple harmonic motion parallel to the direction of wave propagation.
Just as the energy in simple harmonic motion is proportional to the
square of the amplitude (A) and the square of the frequency, so too
sound intensity is directly proportional to the square of the amplitude
and the square of the frequency of the particle vibrations
I  A2
The ear-brain combination can accommodate a range of sound
intensities. The just detectable sound intensity known as the threshold
of hearing I0 (minimum intensity heard by a normal human ear at 1
kHz) is taken to be 10-12 W m-2. The sound intensity that produces a
sensation of pain called the pain threshold is taken to be 1 W m-2. This
is painful to the ear and can cause permanent deafness.
A sound wave can also be considered as a pressure wave because the
particle vibrations cause harmonic variations in the density of the
medium. The pressure variations corresponding to the hearing threshold
and the pain threshold are 3 ×10–5 Pa to 30 Pa respectively
superimposed on atmospheric pressure of about 101 kPa.
Since this is a range of 1012 and since the ear is logarithmic in its
response, it is convenient to use a logarithmic scale, for sound intensity.
The intensity level in decibels (dB) of a sound of intensity I is defined
I
as 10 log 
 I 0 
, where I 0 is the threshold intensity of the human ear, as
defined above.
The unit used is the bel. One bel is defined as the logarithm to base 10
of the ratio of two sound intensities, with relative intensities in the
ratio 10:1.
Defects of hearing
Deterioration of hearing can occur due to age and due to exposure to
excessive noise. Fig. O4.32 shows the effect of age on the threshold of
hearing.
• Age-related deterioration occurs at all frequencies and is greater the
higher the frequency.
• The effects of exposure to loud sounds
Excessive and prolonged exposure to noise in a narrow frequency range
(e.g. machine noise) can cause deterioration in that frequency range
only. Short-term exposure to sounds over 100 dB can damage the hairs
in the cochlea, leading to tinnitus or ringing in the ears. As the length of
time one is exposed to a sound increases, the loudness also increases, as
does the likelihood of sustaining damage. This is why people who work
with everyday machinery like lawnmowers, which are not particularly
loud, wear ear protectors. Long exposure to sounds above 90 dB can
lead to permanent hearing loss as the hair cells in the cochlea begin to
die. Most engine-saw operator develops severely reduced hearing,
probably due to prolonged noise of the saw.
00 Normal
Hearing loss (dB)
10
Machine
20 induced
loss
30
40
Age loss
50
00 5 10 15 20
Frequency/Hz
Fig. O4.32
Hearing loss can be tested by obtaining equal loudness curves and
comparing the results with the corresponding curves for normal hearing.
The hearing loss at any given frequency may be expressed as the
difference between the threshold intensity level for normal hearing and
for the person being tested. For example, a person with a threshold
552
intensity level of 65 dB at 10 kHz in comparison with 40 dB for a
person with normal hearing has a hearing loss of 25 dB at that
frequency.
intensity level is given by. Physically, every 6 dB increase corresponds
to a doubling of the sound pressure level. For our perception, every 10
dB increase sounds to twice as loud. For adults (subjects) there are
loss at each frequency. These ranges are:
10 dB to 20 dB (normal hearing)
21 dB to 45 dB (mild hearing loss)
The victim will have difficulty hearing sot speech or normal
conversations but would manage fine if the speech is clear. Mild
hearing loss in the high frequencies in both ears suggests noise damage.
The victim would miss some consonant sounds such as s‟s, z‟s, th‟s,
v‟s, even under perfect listening conditions. Under noisy conditions, the
victim would experience more difficulty with hearing these sounds. The
victim does not need a hearing aid, but should protect their remaining
hearing by avoiding loud noise and using effective ear protection.
46 dB to 60 dB (moderate hearing loss)
The victim will experience difficulty with multi-conversations
especially if there is background noise. Much of the loudness of speech
will be lost and there will be confusion amongst heard words due to the
misinterpretation of consonant sounds. The volume for TV and radio
would need to be increased and talk louder during gathering. A hearing
aid would help provided that the speech discrimination was good and
the background noise is minimised.
61 dB to 75 dB (moderately severe hearing loss)
This is a common result amongst the old due to the effects of an ageing
inner ear. The victim has moderately severe hearing loss in both ears
usually in the higher frequencies meaning that it would be hard to
distinguish one word from another. A hearing aid is needed to amplify
sot sounds considerably, moderate sounds a little and loud sounds not at
all but the aid must also leave the low frequencies unchanged.
76 dB to 90 dB (severe hearing loss)
Normal conversational speech is inaudible. A hearing aid will only help
a little. The victim is likely to lip-read.
91 dB and above (profound hearing loss)It is unlikely that a hearing aid
will help. Hearing losses can be conductive, sensory or neural. A
conductive hearing loss occurs due to an abnormality in the outer and/or
middle ears, and as a result, the sound energy cannot be conducted to
the inner ear and then to the brain as it should be.
Outer ear disorders
These are often due to obstruction of the ear canal due to either an
accumulation of wax or growths in the bony external ear that prevent
sound energy from reaching the eardrum. Furthermore, bacterial or
fungal infections can cause swelling that obstructs the pathway of the
external auditory canal. One form of this is called swimmer‟s ear. In
most cases, conductive hearing loss can be treated medically or
surgically.
Middle ear disorders
A common complaint called „fluid in the ear‟ arises when the
eustachian tube is unable to drain fluid to the throat. It can be caused by
allergies or infections in the throat and it causes severe earaches. It is
quite common in children. Otosclerosis is a condition found in adults in
which the stapes bone begins to grow a spongy mass that prevents it
from vibrating correctly in the oval window. Surgery can sometimes
improve the hearing loss. A heavy blow to the auricle bone or the head
can cause perforations in the eardrum or damage to any of the ossicles.
The conductive mechanism is disrupted and there may be no surgical
solution.
Inner ear disorders
A sensory hearing loss is caused by damage to the inner ear without
damage or abnormality of the outer and/or middle ear. In most cases,
sensory hearing losses are irreversible through surgical intervention.
Cochlear implants are a possible solution in some cases. Most sensory
hearing losses are of a hereditary or congenital nature but post-birth
acquired sensory hearing loss can also occur. Hereditary hearing loss is
due to the genetic make-up of the subject. The cochlea and its
associated neural functions or the auditory nerve can be impaired by the
genetic make- up in association with other degenerative diseases of the
nervous system, albinism or metabolic disorders. Congenital hearing
loss is due to a condition occurring during pregnancy and foetal
formation. It may be caused by maternal rubella, the breakdown of red
blood cells causing neonatal jaundice, birth injury, drug ingestion or
degrees of prematurity to name but a few. Post-birth acquired sensory
hearing loss results from trauma, disease or toxic agents that damage the
structures of the inner ear. It can occur in infants, children and adults.
Noise-induced sensory hearing loss can permanently damage the hair
cells of the inner ear and prevent proper stimulation of incoming sound
signals. Many common drugs including antibiotics, aspirin and quinine
if taken in large amounts can damage the structures of the cochlea and
the semi-circular canals. he measles and mumps viruses are well known
to cause sensory hearing loss. Some statistical analyses suggest that
sensory losses due to degenerative changes associated with aging will
affect 30% of people in the 65–70 age categories.
A neural hearing loss is when the outer, middle and inner ear are
functioning normally but there is an abnormality or growth of tissue on
the auditory nerves. Common problems are loss of hearing to one ear,
ringing in the ear (tinnitus) and balance problems. Degenerative
diseases caused by multiple sclerosis, muscular dystrophy or traumas
due to a stroke or brainstem and brain injury cause damage to the
auditory structure.
Hearing tests and audiograms
The science of hearing is called audiology. Audiometry is the
measurement of hearing for various frequencies of sound, particularly
of impaired hearing. An audiogram is a graph of a person‟s hearing
ability and is a measure of the softest sound that a person hears at least
50% of the time.
Hearing tests are carried out by audiologists and the tests begin with an
initial recognition of the problem in the surgery with the use of pure
sounds from beeps and whistles being made in each ear (air conduction)
or by using a vibrating tuning fork placed on the mastoid bone behind
the ear (bone conduction). Once the audiologist does this initial test, the
subject is asked to sit in an acoustic booth and listen to a number of
pure tones (pure tone audiometry), and indicate when the tones can be
heard. The tones are reduced in intensity until they can just be heard.
The hearing threshold is then marked on an audiogram.
For air conduction, hearing is measured with pure tones through a set of
headphones placed on the ears. He subject is asked to push a button
when they hear certain frequencies. This is known as the air threshold
method as sound must travel through the air of the ear canal, through
the middle ear, and through the inner ear cochlea.
When the sensitivity of the inner ear needs to be directly measured, the
bone conduction method is used. His method allows for the outer ear
and the middle ear to be bypassed. A vibrator is placed on the mastoid
bone behind the ear, and this is held in place by a small metal band
stretching over the top of the head. This method transmits sound by
direct vibration of the bone and these vibrations are carried by the skull
bones, tissues and fluids directly to the cochlea in the inner ear.
The standard audiogram reads:
• the frequency in hertz from the lowest to the highest pitch within an
audible hearing range of the average person on the horizontal axis.
• the range used is 125 Hz or 250 Hz on the left side and 8000 Hz on
the right side. The scale is based upon octave intervals of a particular
note like on a piano keyboard. Lows are to the let of 1750 Hz and
highs are to the right of this imaginary vertical line
• .the loudness (intensity) in decibels is on the vertical axis and from –
10 dB to 0 dB at the bottom, and 110 dB at the top.
• 0 dB does not mean the recognition of no sound but rather it is the
softest sound that a person will hear 50% of the time. Normal hearing
is in the 0 to 20 dB range at all frequencies. Soft sounds are below 35
dB, moderate sounds are then from 35 dB to 70 dB, and loud sounds
are above 70 dB.
• represents the left ear and represents the right ear in air threshold
hearing curves detected using headphones. If the bone-conduction
vibrator technique is used to determine the threshold, a > is used for
the left ear, and a < is used for the right ear.
Intensity
level
/ dB/ dB
20
10
0 dBA scale, which is used on some sound level matters?
250 500 1000 2000 4000 8000
Frequency (logarithmic scale) / Hz
Fig. O4.35
553
A typical audiogram is illustrated in Fig. O4.35 for a normal hearing
range - all frequencies are in the 0 – 20 dB band. If all the and
readings fall above the 20 dB line then you have normal hearing. If
anything is below this line, then you have a hearing loss. Sometimes, a
frequency interval showing a 3000 Hz and 6000Hz line is included
making the audiogram longer by two intervals. This was obtained using
the air or bone conduction method.
A comparison of the air and bone hearing curves can determine whether
the hearing defect is conductive (when the air conduction curve shows a
hearing loss but the bone conduction curve is normal), sensorineural
(when the air conduction and bone conduction curves show the same
amount of hearing loss), or a combination of both.
Attenuation of ultrasound
When the ultrasound propagates through a heterogeneous medium; its
energy decreases as a function of distance. The energy is reduced
because it is absorbed or reflected or scattered by the medium.
Reflected and scattered energy has just changed the direction of
propagation, but the absorbed sound energy due to frictional effects is
mainly converts into heat. The energy absorption is detected as the
reduction of sound wave amplitude and consequently sound wave
intensity or audible pressure. The decrease in intensity is exponential
function of depth, x:
I ( x)  I (0)e  x or p( x)  p(0)e  x
where, α is the absorption coefficient characteristic for the tissue and
dependent on wave frequency. It is bigger for higher frequencies,
meaning that the higher frequencies are better absorbed in the tissues.
The half-value thickness is the tissue thickness needed to decrease the
starting intensity to its half value
ln 2
X1 
2

The half-value thickness decreases with increasing frequencies, and that
put the limit to the maximum frequency that can be clinically use.
There is small benefit of the absorption for diagnostic processes, mainly
because of the complicated functional dependence of attenuation on
frequency. Sometimes it is used for imaging symmetric organs and to
compare their functions.
Deafness
Deafness is the partial or complete hearing loss. That is, the inability
of the ear to partial or complete detect sound waves. Levels of hearing
impairment vary from a mild to a total loss of hearing. There are two
main types of hearing loss: conductive and sensorineural (nerves).
Conductive hearing loss means that the vibrations are not passing
through from the outer ear to the inner ear, specifically the cochlea. This
type can occur for many reasons, including: an excessive build-up of
earwax, glue ear, an ear infection with inflammation and fluid buildup,
a perforated eardrum, malfunction of the ossicles and a defective
eardrum. Ear infections can leave scar tissue, which might reduce
eardrum function. The ossicles may become impaired as a result of
infection, trauma, or fusing together in a condition known as ankylosis.
Sensorineural hearing loss is caused by dysfunction of the inner ear,
the cochlea, auditory nerve, or brain damage or the inability of the
cochlea to convert mechanical vibration from the eardrum into nerve
impulse for the brain to interpret. This kind of hearing loss is normally
due to damaged hair cells in the cochlea. As humans grow older, hair
cells lose some of their function, and hearing deteriorates. Long-term
exposure to loud noises, especially high-frequency sounds, is another
common reason for hair cell damage. Damaged hair cells cannot be
replaced. Currently, research is looking into using stem cells to grow
new hair cells. Sensorineural total deafness may occur as a result of
congenital deformities, inner ear infections, or head trauma.
The combination of conductive and sensorineural hearing loss is known
as mixed hearing loss. Long-term ear infections can damage both the
eardrum and the ossicles. Sometimes, surgical intervention may restore
hearing, but it is not always effective.
Worked Examples
1) a) The threshold of hearing is quoted as 1.0  10–l2 W m–2 . Explain
what is meant by the threshold of hearing and state the frequency at
which the threshold has this value.
b) Sound intensity levels are usually measured in decibels. Give three
reasons why this logarithmic scale is used.
c) Why was it necessary to introduce an adapted scale referred to as the
Solution
a) The lowest level of sound intensity which the normal human ear can
detect is 1 kHz
b) The ear has a logarithmic response (or logarithmic scale chosen to
match perceived response of the ear) to accommodate very wide
range of sound intensities to which ear can respondperceived change
in loudness is proportional to fractional change in intensity 10-fold
increases in intensity are perceived as steps of equal increase in
loudness log scale means that numerical values on the scale
represent ratios of two sounds, expressed as the log of that ratio.
c) The dBA scale takes account of the frequency dependence of the
sensitivity of the ear (or to match the ear‟s frequency response or
meters calibrated on a dBA scale give frequency-weighted readings)
2) a) A sound source of constant output power is used to generate
a sound which is measured using a sound meter. When set to
the dB scale, the sound meter displayed 60 dB as the reading
when the frequency of the sound was 1 kHz.
i) State and explain what the reading would be for a sound of
frequency 1 kHz if the meter was changed to the dBA scale.
ii) State and explain what would happen to the reading on each scale if
the frequency of the sound was changed to 500 Hz.
b) A drill is operated in an otherwise silent room. The drill produces
sound of power 2.0 W which is given out equally in all directions. A
sound meter is placed 5.0 m from the drill and is set to the dB scale.
Calculate the reading on the sound meter. I0 = 1.0 × 10–12 W m–2
Solution
a) i) The reading of 60 dBA as 1 kHz is the reference frequency is the
threshold of hearing.
ii) dB reading would be 60 dB as power is not frequency dependent.
dBA reading would be less than 60 dBA as 500 Hz has a higher
threshold intensity and ear is less sensitive.
P 2
b) Intensity at meter =   6.37  10 3 W m 2
A 4 (5) 2
 6.37  103 
Intensity reading = 10 log   98 dB
 1.0  1012 
3) Describe how the vibrations of a sound wave are transmitted from
the outer ear to the inner ear
Solution
Sound waves reaching the ear are collected by the ear flap and channel
to the ear canal. The sound (pressure) waves in ear canal force
eardrum to vibrate. This vibration of eardrum passed via lever system
of middle ear forces the oval window to vibrate. This lever system
amplified the force by about 1.5 times. Since the oval window about
1
the area of the eardrum the pressure waves further increased to a
20
large amount. This vibration of the oval window sets pressure waves in
fluid filled cochlea of the inner ear.
4) Fig.O4.25 a vertical section through the human ear. Solid bone is
shaded grey.
Fig. O4.25
Name and state the function of the parts labelled A, B, C and D.
Solution
- A is ear drum transfers sound waves from the outer ear to the ossicles
of the middle ear
- B is ossicles system of levers with a mechanical advantage of 1.5
(amplification) (which links two membranes (ear drum and oval
window) or transmits sound vibrations from outer to inner )
- C is oval windows: oval and round allow sound vibrations to enter the
fluid of the inner ear (or allows sound vibrations to be transmitted
around the cochlea or contain the inner ear's fluid while allowing the
fluid to move
- D is cochlea convert pressure waves [or vibrations] in the fluid into
electrical signals [or stimulates (auditory) nerves to send signals to the
brain]
5) Sometimes a lot of wax is produced in the ear. The wax rests against
the eardrum. Give four reasons why we cannot hear very well when
our ears contain a lot of wax.
554
Solution
• wax stops some of the sound waves reaching the eardrum
• wax absorbs some of the sound waves
• the eardrum vibrates less since it is loaded
• some of the sound waves are reflected by the wax
6) a) State two reasons why the logarithmic dB scale is used to
compare sounds of different intensities.
(b) Another scale used to compare sounds of different intensities is the
dBA scale. What are the main differences between the dBA and the
dB scales?
c) A reading of 94 dB is obtained on a sound meter placed near a drill.
Calculate the intensity of the sound incident on the meter. Reference
threshold intensity I0 = 1.0 × 10–12 W m–2
(d) An identical drill is now placed next to the first drill and both are
switched on. Calculate the new reading on the sound meter.
Solution
a) The ear has logarithmic response and can accommodates wide range
of intensities
b) dB scale has a flat response with frequency dBA scale is frequency
compensated for dBA, threshold intensities are different for different
frequencies
 I 
c) 94  10 log 
 1.0  1012 
I  1.0  1012  109.4 = 2.5 × 10–3 W m–2
d) Intensity = 2 × 2.5 × 10–3 W m–2
 5.0  103 
Intensity level  10 log 
 1.0  1012 
= 97 dB
7) (a) State what is meant by the threshold of hearing and state the
frequency at which the reference threshold is quoted.
(b) Sketch a curve to show how the threshold of hearing varies with
frequency across the full range audible to a normal human ear. Add a
suitable frequency scale to the frequency axis.
(c) (i) Calculate the intensity of a sound which is found to have an
intensity level of 60 dB above the threshold of hearing. The intensity
of the threshold of hearing is 1.0 × 10–12 W m–2.
(ii)The smallest increase in sound intensity which the human ear can
detect is about 12%. Express this change in decibels.
Solution
a) threshold of hearing – lowest intensity of sound detected by normal
human ear reference intensity (1.0 × 10–12 W m–2) is taken at 1 kHz
b) Basic shape range (30Hz – 20kHz approximation) minimum
between 1 kHz and 3 kHz scale, including units logarithmic . See Fig.
O4.37.
Fig. O4.37
c) (i) I2 = 106 × 1.0 × 10–12 = 1.0 × 10–6 W m–2
 112 
(ii) number of dB = 10log 
 100 
= 0.5 dB
8) State the frequency of sound at which the normal ear is most
sensitive.
(b) State the main features of hearing loss in terms of frequency
response for
(i) age-related hearing loss,
(ii) noise-related hearing loss.
(c) At the site of a machine in a factory, a sound meter was used to
measure the sound level. The relative intensity level with the
machine operating was 86 dB. The sound intensity reaching the
meter when the machine was not operating was 7.0 × 10–5 W m–2.
i) Show that with the machine operating, the sound intensity reaching
the meter was about 4 × 10–4 W m–2.
ii) Calculate the relative intensity level due to the machine alone.
 Solution (a) (i) Listen to sound at a frequency of 1 kHz and intensity level 10 dB
(a) 3 kHz listen to sound at different frequency and loudness and alter loudness
(b) (i) age related as frequency increases, loss increases switch between 1 kHz, 10 dB and new f and loudness until same
(ii) noise related loss is maximum at 4 kHz loudness is perceived repeat for f between 20 Hz and 14 – 20 kHz
c)i) I = 1.0 × 10–12 × 1086/10 = 3.98 × 10–4 W m–2 (ii) Equal loudness curve to show: line almost flat at 100 dB with dip
 3.98  104  7.0  105  at 3 kHz
ii) Intensity level  10 log   =85.2 dB b)i) The minimum of intensity of sound heard by normal human ear at
 1.0  10 12 frequency of 1 kHz
9) a) Define the threshold of hearing, I0.  1.3  103 
ii) Intensity level  10 log 
 1.0  1012 
b) A hearing test was used to obtain threshold hearing audiograms for = 91 dB
several people. The audiogram shown in Fig.O4.33 was obtained for
a person with normal hearing. 11) The sound intensity at a distance of 20 m from a fire alarm is 5.0 ×
10–3 W m–2. Calculate the sound intensity at a distance of 50 m.
Intensity level /dB

80
Solution
k  I1d12  I 2 d 22

 I2 
I1d12

 5.0  10   20
3 2

 8.0  104 W m 2
/dB

40
d 2
2  50 2

12) A ship sounds its foghorn. A person on a cliff hears the sound which
has an intensity of 0.13 mW m–2. The sound suffered attenuation in
0
travelling between the ship and the person.
a) (i) Define intensity.
(ii) State what is meant by attenuation and what causes it.
0 30 100 300 1000 3000 10000 b) Calculate the intensity level of the sound heard by the person
Frequency (Hz) described above. threshold of hearing I0 = 1.0 × 10–12 W m–2
Fig.O4.33 Solution
On the same axes: a) (i) intensity is the power per unit cross-sectional area in path of wave
i) sketch a curve, labelled Q, for a person suffering hearing loss due to (ii) attenuation is the reduction in intensity of the sound as wave
old age travels through a medium due to absorption or scattering or
ii) sketch a curve, labelled R, for a person suffering hearing loss due to diffraction
excessive noise  1.3  104 
b) Intensity level  10 log 
 1.0  1012 
Solution = 81 dB
a) This is the minimum intensity that a normal human ear can hear at a
frequency of 1000 Hz 13) A lathe in a workshop exposes its operator to sound at an intensity
b) Note that in the graph below: level of 80 dB when it is in operation. The operator standing at the
i) increased loss with increased frequency lathe also experiences sound at an intensity level of 78 dB from a
ii) increased loss followed by decreased loss and with maximum loss at drill when that is in operation with the lathe switched off. Calculate
4 kHz. See Fig. O4.34 the intensity level experienced by the lathe operator at the lathe when
both machines are switched on.
80
Intensity level (dB)

Solution
Q
 I1 
80  10 log   I1  1.0  108 I 0
 I 0 
 I2 
(dB)

40
78  10 log   I 2  6.3  107 I 0
R  I 0 
Intensity due to both machines, I =
1.0  108 I 0  6.3  107 I 0  1.63  108 I 0
0
Intensity level due to both machines
I
 10 log    10 log 1.63  108   82 dB
0 30 100 300 1000 3000 10000  I0 
Frequency (Hz)
14) Calculate the sound intensity level in dB of a sound from a
Fig. O4.34
loudspeaker with a sound intensity of 8.0 × 10-4 W m-2
10) A patient has a hearing test to obtain an equal loudness curve at a
Solution
level above the threshold of hearing. The curve obtained is shown in
Fig. O4.38 I  8.0  104 
b  10 log    1.0  1012   89 dB
 I 0 
10 log
Intensity level/dB
15) a) Consider the ear to be a pipe closed at one end, and that the length
of the human auditory canal is approximately 28 mm. If the velocity
of sound in air is 340 m s–1, then what is the fundamental note of the
ear?
b) The ossicles in the human ear act as a level, what does that mean?
Solution
v 340
a) f    3035 Hz
4 L 4(28  103 )
b) The ossicles is made up of three tiny bones, malleus, incus and
stapes. These bones act as a lever which means that the force of the
vibrations is amplified when transferred through these tiny bones
to the oval window. When the eardrum vibrates, it moves the
Fig. O4.38 malleus, connected to its center on the inner side, from side to side
(a) (i) Describe how such a curve is obtained. like a lever. The other end of the malleus connected to the incus is
(ii) On the diagram draw an equal loudness curve which passes attached to the stapes. The other end of the stapes rests against the
through 100 dB at a frequency of 1 kHz. cochlea, through the oval window. The malleus moves a greater
(b) i) Define the threshold of hearing, I0. distance, and the incus moves with greater force (energy = force ×
ii) A drill is heard by a passer-by. The intensity of the sound reaching distance).
the passer-by is 1.3 × 10–3 W m–2. Calculate the intensity level of 16) A sound level meter placed near a circular saw registers a value of
the sound heard. I0 = 1.0 × 10–12 W m–2 92 dB. What is the intensity corresponding to this intensity level?
Solution Solution
555
 I  I  Action Potential or Nerve Impulse
b  92  10 log    10 log  12 
 I0   1.0  10 
 I  109.2  1012  1.6  103 W m2
17) a) Sound waves are incident on the ear canal of a normal human ear.
Describe the physical processes involved in the transmission of the
energy from the air through to the inner ear. Include an outline of
how the variations in air pressure in the ear canal are amplified to
produce greater pressure variations in the inner ear.
b)i) Define intensity of sound.
ii) A human ear has a threshold of hearing of 54 dB at a given
frequency. Calculate the intensity of sound incident on the ear at this
frequency. Give your answer to an appropriate number of s.f. Io =
1.0 × 10–12 W m–2.
Solution
a) The pinna acts as a funnel gathering sound pressure waves into the
ear canal onto eardrum. The sound pressure waves in the air,
impinging on the eardrum cause it to vibrations. The mechanical
vibrations passed through a system of three bones acting as levers,
from malleus to incus and to stapes. The three bone lever system
increase mechanical force to about 1.5 times it incident sound. The
last bone (stapes) sets the oval window into mechanical vibration;
pressure waves are set up and transmitted through the fluid in the
cochlea, up the vestibular channel in the perilymph. The cross
sectional area of the oval window about 20 times less than the cross
sectional area of the eardrum, hence the larger force on a smaller area
setup an amplified pressure to about 30 times greater.
b) i) Intensity is the power per unit cross-sectional area in path of the
wave at normal incidence.
 I 
ii) 54  10 log 
 1.0  1012 
 I  105.4 (1.0  1012 )  2.5  107 W m2
BIOLOGICAL MEASUREMENT
The human body may be thought of as a complex electrical machine. In
order to understand the pattern of electric potentials in the heart muscle,
it helps first to consider nerve cells. Electrical signals are conducted
around the body along these specialised cells. Nerves are made of fibres
that can be up to a metre long, but are usually only a few micrometres in
diameter. Signals travel along these fibres in the form of a changing
potential difference, which is generated by the movement of ions across
cell membranes.
dendrite
nerve cell
nucleus
myelin sheath
axon
impulse node of ranvier
axon terminal
Fig.O4.41
These impulses may originate in sensory cells in the body or in the
brain or in the case of the heart in a small region called the sino-atrial
node. Nerve cells transmit electrical impulses to one another or to
„effector‟ cells in the muscles or brain via gaps called synapses.
These gaps are of the order of nanometres in width and ensure the
impulses pass in one direction only. Fig.O4.41 shows the structure of a
nerve cell which transmits electrical impulses to muscle fibres.
Dendrites are branches of the main part of the nerve cell. They receive
electrical impulses from other nerve cells. The main part of the nerve
cell contains its nucleus.
The axon of the nerve cell is the nerve fibre which transmits electrical
impulses to effector cells in the muscle fibres to make the fibres
contract. An axon from the spine to the foot may be several
micrometres in width and more than a metre in length. The axon is
insulated from the surrounding tissue by a sheath of myelin which has
gaps at intervals of about a millimetre. The gaps, referred to as nodes of
Ranvier, boost the speed of the nerve impulses, making each impulse
jump from gap to gap.
556
Action potentials occur in several types of animal cells called excitable
cells. These include neurons, muscle cells, and endocrine cells, as well
as in some plant cells. The „action potential‟ is the name of an event
during which the electrical membrane potential of a cell rapidly rises
and falls - 'exciting' the cell. In neurons, they play a central role in cell-
to-cell communication. Action potentials in neurons are sometimes
called nerve impulses or spikes. A neuron that emits an action potential
is often said to fire.
Terminology
- Resting state:- When the cell is in a resting state, the cell membrane
keeps sodium ions outside the cell so the interior is negative relative to
the exterior. The cell membrane is then said to be polarised.
- Depolarisation and Reverse polarisation: When a nerve cell is
stimulated, the cell membrane suddenly becomes permeable to sodium
ions which then move into the axoplasm from their higher
concentration area outside. The increase in positive charge inside the
cell leads to a change in the membrane potential from about –70 mV
to +30 mV.
- Repolarisation: Almost immediately, the membrane becomes
impermeable to sodium ions and permeable to potassium ions, which
consequently leave their high concentration area inside the fibre and
move out, thereby restoring the original membrane potential of –70
mV.
- Propagation of the signal: The depolarised (active) region of a fibre
acts as a trigger, stimulating adjacent region to follow through the
same action potential. How fast the action potential moves along the
axon depends on several factors including type of cell, fibre diameter
and temperature.
Electrical signals in the body.
The membrane of nerve cells allows water to diffuse freely into or out
of the cell. The membrane is much less permeable to the passage of
sodium ions (Na+) and potassium ions (K+), but there are „channels‟
through which ions can be transferred into and out of the cell. In all
cells in their resting state, there is a high potassium concentration and a
low sodium concentration, whereas the fluid surrounding the cell has a
low potassium concentration and a high sodium concentration. It is the
imbalance in the numbers of sodium and potassium ions that causes a
potential difference across the cell membrane. A biopotential is a
potential difference generated inside the body. The concentration
gradient tends to cause potassium ions to leave the cell, carrying their
single positive charges with them. Potassium ions continue to leave the
cell until the excess positive charge outside the cell is large enough to
stop them. This happens when the inside of the cell is at a potential of
−70 mV compared to its surroundings. At this resting potential, an
equilibrium exists between the concentration gradient and the potential
gradient, and the cell is said to be polarised as shown in Fig.O4.42 (a).
In this resting state, there is an imbalance of ions – more potassium ions
inside the cell and more sodium ions outside. This causes a potential
across the membrane of −70 mV. The cell is polarised.
(a) The cell resting and polarised (imbalance of ions)
outside the cell
inside the cell
(b) An electrical signal is initiated: depolarisation
outside of cell
inside of cell
(c) Repolarisation (Potassium ions leave the cell.)
 pumps approximately five litres of blood round the body every minute,
outside of cell using energy at a rate of just a few watts.
Fig.O4.44 shows a cross-section of the human heart. In effect, the heart
is a double pump. It drives blood from the right ventricle to the lungs
then back from the lungs into the left atrium then into the left ventricle
inside of cell then out to the rest of the body and then back the right atrium.
(d) Original ion concentrations are restored blood blood
pulmonary
artery to lungs to body aorta
Fig.O4.42
blood
When a nerve impulse is initiated, channels in the cell membrane blood from lungs
suddenly become much more permeable to sodium ions. For a period of from body
right pulmonary
about 1 ms, sodium ions move into the cell as shown in Fig.O4.42 (b). vena cava atrium left vein
As the sodium channels open and sodium ions rush into the cell. The atrium
inside of the membrane becomes positive with respect to the outside – SA node
semi-lunar bicuspid
the membrane is depolarised. This causes the potential difference across valve
valve
the cell membrane to rise to +35 mV before the sodium channels close.
tricuspid tendon
Reaching this positive potential triggers another set of channels, which supporting valve
valve
permit potassium ions to leave the cell. The resting potential of −70 mV
is then restored and the cell is repolarised as shown in Fig.O4.42 (c). right left ventricle
ventricle
The increase in potential in the cell closes the sodium channels and
muscle
opens the potassium channels. Potassium ions leave the cell. The
potential drops again to −70 mV; it is repolarised. AV node
The original sodium and potassium ion concentrations are restored as Fig.O4.44
shown in Fig.O4.42 (d) by means of a „sodium–potassium pump‟, Each time the heart beats, its electrical potential changes by more than
which need not concern us here. 100 mV as the muscles of the heart contract and relax in a sequence that
forces blood from the two atrial chambers of the heart into the
membrane
voltage (mV) corresponding ventricles and then out to the arteries. This sequence is
peak due to nerve cells that conduct electrical signals generated at the sino-
+30
overshoot

atrial (SA) node in the right atrium. These nerve cells extend from the
rising phase

SA node across the surface of the heart, making the muscles of the atrial
falling phase

chambers contract and stimulating the atrio-ventricular (AV) node. This

0
threshold failed
–55
initiation
resting potential
–70
stimulus
0 1 2 3
Fig.O4.43: Membrane potential of a nerve cell
This pattern of changing potentials is called an action potential shown
in Fig.O4.43. A changing potential in one part of the nerve initiates a
new action potential at an adjacent site. In this way, the action potential
propagates along the fibre.
At the action potential, the cell membrane now becomes permeable to
potassium ions (K+) which flow out through the cell wall, causing the
cell to repolarise until the interior near that section of membrane is
again at negative potential of −70 mV.
The whole process in which the potential changes from −70 mV to +30
mV and back to −70 mV takes no more than about 5 milliseconds and
stimulates the adjacent parts of the membrane. The balance of sodium
and potassium ions is gradually restored to the state at the resting
potential in the next 50 milliseconds or so, preventing the stimulus from
backfiring and ensuring that this section of the membrane can receive
and transmit the next impulse. The electrical impulse moves away from
where it was received and is transmitted across the main part of the cell,
along the axon and on to the synapse at the end of the axon.
Ion channels
The membrane of a cell contains certain protein molecules which form
channels in the cell membrane which sodium ions or potassium ions can
pass through. Whether or not a sodium ion or a potassium ion can pass
through a channel depends on the electrical potential difference between
the interior and exterior of the membrane on the type of molecule.
Basic Structure of the Heart
The heart function basically in regulating blood pressure, pumping
blood, conducting electrical impulse and regulating body temperature.
The heart is, however, different from other muscles since the electrical
stimulus originates in the heart itself. The heart muscle consists of
millions of cells, each negatively charged on the inside and positively
charged on the outside, producing a potential difference of around 80
mV (known as the resting membrane potential) across the cell
membranes.
Charges continually migrate across the membrane, until a point is
reached (the threshold) when charge movement becomes very rapid and
membrane depolarisation occurs. This effect moves through the region
as adjacent cells depolarise. The human heart beats at a normal rate of
about 70 times per minute without stopping, from birth to death. It
relays the electrical signals to further nerve cells which make the
ventricles contract. Valves ensure the blood passes one way only
through the heart from each atrial chamber, as shown in Fig. O4.44
Fig.O4.45 shows how the potential of the heart changes each time the
heart beats. An electrical impulse from the SA node depolarises then
repolarises the nerves of the atria, making the atria muscles contract
undershoot then relax. The impulse reaches the A-V node which, after a delay, then
4 5
stimulates the nerves of the ventricles, making the muscles of the
time (ms) ventricles relax.
The heart rate is determined by the rate at which cells leak charge; these
cells occur in the sino-atrial node (S-A node) of the heart (sometimes
referred to as the pacemaker). The bio-electrical signal (or
depolarisation wave) leaves the S-A node and spreads over the top of
the heart, which contains the right atrium and the left atrium, causing
these chambers to contract and force their contents through one-way
valves (mitral and tricuspid) into the respective ventricles. The signal
then reaches the atrio-ventricular node (A-V node), where it is slightly
delayed until all the blood has moved into the ventricles. The signals is
passed to the whole ventricular mass, then the right and left ventricles
contract and pump blood through two more one-way valves (the
pulmonary and aortic valves) to the lungs and body respectively
membrane
potential/V
+40
0
time/ms
threshold 200 ms
contraction
1 ms
– 80
leakage repolarisation
rapid depolarisation
Fig. O4.45
This masks the repolarisation and relaxation of the atria. The last part of
the cycle is the repolarisation and relaxation of the ventricles.
Electrocardiograms (ECG)
Electrocardiogram is a graphic record of the electrical activity of the
heart. An ECG trace provides important information about the
condition of the heart. The change of electrical potential of the heart is
conducted through body fluids and tissue to the skin, causing changes of
potential of the order of 1 mV which can be detected by electrodes
connected to an amplifier.
The change of electrical potential of the heart is conducted through
body fluids and tissue to the skin, causing changes of potential of the
order of 1 mV which can be detected by electrodes connected to an
557
 amplifier. An electrocardiograph is designed to measure and record the up to about 20 Hz. Beyond this frequency, unwanted signals due to
potential difference between two points on the surface of the body. An muscle activity or from the mains supply must be filtered out.
ECG trace provides important information about the condition of the  Its frequency response should be even across the frequency range
heart. The potential difference between any two points on the body‟s otherwise the output voltage from the amplifier will be distorted.
surface is due to:  A high input impedance (i.e. opposition due to effects such as
 the conductivity of the body fluids resistance, capacitance and back emf) is essential otherwise a
 the position of the points on the body significant fraction of the input pd will be lost due to body resistance
 the action potential of the heart. and contact resistance where the electrodes are on the skin. Contact
Since body materials, particularly skin, are poor electrical conductors, resistance is lowered as much as possible by using a conducting paste
the selection and preparation of electrode site are most important. A between the electrode surface and the skin. However, the remaining
suitable site must be: resistance due to body fluids can be as much as 1000 Ω. The input
- well-cleaned, resistance of the amplifier and the patient‟s electrical resistance form a
- hair-free and potential divider so the „source‟ pd is split between the two
- rubbed to remove some outer cells. resistances. If the input resistance is not much higher than the patient‟s
A conductive, yet non-irritant, electrode paste is rubbed into the site to resistance, the input pd to the amplifier will be significantly less than
improve the electrical contact and the applied electrode is then held the source pd.
firmly in place using tape.  The amplifier must have a high signal-to-noise ratio otherwise the
The record of the variation of the traces of the potential difference output signal is masked by random electrical signals (i.e. noise)
between two points on the surface of the body with time on a generated in the amplifier itself. The output pd of the amplifier is
electrocardiograph is called an ECG. An ECG will give a trace of a either displayed on an oscilloscope, a chart recorder or a computer
healthy heart that looks like the graph in Fig. O4.46. Each trace is a screen.
single heartbeat and therefore lasts about 0.8 s. The main features of the In order to ensure good transfer of the signal voltage to the amplifier,
trace are marked on it. the input impedance of the amplifier must be much greater than that of
ventricles stimulated the signal source. Unwanted signals, that is, noise, which can be of
biological or electrical origin, may have the same order of magnitude as
p.d./mV the signal itself.
R
1
atria
stimulated

P T U
0
Q S
0 0.2 0.4 0.6 0.8 time/s
S-A node heart muscle repolarises
Fig. O4.48
„fires‟ If the patient is tense or uncomfortable, for example, muscle tremors are
stimulus delayed at A-V node detected in an ECG, so the patient should be as relaxed and as
Fig.O4.46 comfortable as possible. Electrical noise has many origins, the most
The study of this cardiac waveform is known as electrocardiography common being nearby power cables and electrical equipment which
(ECG); the machines used are known as electrocardiographs which induces charge on the patient. Noise caused in this manner will be of the
produce electrocardiograms. In addition to the arms, same magnitude in each connection; thus, if a differential amplifier is
electrocardiographers use other standard electrode sites which allow used, the output will be proportional to the difference of the potentials
observation of the heart‟s electrical activity to be made. These standard at each input so that the noise will be much reduced if not eliminated
sites are connected in pairs to the two terminals of an ECG amplifier to completely.
give twelve alternative connection systems (known briefly as .leads.). Hence, electrocardiogram usually abbreviated ECG, a record of the
The main features of the ECG trace in the above figure can be trace variation voltages created by depolarization and repolarization
summarised as follows. with time, especially in the heart. ECG recordings can help doctors
 The peak p.d. is about 1 mV and lasts about 0.3 s. diagnose heart attacks that are in progress or have happened in the past.
 The main features of the trace are labelled as P, Q, R, S and T according This is especially true if doctors can compare a current EKG recording
to convention. to an older one. An ECG also can show:
 The wave at P is due to the atria depolarising and contracting. • lack of blood flow to the heart muscle (coronary heart disease).
 QRS is due to depolarisation and contraction of the ventricles; this • a heartbeat that's too fast, too slow, or irregular (arrhythmia).
masks the repolarisation and relaxation of the atria. • a heart that doesn't pump forcefully enough (heart failure).
 The wave at T is caused by repolarisation and relaxation of the • heart muscle that's too thick or parts of the heart that are too big
ventricles. (cardiomyopathy).
To measure and display an ECG waveform, the p.d. between two • birth defects in the heart (congenital heart defects)
chosen points on the body surface must be amplified from about 1 mV • problems with the heart valves (heart valve disease).
to about 1 V to enable it to be displayed on an oscilloscope, a chart • inflammation of the sac that surrounds the heart (pericarditis).
recorder or a computer VDU screen.
Fig. O4.47 represents the amplifier with leads from the patient to the
Main functions of the heart
amplifier‟s input terminals and a suitable instrument connected to the
The heart function mainly in regulating blood pressure, pumping of
amplifier‟s output terminals
blood, conducting electrical impulse and regulating body temperature.

Blood Pressure (BP)

Fig. O4.47
The amplifier must have the following characteristics.
 Its voltage gain (i.e. the amplifier output p. d. divided by the input p.d.
to the amplifier) must be of the order of 1000 over a frequency range
Blood pressure can be measured using either invasive or non-invasive
methods. Non-invasive methods are usually used to measure blood
pressure even though invasive measurements give more accurate
readings. This is because non-invasive method has less chance of
infection, scarring or bleeding and has no incision. It is less stress for
patient and therefore less chance of false reading due to stress. Invasive
is more accurate because the probe of the measuring instrument is in
contact with the blood itself and therefore not measuring through other
tissue. A non-invasive method uses sphygmomanometer and
stethoscope shown in Fig.O4.56. For a nurse to do this, she need to
wraps the sphygmomanometer cuff around the patient‟s upper arm, to
level with their heart. She inflates the cuff, whilst using the stethoscope
to listen the blood flow.

558
 iii) Body resistance varies from person to person. If the body resistance
was lower, the initial current would be greater. State how this lower
body resistance affects the charge passed through the body from the
defibrillator.
Solution
a) Q = 150 × 10-6 F × 1200 V = 0.18 C
b) W = 12 × 150 × 10-6 F × (1200 V)2 = 108 J
stethoscope V 1200
c) i) R   = 85.7 Ω
sphygmomanometer I 14
 t RC
Fig. O4.56 ii) 0.25Q0  Q0 e
When the blood flow has stopped, she stops inflating the cuff and then  t  (85.7  150  106 ) ln(0.25)  0.0178 s
starts to deflate the cuff, while still listening the blood flow. When she
first hears the blood flowing again, she notes the pressure reading on the iii) Same charge flows for shorter time
sphygmomanometer scale. This gives the value of systolic pressure. She 3) Blood clots can lead to heart attacks. Blood flow through arteries is
deflates the cuff further and notes the pressure reading when she can no normally laminar, but an obstruction may cause the blood flow to
longer hear the blood flow. become turbulent. This can lead to the formation of blood clots.
Blood pressure is measured using two numbers. The first number, (a) Fig. O4.50 is an artery containing an obstruction.
called systolic blood pressure, measures the pressure in your blood
vessels when your heart beats. The second number, called
diastolic blood pressure, measures the pressure in your blood vessels
when your heart rests between beats. If the measurement reads 120
systolic and 80 diastolic, you would say „120 over 80‟ or write „120/80 Fig. O4.50
mmHg.‟ A healthy blood pressure is under 120/80 mmHg. A blood After passing the obstruction the laminar flow becomes turbulent in the
pressure reading of 120 to 139 systolic or 80 to 89 diastolic is defined as area marked T.
“prehypertension”, which means they are at high risk for high blood i) Add flow lines to the diagram to show laminar flow changing to
pressure. turbulent flow after passing the obstruction.
The normal resting pulse rate for a healthy young adult ranges from 60 ii) Explain what is meant by laminar flow and turbulent flow.
to 80 bpm. To locally measure the resting pulse rates, placed your (b) In one experiment on blood flow, the viscosity of the blood and the
finger(s) on inside of wrist, brachial or carotid artery. Then count the velocity of blood flow were measured.
number of beats in a set time. i) Describe how you would expect the velocity of blood flow to vary
with the viscosity.
Blood Pressure Levels ii) Suggest and explain how a rise in the temperature of the blood
Normal systolic: less than 120 mmHg would affect the velocity of flow.
diastolic: less than 80mmHg Solution
At risk (prehypertension) systolic: 120 –139 mmHg a) i) Fig. O4.51
diastolic: 80 – 89 mmHg
High systolic: 140 mmHg or higher
diastolic: 90 mmHg or higher

Worked Example Turbulent flow not to start before object

1) Why must the blood leaving the heart for the lungs be at a much Fig. O4.51
lower pressure than the blood leaving the heart through the aorta? ii) In laminar flow, there is no abrupt change in velocity of flow while
Solution turbulent flow is the abrupt, random changes in speed and direction
The left side of the pump is thicker and provides a higher pressure to of flow.
get the blood around the rest of body. b) i) Greater velocity with lower viscosity.
2) A defibrillator is a machine that is used to correct an irregular ii) Rise in the temperature result to lower viscosity and so faster
heartbeat or to start the heart of someone who is in cardiac arrest as in flow.
Fig. O4.49. 4) Fig. O4.52 shows how the membrane potential of a nerve cell varies
with time.
Membrane potential

Fig. O4.49
The defibrillator passes a large current through the heart for a short
time. The machine includes a high voltage supply which is used to
charge a capacitor. Two defibrillation „paddles‟ are placed on the
chest of the patient and the capacitor is discharged through the patient.
a) The 150 μF capacitor is first connected across the 1200 V supply.
Calculate the charge on the capacitor.
b) Calculate the energy stored in the capacitor.
c) When the capacitor discharges there is an initial current of 14 A in
the chest of the patient.
i) What is the electrical resistance of the body tissue between the
paddles?
ii) Calculate the time it will take for three quarters of the charge on the
capacitor to discharge through the patient.
D
A
time
Fig. O4.52
a) Copy and complete Fig.O4.52 by adding units and values to both
axes.
b) (i) State the value of the resting potential.
(ii) Name the process involved between points A and B on the curve
and describe the ion movement which produces this change.
(iii) Name the process involved between points C and D on the curve
and describe the ion movement which produces this change.
Solution
a) Unit on membrane potential axis is mV and on time axis ms.

559
 Time scale 0 to 5 overall time for peak shape to be > 0.75 ms and <
4 ms; potential scale resting -70 to peak +30
b) i) – 70 mV
ii) Depolarisation, Na+ into the membrane
iii) Repolarisation, K+ out of the membrane
5) a) Sketch the action potential curve of a nerve cell to show its main
features. Indicate units and scales on both axes.
b) Using you sketch above; explain in terms of ion movement, starting
at resting potential, how bioelectrical signals are produced in muscle
fibres.
Solution
a) Note that the pulse lasting not less than 1 ms and not more than 5
ms (see Fig. O4.53)
membrane
order of magnitude as the signal itself. If the patient is tense or
uncomfortable, for example, muscle tremors are detected in an ECG
(electrocardiograph), so the patient should be as relaxed and as
comfortable as possible. Electrical noise has many origins, the most
common being nearby power cables and electrical equipment which
induces charge on the patient. Noise caused in this manner will be of
the same magnitude in each connection; thus, if a differential amplifier
is used, the output will be proportional to the difference of the
potentials at each input so that the noise will be much reduced if not
eliminated completely.
b) In Fig. O4.554 of the ventricles; this masks the repolarisation and
relaxation of the atria
10
P = atria depolarising and contracting.

surface potential (mV)

voltage (mV) R
peak potential 8 R = depolarisation of ventricles and repolarisation o
+30

reverse polarisation overshoot T = repolarisation and relaxation of the ventricles.

6
0

depolarisation repolarisation (K+ out) 4

(N+ in) S-A node „fires‟
failed
initiation heart muscle repolarises
–55
threshold value 2
T
resting potential P
–70
stimulus undershoot 0
1.0 time (s)
0 1 2 3 4 5 Q S
time (ms) –2
stimulus delayed
Fig.O4.53
at A-V node
b) The resting potential of a nerve cell including the axon is about −70
mV relative to the exterior. At this potential, there is high
concentration of K+ inside membrane and Na+ outside. This potential 8) State and explain three problems associated with heart that ECG is
difference between the interior and exterior of the cell because the used as a diagnostic tool for.
cell wall is a semi-permeable membrane. When the cell is in a resting Solution
state, the cell membrane keeps sodium ions (Na+) outside the cell so • Arythmia which is an irregular pumping pattern which is quite common
the interior is negative relative to the exterior. The cell membrane is in young people, increased by exercise.
then said to be polarised. When the cell receives an electrical impulse • Blockage of part of the blood supply for the heart. This can lead to the
(stimulus), the section of the cell membrane where the impulse is heart muscle getting tired, or in extreme cases death of the heart muscle,
received becomes more permeable to sodium ions (Na+) which then myocardial infarction (heart attack).
move through the cell membrane into the cell. The result is that the • Fibrillation in which there is no coordinated pumping activity, which
cell potential near that section of the membrane depolarises (that is, will lead to death if not treated very quickly.
its potential increases to zero) and reverse polarisation occurs until the 9) a) Explain what is meant by a resting potential and an action
action potential of +30 mV reach. At the action potential, the cell potential in nerve activity.
membrane now becomes permeable to potassium ions (K+) which b) How does an action potential in heart muscle differ from that in
flow out through the cell wall, causing the cell to repolarise until the nerve cells?
interior near that section of membrane is again at negative potential of c) What happens in the cycle of the heart beat at
−70 mV. This whole process in which the potential changes from −70 i) depolarisation?
mV to +30 mV and back to −70 mV takes no more than about 5 ms ii) repolarisation?
and stimulates the adjacent parts of the membrane. After this, the Solution
balance of sodium and potassium ions is gradually restored to the a) The resting potential is an electrical potential across the nerve cell
state at the resting potential in the next 50 ms or so, preventing the membrane caused by an imbalance of ions. This leads to a potential
stimulus from backfiring and ensuring that this section of the difference across the nerve cell membrane and the cell is polarised.
membrane can receive and transmit the next impulse. The electrical The action potential occurs when the nerve is stimulated. Movement
impulse moves away from where it was received and is transmitted of ions causes the potential difference across the nerve cell
across the main part of the cell, along the axon and on to the synapse membrane to reverse. The cell is depolarised and subsequently
at the end of the axon. repolarised.
6) a) Why does the patient need to be relaxed during b) The action potential in heart muscle is similar to that in a nerve cell
electrocardiogram? – depolarisation from the resting state and then repolarisation – but
b)The operator using a defibrillator often shouts „stand clear‟ before the depolarised state lasts longer and the time for the whole cycle is
operating the machine. Explain why? longer.
Solution c) i) contraction
a) The electrical activity of other nerve cells and muscles could mask the ii) relaxation
electrical activity of the heart. 10) Electrodes are attached to the chest of a healthy person and a normal
b) It operates with high voltage of about 3000 V at 20 A, which could ECG waveform is obtained.
give a serious electrical shock to nearby persons. a) What is an ECG?
7) a) An ECG trace is to be obtained for a patient. State and explain the b) State three ways of ensuring good electrical contact between the
procedure and some design features of the equipment needed to electrodes and the person.
ensure a good trace is obtained. c) State three properties of the amplifier needed to amplify the signal
b) Sketch an annotated diagram to show the ECG of a healthy person. from the electrodes.
Solution Solution
a) Bio-electrical signals are detected at the body‟s surface by metal a) A record of the variation of the traces of the potential difference
plate electrodes held in position by adhesive. To reduce the impedance between two points on the surface of the body with time on an
of the electrode-skin interface, the skin is first rubbed with abrasive electrocardiograph.
paper to remove unwanted hairs and some dead skin, and a conducting b) Electrodes made from a material which does not become polarised.
electrode gel is used between the metal electrode and the skin. This The electrodes coated with conducting gel hair and dead skin
contains a strong electrolyte in a non-irritant base gel and can lower removed.
the impedance to around 1 kΩ and give an effective capacitance of 1 c) high gain, high input impedance and low noise
μF cm.2. In order to ensure good transfer of the signal voltage to the 11) Electrodes are placed on the surface of a body to record an ECG
amplifier, the input impedance of the amplifier must be much greater trace for a healthy person. The trace obtained for one heartbeat is
than that of the signal source. Unwanted signals may have the same shown in Fig. O4.57

560
 VC/V

Potential at body surface/mV

4.0
2.0
0
time

C is discharging through R1

C is discharging through R1

C is discharging through R1
C is C is C is
charging charging charging
through through through

Square wave output /V

Time/s
Fig. O4.57
(a) (i) Copy and Label approximate scales on each axis.
(ii) State what electrical event happens at points A and B and the
physical change that results.
(b) State, giving a reason, one precaution you would take when
attaching the electrodes to the surface of the skin to ensure a good
signal is obtained.
(c) The amplifier used must have a high gain. State two other
properties of the amplifier.
Solution
(a) (i) vertical -scale: +1 to – 0.2 V horizontal -scale: 0 to 0.8 s
(ii) Position A: event - sino atrial node fires result - atria contracts
Position B: event - ventricular node fires result - ventricles contract
b) Remove dead skin [or use conducting/electrode gel] reason: to give
best possible contact between person and electrode
c) low noise high input impedance
12) Describe the processes involved in the production of action potential
when a nerve is stimulated.
Solution
When a nerve is stimulated, Na+ ions move into cell, the potential
difference rises from –70 to 0 or +30, called depolarisation. K+ ions
move out of nerve, the potential difference returns to –70, a resting
potential called repolarisation. Na+ moving from 0 to +30 called
reverse polarisation to restore starting equilibrium of ions to the
Na/K pump operates
13) a) Describe the response of the heart to the action potential
originating at the sino-atrial node.
b) The cell membrane action potential changes with time as shown in
Fig.O4.58.
B changed
potential/mV
R1 R1 R1
6
0
t0 time
Fig.O459
The timing circuit senses the potential difference, Vc, across the
capacitor and produces a 6 V output when it detects that Vc is greater
than 2.0V. When Vc reaches 4.0 V, the timing circuit causes the
capacitor to begin discharging through a resistor of resistance R2 and
automatically sets the square wave to 0V. As soon as the capacitor
has discharged so that Vc is down to 2.0V, charging begins again and
the timing circuit output changes back to 6V.
The square wave required by the pacemaker has a frequency of 0.85
Hz. The duration of time for which the wave has a value of 6 V is
twice that for which it has a value of 0 V.
i) Show that, for each charge – discharge cycle, the time for which the
output is 0 V is approximately 400 ms.
ii) R2 has a resistance of 2.5 kΩ. Calculate the capacitance of the
capacitor, C, such that Vc decays from 4.0V to 2.0V in 400 ms.
iii) Suggest a value of the resistor R1 that would produce a charging
curve as shown in the figure. Explain your choice.
iv) Sketch a graph of charging and discharging current against time for
two charge – discharge cycles of the capacitor, C, starting from the
time shown as to on the figure. Label your axes with appropriate
values.
Solution
a) i) Battery or pacemaker within body has a capacitor the discharges
through heart muscleat a rate appropriate to body demands / can be

+40 C
ii) Heart muscle is the resistor in the decay circuit. Time constant (RC)
0 controls the time for the discharge and hence heart rate.
1 1
b) i) T    1.176 s
V

–40
f 0.85
A
–80 D 1
3T  13  1.176 s  0.392 s
time/s
0 0.2 0.4 0 .6 ii) t1/2 = RC ln(2)
Fig. O4.58 0.400
C   2.31  104 F
The change in action potential results from ion movement in the same 2500 ln(2)
way as does the change of action potential across a nerve membrane. iii) Any value from 4000 Ω to 10 000 Ω. Change takes longer or twice
AB is a region of depolarisation. CD is a region of repolarisation. as long, that is, time constant is larger or twice the size.
i) Describe the ion movement which produces depolarisation.
V 4
ii) Describe the ion movement which produces repolarisation. iv) I max(short )  0   1.6 mA
Solution R2 2.5  103
a) Pulse causes atria muscles to contract, blood forced into ventricles Current/mA
and pulse delayed before firing ventricular node. The ventricles 1.0
contract forces blood out of heart to lungs and body
charger
b) (i) Na+ from outside to inside
(ii) K+ from inside to outside 0 Time/s
0.8 1.2 2.0 2.4
14) An ECG trace is to be obtained for a patient. State and explain the
procedure and some design features of the equipment needed to discharger
ensure a good trace is obtained.
Solution –1.6
To reduce contact resistance, the targeted spot on skin is sandpaper to Fig. O4.60
remove hairs and some dead skin; and conducing gel applied to it. To Note:
the spot on the skin more than one electrode is attached. To remove Both sections exponential decay
unwanted signals, the electrodes is non-reactive, the patient to remain One shown as positive and the other as negative
relaxed and still with shielded leads to reducing interference from a.c. Short section has maximum current of 1.6 mA
sources. The amplifier has large input impedance, high gain and low Longer section has smaller maximum current
noise Short section is 0.4 s and long section is 0.8 s
15) a) i) Explain how a heart pacemaker helps to keep the patient‟s heart 16) When obtaining an ECG, electrodes are attached to the patient. State
beating at appropriate rates without any external connections. and explain four precautions which should be taken when attaching
ii) Explain the importance of knowing the electrical resistivity of heart the electrodes to ensure reception of the best signal.
tissue when designing a pacemaker. Solution
b) A designer requires a timing circuit to drive a pacemaker. The circuit - It is attached firmly to the body to stop noise.
uses the charging and discharging of a capacitor, C, to generate a - Sand paper the skin or shave to remove hairs and some dead skin as to
square wave as shown in Fig. O4.59. A 6.0 V supply is used for both reduce contact resistance.
the capacitor and the timing circuit. In the first part of the cycle, the - Apply conducing gel to the spot on the body to remove air for better
capacitor charges through a resistor of resistance R1. electrical contact.
561
 - Attach more than one electrode to get largest pd
17) Fig. O4.61 shows an ECG trace for a healthy person.
QRS
complex
R body‟s surface
ST
PR segment
segment
T
P
Q
PR interval S
QT interval
Fig.O4.61
What changes would you expect to the pattern in Fig.O4.61 if:
(i) a person had high blood pressure due to the ventricles working too
hard;
(ii) the atrium was not contracting properly;
(iii) the ECG trace was taken for a person who had recently had a mild
heart attack (myocardial infarction MI)?
Solution
i) QRS wave becomes higher and more spiked
ii) P wave becomes flatter and extended, hence, prolonged PR interval.
iii) Deepening of Q wave and may ST despair.
MEDICAL IMAGING
Medical imaging is the technique and process of creating visual
representations of the interior of a body for clinical analysis and
medical intervention, as well as visual representation of the function of
some organs or tissues Medical imaging seeks to reveal internal
structures hidden by the skin and bones, as well as to diagnose and treat
disease.
Medical imaging also establishes a database of normal anatomy and
physiology to make it possible to identify abnormalities. They are two
main categories of medical imaging techniques: non-ionising and
ionising.
I) NON-IONISING IMAGING TECHNIQUES
Non-ionising imaging techniques do not involve exposure of the body
to ionising radiation. That is, radiation that does not have sufficient
energy to ionise matter – can produce images of the internal structures
of the human body without risk of harm. Hence, they can be safely
used in people who might be particularly vulnerable to the effects of
radiation, such as pregnant women and babies. The methods of
imaging using non-ionising radiation that you will study here are
ultrasound scanning, nuclear magnetic resonance imaging (NMRI)
and optical imaging, including endoscopy, which uses optical fibres
to produce images both for diagnostic purposes and during surgical
treatment.
A) ULTRASONIC IMAGING
Ultrasound Generation
Ultrasound is sound with frequencies greater than 20 000 Hz. This
ultrasound is mechanical waves and interacts with matter. Three
properties they possess are: they can be reflected, refracted and
absorbed by a medium.
SONAR (sound navigation and ranging) was developed during World
War 1. It is basically the use of sound waves to detect and estimate the
range of submerged objects. In the 1930s it had its applications in
medical therapy. In the 1940s diagnostic ultrasound developed in
parallel with SONAR.
Ultrasound from 20 000 Hz to several billion hertz can be produced by
ultrasound transducers (a device that converts energy from one form
to another) using mechanical, electromagnetic and thermal energy.
Normal sound waves are not useful for imaging because their
resolution is poor at long wavelengths. Medical ultrasound uses
frequencies in the range greater than 1 MHz to less than 20 MHz. In
this range with speeds around 1500 m s-1 in body tissue the
wavelengths are about 1-2 mm.
Imaging
Ultrasonic is sound waves at frequencies above the upper frequency
limit of the human ear which is approximately 18 kHz. Ultrasonic at
frequencies between 1 MHz and 10 MHz are used for medical
applications. This frequency range represents a compromise between
562
lower frequencies which would diffract and spread out too much and
higher frequencies which would be absorbed too easily by tissue.
When an ultrasonic scan is carried out:
• pulses of ultrasonic waves are emitted by an ultrasonic probe on the
• the ultrasonic waves travel into the body and partially reflect at any
boundaries (including the skin) which they encounter
• the reflected pulses return to the surface and are detected by the probe
and are then used to generate an ultrasonic image.
Fig.O4.65
The higher the frequency, the smaller the wavelength of the ultrasonic
waves and so the greater the detail of image because diffraction is less.
The frequency used for a particular application depends on the depth
and density of the organ to be imaged. Low density organs near the
body‟s surface (e.g. the eye) can be imaged in more detail than high-
density internal structures (e.g. a baby in the womb) because higher
frequency ultrasonic waves can be used for lower density organs near
the surface. Such high frequency ultrasonic waves would be mostly
absorbed by tissue they have to pass through before they reach the
internal organ.
Ultrasonic Probe
The common transducer used in ultrasound is the piezoelectric crystal
transducer shown diagrammatically in Fig.O4.66.
The ultrasonic probe contains a piezoelectric transducer in the shape of
a disc which vibrates when an alternating potential difference is applied
across it. When the applied frequency is equal to the natural frequency
of vibration of the transducer disc, the disc vibrates in resonance and
creates sound waves in the surrounding medium at the same frequency
as the alternating potential difference.
coaxial cable acoustic insulator
piezoelectric crystal
electrode
plastic membrane
metal case
backing material earth
Fig.O4.66
The disc thickness determines its resonant frequency in the same way
that any vibrating object can be made to resonate by applying a periodic
force of suitable frequency to it. An absorber or „backing‟ block behind
the disc prevents ultrasonic waves being created at the rear surface of
the disc otherwise the ultrasonic waves from the two disc surfaces
would cancel each other out. The block is made of a suitable absorbing
material (e.g. epoxy resin) which damps the disc vibrations rapidly at
the end of each pulse before the next pulse is produced.
Piezoelectricity
Piezoelectricity is the generation of a potential difference across
opposite surfaces of an object made of certain materials when the object
is compressed. The potential difference is proportional to the force
applied to the object. When a potential difference is applied across any
piezoelectric material, the length of the material across which the
potential difference is applied changes in proportion to the potential
difference. If an alternating potential difference is applied, the length
alternates due to the alternating potential difference.
When ultrasound meets an interface between two media, the ultrasound
wave can undergo reflection, transmission, absorption and scattering.
This is similar to when light from air enters glass. The same laws of
reflection and refraction occur. For example, with refraction
(transmission) the frequency of the ultrasound source will remain
constant but a change in the wave‟s velocity as it crosses the boundary
will change the wavelength
Ultrasonic scanning systems
When image resolution is not a problem (e.g. scanning a baby in the
womb), ultrasonic scanning is preferred to X-ray imaging. This is
because ultrasonic waves, unlike X-rays, are non-ionising and therefore
do not damage or kill living cells.
In making an ultrasonic scan, the transducer probe is connected to a
control system that includes a visual display unit (VDU). In a typical
ultrasound scan, a piezoelectric transducer is placed in close contact
with the skin. To minimise the acoustic energy lost due to air being Note that the strength of a received pulse depends on the distance
trapped between the transducer and the skin, a gel is applied between travelled by the pulse in the body as well as the reflection coefficient at
the transducer and the skin. If the gel was not present, the ultrasonic each boundary it encounters.
waves would be almost completely reflected at the body surface and the
pulses entering the body would be too weak to give reflected pulses that Advantages of using ultrasound
can be detected. • Relatively cheap to use.
Each pulse entering the body is partially reflected at the surface of • Abundant ultrasound machines.
internal organs and at tissue boundaries. The reflected pulses are • No ionising radiation.
detected by the transducer probe which acts as a receiver when it is not • Non-invasive (the patient does not have to be cut open or have
producing pulses. As each boundary in the body is a partial reflector of anything inserted into him/her) of monitoring foetal development
pulses, each pulse from the transducer produces a series of reflected using ultrasonic acoustic waves.
pulses which return to the transducer. • Good for soft-tissue diagnosis.
The reflected pulses are detected by the transducer when it is in • Can break down gallstones and kidney stones.
„receiver‟ mode so a pulsed signal is received by an amplifier connected • Good for measuring bone density.
to the transducer. The signal is amplified and displayed on an
oscilloscope screen (A-scan) or used to modulate the brightness of an Disadvantages of using ultrasound
image built up on a VDU as the probe is moved across the body surface • Highly reflective boundaries between bone/tissue and air/ tissue
(B-scan). prevent effective imaging.
The electronic representation of the data generated from the repetition • High frequency ultrasound has low penetrative ability.
of this process is displayed as an ultrasonic image. Thus the distance, • A limit to the size of objects that can be detected.
size and location of hard and soft tissue structures can be determined.
The rate at which pulses are generated is determined by the speed of Biological effects of ultrasound
ultrasonic waves in the body and the distances they travel which can,
In diagnostic with ultrasound the mechanical energy of sound wave is
back and for across the body, be over a metre. The speed of the waves
partially absorbed by the body and therefore can change some of its
varies according to the type of tissue. Using an average speed of 1500 m
properties. The possible harmful consequences are dependent on the
s−1, gives a transit time for a pulse of less than a millisecond. Hence the
amount of energy absorbed. The bioeffects includes
pulses need to be generated at a rate of no more than about 1000 per
 Localized temperature rise in tissue.
second to allow the received pulses from each transmitted pulse to
return to the probe before the next pulse is transmitted. Otherwise  cavitation (growth of gas bubbles),
successive transmitted pulses result in reflected pulses that overlap and  steady radiation force exerted on tissue structures which may result in
cannot be identified. In addition, the pulses must last no more than a movement,
few microseconds to ensure the end of each transmitted pulse is clear of  streaming agitation in liquids,
the probe before the front end of the first reflected pulse returns to the  shear stress of objects in the streaming liquid and the oscillatory force
probe. of the sound field on all structures

Acoustic impedance A-Scan and B-Scan imaging Techniques

When ultrasonic waves pass through a substance, some of the power
from the waves is dissipated by the substance. The opposition to the
passage of ultrasonic waves through a substance is referred to as the
acoustic impedance, Z, of the substance. The acoustic impedance Z of a
substance can defined as the product of its density,  , and the speed of
sound, c, through the substance.
Z  c
Hence, the acoustic impedance depends on the density of the tissue and
the speed of sound in the tissue. The unit of acoustic impedance is the
rayl. This is equivalent to the SI unit kg m-2 s-1. Energy is absorbed by a
substance when ultrasonic waves pass through it, so the amplitude of
the waves decreases the further the waves travel through the substance.
This reduction in amplitude with distance is referred to as attenuation.
The greater the acoustic impedance of a substance, the greater the
attenuation of an ultrasonic wave passing through it. Hence, the larger
the acoustic impedance between two tissue types, the stronger the
reflection at their interface.
When ultrasonic waves reach a boundary between two substances with
different acoustic impedances, partial reflection occurs so the waves
passing through the boundary are reduced in amplitude. For incident
waves of intensity I0, the intensity of the reflected waves IR is given by
the equation
IR 
Z 2
 Z1 
 I0
2
Amplitude of a trace varies scan (A-Scan)
The A-scan system is used where precise locations of internal
boundaries are to be measured. To perform an A-Scan you only need a
probe with a single transducer. An A scan relates the amplitude of a
signal with the strength of reflection.
To prepare the patient for a scan a coupling gel is smeared onto the
body to expel the air from between the probe and the patient's skin. The
ultrasound transducer or probe is set to emit short, sharp pulses of
ultrasound of a few microseconds duration and linked to output data to a
cathode ray oscilloscope.
The probe head is then placed on the body of the patient. At the same
time as a pulse of ultrasound is emitted by the transducer, the spot on a
cathode ray oscilloscope screen is triggered and starts moving across the
screen.
The ultrasound pulse travels into the body and, when it reaches an
interface or boundary between different tissues in the body, some of the
sound energy is reflected back towards the transducer where it causes
an electrical signal to be generated.
The signal causes the spot on the screen to be deflected vertically for
the duration of the received echo pulse. The spot then returns to its
original level and continues to move across the screen. The returning
echo pulse is also displayed as a deflection of the trace on the screen of
the oscilloscope as shown in Fig.O4.68

Z
 Z1 
2
2

where Z1 and Z2 are the acoustic impedances of the incident and

reflected intensities respectively
The reflection coefficient of the boundary, R is defined as


IR

Z 2
 Z1 
2

I0 Z 2
 Z1 
2

R can be calculated using the above formula for different types of

boundaries in the body and at the body surface. Such calculations show:
• An air–skin boundary has a reflection coefficient of almost 1 which
means almost 100% of the incident ultrasonic energy is reflected. This
is why the probe is applied to the body via a suitable gel or a water
bag so that most of the ultrasound energy enters the body.
• Ultrasonic waves reflect significantly at the boundaries between
different types of soft tissue in the body. Hence an ultrasonic imaging
system can detect and display such boundaries unlike an X-ray
imaging system which cannot.
• The intensity of the waves transmitted through the boundary IT = I0 −
IR Fig.O4.68
563
Hence, A-scan is produced by a single transducer when a single bit of
information with a one-dimensional base is displayed is called an
amplitude-modulated mode scan.
• The transmitted pulse appears as the pulse nearest the left-hand edge of
the screen. This is because the pulse generator used to generate the
electrical pulses supplied to the transducer is also used to trigger the
time base of the oscilloscope. The pulse intensity decreases due to
attenuation.
• The time base can be adjusted so the last reflected pulse towards the
right-hand side of the screen is due to the body–air boundary on the far
side of the body. The A-scan system is used where precise locations of
internal boundaries are to be measured.
• The distance d from the transmitted pulse to each reflected pulse on the
oscilloscope screen is proportional to the time taken by the reflected
pulse to travel from the probe to the reflecting boundary and back. The
distance x from the body surface to the reflecting boundary can be
calculated by measuring distance d on the oscilloscope screen and:
 either using the time base setting to calculate the transit time, t, of the
pulse (i.e. the time taken by the pulse to travel from the body to the
boundary and back) using t = d × the time base setting in time per unit
distance. Given the speed of the ultrasonic waves, c, distance x can
then be calculated from the equation
x = 12 ct (speed × half the transit time)
 or by adjusting the time base so the far-side reflected pulse is visible
on the screen, measuring the screen distance d as a proportion of the
screen distance D from the transmitted pulse to the far-side reflected
pulse from the body surface to the reflecting boundary, distance x can
be calculated from the equation
d
x  X
 D
where X is the distance from the probe to the far side of the body.
Pulse Production in an A-scan
A-scan is produced by a single transducer when a single bit of
information with a one-dimensional base is displayed is called an A-
scan. The transducer scans along the body and the resulting echoes are
plotted as a function of time as shown in Fig. O4.69.
Fig. O4.69.
When a pulse of ultrasound passes through the body, the amplitude of
the pulse is attenuated (some energy is absorbed by tissue - some passes
through to other lays, some is scattered in directions that are not picked
up by the probe).
This means that echoes from surfaces further away from the transducer
require to be amplified more than those from surfaces nearer the
transducer. This amplification is achieved by a swept-gain amplifier
linked to the time base of the oscilloscope.
The A-mode measures the time lapsed between when the pulse is sent
and the time the echo is received. The first echo display on the screen is
from the skin, the second and third pulses are from either side of the
first organ, the fourth and fifth echo are from either side of the second
organ. The pulse intensity decreases due to attenuation.
Since the pulse was emitted at the same time as the spot started to move
across the screen, the displacement of the echo from the starting point is
a measure of the time taken for the transmitted pulse to reach the first
surface plus the time for the echo to return to the transducer (2t) as said
before.
From the time-base setting of the oscilloscope and the screen visual
display the operator can calculate the time taken for the ultrasound
wave to move across an organ's depth = 12 t .
The section depth d of the organ can then be calculated using a simple
calculation:
d  12 ct
Where 'c' is speed of ultrasound within a particular organ.
564
The A-scan method is used to measure the bi-parietal diameter (size of
the foetal head) which may be used in order to determine the length of
gestation and also to monitor the growth of the foetus. The greatest
density difference is between the bone and tissue - therefore the two
large spikes correspond to the beam being reflected from the near and
far side of the baby's skull.
Brightness of the image varies scan (B-scan)
In an ultrasound B-scan outlines of structures are produced by using a
multitransducer probe. Images of sections through the body are
displayed on a screen. In a B-scan the echo signals are not applied to the
Y-plates of the oscilloscope but are used instead to control the
brightness of the spot on the oscilloscope screen as shown in Fig.
O4.72. The brightness of the spot is proportional to the amplitude of the
echo.
Fig. O4.72
Rocking the probe
It should be noted that echoes are received only if the interface is
normal to the beam of ultrasound. The interfaces inside the body are
generally curved and at different orientations to each other; so, in order
to obtain the best information about an interface, the probe may need to
be rocked while it is moved on the surface of the body. This rocking is a
skilful operation since the probe must be kept in contact with the
surface; otherwise any air space will reflect the ultrasound before it can
enter the body.
In order to ease the movement of the probe and to provide the required
coupling between the transducer and the surface, oil is smeared on the
patient's skin.
The scan head containing many transducers is arrayed so that the
individual B-scans can be built up to produce a two-dimensional image.
The scan head is rocked back and forth mechanically to increase the
probability that the pulse will strike irregular interfaces.
Hence, the main difference between the probe used in an A-scan and
that used in a B-scan is that an A-scan has a single transducer probe
whereas a B-scan uses a multi-transducer probe.
Uses of the B-Scan
• The largest diameter of the foetal head perpendicular to the midline is
the bi-parietal diameter and is measured on the A-scan. In order to
select the correct place for the A-scan, a B-scan is used to search for
an echo from the midline structure of the brain. Such an echo
produces a sharp line bisecting the image of the foetal skull.
• An important use of the B-scan in obstetrics is to determine the
position of the placenta in relation to the entrance to the cervix. The
condition called placenta praevia, ie when the placenta covers the
entrance to the cervix, can then be diagnosed and the baby delivered
by Caesarean section.
• A further use of the B-scan is prior to and during amniocentesis,
which involves inserting a tube into the uterus to remove some fluid
and cells surrounding the foetus in order to carry out a genetic test on
the chromosomes of the cells of the foetus. The position of the foetus
and placenta has to be located accurately, which is done by the B-
scan.
The basic difference between A-scan and B-scan
The most basic way to display the data in an A-scan is to plot a graph of
the strength of the reflected beam against time. From this it is possible
to see the position of any changes in medium in the body directly in
front of the probe. To gain more information about the organ, the probe
can be moved up and down; this will reveal the size, shape and changes
in thickness. An A-scan gives information, but it doesn‟t give an image
of the organ. A B-scan converts the signal into a dot, the brightness of
the dot corresponding to the strength of the signal. If the probe is swept
across the organ this can be converted into an image. Instead of
sweeping the probe, a probe with many transmitters can be used.
B-scan produces two-dimensional image whereas A-scan produces one-
dimensional.
Choice of diagnostic frequency
Resolution (the fine detail that can be detected) is an important factor in
ultrasound imaging. A patient may have a small tumour say in the liver
and the doctor wants to see the photo of the fine detail. The smaller the
wavelength, the greater the resolution. That is, higher frequency
ultrasound gives more finer detail. If the ultrasound beam is reflected,
transmitted, absorbed and scattered, its intensity will decrease. If the
frequency of the source is increased too much, the attenuation (the
reduction in intensity) in fact increases as does the penetration depth.
Furthermore, the resolution also decreases if the frequency is increased
beyond an optimum point. In a typical pulse-echo diagnostic procedure,
the maximum mean ultrasound power delivered is about 10-4 W, and the
frequency is in the range 1-5 MHz
High frequency ultrasound waves
• less divergence
• provide better resolution of small structures.
• More energy however is absorbed and scattered by the soft tissues so
that higher frequencies have less penetrating ability.
Low frequency ultrasound waves
• provide greater depth of penetration but
• provide less well defined images.
Examples Probe Design Related to Probe Use:
• A trans-oesophageal probe is a transducer array with narrow flexible
tube which can be swallowed by the patient. This can be used to scan
the patient's heart. Swallowing avoids having to scan between the gaps
in a patient‟s ribs.
• In an obstetric scan the probe used is usually one that looks like a
curved soap bar (more accurately known as a 'convex-array'
transducer, and the one with a flat surface a 'linear-array' transducer )
which can be slid over the maternal abdomen while maintaining good
surface contact to the abdominal surface for the whole width of the
probe. It has no moving parts. It is comparatively inexpensive and can
be used by relatively unskilled operators.
• In a vaginal scan, the probe has to be a long and slender piece to fit
into the vagina.
• Accurate distances within the eye can be measured using a type of
probe designed especially for ophthalmic use. It can be used to
measure the thickness of the cornea and be used to ascertain whether a
person is suitable for laser eye surgery.
• The scanner is either placed in direct contact with the eye or via a
water bath (less risk of damage to eye surface) it therefore needs to be
small and the transducer head suited to the curvature of the eye. It is
used in A-scan mode with a frequency of 8-13MHz.
Worked Examples
1) In an ultrasound scan, ultrasonic waves of intensity 6.0 × 10−8 W m−2
are directed through fat into soft tissue.
a) Use the data in Table 1 to calculate the acoustic impedance of:
i) fat ii) soft tissue.
b) Calculate the reflection coefficient of the interface between the two
substances.
c) Calculate the intensity of:
i) the reflected waves
ii) the waves transmitted through the interface.
Solution
−2 −1
a) i) For fat, Z1 = ρ c = 900 × 1450 = 1.31 × 10 kg m s
6
ii) For soft tissue, Z2 = ρ c = 1050 × 1550 = 1.63 × 106 kg m−2 s−1
 Z 2  Z1 2 1.63 10 
2
6
 1.31 106
b) R   0.0118
 Z 2  Z1  1.63 10 
2 2
6
 1.31 106
−8
c) i ) IR = R × I0 = 0.0118 × 6.0 × 10 = 7.1 × 10−10 W m−2
ii) IT = I0 − IR = 6.0 × 10 − 7.1 × 10 = 5.9 × 10−8 W m−2
−8 −10
2) The photograph in Fig. O4.67 shows the image of a fetus inside its
mother‟s uterus. Ultrasound was used to produce this image.
Fig. O467
a) Explain how ultrasound pulses can be used to build up the image of
the fetus in the uterus.
565
b) Explain how the Doppler effect is used to detect the heartbeat of the
fetus.
c) The smallest detail that can be seen on the image is half the length of
the ultrasound pulse. The thumbnail on the fetus is 0.50 mm thick.
The speed of ultrasound in the thumbnail is 2000 m s–1. Calculate the
maximum pulse duration if the thumbnail is to be seen on the image.
Solution
a) Ultrasonic probe on the body‟s surface produces pulse. The pulse
reflected at boundary where density changes. Time for the reflected
pulse to return measured. The time to return depends on depth of the
fetus inside its mother‟s uterus. Large number of pulses results.
Probe is moved to different positions. Ultrasound travels as pulses so
that one pulse is detected before the next pulse is sent.
b) Doppler Effect is the phenomenon in which the detected frequency
is not identical to the frequency of the source. As heart of the fetus
beat toward and away, it acting like moving reflector for the
ultrasound and hence, changing frequency (wavelength). This causes
wavefronts to be compressed when heart moving towards and away
from detector. Hence, the frequency of the heat is determined.
c) Distance = thickness × 2 = 5 × 10-4 m × 2 = 1.0 × 10-3 m
103
time   5.0  107 s
2000
3) How is a piezoelectric crystal used to generate waves of ultrasound?
Solution
The two surfaces of the thin slice of the crystal are used as electrodes.
These electrodes are connected to a very high frequency alternating
e.m.f. source. The applied e.m.f. causes a rapidly alternating electric
field across the crystal sandwich between the electrodes. The crystal
expands and contracts at the same frequency as the e.m.f. which is
applied. These vibrations of the faces of the crystal produces pressure
waves called ultrasound.
4) In an A-scan, the distance on the oscilloscope screen from the
transmitted pulse to a reflected pulse was 3.5 cm. The oscilloscope
time base setting was 0.20 ms cm−1. Calculate the distance from the
body surface to the internal boundary that caused the reflected pulse.
Assume the speed of sound in the body is 1500 m s−1.
Solution
Transit time of pulse, t = 3.5 cm × 0.20 ms cm−1 = 0.70 ms
Distance x from the body surface to boundary= 12 ct
= 12 × 1500 × 7.0 × 10−4 = 0.53m
5) Fig.O4.70 shows an ultrasound transmitter sending waves into a
patient‟s body. The waves enter the body and move towards a
kidney.
Fig.O4.70
The transmitter also detects the ultrasound waves. The transmitter is
connected to an oscilloscope. Fig.O4.71 shows the trace on the screen
of the oscilloscope. J represents the intensity of the waves emitted by
the transmitter.
Fig.O4.71
i) Explain the intensities at K, L and M.
ii) The speed of ultrasound waves in the body is 1500 m/s. Use
information from Fig.O4.71 to calculate the maximum width of the
kidney.
Solution
i) K is due to the very little reflection from the skin, so small
amplitude pulse.
L is due to the large amount of reflection from the kidney, so large
peak pulse.
M is due to the reflection from the back part of the kidney. Hence,
smaller peak due to absorption of some of the ultrasound in kidney.
ii) d  12 vt  12  1500  8  105  0.06 m
6) a) The speed of an ultrasound in blood is 1570 m s-1 and the density 0.00104 I i
of the blood is 1060 kg m-3. Calculate the acoustic impedance of % transmitted =  100%  0.10%
Ii
blood.
b) Calculate the thickness of a slice of muscle tissue if its fundamental ii) The gel between the probe and the skin to exclude air. The gel should
resonant frequency is 1.5 MHz. have acoustic impedance equal or close to that of the skin to ensure
c) The time delay for a pulse going through fat is 0.133 ms and the maximum transmission of the ultrasound into the body by greatly
speed of ultrasound in the fat is 1450 ms-1. Determine the depth of reducing reflection at body boundary
the fat. 8) a) Explain how and why ultrasound is used to obtain an image of an
Solution unborn foetus. You might consider the following points in your
a) Z = rρ = 1570 m s-1 × 1060 kg m-3 = 1.66 × 106 kg m-2 s-1. answer
v 1580 - the method of obtaining the image
b) The wavelength =   1.05  10 3 m - practical considerations for the scan
f 1.5  10 6
- safety issues.
Now the ultrasound has to go down and back. Therefore, the actual b) Explain why the pulses of ultrasound used in medical imaging must
wavelength = 12 (1.05  103 ) = 5.25  104 m be of short duration.
c) The time taken to reach the boundary of the fat Solution
a) In making an ultrasonic scan, the transducer probe is connected to a
= 12 × 1.33 × 10-4 s = 6.65 × 10-4 s
control system that includes a visual display unit. Each transducer
Distance = speed × time = 1450 m s-1 × 6.65 × 10-4 s = 9.6 cm has piezoelectric crystal which generates ultrasound. In operation,
The A-scan technique is fine if the surfaces of interest within the body the probe is held in contact with the body surface via a gel so that
lie along a particular line. For more complex structures, however, it ultrasonic pulses are directed into the body
becomes very difficult to identify the surfaces which give rise to
particular echoes, it is then useful to perform a B-Scan
7) Fig. O4.73 shows an ultrasound transducer used in an A-scan.
coaxial cable acoustic insulator
piezoelectric crystal

electrode
plastic membrane
metal case
backing material earth
Fig. O4.73
a) Ultrasound is incident on the boundary between two materials. Some
of the ultrasound is reflected at the boundary and the remainder is
transmitted across the boundary. The ratio of the intensity of the
reflected ultrasound, Ir, to the intensity of the incident ultrasound, Ii,
is given by the equation
Ir

Z 2
 Z1 
2

Ii Z 2
 Z1 
2

where Z1 and Z2 are the acoustic impedances of the two materials.
i) Calculate the percentage of the incident ultrasound which would be
transmitted into the skin when incident on an air-skin boundary.
acoustic impedance of air = 4.29 × 102 kg m–2 s–1
acoustic impedance of skin = 1.65 × 106 kg m–2 s–1
ii) When obtaining the ultrasound image of an unborn foetus, a
coupling gel is used. Explain why a coupling gel is needed and state
the property of the gel that ensures a good quality image.
Solution
a) The alternating potential difference applied across the crystal, it
causes the crystal to expand and contract. As a result, creating pressure
waves in the plastic membrane. The piezoelectric transducer vibrates
with the application of alternating potential difference across it. When
the applied frequency is equal to the natural frequency of vibration of
the piezoelectric crystal, the crystal vibrates in resonance and creates
sound waves in the surrounding medium at the same frequency as the
alternating potential difference. This resonant frequency of crystal is
above 20 kHz. The piezoelectric crystal thickness determines its
resonant frequency in the same way that any vibrating object can be
made to resonate by applying a periodic force of suitable frequency to
it. Short application of the a.c. produces short pulse. An absorber or
„backing‟ block behind the piezoelectric crystal prevents ultrasonic
waves being created at the rear surface of the piezoelectric crystal
otherwise the ultrasonic waves from the two piezoelectric crystal
surfaces would cancel each other out. The block is made of a suitable
absorbing material which damps the disc vibrations rapidly at the end
of each pulse before the next pulse is produced.
Z  Z1  1.65  10 
2
 4.29  10 2
2 6
R 2
 - The electrodes should be non-reactive.
Z Z  1.65  10  4.29  10 
2 2 2
b) i) 6
2 1
 0.99896
10) (a) Explain how a piezoelectric crystal is caused to generate waves
I r  0.99896 I i
Assuming no incident ultrasound was absorbed,
I r  It  Ii
Intensity transmitted,
It  I i  I r  (1  0.99896) I i  0.00104I i
Fig. O4.74
If the gel was not present, the ultrasonic waves would be almost
completely reflected at the body surface and the pulses entering the
body would be too weak to give reflected pulses that can be detected.
The transducer emits short, sharp pulses of ultrasound of a few
microseconds duration in turn
Each pulse entering the body is partially reflected at the surface of the
unborn foetus and mother‟s tissue boundaries. The reflected pulses
are detected by the transducer probe which acts as a receiver when it
is not producing pulses. As each boundary in the body is a partial
reflector of pulses, each pulse from the transducer produces a series of
reflected pulses which return to the transducer. Each reflected pulse is
represented by a spot of a different shade of grey on an oscilloscope.
The brightness of the spot is proportional to the intensity of the
reflected pulse. The signals, after suitable processing, are fed to the x-
and y-plates and the position of the spot on the screen and time
determined. The images are produces at about 25 per second and thus
appear as a real time moving image. Ultrasound is non-ionising and
thus has no known side effects to the foetus. (note that this is B-
screen)
b) As the transducer acts as both the emitter and receiver, it need to be
stop oscillating before the reflected signal returns to it. This time of
emission and receiving is very short as distances travelled are short.
The emitted pulse must cease before echo arrives so that there is no
overlapping (interference) at the transducer.
9) Unwanted signals are often remove from an ECG. State the
precautions which should be taken.
Solution
- The patient to remain relaxed and still
- Shielded leads to reduce interference from ac sources
of ultrasound.
(b) In medical applications of ultrasound a short pulse of duration about
1 μs is often used.
(i) Explain why the pulse of ultrasound must be short.
(ii) Short voltage pulses applied to the piezoelectric crystal make it
vibrate and emit short pulses only if the crystal assembly is
modified. Explain the modification which is necessary.

566
 (c) (i) Under what conditions is ultrasound reflected strongly at
boundaries between two types of material?
(ii) State two physical properties of the materials which determine the
proportion of ultrasound which is reflected at a boundary.
(iii) Explain what a coupling medium or gel is and why, and where, it is
used.
Solution
a) Two faces of a thin slice of crystal coated with a thin layer of silver)
act as electrodes. Electrodes connected to high frequency several
MHz source of e.m.f. As applied e.m.f. alternates it applies
alternating rapidly reversing direction electric field across the slice
of crystal between the electrodes. Crystal expands and contracts at
the same frequency as the applied e.m.f. The vibrations of the faces
of the crystal slice produce ultrasound pressure waves
b) i) The pulses are short compared with the transit time. Pulses are
used for timing echoes which give measurements of depth in the
body. Pulse must be short enough to ensure the leading edge returns
after the trailing edge departs
ii) Behind the crystal a vibration-absorbing backing material is attached.
This stops the vibrations quickly after the electrical signal is stopped,
ensuring that the pulse is short
c) i)When there is a large difference in acoustic impedance [or
significant change in density or significant change in elasticity or
texture of tissue]
ii) Tissue density and tissue elasticity
iii) Ultrasound is reflected back at boundaries with air. Gel between
transducer and skin prevents loss of signal due to boundary
reflection. Acoustically well -matched gel gives good transmission
with minimum reflection at skin boundary
11) a)Fig. O4.75 shows how the displacement s of the particles in a
medium carrying a pulse of ultrasound varies with distance d along
the medium at one instant.
s/10–5 m
2 b) State and explain what would be seen on the CRO screen if gel had
0 2 4 6 8 10
d/10–4 m
–2
Fig. O4.75
i) State the amplitude of the wave.
ii) The speed of the wave is 1200 m s-1. Calculate the frequency of
oscillation of the particles of the medium when the ultrasound wave
is travelling through it.
b) An ultrasound transmitter is placed directly on the skin of a patient.
Fig.O4.76 shows the amplitudes of the transmitted pulse and the
pulse received after reflection by an organ in the body.
amplitude transmitted pulse
reflected pulse
95 μs
time
Fig. O4.76
i) Give two possible reasons why the amplitude of the received pulse is
lower than that which is transmitted.
ii) The speed of ultrasound in body tissue is 1200 m s-1. Calculate the
depth of the reflecting surface below the skin.
Solution
a) i) 2.0 × 10–5 m
ii) λ = 4.0 × 10–4 m
v 1200
f    3.0 MHz
 4.0  10 –4
b) i) The ultrasound pulse energy spreads out from the transmitter.
Energy is absorbed by or lost to the transmitting tissue. The incident
ultrasound energy is not all reflected by the reflecting object as some
is transmitted, absorbed by the organ or is reflected at different
angles and so does not return to detector. Some of the ultrasound
energy is reflected by the skin since gel was not used.
ii) Distance travel = v × t = (1200) × (95×10–6) = 0.114 m
12) (a) Describe how a piezoelectric crystal used in an ultrasound probe
is made to generate a pulse of ultrasonic waves.
(b) In medical diagnostic imaging, explain why a short pulse of about
1 μs is used.
(c) Under what condition is ultrasound strongly reflected at the
boundary between two media?
567
(d) Given the following equation, calculate the percentage of
ultrasound which is transmitted when travelling from the skull into the
brain.
Ir

Z 2
 Z1 
2
I0 Z  Z1 
2
2
Ir = reflected intensity, Io = incident intensity
Z2 = acoustic impedance of the brain tissue = 1.58 × 106 kg m-2 s-1
Z1 = acoustic impedance of the skull bone = 7.78 × 106 kg m-2 s-1
Solution
a) Apply an alternating voltage across faces of the crystal at the natural
frequency of the crystal at frequency greater than 20 kHz
b) The transducer acts as both emitter and receiver The emitted pulse
must have stopped its forced vibration before the reflected pulse is
received - due to the small distances involved, the time of the pulse
has to be very small
c) When the acoustic impedances of the two materials are very different
d) Reflected ratio I r IO = 0.44 so % = 44
Percentage transmitted = 100 – 44 = 56%
13) Fig. O4.77 shows a trace on a cathode-ray oscilloscope (CRO) of an
ultrasound reflection from the front edge and rear edge of a foetal
head. The CRO time-base is set to 20 ms cm–1.
20 μs
Fig. O4.77
The speed of ultrasound in the foetal head is 1.5 × 103 m s–1.
a) Calculate the size of the foetal head.
not been applied between the ultrasound transducer and the skin of
the mother.
Solution
a) Number of squares between two pulses on time base = 5.4 cm
Actual distances travel = 5.4 × 20 μs cm–1 × 1.5 × 103 m s–1 = 0.162
m
Size of the foetal head = 12 × 0.162 = 0.081 m
b) High reflection at the air-skin boundary as little ultrasound enters
the body. A very large peak right at the start due to large difference
in acoustic impedance and very low peaks at the end.
14) Why is a gel used between the patient and the transducer when an
ultrasound scan is taken?
Solution
The gel excludes air between the tissue and the ultrasound transducer.
Air has a very different impedance to soft tissue and so most of the
ultrasound would be reflected. Gel has a similar acoustic impedance
to soft tissue and so transmission of ultrasound is maximised.
15) An ultrasound transducer is used to obtain an A-scan of an internal
organ. The A-scan pulses shown in Fig. O4.78 were identified as
coming from the front and rear surfaces of the organ.
Fig. O4.78
a) Describe the practical process, including details of the use of the
transducer and the adjustment of the oscilloscope, required to produce
this A-scan.
b) From the A-scan, estimate
i) the thickness of the organ if the speed of ultrasound in the tissue is
1500 m s–1 (the horizontal scale is 0.02 ms/cm),
ii) the duration of the first ultrasound pulse.
c) Give three reasons why the height of the second pulse is smaller than
that of the first pulse.
Solution
 a) The surface of body covered with an oil (gel) to improve
transmission from ultrasound transducer to body. The short
ultrasound pulses sent into the body and echoes received from
surfaces detected by the transducer. The oscilloscope sweep time
synchronised with the ultrasound pulse frequency
b) i) Thickness = 12 × 1500 × 0.08 × 10–3 (m) = 0.06 m
(ii) Pulse duration = 0.3 × 0.02 = 0.006 ms
c) The extra distance in tissue results in more signal absorption.
Smaller fraction of signal reflected at second surface. Pulses are
more spread over time and some signals are diffracted
16) a) Outline the use of ultrasound to obtain diagnostic information
about internal body structures.
b) Suggest and explain why, in many medical applications, the
ultrasound probe is made up of a number of crystals.
Solution
a) Pulse of ultrasound is reflected at boundary between the two media
in concern. The reflected pulse detected by piezoelectric crystal.
The signal from crystal amplified, processed and displayed on a
computer screen.
b) The crystals are at different orientations and the signals from all
crystals are combined to build up a two dimensional image.
17) a) A piezoelectric ultrasound transducer is made from a thin slice of
an artificial ceramic such as lead zirconate titanate (PZT).
(i) Describe what happens when an alternating voltage is applied to a
PZT transducer so that ultrasound is produced.
(ii) Under what conditions will maximum energy conversion into
ultrasound occur?
(b) Fig. O4.79 shows the oscilloscope display of pulse amplitude
against time for an ultrasound A-scan through a person's abdomen.
Assume that the weaker echoes come from internal organs.
Strength
of signal
Time/ms
0.0 0.1 0.2 0.3
Fig. O4.79
i) Describe the procedures which are used to obtain this type of scan.
ii) Explain how the spacing of the pulses is interpreted.
iii) Give two reasons why the amplitude of the reflected pulses varies.
iv) If the speed of ultrasound through water and soft tissue is about
1500 ms–1, estimate the distance between the front of the patient's
abdomen and the spinal column.
Solution
a) i) The electric field across a transducer causes a change in physical
dimensions. If and alternating voltage is applied the transducer
vibrates at the same frequency
ii) Maximum energy transfer occurs when the frequency of the applied
voltage is equal to the natural mechanical vibration frequency of the
transducer causing resonance to occur.
b) i)The ultrasound transmitter or receiver or transducer is placed in
contact with skin. Transmission is improved by using a contact gel
layer between transducer and skin, this allows the pulses of
ultrasound to be transmitted into the body more effectively
ii) Echoes reflected back to transducer appear as voltage peaks or pulses
on c.r.o. The spacing of the peaks gives the time delay between
transmitted pulse and echoes.
Distance s between transmitter and a reflecting surface is given by:
s  12 ct
where c = speed of ultrasound in tissue and t is the time delay
between pulses
iii) The amplitude of pulses is attenuated as it penetrates deeper caused
by absorption and dispersion. The amplitude of the echo pulses
depends on the proportions of ultrasound which are reflected and
transmitted at each surface or boundary (or depends on the acoustic
impedences of the two materials at the interface)
iv) From the figure
t  0.32  0.08  0.24 ms
s  2 ct  12 1500  0.24 104  0.18 m
1
18) An A-scan is used to find information about the depth and size of
organs within a patient's body. Explain
a) the basic physical principles behind the A-scan,
b) how the results are used to find the size of an organ.
Solution
a) The transmitter produces short pulses. At an internal boundary some
reflected, rest transmitted to next boundary. The reflected pulse
received by probe and signal sent to oscilloscope. The oscilloscope
sweep is started when pulse is first transmitted
568
b) Time taken between pulses from front and back of organ from
oscilloscope.
distance  speed  12 time
19) Why can lung disease not be detected by ultrasound?
Solution
About 99.9% of ultrasound waves are reflected at the lung-air
boundary. There is so little transmission and even less reflection at
the other side so that getting images is impossible.
20) a) Ultrasound can be used to carry out two different types of test,
A-scan and B-scan. State the differences in the type of information
obtained from an A-scan and a B-scan.
b) Give three examples of when a B-scan would be used in medicine.
c) An A-scan is used to determine the thickness of a layer of skin and
fat in a patient‟s body. The grid in Fig.O4.80 shows the interval
between the initial pulse and the reflected pulse on a CRO. The time
base is set so that 1 cm represents 2 μs.
O4.80
i) If the speed of ultrasound in skin and fat is 1.45 × 103 m s–1,
calculate the thickness of the layer of skin and fat.
ii) How would the trace on the figure above change if no gel was placed
between the ultrasonic probe and the patient‟s skin?
Solution
a) A-scan measures distances whereas B-scan provides pictures.
b) Development of foetus, scanning young babies' skulls, imaging liver,
kidneys, heart, locating arteries and locating fluid inside body.
c) i) Time, t  7.5  2 s =15 s
s = 1.45  103  15  106  2.18  102 m
Thickness = s = 12  2.18  102 = 1.09  102 m
ii) Both pulses at start or only the first pulse would be seen.
21) Write down five advantages of using ultrasound as a diagnostic tool
and five disadvantages.
Solution
Advantages
• There are no known hazards with low frequency (low energy) beams.
• It is non-invasive.
• There is no discomfort apart from a cold probe!
• More effective than X-ray techniques in producing images of soft
tissue;
• The equipment is relatively inexpensive, can be moved about very
easily, and does not need a specialist room.
• There are no hazards for the operator.
Disadvantages:
• The sonographer has to be skilled at operating the probe and its
associated equipment to get a decent image.
• The image needs skilful interpretation.
• Attenuation can reduce the resolution of the image.
• Bone absorbs ultrasound so that brain images are hard to get;
• Gas-soft tissue interfaces reflect 99.9% of the incident energy. Images
of tissues on the far side of lungs are impossible to get.
22) An ultrasound-scan can be used on the human eye in order to
obtain accurate measurements of the thickness of the lens. Fig.O4.81
is a copy of such a scan.
Probe/ Ant Post
Cornea Lens Lens Retina Sclera
orbital tissues
0 10 20 30 time/μs
Fig.O4.81
i)What type of ultrasound scan was used?
ii) Use the information in the diagram to calculate the lens thickness.
The spike labelled „Ant Lens‟ corresponds to the front of the lens and
 the spike labelled „Post Lens‟ corresponds to the back of the lens. The b)i) Calculate the fraction of ultrasound reflected at an air–skin
–1
velocity of ultrasound in the lens is 1640 m s . boundary, using the value for the acoustic impedance of skin used in
Solution (a)(i) (take the acoustic impedance of air to be 4.29 × 102 kg m−2
i) A-scan s−1).
ii) Time taken from scale = 8 – 3 = 5 μs ii) A gel is used between the ultrasonic transducer and the skin. Using
1 –6 –3 your values for acoustic impedance for skin and gel calculated in (a),
Thickness = 2 ×1640 ×5×10 = 4.1× 10 m
23) Higher-frequency ultrasound gives better resolution images. calculate the fraction of ultrasound reflected at a gel–skin boundary.
Suggest why 7 MHz can be used for infants but only 2 MHz for c) By considering your answers in (b), explain why a gel is used
adults. between the ultrasonic transducer and the skin when scanning.
Solution Solution
Attenuation is greater for higher frequencies. There is less body tissue a) i) Zskin  c  1150  1730  1.99  106 kgm2 s1
to travel through in an infant, so attenuation is not such a problem as ii) From the equations Z  c and c  K  , then
compared to adults.
24) An ultrasound transducer has a material inside that uses the Z gel  K  2.03  109  1060  1.47  106 kg m 2 s 1
piezoelectric effect to both emit and receive ultrasound.
 Z skin  Z air   
2
1.99  106  4.29  102
2
i) Explain what is meant by the piezoelectric effect.
b) i) R    0.999
ii) Suggest three main differences between a pulse of ultrasound of
 Z skin  Z air   
2 2 2
frequency 1 MHz in air and the same ultrasound pulse passing 1.99  10 6
 4.29  10
through a patient. About 99.9% of the wave is reflected.
iii) Define the acoustic impedance of a material.
   
2 2
Z skin  Z gel (1.99  1.47)  106
Solution ii) R     2.26  102
   
2 6 2
i) Applying a p.d across the material makes it expand and compress. Z skin  Z gel (1.99  1.47)  10
ii) • The pulse travel slower in air than in tissues.
• Ultrasound has shorter wavelength in air than in tissues. That is, just over 2.3% of the wave is reflected.
• It has greater attenuation inside patient than in air. c) When the gel is applied between the transducer and the skin, most of
iii) It is the product of the density of material and speed of ultrasound the incident ultrasound enters the skin. If there is an air gap between
in the material. the transducer and the skin, then almost all of the ultrasound is
25) A B-scan image of an ultrasound scan of 12 week foetus is reflected and very little is transmitted. For this reason, gel is applied
necessary for an expecting mother. Describe and explain the to make sure there is no air gap, and enough acoustic energy is
principles of a B-scan. present to reflect off internal structures in the body.
Solution
Many piezoelectric transducers are gel and attached to the surface of B) ENDOSCOPY IMAGING TECHNIQUE
the mother stomach and switched on. The ultrasound produced is If light enters a glass rod so that the refracted light is incident on the
reflected at boundary between the materials. B-scan takes place in side of the rod at an angle greater than the critical angle, then total
different directions. The intensity of the reflected ultrasound depends internal reflection occurs. If light continues to be internally reflected,
on the acoustic impedances of the materials. This is greater when the the light emerges at the other end with very little loss of intensity.
difference between the acoustic impedances is greater.
26)a) i) State two main properties of ultrasound. Total internal reflection
ii) Describe how the piezoelectric effect is used in an ultrasound When a light ray travels from one substance to another, total internal
transducer both to emit and receive ultrasound. reflection takes place at the point of incidence on the interface between
iii) Explain why a gel is used between the ultrasound transducer and the two substances if:
the patient‟s skin during a scan.  the incident substance has a larger refractive index than the other
b) Explain a method using ultrasound to determine the speed of blood substance . That is, for a ray of light travelling from a denser
in an artery in the arm. medium to a dense medium.
Solution  the angle of incidence exceeds the critical angle.
a) i) They are longitudinal waves with frequency greater than or equal If both conditions above are met, the light ray reflects at the interface
to 20 kHz. without loss of intensity.
ii) Emission: The piezoelectric crystal connected to an alternating Refracted ray
e.m.f causes crystal to resonate and hence emits ultrasound. Normal
r
Reception: The ultrasound makes the piezoelectric film resonate 90o
and this produces an alternating e.m.f. which can be display on a Glass i
screen. c
iii) Without the gel, much of the ultrasound wave would be reflected
Incident ray
at the skin-air interface (that is, the gel allows maximum
transmission of ultrasound into the body). This is because the gel Incident ray Weak Critical
and skin has similar acoustic impedance values. But there is a reflected ray angle
Refracted ray
large difference between the impedance values of air and skin. Normal
r
b) A piezoelectric transducer is gelled, switched on and placed at an 90o Refracted ray
angle to the arm. The ultrasonic wave has its largest Glass amplitude for ia
c i
given input of electrical energy. As ultrasound travels through a
material, its intensity is reduced because the material absorbs some
Incident ray
of the wave‟s energy, transferring it to internal energy. (In medical Incident ray
Totally
Incident
applications, this causes a heating effect in the body tissue. In ray Weak Critical Stronger
addition, some of theRefracted
wave‟s energy is scattered from its original reflected ray angle reflected ray
ray
Normal
path, which alsor reduces the intensity). The some of the ultrasound
90o
pulses are reflected by moving blood cells. The frequency of Refracted ray
ultrasound isi changed and this changed in frequency is directly
Glass i
c
related to the speed of blood. (There is a special backing material in
the transducer to dampen excessive vibrations. This allows short
Incident ray Incident ray
pulse lengths, and therefore better resolution, to be achieved–so that Totally internally reflected
Incident ray Weak the echo pulse arrives.
the emitted pulse ceases before Otherwise, Stronger
Critical
ray
because of the very short reflected
returnray overlapping at reflected ray
time, there would be angle Fig. O4.89
the transducer between the transmitted and reflected pulses). If only the first condition is met and the angle of incidence is equal to
27) a)i) The speed of sound in skin is 1730 m s−1 and the density of the critical angle ic, the angle of refraction is 90° because the light ray
skin is 1150 kg m−3. Calculate the value of the acoustic impedance emerges along the boundary. Therefore, applying the law of refraction
for skin. n1sinic = n2sin90 where n1 is the refractive index of the incident
ii) A gel used in performing ultrasound scans has a density of 1060 kg substance and n2 is the refractive index of the other substance. Since
m−3 and a bulk elastic modulus of 2.03 GPa. Show that the acoustic sin c  1 , then
impedance of the gel is 1.65 × 106 kg m−2 s−1 if the speed of sound in
the gel is 1192 m.
569
 n2
sin ic 
n1
If the angle of incidence is less than the critical angle, ic, the light ray is
partially transmitted and partially reflected at the interface. The figure
below shows these different situations
Optical Fibre
This is a long thin flexible glass rod with a plastic coating that is used
in transporting signals (light) from one point to another. The light
bounces off the walls of the fibre and can even bounce around corners.
This does not cancel the fact that light travels in straight line. Optical
fibres are made up of two glasses; thin good quality glass of high
density (higher refractive index) called the core, where the signal
travels, coated on the surface with a layer of glass of lower density
(lower refractive index) called the cladding, that reflects the signal back
into the core as Fig.O4.90.
The physical principle behind this is total internal reflection. When two
or more fibres have sidewalls in contact over some distance, the light
can leak from individual fibres into neighbouring ones. Leakage also
occurs if the walls of the fibres are not clean. In order to avoid these
losses, it is usual to clad the glass fibre in a glass skin which has a lower
refractive index than that of the fibre. The cladding protects the fibre
surface and isolates it from its neighbours.
glass of glass of
higher density lower density
i are in the same relative positions. This ensures the image formed by the
i >c normal
Fig.O4.90
The angle of incidence, i as shown in Fig.O4.90, at which the light
strikes the core-cladding boundary is greater than the critical angle and
total internal reflection takes place, trapping the light inside the core.
This repeats itself several times and the light finally emerges from the
other end. Because the cladding does not absorb any light from the core,
the light wave can travel great distances with negligible attenuation.
The properties of optical fibres make them useful for a wide range of
applications including:
• Medical - to transmit pictures of organs and arteries
• Industrial - to transmit pictures of the inside of complex machinery
• Communications - to transmit data over long distances without
transmission loss
Loss of light from a fibre reduces the brightness of the image. In
addition lost light may enter a different fibre. This fibre will then give a
contribution that is brighter than it would be if no light was lost from
other fibres. Thus, although some light in the cladding may re-enter the
core, light loss through the outer cladding surface will cause a loss in
the quality of the image.
Keyhole surgery using optical fibres results in smaller operation
wounds, meaning less pain, less risk of infection and a faster recovery.
The scars produced by insertion of the endoscope are smaller, resulting
in a better cosmetic result. For some procedures, keyhole surgery means
that an earlier discharge home from hospital is also possible.
The Principle of the Endoscope
The endoscope contains two bundles of fibres, the coherent bundle
which transmits light out of the body and the incoherent bundle which
transmits light into the body. The endoscope is inserted into a body
cavity to be observed which is then illuminated using light sent through
the incoherent fibre bundle. A lens (or camera as in modern endoscope)
over the end of the coherent fibre bundle is used to form an image of the
body cavity on the end of the fibre bundle. The light that forms this
image enters the coherent fibres and travels along the fibres to the other
end of the fibre bundle where the image can be observed.
The image on the outside end of the coherent bundle consists of dots,
each being at the end of a fibre that carries light from inside the body as
shown in Fig.O4.92.
The coherent bundle contains tens of thousands of fibres, each with a
diameter of about 0.01mm, forming a bundle several millimetres in
diameter. The bundle is constructed so that the fibre ends at each end
lens is seen as a „coherent’ image on the end outside the body by the
observer. Without this arrangement, the observer would see a
„scrambled’ image without discernible features. A TV camera is usually
used to display the „coherent‟ image on a TV monitor.

Modal of Optical Fibre

The light travelling down a fibre from the source to the detector can be
incident at a variety of different angles to the core-cladding interface.
This means that different waves can travel in different paths (or modes
as they are called) in the fibre. Therefore, pulses associated with
different waves will arrive at the detector at different times. The
possible paths are called modes.

Optical Fibre and Medicine

Optical fibre is used in medical endoscopes, to see inside the body,
consist of a transparent core surrounded by transparent cladding of
lower refractive index.

Fig.O4.92
In addition, the endoscope also includes a tube to insert and manipulate
Fig.O4.91
small cutting tools and to supply a jet of water and or air for cleaning
A step-index optical fibre has a core with the same refractive index
the lens and the fibre ends in the cavity.
throughout and cladding of constant refractive index that is lower than
the core refractive index. The core area of cross-section is typically
about 60% of the total area of cross-section. Imaging Techniques of Endoscope
If angle of incidence of a light ray at the core–cladding boundary is less The endoscope thin, flexible tube is passed through the mouth, into the
than or equal to the critical angle, the light ray will enter the cladding. oesophagus and down to the stomach as shown in Fig.O4.93 or any
This can happen if the fibre is bent too much, as shown in Fig.O4.91. other opening such as the anus, virginal penis to the targeted area. It
The light ray in the cladding could then leave the cladding at the air– consist two light guides glued together, one with a tiny cameral or lens
cladding boundary if: fitted tip.
 the angle of incidence at this boundary is less than or equal to the
critical angle for this interface, or
 the outer surface is rough or greasy or in contact with another fibre at
the point of incidence.
570

eye piece
optical
fibres doctor ‟s
eyes
light into
fibres
oesophogus
stomach
endoscope
camera fitted tip
duodenum
Fig.O4.93
Light is carried down into the patient by the incoherent bunch of the
optical fibres by the process of total internal reflection. At the tip of the
fibre, the light is emitted to illuminate the inside of the patient. After
reflection and scattering, the light that forms the image of the inside is
carried back to the eyepiece along a coherent bundle of the fibres still
by process of total internal reflection. After viewing by medical
personnel, the information is fitted into a monitor for better observation
and analysis.
The image can be seen on a lens but this is often awkward and so this is
displayed as a full colour-moving image on a television screen - the
results can be recorded for further inspection after the procedure and to
be kept as a record for further consultation.
NOTE
• Water pipes:- Carry water to wash the lens and keep the view clear.
• Operations channel :- Carries accessories to the distil end for surgery.
• Control cables :-Controls which way the distil end is bent.
• Additional optional channel:-Carries air or carbon dioxide to and
from the distil end
The effect of different refractive index values
The viewing cone at the end of each coherent fibre in the body as shown
in Fig.O4.94 defines the field of view of the fibre.
Fig.O4.94
Consider a light ray on the edge of the viewing cone that enters the flat
end of the fibre core. This light ray will be refracted towards the normal
on entry to the core such that it reaches the core–cladding boundary at
the critical angle.
 Any light ray that enters the flat end of the core from within the
viewing cone will undergo total internal reflection at the core–
cladding boundary of a straight fibre because its angle of incidence at
the core-cladding boundary is greater than the critical angle.
 Any light ray that enters the flat end of the core from outside the fibre
will be refracted at the core-cladding boundary into the cladding
because its angle of incidence at the core-cladding boundary is less
than the critical angle.
For total internal reflection at the core-cladding boundary, the
maximum angle of incidence at the point of entry, imax, is equal to half
the angle of the viewing cone. This angle can be calculated from the
critical angle of the core-cladding boundary, ic, refractive index of the
core (n1) and of the substance outside the fibre (n0) as the angle of
refraction at the flat end for the core-cladding critical ray is equal to
90° − ic.
Applying the law of refraction to this ray at the flat end therefore
gives the following equation from which imax can be calculated.
n0 sin(imax )  n1 sin(90  ic )
If the viewing cone is too narrow, the coherent bundle will only
receive light in a small cone and only a restricted area of the organ
will be seen. If the viewing cone is too wide, loss of contrast may
occur as each fibre will collect light from a wide area.
571
Advantages of Using Optical Fibre in Endoscope
• Less expensive - Several kilometres of optical cable can be made
cheaper.
• Thinner - Optical fibres can be drawn to smaller diameters.
• Higher carrying capacity - Because optical fibres are very thin, more
fibres can be bundled into a given-diameter cable.
• Less signal degradation - The loss of signal in optical fibre is very
small.
• Less interference - Light signals from one fibre do not easily interfere
with those of other fibres in the same cable. This means clear image
reception.
• Low power - Because signals in optical fibres degrade less, lower-
power transmitters can be used. This saves money.
• Digital signals - Optical fibres are ideally suited for carrying digital
information, which is especially useful in computer analysis.
• Non-flammable - Because no electricity is passed through optical
fibres, there is no fire hazard.
Advantages Endoscope in Medicine Imaging
The use of endoscopes is much less invasive than open surgery
because only a small incision in the body is required where as open
surgery requires deep incisions. This also means that recovery is
quicker and there is less swelling, scarring and risk of infection.
Endoscopes can be used by an outpatients department and does not
need to be done by a hospital. This reduces costs. It is also non-
ionizing.
Disadvantages Endoscope in Medicine Imaging
However, endoscopy is not risk free as internal organs may be
damaged if the endoscope is not used extremely carefully or if the
internal organs are in very poor condition.
Worked Examples
1) Calculate the critical angle for the core–cladding boundary of an
optical fibre that has a core of refractive index 1.62 and cladding of
refractive index 1.52.
Solution
n 1.52
sin ic  2   0.938
n1 1.62
 ic  70o
2) Calculate the angle of the viewing cone for an optical fibre in air
which has a critical angle of 70° for its core–cladding boundary and
a core refractive index of 1.52.
Solution
n0 = 1 for air, n1 = 1.52, ic = 70°
sin imax = n1sin(90 − ic) = 1.52 × sin20 = 0.520
Hence, imax = 31°
3) An endoscope contains two bundles of optical fibres.
a) Name the two bundles. For each bundle state clearly the arrangement
of the fibres and explain its purpose in the operation of the
endoscope.
b) Each fibre has a core surrounded by cladding. Calculate the critical
angle at the core- cladding interface of a fibre. (refractive index of
core = 1.60 and that of cladding = 1.55)
Solution
a) The non-coherent bundle has no relative order to the fibres as it is
suitable only for the transport of light into the body to illuminate the
area under observation.
The coherent bundle has same relative position of fibres at both
ends. As the image falls on a certain number of fibres and each fibre
receives light forming a small part of the image. The fibres each
transmit a small part of the image and it is possible to see the
transmitted image at the opposite end of such a „coherent bundle‟ of
fibres.
 1.55 
b) iC  sin 1   75.6o
 1.60 
4) Fig. O4.95 shows a glass optical fibre with a central core of
refractive index 1.55 and a surrounding cladding of refractive index
1.40.
Fig. O4.95
(b) Calculate the critical angle, C, for the boundary between these two η
types of glass. 1.5
(c) Copy and complete the path of the light ray shown in Fig. O4.95.
(d) State and explain whether the following changes in the optical fibre 1.0
would increase or decrease the probability of light escaping from the
fibre. 0.5
i) increasing the refractive index of the cladding
ii) bending the fibre into a tighter curve . 0.0
A B C D
Solution radial distance
 1.40 
a) C  sin 1   64.6o Fig. O4.97
 1.55  sin i
b) on outer edge only of core two to four reflections ii) 1.5   i  15.1o
sin10
c) i) The smaller difference between the core index and cladding index 7) In the optical system of a flexible endoscope there are two types of
makes critical angle larger and therefore increases the chance of fibre bundles, coherent and non-coherent. Explain the purpose of
light escaping each of these two types of bundle.
ii) It makes the internal angle of incidence at core-cladding interface Solution
more likely to be less than the critical angle and therefore increases The non-coherent is used to transmit light into body to provide
the chance of light escaping illumination.
5) Bundles of optical fibres are described as either coherent or non- The coherent to transmit light to form an image from inside to
coherent. viewer
a) Describe how the fibres are arranged in each type of bundle and 8) i) Briefly describe how an endoscope works.
explain how the different designs determine their optical Solution
characteristics. An endoscope works by transmitting an image from inside the patient to
b) State an application for each type of bundle. allow doctors to see organs without risking infection.
c) (i) Give two advantages of a bundle consisting of fibres of very
distal tip
small diameter over a bundle consisting of larger fibres. fibre optics
diathermy
(ii) Give two reasons why a glass cladding is used around the central
core of each fibre in a coherent bundle. irrigation pot
Solution detail biopsy pot
a) Coherent bundle: fibres maintained in fixed positions relative to
each other and non-coherent bundle: fibres have no fixed relative illumination
positions. This means that a coherent bundle can be used to transmit
images up of light energy whereas non-coherent ones just transfer long flexible tube
the light energy and image transfer is not possible. to light source
b) Coherent bundles of fibres can be used to transmit images of internal
organs of the body so a doctor can 'see' inside a patient.
Non-coherent bundles can be used to transmit (or conduct) light to
the inside of the human body. This illuminates the site that the
doctor wishes to view. locking control
c) i) High resolution fine detail images can be seen if the fibres are of air/water control
small diameter. The bundle would also be more flexible than if
thicker fibres were used. The fine fibres would also allow bending tip deflection
aspiration control control
around tighter curves without light escaping.
ii) Scratches on the outer surface would allow light to escape - the opening channel eye piece
cladding protects the outer surface. Close contact between adjacent
fibres (or liquid penetrating between fibres) would allow light to pass Fig.O4.99
from one fibre to another, the cladding ensures that image is not Endoscope uses the principle of total internal reflection at the core-
confused (corrupted, scrambled) - it prevents light passing between cladding interface. It consists of coherent and non-coherent fibre
individual fibres. bundles. The coherent bundle transmits light out of the body and the
a) han the critical angle for the material so no refraction occurs incoherent bundle transmits light into the body.
6) (a) State and explain two physical properties of the light produced The endoscope is inserted into a body cavity to be observed which is
by a laser which makes it different from the light produced by a then illuminated using light sent through the incoherent fibre bundle. A
filament lamp. lens over the end of the coherent fibre bundle is used to form an image
(b) An endoscope may use light from a filament lamp and light from a of the body cavity on the end of the fibre bundle. The light that forms
laser. State this image enters the coherent fibres and travels along the fibres to the
i) the use of the light from a filament lamp, other end of the fibre bundle where the image can be observed. The
ii) a use of the light from a laser. image on the outside end of the coherent bundle consists of dots, each
c) Fig. O4.96 shows a cross-section through an optical fibre used in an being at the end of a fibre that carries light from inside the body.
endoscope. The core is made from glass of refractive index 1.5. The coherent bundle contains tens of thousands of fibres. The bundle is
D constructed so that the fibre ends at each end are in the same relative
air C cladding positions. This ensures the image formed by the lens is seen as a
o
B „coherent‟ image on the end outside the body by the observer. Without
80 A core
i this arrangement, the observer would see a „scrambled‟ image without
cladding discernible features. This „coherent‟ image is display on a monitor.
Fig. O4.96 9) Fig.O4.98 shows how non-ionising imaging technique is being used
(i) Sketch a show how the refractive index changes with radial distance by a physician to look inside a patient‟s stomach.
along the line ABCD in the figure above. Light in
Eye piece
(ii) Calculate the value of the angle of incidence, i, shown in Fig. O4.94. Optical fibres
Solution Doctor‟s
a) Monochromatic waves meaning of single frequency, collimated as eyes
it produces an approximately parallel beam and coherent waves as Stomach
they are produced in constant phase with each other
b) i) Illuminate the inside of a body
ii) Stopping bleeding, cutting tissue, treatment of tumours Patient
c) i) η (constant) = 1.5 from A to B, slight decrease and constant from
B to C at 1 from C to D Fig.O4.98
Name and explain how this imaging technique is used in medical
diagnosis.
Solution

572
 The imaging technique is endoscope. Light passes through a bundle of
optical fibres by means of total internal reflection into the patient‟s
stomach. The inside of the stomach reflects some of the light. The
reflected light passes through a second bundle of optical fibres which
takes the light to the eyepiece. The doctor looks through the eyepiece
and sees the inner part of the patient‟s stomach.
10) a) Give four practical uses for optical fibres.
b) Explain, as fully as you can, why the light ray stays inside the
optical fibre.
Solution
a) In an endoscope for doctors to see inside a patient‟s body or use in
keyhole surgery
In telephone cables
In fibre optic lamps such as used in artificial Christmas trees and
decorative or ornamental lighting
Use for data transfer or internet connection
b) Total internal reflection occurs making the ray reflect at the fibre
boundary rather than pass through it, this happens because when the
ray hits the boundary between the fibre material and air the angle of
incidence is greater than the critical angle.
C) NUCLEAR MAGNETIC RESONANCE
Magnetic resonance imaging (MRI) works by measuring the way that
hydrogen atoms absorb and then relax and re-emit electromagnetic
energy. Most of the human body is made up of water molecules,
which consist of hydrogen and oxygen atoms and fat, which also
contains hydrogen atoms. The human body is made up of about 60%
hydrogen atoms.
The nucleus of a hydrogen atom is a proton, and protons are very
sensitive to magnetic fields since they are charged particles. When the
proton spins it generates a magnetic field, therefore the nucleus of a
hydrogen atom behaved like a tiny magnet. When the body is in a
strong magnetic field, all of the hydrogen nuclei line - just like a row
of compass needles lining up with a magnetic field.
The phenomenon known as nuclear magnetic resonance is the basis of
the diagnostic tool known as magnetic resonance imaging (MRI). It is
a technique used for imaging blood flow and soft tissue in the body. It
is the preferred diagnostic imaging technique for studying the brain
and the central nervous system. The magnetic resonance (MR) scanner
is used in hospitals to scan the hydrogen content in the body.
Basic Principles of NMR Imaging
The patient is laid on a table and moved into a chamber containing
strong electromagnets as shown in Fig.O4.100.
Fig.O4.100
The patient is made to lie inside a large, very strong, cylindrical
magnet. The spinning nuclei inside the body align themselves with the
magnetic field. An electromagnetic pulse of specific radiofrequency
(RF) is applied which causes the nuclei to align in a different
direction. When the pulse is removed by switching off the
electromagnet, the nuclei return to their equilibrium positions and
release RF radiation. This occurs over a period of time called the
relaxation time, different types of tissue having different relaxation
times.
A ring of detectors pick up the emitted radiation pulses, and this
information is fed into a computer which translates the information
into a sectional image.
In a strong magnetic field, a nucleus which has a magnetic moment
tend (like a spinning top) to align their rotation axis precesses about
the direction of the external magnetic field just as the axis of a tilted
spinning top precesses about a vertical line. Relative to the magnetic
field, the nucleus has just two energy levels corresponding to the two
different alignments relative to the magnetic field as shown in
Fig.O4.101.
A nucleus in a magnetic field can be excited into the higher energy
level using radio waves of the same frequency as the frequency of
precession of the nucleus. This process of excitation is known as
573
nuclear magnetic resonance. As the frequency of precession is
proportional to the external magnetic flux density, it can be changed
by changing the magnetic flux density of the external field. Nuclear
magnetic resonance can therefore occur by adjusting the magnetic flux
density until the precession frequency is equal to the frequency of the
radio waves
Fig.O4.101
In a sample of nuclei in a magnetic field, some nuclei will be in the
higher energy level due to the thermal energy of the atoms. At room
temperature, there is a slightly higher proportion of nuclei in the lower
energy state.
The NMR scanner
The key design feature of an MR scanner is that it applies a magnetic
field of specific flux density to the patient at a precise and well-defined
location that changes systematically with time so as to scan a cross-
section of the patient as illustrated in Fig.O4.102.
At this specific flux density, the magnetic field causes excitation of the
hydrogen nuclei at a definite location. As the nuclei de-excite before the
next pulse is emitted, the signal received by the detector must therefore
have come from that location. The intensity of the signal depends on the
number of nuclei excited at that location.
In the scan, the location of the excited nuclei changes along a „raster‟ of
successive straight lines in a single plane through the patient, like the
lines that build up a visual image on a TV screen. The detector, pulse
transmitter and magnetic field coils that create the scanning raster are
connected to a computer which is programmed to create a visual image
of a cross-section of the patient. By scanning adjacent cross-sections
systematically, a three-dimensional image of any scanned part of the
patient can be displayed.
Fig.O4.102
Here, tissue discrimination is possible because the rate of decay of the
detected signal after each pulse (the relaxation time) depends on the
type of molecules surrounding the water molecules. The magnetic fields
of surrounding magnetic nuclei delay the de-excitation of excited nuclei
to different extents, according to their relative arrangement. For
example, grey matter in the brain has a relaxation time of 0.37 s
compared with 0.30 s for white matter. In addition, the strength and
length of the pulse affects the proportion of excited to unexcited nuclei
in different types of tissue and therefore contributes to the relaxation
time of the signal. The relaxation time is therefore used to identify
tissue types.
The shape of the field is that of a solenoid. It is uniform in the area
where the patient lies as shown in Fig.O4.103.
Fig.O4.103
 MRI scans do not expose patients to ionising radiation as X-ray scans
do and seem to cause little or no physiological harm. Brain research and
medical diagnosis have moved forward very dramatically as a result of
MRI scanners which although extremely expensive are now in
operation at major hospitals in the World. Examples of brain research
include monitoring the sites in the brain of increased blood flow due to
increase of brain activity when undertaking specific physical or mental
activities. Other examples include:
• arteries to detect narrowing or potential ruptures
• spinal discs to assess damage such as rupture or movement out of place
• hip and knee joints to detect early osteoarthritis (by early detection of a
chemical substance known to be associated with osteoarthritis).
Bone shows no MRI signal.
Magnetic Resonance Imaging Technique
The patient is laid on a table and moved into a chamber containing
magnets that produces uniform strong magnetic field. Pulses of non-
uniform radio-frequency electromagnetic waves bombard the patient. At
particular frequency (Larmor frequency), some of the hydrogen nuclei
in the targeted tissues absorb this radio-frequency wave photon and
resonance occurs, causing them to become excited to higher energy
states.
When the radio pulse is stopped, the protons de-excite: they return to
their original states and emit radio frequency signals. The strength of
the radio frequency signal depends on the proton density in different
regions of the body, which is itself linked to the amount of water in the
tissue.
This information (radio frequency) signal is fed into a computer that
decodes it and produces a two-dimensional or three-dimensional image
on a computer monitor screen for medical analysis.
NOTE
If hydrogen nuclei are placed in a strong external magnetic field, they
will tend to align their rotation axes with the external field direction.
Some will align with the magnetic field and others align themselves in
the opposite direction to the magnetic field. When a weak oscillating
magnetic field in the form of pulses of radio waves is superimposed
on the strong magnetic field, the oscillating field rotates at right angles
to the strong field. If the radio frequency is not a certain frequency
known as the Larmor frequency, the axis of the rotating particle will
wobble. If the applied frequency is equal to the Larmor frequency of
precession, the charged particles resonate and absorb energy from the
varying radio-frequency wave magnetic field. The magnetisation of
the material is changed and this is detected by a radio-frequency
signal emitted from the sample.
Advantages of nuclear magnetic resonance
 MRI scans do not involve ionising radiation.
 The ability to distinguish different types of soft tissue is better than
that of a computed tomography scan
• The resolution for soft tissue is better than a computed tomography or
ultrasound scan
• It can show both three-dimensional and cross-sectional images
• It is non-invasive
• Clearest images of the brain.
• Best image of the central nervous system.
• they are particularly useful for showing soft tissue structures, such as
ligaments and cartilage, and organs such as the brain, heart, and eyes,
and
• they can provide information about how the blood moves through
certain organs and blood vessels, allowing problems with blood
circulation, such as blockages, to be identified.
Disadvantages of nuclear magnetic resonance
• MRI scans cannot be used if the patient has any metallic implants,
such as a pacemaker
• The patient might have to be still for up to an hour
• Bone and calcium do not show up on this type of scan
• The cost is greater than any other scan
• Scan time up to 40 minutes.
• MRI scanners can be affected by movement, making them unsuitable
for investigating problems such as mouth tumours because coughing,
or swallowing, can make the images that are produced less clear.
Worked Examples
1) Discuss briefly the advantages and disadvantages of scanning using
MRI techniques.
Solution
574
This method does not use ionising radiation, hence no radiation hazard
to patient or staff. It gives better soft tissue contrast than CT scans,
generates data from a 3D volume simultaneously. Information can be
displayed on a screen as a section in any direction. There are no
moving mechanisms involved in MRI. There is no sensation, after
effects at the field strengths used for routine diagnosis.
Strong magnetic field could draw steel objects into the magnet.
Metallic objects may become heated. Cardiac pacemakers may be
affected by the magnetic fields. CT scanners better for viewing bony
structures
2) a) Give three hazards to a patient which could be associated with
MRI and describe an associated safety precaution.
b) State two advantages of X-ray imaging compared to MRI
c) Name the region of the electromagnetic spectrum used in MRI scan
d) The commonest elements present in the human body are oxygen,
carbon and hydrogen. Explain why it is justifiable to say that the
nuclei imaged in an MRI scan are those of hydrogen?
Solution
a) It may lead to noise and ear damage which can be overcome by
wearing ear plugs.
Any metal around may result to magnetization. For safety
precaution, remove earrings, watches and other magnetic materials
around during the scan.
Patient need to be confined space still for up to hours as a result,
they need counselling or sedation
b) X-rays are cheaper, quicker, relatively portable, can be used if
patients have metal implants and gives better images of bones.
c) Radio waves
d) The nucleons in carbon and oxygen are paired and so the tiny
magnetic moments due to magnetic spins cancel out. Thus, resonant
signals are only emitted from nuclei of odd nucleon number. H2 has
a single proton.
3) Explain, briefly, how MRI can produce detailed images of slices
through the body.
Solution
When a magnetic field is applied, the nuclei wobble around field
lines. The nuclei absorbed radio-frequency waves at resonance
frequency and change their orientation. When the magnetic field is
removed, the orientation goes back to field direction while emitting
radio-frequency waves.
4) Explain how a visible image of a cross-section of a patient‟s body is
produced by MR scanner.
Solution
MR scanner applies a magnetic field of specific flux density to a
patient at a precise and well-defined location that changes
systematically with time so as to scan a cross-section of the patient.
At this specific flux density, the magnetic field causes excitation of
the hydrogen nuclei at a definite location. As the nuclei de-excite, it
emit radio frequency signal which are received by the detector. Fed
into a computer for the production of a visual image.
5) a) Outline briefly the use of magnetic resonance to obtain diagnostic
information about internal body structures.
b) In some medical applications, the diagnostic information may be
obtained using magnetic resonance or using X-rays. State two
disadvantages of the use of magnetic resonance.
Solution
a) A large uniform magnetic field applied to patient body. The pulse of
radio-frequency produced causes the hydrogen nuclei in the targeted
tissues to be excited at particular frequencies. When the radio-
frequency pulse ends, nuclei give off radio-frequency waves during
de-excitation which are detected and processed by a computer to
give positions of the hydrogen atoms. The non-uniform magnetic
field enables positions of resonating atoms to be defined.
b) Magnetic resonance is more expensive, not portable, not popular in
developing countries\ and required more time.
6) In an MRI scanner, a gradient field is applied to the patient and radio
frequency, r.f., waves are passed through the body. The r.f. waves
cause protons in the body to precess.
a) i) State what is meant by a gradient field.
ii) State what happens to protons in the body when a gradient field is
applied at the same time as the r.f. waves and explain how the gradient
field helps to image a single thin section of the patient.
iii) Describe how the precessional energy of the protons in a part of the
patient‟s body can be used to image that part of the body.
vi)Describe how a complete body image is produced by the MRI
scanner.
b) Another device that may be used to produce a three-dimensional
image of a patient is a computerised tomography (CT) scanner.
Describe one advantage and one disadvantage of an MRI scanner
compared with a CT scanner.
 Solution
a) i) Gradient field means that the magnetic field varies linearly in
strength across the body in different parts of the body.
ii) The protons process at particular frequency which is proportional to
the magnetic field intensity. The radio-frequency waves cause
resonance only when they match a particular frequency.
iii) When the radio frequency waves switched off, the process protons
are de-excited; radiating energy as radio-frequency waves whose
intensity depends on number of hydrogen atoms present.
iv) By change RF to different frequency. Each RF produces an image of
one slice (cross-section). A computer is used to construct the whole
body image from many individual slices.
b) MRI doesn‟t involve ionising radiation, can image tissue within
bone, better contrast between tissues and condone resolution.
- MRI is expensive, time taken for scan, limited patient size, can be
used in patient with magnetic material implanted, patient may have
to be sedated.
6) How does an MRI machine works in medical imaging?
Solution
MRI scanner applies a magnetic field of specific flux density to a
patient at a precise and well-defined location. Pulses of non-uniform
radio-frequency electromagnetic waves bombard the scan location. At
particular frequency, the hydrogen nuclei in the targeted tissues
absorb this radio-frequency wave photon and are excited. When the
radio-frequency pulse is switched off, these excited nuclei are de-
excited, emitting photons of radio frequency signals as they flipped
back to their equilibrium position. The relaxation time of the protons
depends on the surrounding tissue. The emitted radio-frequency
waves are picked up by receiver, fed into a computer that decodes the
information and display on screen for analysis.
7) During magnetic resonance imaging to obtain information about
internal body structures, a large constant magnetic field is used with a
calibrated non-uniform magnetic field superimposed on it. State and
explain the purpose of
i) the large constant magnetic field
ii) the non-uniform magnetic field.
Solution
i) To align the nuclei and causes radio-frequency of precession.
ii) The frequency of precession depends on the nature of the nucleus
and the strength of the applied magnetic field. The frequency of
precession is found to lie in the radio-frequency (RF) region. If radio
wave of frequency equal to the frequency of precession is applied, the
nuclei will resonate, absorbing energy. When the pulse ends, the
nuclei will return to their original equilibrium state after relaxation
time. In so doing, RF radiation is emitted by the atoms. There are, in
fact, two relaxation processes and it is the times between these that
form the magnetic resonance imaging (MRI).
8) a) Describe what happens to the nuclei of hydrogen atoms in the
body when exposed to a high magnetic field in an MR scanner.
b) Explain how the nuclei in the body can be stimulated to emit radio
frequencies in an MR scanner.
c) What types of tissue are best imaged by an MR scanner?
Solution
• The hydrogen nuclei (protons) align themselves with the direction of
the external magnetic field and precess around its direction at the
Larmor frequency.
• An external radio pulse equal to the Larmor frequency excites the
nuclei to higher energy states. As they de-excite, they emit radio
frequencies.
• Soft (non-bony) tissues.
9) A patient is placed in an MRI scanner. The protons inside the patient
process in the strong magnetic field of the scanner with an angular
frequency of 4.0 × 108 rad s−1.
i) Calculate the wavelength of the radio waves absorbed by the
resonating protons within the patient.
ii) Explain what is meant by the relaxation time of protons.
Solution
 4.0  108
i) f    6.37  107 Hz
2 2
c 3.0  108
   4.7 m
f 6.37  107
ii) The mean time taken by nuclei to return to initial energy state.
10) Outline the basic principles of a magnetic resonance (MR) scanner
used to scan a patient‟s brain.
Solution
The patient‟s head is made to lie inside a large, very strong,
cylindrical magnet producing magnetic field. This supplies radio-
frequency pulse is used to excite the hydrogen nuclei in the tissues.
The spinning nuclei align themselves with the magnetic field. At
575
pulse Larmor frequency, the nuclei align themselves in a different
direction. When the pulse is removed, the nuclei return to their
equilibrium positions and releasing radiofrequency radiation over
relaxation time. Different types of tissue having different relaxation
times. A ring of detectors pick up the emitted radiation pulses, and
this information is fed into a computer which translates the
information into a sectional image.
II) IONISING IMAGING TECHNIQUES
Ionizing radiation is the radiation that carries enough energy to
detach electrons from atoms or molecules, thereby ionizing them. One
main disadvantage of ionising imaging technique is the exposure of
patients to ionising radiation that may be harmful to living cells or soft
tissue. This is particularly dangerous to pregnant women and babies as
it causes mutation. In this book we are going to see two of them, x-ray
and radioactive radiation.
X – RAY IMAGING TECHNIQUES
X-rays are high-frequency electromagnetic radiations produced when
fast moving electrons are stopped suddenly by a metal target. Hence,
x-rays are high-energy photons with wavelength of the order of 1010 m
or less. They are used for medical imaging because they penetrate
matter and darken photographic film. They ionise substances and
damage living tissues so their use must be monitored very carefully.
There are a number of X-ray tubes used for medical purposes. The tubes
can be classified as either diagnostic or therapeutic. We will concentrate
in this section on diagnostic details because we are interested in medical
imaging at the moment.
X-RAY MACHINE
Most diagnostic X-ray machines use a rotating anode X-ray tube shown
in Fig.O4.104.
Fig.O4.104
Electrons are emitted by the filament wire when it is heated by an
electric current. These electrons are attracted by the rotating metal
anode when it is positive relative to the filament. A step-up transformer
provides a high alternating potential difference (typically around 15
000V in hospital machines) for the filament wire and a much larger
alternating potential difference between the anode and the filament.
Because a large number of electrons are released, they experience
forces of repulsion and tend to spread out. To prevent this spreading
out so that a small area of the anode target material is bombarded, the
cathode-focusing cup produces electrical forces that cause the electron
stream to converge onto the anode target at a focal spot. The area of the
anode from which X-rays are emitted is referred to as the focal spot.
This area must be as small as possible otherwise features in the image
would be blurred instead of being sharp as shown in Fig.O4.105.
X-rays from the edge
of small focal photographic film
cross-section of bone
shadow of
image formed
by X-rays
anode from small
focal spot
X-rays from the edge of an
over-large focal spot
blurred edges of image formed
if the focal sport was larger rays
Fig.O4.105
The anode surface is at an angle of about 70° to the electron beam so
that the X-rays effectively originate from a much smaller area than the
impact area of the beam.
Most of the energy of the electrons is converted to heat in this collision
due to their sudden deceleration with less than 1% being converted to
X-radiation. Because large amounts of heat are produced at the focal
spot of the electron beam, the tungsten disc anode is made to rotate
using an induction motor so that the heat loading on any particular point
on the disc is reduced. That is, the anode is made to rotate at steady reflected low
electron
speed so the point of impact continually changes to prevent overheating. x-ray photon
energy
incident low energy
Intensity x-ray photon shell
Fig.O4.106 shows how the intensity of the X-rays from an X-ray tube
varies with photon energy. Fig.O4.108
relative
intensity It is the dominant mechanism in soft tissue in the 1 to 30 keV range.
tube voltage V2 > V1
Photoelectric effect
tube voltage V1 In the photoelectric effect mechanism the incoming X-ray photon has an
beam current I1 energy greater than the energy required to remove inner-shell electrons,
and photoelectrons and positive ions are produced as shown in
tube voltage V1
beam current Fig.O4.109.
As other electrons in the atom fill the vacant spots of the ejected
photoelectrons, characteristic lower-energy photon emission occurs.
eV1 eV2 photon light photon
energy inner-shell electron emitted
Fig.O4.106
The X-ray tube produces a continuous spectrum of photon energies up incident high energy electron
x-ray photon movement
to a maximum value of eV, where V is the anode p.d. This is maximum
because the kinetic energy of the electron beam at the anode is equal to shell
the work done eV on it by the anode p.d; an X-ray photon created by the
stopping of an electron therefore cannot have more energy than eV. Fig.O4.109
Each curve for a certain anode p.d., V terminates on the x-axis at photon It is the dominant mechanism in soft tissue in the 1 to 100 keV range.
energy equal to eV. The higher the tube p.d., the further along the x-axis The optimum photon energy for diagnostic radiography is around 30
the curve terminates (because the maximum photon energy is greater) 000 kV where the photoelectric effect predominates because this gives
the higher the intensity peak (because more X-ray photons are emitted the maximum contrast between body tissues and bones.
per second).
For a photon of maximum energy eV, its frequency f max is given by Compton scattering
This occurs when the X-ray photon ejects outer-shell recoil electrons
hf max  eV
and the X-ray photon moves off in a different direction with a slightly
Thus an X-ray tube operating at p.d., V emits a continuous spectrum of lower energy as shown in Fig.O4.110.
frequencies up to a maximum frequency f max . high energy
The graph in Fig.O4.107 shows the intensity distribution in terms of x-ray photon
wavelength as a continuous distribution from a minimum wavelength electron low energy
x-ray photon
min upwards.
relative
intensity shell

0 energies are preferred.
λmin photon
wavelength
Fig.O4.107
 The spikes on the intensity curves are due to beam electrons knocking
out electrons from the innermost shells of the atoms in the anode.
These shells are at deep energy levels and when a vacancy in such a
shell is filled by an outer shell electron or a conduction electron, an X-
ray photon of specific energy is emitted.
 The energy of a X-ray photon is often expressed in kiloelectronvolts
(keV), where 1 keV = 1000 eV = 1.6 × 10−16 J
Notes : As the wavelength λ of a photon of frequency f is given by
v thickness x, the attenuation or fractional reduction in intensity I is given
  , an X-ray photon of frequency f max has a wavelength since
f
c hc
min   .
f max eV
Attenuation of X-Ray
The attenuation of an X-ray beam is the reduction in its intensity due
to its passage through matter. When a beam of X-rays passes through a
material such as the soft tissue of the body or bone, some of the X-rays
will be absorbed. There are three main attenuation mechanisms where
energy can be lost due to absorption in matter:
• simple coherent scattering
• the photoelectric effect
• compton scattering
Simple coherent scattering
This occurs when the energy of the incoming X-ray photon is smaller
than the energy required to remove inner-shell electrons from an atom.
When the incident X-ray photon interacts with an atom, it is scattered in
a new direction without a loss of energy as shown in Fig.O4.108.
recoil electron
Fig.O4.110
High energy X-ray photons can produce electron-positron pairs. The
Compton scatter is used in therapeutic radiology where higher
The attenuation (reduction in intensity) of X-rays occurs in two ways:
• the intensity of the X-ray beam may decrease with distance from the
source (tungsten target) as they diverge or spread out in spherical
wavefronts.
• the intensity of the X-ray beam decreases as the X-ray photons are
scattered or absorbed by a material.
The radiation emitted by an X-ray tube is heterogeneous because it is
made up of photons with a range of energies.
A beam of homogenous, monoenergetic X-rays contains photons of
only of one energy and thus only one wavelength. When a beam of
monoenergetic X-rays of intensity I0 passes through a medium with a
by:
I  I 0ex
where μ = the constant of proportionality called the linear attenuation
coefficient. Its value depends on the energy of the X-ray photons and
the nature of the absorbing material.
The intensity of a beam of X-radiation (and of any type of radiation or
wave) is defined as the energy per second per unit area incident
normally on a surface. The unit of intensity is J s−1 m−2 or W m−2.
When a beam of X-rays passes through matter, some X-ray photons are
absorbed and some are scattered. The intensity of the transmitted beam
is said to be attenuated because its intensity decreases the further it
travels through the matter. This is illustrated in Fig.O4.111.
material medium
transmitted
incident
intensity, I
intensity, I0 x
Fig.O4.111
For a beam of X-rays that passes through an „absorber‟ of thickness x,
the transmitted intensity I is given by
I  I 0ex

576
where I0 is the incident intensity of the beam and μ is the attenuation
coefficient (sometimes called the absorption coefficient) of the absorber
substance. The unit of μ is m−1.
The intensity of the monoenergetic beam decreases exponentially with
absorber thickness. The value of the attenuation coefficient increases as
the X-ray energy decreases and higher absorption results.
X-Ray Detection, Recording and Display Techniques
Fig.O4.112 shows the components of the process of a patient being X-
rayed to produce a radiographic image on a photographic plate.
Patients who need an X-ray of their digestive tract often eat a „barium
meal‟, a thick suspension of barium sulphate that is taken orally.
Barium sulphate is X-ray opaque, and areas coated with it will appear
white on the X-ray image as illustrated in Fig.O4.115 and be easier to
see.
Barium sulphate is toxic, but it is safe to use because it is insoluble and
so is prevented from entering the blood.
• The image contrast is improved by using a lead collimator grid to
prevent X-rays scattered by tissue and bone in the patient from reaching
the film. Scattered X-rays would „fog‟ the film in the shadow areas, thus
reducing the contrast between clear and dark areas of the film. This
contrast process is as shown in Fig.O4.116.

Fig. O4.112
The X-ray beam passes through the glass wall of the X-ray tube, a layer
of oil then a thin aluminium plate to filter out low energy radiation. It is
then collimated by thick lead plates to ensure a narrow beam. The X-
rays enter the patient where they are either scattered or absorbed. In
order to decrease blurring on the radiograph due to scattering, a lead
grid system is inserted before the photographic film.
Direct X-rays pass between the grids while the scattered X-rays are
absorbed by the lead plates as show in Fig.O4.113.

Fig.O4.116
Only non-scattered X-rays pass through the channels in the grid to reach
the film. Lead is much more effective at absorbing X-rays than any
other commonly available metal.
Screening for breast cancer is normally carried out by directing low
dose X-rays into breast tissue. X-rays able to detect breast cancer
because:
Fig. O4.113 • absorption depends on density of tissue,
The direct X-rays then fall on an intensifying screen cassette containing • cancerous tissue has different density from non-cancerous tissue,
double-sided film sandwiched between two fluorescent screens, as • absorption is different for cancerous and non-cancerous tissue.
shown in Fig.O4.114. • The image sharpness is improved by making the focal spot, the area
x-rays from patient‟s body on the anode from which the X-rays are emitted, as small as possible.
plastic front
front Reducing exposure to X-rays
double
intensifying sided film To reduce exposure to X-rays, the patient should not be exposed to the
screen
X-ray beam any longer than is necessary. In addition:
metal back felt pad

Fig. O4.114
The standard X-ray machine used in radiography can produce images of
some of the internal organs of the body and bones. Air pockets, fat and
soft tissues can be differentiated from each other because they can
attenuate the X-ray beam in different ways. Bones produce a white
image because they contain heavier body elements such as calcium and
phosphorus in a dense matrix that attenuate the X-ray beam more than
the softer tissues. Tissues that contain lighter elements such as
hydrogen, carbon, nitrogen and oxygen produce a grey image on the
radiograph. It is easy to distinguish a black lung image because it
contains lower density air when compared with more dense water that is
present in abundance in tissues.

Improving the quality of the image

• Contrast enhancement: The contrast between images of different soft
tissue, or between normal tissue and a tumour, is often very small
owing to their similar proton numbers. One way to visualise internal
organs in which the proton numbers are similar is by using a contrast
medium.
Fig.O4.117
• beam definers consisting of two pairs of thick lead plates are used to
ensure the beam is no wider than necessary to obtain the X-ray image
as illustrated in Fig. O4.117
• a metal filter between the X-ray tube and the patient is used to filter
out low energy X-rays which would otherwise be absorbed by tissue.

Image intensification
An intensifying screen is used in X-ray imaging to reduce the time
needed for X-rays to expose photographic film. An intensifying screen
is made up of crystals, such as calcium tungstate or zinc sulphide, which
Fig.O4.115 absorb X-ray photons. The electrons in the atoms of the crystal become
This is a substance that has a high proton number and absorbs X-rays to excited to higher states and return to their equilibrium states, emitting
a greater degree than the surrounding tissue and is thus X-ray opaque.
577
light in all directions. Double-sided photographic film is sandwiched The following effects can be observed:
between two intensifying screens as shown in Fig.O4.118. The film is  Emax increases.
in close contact with the screens, so most light photons are captured,
forming a sharp image.  min decreases.
plastic coating  the peak of the continuous spectrum moves towards higher energies.
relative
front intensifying screen intensity high voltage curve

double-sided film characteristic X-ray

rear intensifying screen
metal back low voltage curve
Fig.O4.118
Since the film is more sensitive to light than to X-ray photons, the
imaging is speeded up and the X-ray exposure time is less, reducing the
dose to the patient. 0
photon energy
Doctors often need to see moving images to aid diagnosis, perhaps to Fig. O4.120
see the heart in motion, for example, or to view the passage of a barium  the total intensity given by the area under the curve increases, and is
meal through the gut. Fluoroscopy uses a fluorescent screen instead of a ∝ V2 .
film, and this allows the X-ray image of the patient to be produced in  more characteristic line spectrum may appear.
real time. An image intensifier is used in conjunction with the
fluorescent screen shown in Fig. O4.119.
• Tube current
fluorescent electrode
screen Increasing the tube current will increase the rate of thermionic
emission from the cathode. Because there are more electrons available
to produce X-ray photons, the overall intensity increases. Fig.O4.121
demonstrates the effects observed when the tube current is increased.
CCTV
camera relative
X-ray electrons intensity
characteristic X-ray

high current curve

test object in the fluorescent

x-ray beam path photocathode viewing screen
Fig. O4.119
A continuous X-ray beam strikes a phosphor, often caesium iodide,
which then emits light. The light photons strike a photocathode,
releasing electrons, which are focused by electrodes inside a vacuum
tube. The electrons accelerate across the tube until they strike the
fluorescent screen, which provides a visible image.
The output can be recorded via a video camera. The output screen is
smaller than the input screen. This reduction, and the acceleration of the
electrons across the tube, makes an image up to 1000 times brighter
than the original. This means that much lower-intensity X-rays can be
used, reducing the dose to the patient. But even with the use of an image
intensifier, fluoroscopy gives a relatively high dose because a
continuous beam of X-rays is used. The dose is often 15 times that of a
conventional X-ray procedure.
People working with X-rays have to take care as they could accumulate
a high dose as they work:
• They should wear a film badge to check the amount of radiation they
get;
• They should wear lead aprons while the machine is turned on.
• The machine should be in an enclosed room and the controls are in a
separate room.
• Interlocks should be arranged so that nobody can walk into the X-ray
room while the machine is turned on. If that is to happen, the machine
should be turned off immediately.
X-Ray Quality and Imaging Techniques
An X-ray image is a shadow on a photographic film caused by bones or
organs that absorb X-rays more effectively than surrounding tissue
low current curve
0
photon energy
Fig.O4.121
The following effects can be observed:
 Emax remains the same as the voltage is constant.
 the spectral shape remains the same.
 the total intensity (given by the area under the spectrum) increases as
the area under the curve is proportional to I.
• Target material
The target material must have a high melting point so that it will not
melt with the large heat generated by the accelerated electrons
bombarding it.
Furthermore, the target material must have a relatively high atomic
number so that the mass, size and number of protons in the atoms
ensure a greater probability that the bombarding electrons make the
necessary collisions to produce X-rays. Common target materials
include tungsten (Z = 74) and platinum (Z = 78). Tungsten is more
widely used because of its high melting point (3370 oC).
Fig.O4.122 shows the effects observed when the atomic number is
increased. The following effects can be observed:
 Emax remains the same
 the characteristic line spectra are shifted to higher photon energies.
relative
intensity
K-line

does. Ideally, X-ray imaging should produce high-quality images with

exposure to X-rays as low as possible. As the relative intensity of the L-line
high atomic number
X-rays is increases, so too does the electromagnetic spectral range. The K-line
curve
quality of an X-ray beam is a term used to describe its penetrating
low atomic number
power. curve
There are a number of ways that the quality of an X-ray machine can be
increased.
0
• Increasing the tube voltage. Emax photon energy
• Increasing the tube current. Fig.O4.122
• Using a target material with a relatively high atomic number.  the X-ray intensity increases as the area under the curve is directly
• Using filters proportional to Z.
•
Tube voltage • Filters
When the accelerating voltage between the cathode and anode of an X- A thin sheet of material (filter) is placed between the X-ray tube and the
ray tube is increased, the frequency of the X-radiation increases. patient is used to filter out low energy X-rays which would otherwise be
Therefore, the radiation has more energy and the penetration increases. absorbed by tissue. The filter selectively absorbs more lower-energy
As the intensity per unit area increases due to the higher potential, so photons than high-energy photons. The filters need to be made of a
too does the spectral spread out. This is as shown in Fig.O4.120. metal with a high atomic number such as copper, tin or lead. Fig.O4.123

578
shows the effect on an X-ray beam of using a metal filter in the path of Thus the number of electrons reaching the target = (6.25 × 1018 e C-1)
the beam. (3.5 × 10-2 C) = 2.2 × 1017 electrons per second
relative c) E = (1.6 × 10-19 C) × (30 000 V) = 4.8 × 10-15 J
intensity
hc (6.63  1034 )(3.0  108 )
d)     0.0414 nm
curve without filter E 4.8  1015
area removed by filter 2) (a) Ultrasound scanning can be used by doctors to obtain
information about the internal structures of the human body without
curve with filter the need for surgery. Pulses of ultrasound are sent into the body from
a transmitter placed on the skin.
(i) The ultrasound used has a frequency of 4.5 MHz. State why waves
Emin Emax photon energy of this frequency are called ultrasound.
Fig.O4.123 (ii) A pulse of ultrasound enters the body and its reflection returns to the
The following effects can be observed: transmitter after a total time of 1.6 × 10–4 s. Calculate how far the
reflecting surface is below the skin. average speed of ultrasound in
• Emax does not change.
the body = 1500 m s–1
• there is a shit in Emin towards higher energies. (iii) State why the ultrasound is transmitted in pulses.
• there is a reduction in X-ray output. (b) Another way of obtaining information about the internal structures
Although the intensity is reduced, the beam is more penetrating because of the human body is by the use of X-rays.
of the removal of lower energy photons. The X-rays are said to be i) Give one property of X-rays which makes them more hazardous to
harder. use than ultrasound.
ii) State four other differences between X-rays and ultrasound.
Advantages of X-ray imaging Solution
a) i) Because they are above the audible frequency (that is, frequency
• Simple to use. greater than 20,000 Hz)
• Cheapest alternative.
ii) Distance = 1500 × ( 12 × 1.6 × 10-4 ) = 0.12 m
• Abundant X-ray machines around the world.
• Good for certain structures such as bones. iii) One pulse must return before the next is sent.
b) i) X-rays cause ionisation which may damage DNA and result to
Disadvantages of X-ray imaging genes mutation but ultrasound is non-ionising.
ii) X-rays is transverse wave, ultrasound is longitudinal wave, hence
• Poor at body-function diagnosis. X-rays can be plane polarised, and ultrasound can‟t. X rays does not
• Not good for differentiating one structure from another. need a material medium for it transmission while ultrasound need a
• Resolution not as good as others. material medium for it transmission. X ray is electromagnetic
• Sometimes enhancing materials need to be ingested. whereas ultrasound mechanical. X rays have much higher frequency
• Radiation dangerous to health because of its high ionising ability than ultrasound.
3) What are common occupational hazards associated with performing
Hard and soft X-rays medical imaging procedures?
The 'quality' of the X-rays is a technical term describing roughly how Solution
penetrating they are; 'hard quality' rays are more penetrating than 'soft' The risks include a small increase in the chance of developing cancer
rays. the table show some differences between hand and soft X-ray. later in life. In a few interventional procedures, where there may be
high radiation doses to the lens of the eye or to the skin, there are
Hard X-ray Soft X-ray risks, respectively, for developing cataracts and of injury akin to a
High voltage input Low voltage input skin burn.
High penetrating ability Low penetrating ability 4) The half-value thickness of a 30 keV X-ray photon in aluminium is
High quality image Low quality image 2.4 mm. If the initial intensity of the X-ray beam is 4.0 × 102 kW m–2.
High frequency and low High wavelength and a) What is the intensity after passing through 9.6 mm of aluminium?
wavelength low frequency b) Calculate the linear attenuation coefficient of the aluminium.
c) What is the intensity of the beam after passing through 1.5 mm of
aluminium?
Imaging Techniques of X-ray
Solution
X-rays are generated in a special tube where a beam of electrons is
a) Intensity = 161 (4.0 × 102 kW m-2) = 25 kW m-2
accelerated by high voltage, hits a rotating metal disk, and the kinetic
energy is transformed into quanta of emitted. When a control X-ray ln 2
b) x 

1
beam passes through the examining tissues, some of the X-rays are 2

absorbed, some scattered and some transmitted. The transmitted straight

ln 2
x-ray tracks are passed through while scattered tracks are absorbed by    0.29 mm1
the lead plate. The clarity lost if scattered rays reach film and darkening 2.4
 x
image is formed in random places. The lead grid allows only those rays c) I  I 0 e  4.5  105  e (2900.0015)  2.59  102 kW m2
which are not scattered to film, and the image intensity distribution 5) Fig.O4.124 shows a simplified modern X-ray tube.
represents accurately. Tissues of high density and/or high atomic
number cause more X-ray beam attenuation and are shown as lighter
grey or white on a radiograph. Less dense tissues and structures cause A
D
less attenuation of the X-ray beam, and appear darker on radiographs
than tissues of higher density. Hence, dense objects, such as bone, block
the radiation and appear white on the X-ray picture. Radiologists review
the pictures and create a report with their findings to aid in diagnosis.
C
B
Worked Examples
1) An X-ray tube has a beam current of 35 mA and it is operated at a Fig.O4.124
voltage of 30 kV. a) For each of the parts labelled A to D, state what it is and explain its
a) At what rate does the machine transform energy? purpose.
b) How many electrons reach the target each second? b) On a copy of the diagram draw and label
c) What is the maximum energy of the X-rays produced? (Assume no (i) the direction of the electron beam,
thermal energy loss). (ii) the direction of the useful X-ray beam.
d) What is the minimum wavelength of the X-rays produced? Solution
Solution a) A is glass tube which is evacuated, allows electrons to travel
a) P = (3 × 104 V) (3.5 × 10 -2 A) = 1.05 kW unimpeded
b) q = It = (3.5 × 10-2 A) (1 s) = 3.5 × 10-2 C B is rotating anode (or target). The rotation of target is to spread
1 C is the charge on 6.25 × 1018 electrons. heated area on the target. It is made of metal and emits X-rays when
hit by energetic electrons
579
 C is filament (or cathode). The heat source to release electrons from
surface of cathode by thermionic emission.
D is lead housing which prevent X-rays from escaping in unwanted
directions
b) i) path of electrons shown from filament (C) to anode (B)
ii) path of X-rays shown starting at anode (B) and emerging through
window in lead housing (D)
6) The result from a certain X-ray tube target is shown in Fig. O4.125.
X-ray
intensity
0 1.2  102  3.2  102  e32.4 x
photon energy / keV
Fig.O4.125
a) Explain the process which gives rise to spikes at certain photon
energies.
b) A film cassette, placed under a patient being X-rayed, is shown in
Fig. O4.126.
Fig.O4.126
Explain how the intensifying screens in the film cassette achieve their
purpose and state their benefit to the patient.
Solution
a) When the electrons from the cathode strikes anode, some of the
electrons in the inner-shell of the target atoms are excited. The
resultant vacancy in the inner-shell of the target atom is then filled by
electrons falling from an outer higher energy shell to an inner energy
level with the emission of fixed energy photons which formed the
spikes.
b) Some material absorbs X-ray photons and re-emits visible light
photons. The light photons expose the film in correct place due to
closeness of the screens to the film with a reduced radiation dose to
the patient.
7) Ultrasound and X-rays are waves used in hospitals to create images
of the inside of the human body. To produce the images in Fig.O4.127,
the waves must enter the human body.
Fig.O4.127
a) Describe the features of ultrasound and X-rays, and what happens to
each type of wave after it has entered the human body.
b) It would not be safe to use X-rays to produce an image of an unborn
child. Explain why.
c) Ultrasound can be used for medical treatments as well as for
imaging. Give three use of ultrasound for medical treatment.
Solution
a) X-rays are invisible electromagnetic waves, transverse in nature,
with very short wavelength and very high frequency. This very high
frequency gives X-ray very high energy wave photons (hf). The
wavelength of X-rays is of a similar to the size of the diameter of the
atoms producing them. X-rays are ionising radiation.
On the other hand, ultrasound is a longitudinal wave with frequency
above 20 kHz which is beyond a normal human upper limit of
hearing. They are non-ionising.
X-rays are absorbed by bone and are transmitted by soft tissue.
Ultrasound is partially reflected when it meets a boundary between
two different media and travel at different speeds through different
media
b) Because the X-rays are ionising and may damage rapidly growing
cells, hence, increasing chances of mutations.
c) They are used to destruction of kidney (gall) stones, repair of
damaged tissue such as alleviating bruising, repair scar damage,
ligament or tendon damage, physiotherapy and removing plaque
from teeth.
580
8) (a) When an X-ray image is obtained of certain organs, image
contrast enhancement is necessary. Explain why image contrast
enhancement is needed and describe how this might be achieved.
(b) A monochromatic X-ray beam of intensity 3.2 × 10–2 W m–2 is
incident on an aluminium sheet. Calculate the thickness of
aluminium required to reduce the intensity of the X-ray beam to 1.2
× 10–2 W m–2. (The mass attenuation coefficient of aluminium, μm =
0.012 m2 kg–1 and density of aluminium = 2700 kg m–3)
Solution
a) It is to increase the density different between the examining part and
it surrounding, hence making the image clearer. This is because the
part with high density provides good attenuation of X-rays. This may
be achieved by drinking barium sulphate salt in order to obtain
barium.
b) μ = ρ μm = 2700 × 0.012 = 32.4
 x  0.03 m
9) Diagnostic X-rays are produced using a rotating anode X-ray tube.
(a) (i) State two methods which can be used to increase the intensity of
the X-ray beam produced by the tube.
(ii) For each method of increasing intensity, state the effect on the
maximum X-ray photon energy.
(b) Before taking an X-ray photograph, the X-ray beam emerging from
the tube is passed through an aluminium filter. State and explain the
reason for filtering the X-rays.
Solution
a) i) By increasing the potential difference across the tube and by
increasing the tube current or increasing the filament temperature
(ii) Increased in pd will increase the maximum photon energy and
increased in current will not change the maximum photon energy.
b) The aluminium filter reduces the intensity of low energy photons but
hardly changes intensity of high energy photons at all. We need high
energy for the X-ray picture production. Therefore reducing low
energy photons reduces the dose received by patient without affecting
picture quality.
10) The X-ray spectrum, produced by an X-ray tube used to produce
diagnostic images has the features as shown in Fig. O4.128.
P
X-ray intensity (arbitrary units)
10
8
Q
6
0 20 40 60 80 100
Photon energy/keV
Fig.O4.128
a) Explain why the spectrum has
(i) a maximum photon energy and state the circumstances in which a
photon of this energy is produced,
(ii) two lines, P and Q.
b) i) From the graph, estimate the accelerating voltage of the tube.
ii) Calculate the frequency of the line Q.
c) On a sketch copy of the X-ray spectrum draw an intensity curve
which shows the output you would expect from the same tube when
operated at 55 kV.
d) For diagnostic purposes it is important to minimise the X-ray dose
which patients receive. State two steps taken to reduce the dose and
briefly explain how each is effective in reducing patient dose.
Solution
a) i) The maximum photon energy determined by accelerating voltage.
This corresponds to all electron kinetic energy converted to single
photon. Only one electron can contribute to production of X-ray
photon.
ii) The line spectra characteristic of the target material. These
frequencies (energies) correspond to allowed transitions of inner
electrons of target atoms which are produced by de–excitation of
excited electrons of target atoms
b) (i) From the graph,
 Emax  eV  100 keV iii) Radiographers also use gamma ray sources. X-rays are produced by
electrically powered machines. Gamma rays cause similar damage to
100 keV
V   100 kV X-rays, but the radioactive materials giving out gamma rays are
e more dangerous than X-ray machines. Explain why this is so.
ii) Interpolating from line Q to energy axis, the energy is about 67 keV Solution
or 68 keV i) May ionised tissues or causes cancer
67 keV = 67 × 103 × l.6 × l0–19 J ii) Put on special protective clothing to stop them penetrating the body.
E 67  103  1.6  10 19 or decrease the time of exposure to reduce the absorption dose.
f    1.6  1019 Hz iii) X-ray machine can be switched off when not in used whereas
h 6.06  10 34
radioactive sources produce gammas all the time. Gamma rays have
c) See Fig.O4.129
P higher frequency which gives it more energy and higher more
X-ray intensity (arbitrary units)

penetrating ability. Gamma rays come out in all directions and as a

result need more shielding than X-ray which direction specify.
Gammas are more ionising than X-ray. With gamma, there is danger
of contamination by radioactive material.
Q 15) When using an X-ray source to produce an image of part of a

patient a lead grid is sometimes placed between the patient and the
photographic film, as shown in the diagram. The channels in the grid
diverge from the X-ray source is as shown in Fig.O4.130.
 (no line)
X-ray source

0 55  100
Photon energy /keV
Fig.O4.129
d) Image intensifier screen. The low intensity dose of X-rays can be patient‟s body
channel
used because image is enhanced by conversion of X-ray photons into
light photons by fluorescent material. lead
A filters is placed between source and patient so that it can absorbed section of lead grid
soft X-rays not the patient photographic film
11) Explain the shape of a typical X-ray spectrum from an X-ray tube. Fig.O4.130
Solution (a) (i) Why is the grid made of lead?
An X-ray spectrum consists of a continuous spectrum of (ii) By drawing the paths of about 12 rays from the X-ray source to
bremsstrahlung radiation, produced by electrons being decelerated in illustrate your answer, explain how the use of the grid improves the
the target material and giving a full range of photon energies above a clarity of the X-ray image.
minimum. On this there is superimposed a line spectrum, (b) Explain why it is important to use a point source of X-rays for
corresponding to electrons in excited atoms of the target material imaging purposes.
dropping down to lower energy states. Solution
12) a) Explain why in an X-ray tube, the anode (a) (i) lead absorbs X-rays very well
(i) is rotated, (ii) See Fig.O4.131
(ii) has a bevelled edge. x-ray source
b) Define for a material,
(i) the linear attenuation coefficient, μ,
(ii) the half-value thickness. )
c) A monochromatic X-ray beam of intensity 6.0W m–2 is incident on an ray absorbed
aluminium sheet of thickness 2.0 mm. For these X-rays, the half-value by the body
thickness of aluminium is 3.2 mm. Calculate the intensity of the
transmitted beam. patient
Solution
a) i) Heat is spread over a greater sectional area. This allows more straight ray scattered ray
energetic X-rays to be produced without risk of melting the anode. to film absorbed by lead
ii) The bevelled edge gives larger target area for the electrons but a lead
smaller source area from which the X-rays are produced. This gives film
a sharper image beam of X-rays and produces a sharper image. Fig.O4.131
b) i) It is the fraction of X-rays removed per unit thickness of the Straight x-ray tracks are passed through while scattered tracks are
material absorbed by the lead. Some X-rays are also absorbed by the patient
ii) The thickness of the material which will reduce the intensity to half and clarity lost if scattered rays reach film and darkening image is
its original level for a specified energy of the X-rays formed in random places. Lead grid allows only those rays which are
ln 2 not scattered to film, and the image intensity distribution represents
c)    0.22 mm 1 accurately.
3.2
The body structure through which the radiation has passed, grid
I  6.0  e0.22  2  3.9 W m2 moved systematically to prevent it forming image on film
13) In the course of diagnosis and treatment of a child‟s broken arm, b) The point source gives a sharp image as point source produces no
several images of the arm are required. Similarly, to check the progress penumbra.
of a woman‟s pregnancy, several images of the foetus are required. In 16) Fig.O4.132 shows a fluoroscopic image intensifier.
each case, state which imaging technique would probably be used and photocathode
give three reasons for the choice. anodes fluorescent
fluorescent
Solution screen A screen B
For child‟s broken arm, X-ray imaging technique is used because X –
ray produces a sharp image with good contrast and good resolution
For foetus, ultrasound imaging technique is used. This is because
ultrasound is non-ionising and therefore safe to use on the unborn to TV
X-rays

electrons
foetus, can detects change in tissue type and so allows the camera
development to be monitored and allows real-time imaging to check
on heart development and movement.
14) Radiographers work in hospitals and are regularly exposed to X-
rays. X-rays cause damage to the human body. evacuated glass
envelope
i) State the damage that may be caused by X-rays.
Fig.O4.132
ii) Suggest and explain how people working with X-rays can be
(a) State the purpose of:
protected from damage.
(i) the fluorescent screen, A,
581
 (ii) the photocathode, b) Calculate the linear attenuation coefficient of lead for 90 keV X-ray
(iii) the anodes, photons. Half value thickness of lead for 90 keV X-ray photons =
(iv) the fluorescent screen, B. 12mm.
(b) Give one example of a medical application for which an image c) Calculate the thickness of lead needed to reduce the intensity of a
intensifier might be used. Explain why the use of an image beam of 90 keV X-ray photons to 5.0 % of the intensity incident on
intensifier is required. the lead.
Solution Solution
a) (i) It converts X rays to visible photons a) The half-value thickness is the thickness of lead needed to reduce
(ii) It converts photons to emission of electrons intensity of the X-rays of a specific energy by half
(iii) They increases the kinetic energy of electrons travelling from ln 2 ln 2
cathode to anode and they also focus the rays of electrons to produce a b)     58 m1
t 1 0.012
faithful image. 2

(iv) It converts electron energy into light photons c) 0.05  e57.8 x  x  0.052 m
b) It might be used for a dynamic process - such as fluid flow. It cuts 21) Fig.O4.135 shows the design of an X-ray image intensifier.
the radiation dose whilst still providing good image. B
A C
17) Study Fig.O4.133 carefully.
Intensity
D

X- electrons
rays

Fig.O4.133
a) An X-ray tube operates with a pd across the tube of 80 kV. The
figure above shows the X-ray spectrum emitted. Explain why the
spectrum has spikes at specific photon energies.
b) The pd across the tube is increased to 90 kV. Sketch on the figure
above the X-ray spectrum produced at this new pd.
c) At the working pd of 80 kV, the anode current was 120 mA. The X-
ray tube has an efficiency of 0.70 %. Calculate the rate of production
of heat at the anode.
Solution
a) The spikes are specific to the anode target element. The energy level
transitions of electrons within the atoms are fixed. That is why they
are called characteristic spikes.
b) See Fig.O4.134
Intensity (arbitrary units)
Fig.O4.135
The main components are labelled A to D. Name each component and
state its purpose in the process of image intensification.
Solution
- A is the scintillator crystal (fluorescent screen) to convert X-ray
photons into light
- B is the photocathode which takes light energy and releases
electrons. The number of electrons released proportional to X-ray
intensity
- C is the anodes which accelerates the electrons and focus the
electrons to form an image on the screen
- D is the fluorescent screen and converts electron energy into light
photons
22) Fig.O4.136 shows the X-ray spectrum emitted from an X-ray tube
with a potential difference of 80 kV supplied to it.

Bremsstrahlung curve


0
80 90 
photons energy/keV Fig.O4.136
a) i) Sketch on a copy of the figure, the expected X-ray spectrum when
Fig.O4.134 a potential difference of 60 kV is supplied to the tube.
c) Percentage into heat = (100 – 0.70) = 99.3 ii) Explain why the spectrum has sharp peaks at specific photon
Rate of heat produced = 0.993 × 80 × 103 × 120 × 10–3 = 9.53 kW energies.
18) An X-ray tube is operated at a peak voltage of 100 kV and the beam b) i) Calculate the speed of the electrons reaching the anode when the
current is 40 mA. tube operates at 80kV. Ignore relativistic effects.
a) What is the power of the machine? ii) When the tube is operating at 80 kV its efficiency is 0.60%. The
b) How many electrons reach the machine every second? anode current in the tube is 140mA. Calculate the rate of production
c) What is the maximum energy of each photon? What is its of internal energy in the anode, giving your answer to a suitable
wavelength? number of significant figures.
Solution c) Explain the benefits of using a contrast medium when using X-rays
a) P  VI  100  103  0.04  4000 W for medical diagnoses.
0.04 17 1 Solution
b) n =   2.5  10 s
1.6  1019 a) i) Spectrum from 0 - 60 kV below curve with spikes in the same
place
c) E = eV  100  103  1.6  1019  1.6  1014 J
ii) Electrons striking the target (anode) eject inner electrons of target
hc 6.63  1034  3  108
   1.24  1011 m material and outer electrons fall to fill the vacancies. Change of
E 1.6  1014 energy levels results in photon/radiation being emitted.
19) Despite the many advantages of ultrasound over x-ray in
2eV 2  e  80  103
radiography, state why ultrasound cannot totally replaced x-ray. b) i) v    1.68  108 m s 1
Solution m m
Ultrasound cannot penetrate bone, ultrasound picture has low contrast ii) P  VI  80  10  140  103  11, 200 W  1.12  104 W
3

and low resolution compared to x-ray and MR. Ultrasound cannot be
used to scan air-filled organ such as the lungs, highly reflective
boundaries between bone/tissue and air/ tissue prevent effective
imaging. X-ray is simple to use, cheaper and abundant X-ray
machines as compared to ultrasound.
20) a) Explain what is meant by the half-value thickness of lead for X-
rays.
582
c) Attenuation of X-rays, distinguishes tissues, clearer image seen and
weaker X-rays may be used.
23) An X-ray machine is accelerating electrons through a p.d. of 200
kV. The current is 25 mA. The target is a block of heavy metal mass
1.0 kg, and specific heat capacity 300 J kg K-1 and melting point 3000
K. The machine is at 300 K when it is turned on. 10 s after the
machine has been turned on the cooling fails. The machine continues
 to run for 3 minutes to sterilise some instruments and the operator has • Photoelectric effect: Photon ejects an electron from the atom.
gone off somewhere. What do you think the operator will come back • Compton scattering: Photon emerges with less energy and an electron
to? Explain your answer. escapes from the atom.
Solution • Pair-production: Photon produces an electron-positron pair.
P = 200 000 V × 0.025 A = 5000 W • Scattering: Photon is scattered by an electron.
4950 J s 1 In all this, the intensity decreases in the original direction because there
   16.5 K s1 are fewer photons.
300 J kg 1K 1  1 kg
29) Why should an observer not view the viewing screen of X-rays
  3000 K  300 K  2700 K directly?
2700 K Solution
Time taken to melting point =  164 s
16.5 K s 1 The photomultiplier tube is in the X-ray would expose the viewer to a
The anode will have melted. high dose of X-rays. X-rays are ionizing radiation and not good for the
24) An X-ray machine emits X-rays of minimum wavelength 0.030 eyes.
nm. 30) Contrast mediums are often used to improve image quality for X-
i) Sketch a graph of intensity against wavelength for the resulting X- rays. State briefly how contrast mediums help to improve the image.
ray spectrum. Label the main features of the spectrum. Solution
ii) Calculate the accelerating potential difference used to produce a It provides greater attenuation of X-rays than body tissue as it has
spectrum with a minimum wavelength of 0.030 nm. higher absorption coefficient. It goes to particular area of interest and
iii) When diagnosing and treating a child‟s broken arm, images of the highlights a particular area.
arm are needed. What two properties of X-rays make them suitable
for this imaging? COMPUTED TOMOGRAPHY (CT)
iv) X-ray imaging is not suitable for revealing brain tumours. Which Computed tomography (CT) of the body uses special x-ray equipment
imaging technique should be used? Give reasons for your choice. to help detect a variety of diseases and conditions. CT scanning is fast,
Solution painless, non-invasive and accurate. In emergency cases, it can reveal
i) See Fig.O4.134 internal injuries and bleeding quickly enough to help save lives. It also
intensity
called computed axial tomography (CAT) imaging.
line spectrum  Standard X-ray imaging techniques record a longitudinal image on a
continuous spectrum  photographic plate producing 30 shades of grey. Computed tomography
(CT) imaging uses X-rays, scintillation detectors and computer
technology to build up an axial scan of a section of an organ. The tube
voltages are about 130 kV, and the exposure times are greater than that
of standard radiography.
0.030  wavelength / nm An X-ray image taken using photographic film cannot be processed to
make it sharper and clearer like a digital image can be, images of
Fig.O4.137
34
different organs in the path of the beam are superimposed on each other
6.63  10  3.0  108 and it can‟t provide information about the depth of an organ in the body.
ii) V   41 250 V
1.6  1019  0.030  10 9 The CT scanner provides a digital image which can be processed and it
iii) X-ray is able to penetrate muscle but stopped by denser materials to can give an image of any cross-section through the body. In addition,
expose the photographic film. images of parallel planes in the body can be used to reconstruct a 3-D
iv) MRI scan because of it high quality images of soft tissue, it contrast image of an organ.
can be controlled and X-rays are absorbed by bone of the skull while Tomography means the study of body section radiography. It covers
MRI is not absorbed by skull. any technique that gives an image of any cross-section of the body.
25) A typical intensity spectrum for the output of an X-ray tube using a Computed tomography is any such technique that uses a computer to
tungsten target has both background spectrum and the line spectrum. produce the image. CT scanning techniques are used with other forms
a) Explain clearly how each of the two spectra is produced. of radiation such as positrons as well as with X-rays.
b) If the X-ray tube is operated at an accelerating pd of 60 kV calculate
the minimum wavelength of an X-ray photon emitted from the tube. CT Scanning of the Body
Solution Computed tomography, more commonly known as a CT or CAT scan,
a) Line spectrum is produced when inner electrons of target element is a diagnostic medical test that, like traditional x-rays, produces
are knocked out and electrons from higher energy levels fall to take multiple images or pictures of the inside of the body. The cross-
their place. sectional images generated during a CT scan can be reformatted in
Background spectrum is produced when there is rapid deceleration of multiple planes, and can even generate three-dimensional images. These
electrons on collision with target element. images can be viewed on a computer monitor, printed on film or
6.63  1034  3.0  108 transferred to a CD or DVD. CT images of internal organs, bones, soft
b)   19
 2.07  1011 m
1.6  10  60  10 3 tissue and blood vessels provide greater detail than traditional x-rays,
26) How can contrast be enhanced in an X-ray image where there are particularly of soft tissues and blood vessels. Using specialized
tissues of similar proton number? equipment and expertise to create and interpret CT scans of the body,
Solution radiologists can more easily diagnose problems such as cancer,
X-ray contrast can be enhanced by using a contrast medium of higher cardiovascular disease, infectious disease, appendicitis, trauma and
proton number than surrounding tissue and coating the tissue of musculoskeletal disorders.
interest with it.
27) Describe the use of a contrast medium, such as barium, in the Computed Tomography Imaging Technique
imaging of internal body structures. A CT scanner consists of an X-ray tube and a ring of thousands of small
Solution solid-state detectors called a gantry linked to a computer. The patient
X-rays are detected when a dense object highly attenuation the X-ray lies stationary on a bed which is suitably positioned along the axis of
radiation and appear white on the X-ray picture. This dense object has the ring according to the single scan image to be obtained. With the bed
high atomic number. Certain parts of the body are difficult to image in position, the X-ray tube automatically moves round the inside of the
against the background of other body parts. In order to improve the ring, turning as it moves so the X-ray beam is always directed at the
contrast of the image, barium containing meal are given before an X- centre of the ring. Fig.O4.140 shows CT scanner with the X-ray source
ray are taken. This is barium has a large attenuation coefficient and detectors shown in three different positions.
because of its high atomic number. The barium can be introduced x-ray detector patient on couch
through the mouth or the rectum for the imaging of the alimentary
canal or the appendix. The targetted part absorbed more barium than
it surrounding. The image stands out as bright white because barium
is a good absorber of X-rays.
28) A patient is having an X-ray scan. The X-rays interact with the
atoms in the patient. Name and describe the three methods by which
X-rays interact with matter. x-ray beam x-ray source
Solution Fig.O4.140
583
The detector signals are simultaneously recorded by the computer each This gives a detected grid as shown, and this is added to the memory
time the X-ray tube moves round the ring through a fraction of a degree grid.
until the tube has moved through 180°. In this way, the computer Memory
array
collects sufficient data to display a cross-sectional image of the patient.
A schematic diagram of one section is shown Fig.O4.141. 0 0
Add to 2D
0 0 memory Detector voxel array
A fan beam of around 100 X-ray pulses is produced as the X-ray tube plus
and the photomultiplier detectors around the patient make a 3600 5 5 5 4 1
Step 1 X-ray
rotation. A cross-section or slice of an organ from 1 mm to 10 mm in 9 9 9 2 7
thickness is obtained with each rotation. The slice thickness is 5 5 =
X-ray
controlled by the lead collimators. 9 9
banana-shaped detector plus
x-ray tube mounted on gantry 4 1
made up of many small Step 2 4 3
x-ray beam detectors 2 7
9 8 3 7 4
= 3
12 16 7
X-ray
computer plus
lead collimators Step 3
6 8 4 1
15 16 = 6 8 2 7
patient 18 24 6 8
monitor
plus
X-ray
Fig.O4.141 Step 4
11 1
About 1000 profiles or pictures are obtained in each rotation. A series 4 1
2 11
of slices can be made to produce a 3-dimensional picture of an entire 26 17 = 2 7
organ. The time required for the complete scan of an entire organ is 20 35 1
11
normally from 3-5 seconds. However, short scanning times of 500 ms 2
Step 5 Background
can be used when the anatomical region being investigated is affected
by the patient‟s motion and breathing. Deduct 14 14 12 3 ÷3 4 1
= =
The detectors send the information to a series of computers and a host 14 14 6 21 2 7
computer oversees the entire operation. The plane of the tomographic
image is divided into small pixel areas, each of which can be given a Fig O4.143
grey shade value from 1 (black) to 256 (white). The thickness of each Steps 3 and 4
slice is simultaneously built into a volume pixel called a voxel. The The beam is rotated twice more through 45° and each time, the detected
image is produced on a computer monitor, and this image can be values are added to the memory grid as shown.
manipulated and reconstructed to get rid of interference by subtracting
the background. The required well-contrasted image of the organ being Step 5
investigated is then obtained. Now each voxel in the array has been exposed to X-rays from four
CAT scans provide detailed cross-sectional images for nearly every part different directions. How can we extract the original values from the
of the body including the brain and vessels, the heart and vessels, the final memory grid? Note that, in each step, the total density detected
spine, abdominal organs such as the liver and kidneys. had a value of 14 (5 + 9 in Step 1, 4 + 3 + 7 in Step 2, and so on). We
subtract this background value from each square in the memory grid,
Building up CAT Images and then divide the remainder by three. The final values in the memory
grid are the same as in the original 2D array.
As the X-ray tube is rotated around the body, hundreds of pieces of Our 2D array is an example in two dimensions. In three dimensions, we
information are gathered and an image is built up. As shown in Fig would need to consider a 2 × 2 × 2 array of cubes rather than squares.
O4.142, we imagine the body as being divided up into a large number This is known as an 8-voxel cube. A real object would be made up of a
of tiny cubes called voxels. (This is the same as dividing a two- very large number of tiny voxels in three dimensions, requiring very
dimensional picture into a 2D array of pixels, but a three-dimensional powerful computers to analyse all the data collected. Hence, the result
body must be divided into a 3D array of voxels). That is, a voxel is a must be divided by three to allow for the duplication of the views of the
unit of graphic information that defines a point in three-dimensional section.
space.
X-ray victim For a well-defined image in a CT scan, we need the voxels to be small.
tube
Two things are needed to achieve this:
 The X-ray beam must be well collimated so that it consists of parallel
rays – the rays must not spread outwards.
slice through the body  The detector must consist of a regular array of tiny detecting elements
showing voxels – the smaller each individual detector is, the better will be the
beam resolution in the final image.
The pattern of pixels for the section now emerges. In practice, the image
Fig.O4.142 of each section is built up from many small pixels, each viewed from
To understand how the image is constructed from the data, we will many different angles. The collection of the data and its construction
simplify the procedure by considering a section made up of four voxels into a display on a screen requires a powerful computer and
and imagine exposing this 2D grid to a beam of X-rays from four complicated programs. In fact, the reconstruction of each pixel intensity
different directions. Different parts of the body have different value requires more than one million computations. The contrast and
„densities‟; that is, some are stronger absorbers of X-rays. We will brightness of the image of the section as viewed on the TV screen can
represent this by labelling our four voxels with densities 4, 1, 2 and 7, be varied to achieve optimum results.
as shown in Fig O4.143. This diagram shows how the detectors read
different values when the array is exposed to X-rays from different
angles, and how we can then work back to the original densities.

Step 1
The beam passes through the array from the side. The top part of the
beam has passed through voxels with values 4 and 1, which makes 5.
The value for the bottom part is 2+ 7 = 9. This is recorded in a 2D
memory grid as 5, 5 in the top row and 9, 9 below.

Step 2
The beam is rotated through 45° in an anticlockwise direction, so that it
passes through the array diagonally. The top of the beam passes though
just one voxel, of value 4. The central part passes through two voxels
giving 1 + 2 = 3. The lower part passes through one voxel of value 7. Fig.O4.144
584
 In practice, the X-ray beam passes through a number of different
structures and tissues as it travels through the body. The intensity
recorded by the detector depends on the thickness and the value of
linear attenuation coefficient (μ) of each different material. The image is
reconstructed by analysing the intensity measured in many different
directions as shown in Fig.O4.144.
Pregnant Women
Pregnant women are advised not to have CT scans as there is a risk the
ionising radiation may cause some damage to the DNA of the unborn
child.
Advantages of computed tomography scans
• Good for investigating critical bone fractures and calcification of
organs, will also give good image of the brain and abdominal organs
• Better resolution compared to ultrasound and X-ray radiography.
• Gives full cross-sectional image
• It is non-invasive
• .Good for tumours and other lesions.
• Good for stroke detection.
Disadvantages of computed tomography scans
• Poor at organ-function diagnosis
• Often requires patients to hold their breath which some may find hard to
do.
• More expensive than a conventional X-ray picture
• Limited contrast between tissues of similar density: images of the brain
can be distorted by nearby bone.
• Radiation not good for the health as they are ionised.
Worked Examples
1) a) In an X-ray tube, the hardness of an X-ray beam may be
controlled.
i) State what is meant by the hardness of the beam.
ii) State how the hardness of the beam may be decreased.
b) State two advantage and two disadvantage of producing a CT scan
image of a person rather than a standard X-ray image.
Solution
a) i) It is the penetrating ability of the beam.
ii) By decrease the accelerating voltage or by decrease voltage
between cathode and anode
b) Advantages: image gives high depth, image is three dimensional and
the final image can be viewed from any angle.
Disadvantages: greater exposure time which lead to more risk to
health, more expensive and the person under investigation must
remain stationary.
2) a) In an X-ray tube, electrons are accelerated from rest through a pd
of 72.4 kV before they hit the target anode.
i) Calculate the kinetic energy of an electron as it reaches the anode.
Give your answer to an appropriate number of significant figures.
ii) Assuming that the electron gives up all this energy to form an X-ray
photon, calculate the wavelength of the photon.
b) X-rays are used in a CT scanner. Describe briefly how a CT scanner
produces an image.
Solution
a) i) E  1.60  1019  72.5  103  1.16  1014 J
6.63  1034  3.00  108
ii)    1.71  1011 m
1.16  1014
b) A highly collimated, monochromatic narrow fan-shaped beam X-ray
beam is rotated in circular path around patient on a ring. The
transmitted intensity from a single blast of X-rays registered on
detectors positioned on the ring opposite the X-ray generators in an
arc long enough to receive the fan of X-rays. The transmitter and
detectors are then rotated so that the next section can be scanned.
This is repeated while the body slowly moves on a motorised
platform. In this way a spiral scan pattern is obtained. Detector
output is fed into a computer which over time produces a three
dimensional images that can be analysed.
3) Another method for detecting breast cancer is thermography
screening. Thermography is a much safer way of detecting breast
cancer than using X-rays. Explain why doctors prefer to use X-rays
rather than thermography, even though thermography is safer.
Solution
• X-ray images are clearer and therefore, less subjective.
• X-ray images more familiar and hence, easier to interpret accurately.
• CAT scans are too dangerous as very high levels of radiation is used
• CAT scans are far more expensive and hence, money could be spent
elsewhere
585
• CAT scans take too long and therefore many patients could be X-
rayed in the same time.
• CAT scans less available and would have to wait too long for
appointment
4) Explain how a computed axial tomography (CAT) scan is produced.
Illustrate your answer with a sketch diagram.
Solution
X-ray tube
ring of detectors
patient „voxels‟
table
rotation
X-rays
Fig.O4.145
This method of imaging produces images of a cross-section of the
body using fine X-ray beam. A highly collimated, monochromatic X-
ray beam is rotated about the object being scanned, and the
transmitted intensity is registered by detectors (computer) directly
opposite to the source. The X-ray source and the detectors are housed
in the scanner gantry and the patent lies on a couch in the void at the
centre of the gantry. The detected intensities are fed into a computer
which analyses the results and constructs a picture of the cross-
section. The whole scan is repeated after rotating the X-ray generator
for each cross-section.
Several cross-sections are scanned and this allows the area under
investigation to be seen as you move through it. Digital analysis and
combination with the other received pictures form a 3-D image. The
data is computerised and the images can be manipulated to remove
details and/or concentrate on specific organs.
5) Why does the beam used in a CT scanner need to be monoenergetic?
Solution
This is because the computed image depends on the calculated
attenuation. This would vary for different wavelength X-rays and so
confuse the processing.
6) a) i) Describe how ultrasound scanning is used to obtain diagnostic
information about internal structures of a body. In your description
include the differences between an A-scan and a B-scan.
ii) What is meant by acoustic impedance matching? Explain why a gel
is used to produce an effective ultrasound image.
iii) Suggest why it is desirable to have ultrasound of short wavelength
for a scan.
b) i) Describe the use of image intensifiers and contrast media when X-
rays are used to produce images of internal body structures.
ii) A student suggests an image intensifier uses the photoelectric effect.
Explain why this suggestion is incorrect.
iii) Explain how the production of a CAT scan image differs from that
of a simple X-ray image.
iv) Describe the advantages of a CAT scan compared to an X-ray
image.
Solution
a) i) Pulses of ultrasound signal are sent into the body and are reflected
at boundary of tissue. The delay time is used to determine depth or
thickness of the internal organ. The fraction of reflected signal is
used to identify the tissue.
A-scan uses one ultrasound sensor to produced 2-D image used
depth finding, whereas B-scan uses a number of sensors in different
positions to build up a 2-D or 3-D image.
ii) The acoustic impedances of the media are identical. The gel ensures
maximum transmission of ultrasound into the body.
iii) Small wavelength means finer detail can be seen (that is, greater
resolution).
b) i) Intensifier used as X-ray would pass through the film, converting
X-ray photon to many visible light photons which are absorbed by
film. Intensifying screens are used to reduce the time needed for X-
rays to expose photographic film, and so reduce the X-ray dose.
Lower exposure X-rays can be enhanced by using a contrast medium
of higher proton number than surrounding tissue and coating the
tissue of interest with it. To achieve this, a contrast medium such as
barium sulphate with similar proton number is ingested into the body
to enable soft tissues to be shapely visualised on an X-ray image.
ii) X-rays produce visible light whereas in photoelectric effect electrons
are emitted.
iii) Simple X-ray is one directional and produces a single image. CT
images are taken at different angles by a rotating X-ray tube and fed
 into a computer for processing and construction of an image from
many slices.
iv) X-ray image is 2D whereas CT scan produces 3D image, greater
detail of soft tissues can be seen with CT scan and images formed by
CT can be rotated.
7) a) Suggest why a patient may be asked to hold his or her breath
during a CT scan.
b) A patient with an injury to the skull, perhaps as a result of a road
accident, is likely to undergo a CT scan. Explain why a CT scan is
preferable to a conventional X-ray in a case like this.
Solution
a) Breathing causes movement of the body so that organs or bones of
interest may move in the X-ray beam as the image is processed.
b) The skull has bone all round. In a conventional X-ray, the beam must
pass through both sides of the skull and this makes it difficult to see
11) Full-body CT scans produce detailed three-dimensional information
the inner tissue. In a CAT scan, the inner tissue shows up more
clearly and any damage to the skull bones can be pinpointed
accurately.
8) Fig.O4.146 shows an MRI of the human upper arm, an X-ray of a
human right hand and a CAT scan of the human pelvis (hip bone) as
seen in cross-section from below.
Fig.O4.146
a)Identify and explain two advantages of MRI scans over CAT scans.
b) A patient is brought into a hospital out-patients ward complaining of a
severe headache. He explains that he hit his head while playing
football. The doctor thinks that the patient may be suffering from a
fractured skull. Explain why the doctor would order an X-ray to
confirm the diagnosis of a fractured skull.
c) The patient, now diagnosed with a fractured skull, complains of other
symptoms that may indicate that he is suffering from brain damage.
Suggest one additional scan which may be required to confirm this
diagnosis. Justify.
Solution
a) An MRI is less in invasive than a CAT scan. As due to the use of X-
ray, CAT scans can cause cancer especially if performed to much as
X-rays subject the patient to ionised radiation, while MRI use
magnetic resonance of the body‟s nuclei and can therefore be
performed safely and often as needed.
The MRI clearly shows the muscle as well as the bone at very high
accuracy and tears in the muscles/bone cracks can be clearly seen.
CAT however does not show such detail and may not detect small
cracks in bones/muscle tears as MRI can.
b) Because the X-ray will show the structure of the skull and most
likely detect any breakages. X-rays are sufficient to detect such
fractures as the skull is a large bone and will clearly show up on the
X-ray. Additionally, a skull fracture may be very serious and
required immediate attention. An X-ray takes only five minutes,
sufficient for quick result for the doctor act upon and hence,
commences treatment as required.
c) An MRI should additionally be carried out on his head. MRI scan
gives a more accurate picture of his brain which is checked by the
physician for abnormalities. The MRI would show the structure of
the brain as well as any slight abnormalities, tears or damages within
13) Outline the principles of CT scanning.
it to a high resolution. Abnormalities within the brain, if present,
could then confirm this diagnosis.
9) You have the choice of the following forms of medical imaging
techniques: X-ray, ultrasound A-scan, ultrasound B-scan, MRI scan
and CT scan. Which of the above would be the most suitable to image
the following? Justify your choice.
i) The development of an unborn baby.
ii) A lung tumour in a patient who wears a metallic pacemaker.
iii) A brain tumour in an adult patient.
Solution
i) Ultrasound B-scan because it can used to image moving pictures.
ii) CT scan because it can distinguishes soft tissue clearly
iii) MRI scan as it gives high quality images of soft tissue.
10) Both X-ray machines and CT scanners are used to produce images of
the body. Fig.O4.147 shows an X-ray photograph of a broken leg.
586
Fig.O4.147
a) Before switching on the X-ray machine, the radiographer goes
behind a screen. Explain why the radiographer does this.
b) Explain the advantage of a CT scan compared to an X-ray.
Solution
a) X-rays are ionising radiations and hence, may damage cells if
allowed into the body. As the radiographer goes behind a screen, he
or she is been shielded from any stray X-rays absorption from the
screen. This reduces the radiation dose to the radiographer.
b) A CT scan gives a 3-D image. Hence, the image can be observed
from different directions.
about a patient and can identify cancers at an early stage in their
development.
a) Describe how a CT scan image is produced, referring to the physics
principles involved.
b) State and explain two reasons why full-body CT scans are not
offered for regular checking of healthy patients.
Solution
a) The patient is hold still on table while lying flat as motion will cause
blurring of the images and degrade the quality of the examination the
same way that it affects photographs. An X-ray generator and
detectors rotates around patient. The signal passes through the same
section of the body from different directions producing a thin slice.
Most of the X-ray radiation is absorbed by dense material such as
bone of high impedance. Attenuation is by the photoelectric effect and
the using a contrast medium. It better than a simple X-ray at
differentiating other organs and patient is moved a small distance and
the process is repeated in a continue spiral. A computer analyses the
data, identifies the position of organ and forms a 3-D image
b) Patients are exposed to ionising radiation. Ionising radiation could
cause cancer and or damage cells. It‟s expensive and time
consuming as it uses valuable resources.
12) a) Outline the advantages of MRI over CAT scan.
b) Explain why patients are often asked to hold your breath during
CAT scanning.
Solution
a) A CAT scan uses X-rays which causes ionization while MRI uses a
magnetic field which has no known side effects related to radiation
exposure.
MRI gives higher detail in soft tissues than CAT.
MRI has the ability to change the contrast of the images. Small
changes in radio waves and magnetic fields can completely change
the contrast of the image. Different contrast settings will highlight
different types of tissue.
MRI has the ability to change the imaging plane without moving the
patient. Most MRI machines can produce images in any plane.
Contrast agents used in MRI are not made of iodine. There are fewer
documented cases of reactions to MRI contrast and it is considered
to be safer than X-ray dyes.
For purposes of tumor detection and identification, MRI is generally
superior. However, CT usually is more widely available, faster,
much less expensive, and may be less likely to require the person to
be sedated or anesthetized.
CT may be enhanced by use of contrast agents containing elements
of a higher atomic number (iodine, barium) than the surrounding
flesh. Contrast agents for MRI are those which have paramagnetic
properties. One example is gadolinium. Iodine use may be associated
with allergic reactions
b) Any motion, whether breathing or body movements, can lead to
artefacts on the images. Which result to loss of image quality.
Solution
Computed tomography (CT) imaging uses X-rays, scintillation
detectors and computer technology to build up an axial scan of a
section of an organ. X-ray images are taken from different angles of
one section of the patient‟s body. All the images of same plane of that
section combined to give the image of the section. This is done with
successive sections and the images of the different section combined
formed using a computer. The resulting image formed is three
dimensional that can be rotated and viewed from different angles.
14) Images formed using X-rays or ultrasound techniques are used by
doctors to examine organs in the body. Describe two ways in which
the waves used in these techniques differ. Go on to state two
advantages and two disadvantages of using ultrasound when
compared with X-rays for clinical diagnosis.
 Solution a) Background reading = 19
Differences:- 25  19 6
• X-rays are electromagnetic while ultrasound are mechanical waves b) A    2 (divided by 3 since 3-D)
3 3
• ultrasound frequencies are much lower than X-ray frequencies 34  19 15
• X-rays are more penetrating than ultrasound B  5
• X-rays are transverse waves whereas ultrasound are longitudinal 3 3
waves 46  19 27
C  9
Advantages of ultrasound:- 3 3
• less dangerous to patient and operator 28  19 9
• can yield information about fluid flow rate (blood) or organ D  3
3 3
movement c) i) Either A + D = 2 + 3 = 5 or
• no need for e.g. barium meals for contrast B + C = 9 + 5 = 14
• better contrast between soft tissue types ii) Three numbers and „inside‟ number is 8 (B +D) and three numbers
• real time display of movement and „outside‟ numbers are 2 and 9
Disadvantages of ultrasound:- 19) a) X-ray tubes use a hot wire to produce electrons. What happens
• less penetrating to the X-ray output if the current to the hot wire increases? Explain
• reflect from surface so needs gels your answer.
• contrast (resolution) is not as good as with X-rays b) An X-ray tube accelerates electrons through a potential difference of
15) a) Explain the principles behind the use of X-rays for imaging 80 kV, giving a beam current of 0.45 A. Calculate:
internal body structures. i) the number of electrons reaching the target every second;
b) Describe how the image produced during CT scanning differs from ii) the maximum photon energy of the X-rays produced in J.
that produced by X-ray imaging. iii) Computerised axial tomography (CT scans) use a rotating X-ray
Solution tube to build up high contrast images of slices through the body.
a) X-ray beam is directed through body onto detector plate. The Explain why CT scans are not offered for regular checking of healthy
different body tissues attenuate beam by different amounts giving patients.
„shadow‟ image of structures. The lead grid allows only those rays Solution
which are not scattered to film, and the image intensity distribution a) More electrons are emitted and as such higher intensity output
represents accurately. 0.45
b) X-ray image is two-dimensional. CT scan takes many images of a b) i) n  19
 2.81  1018 electrons s 1
1.6  10
slice at different angles to build up an image of a slice through the
body. These series of images of slices is made so that a three- ii) E  1.6  1019  80  103  1.28  1014 J
dimensional image that can be rotated is built up. iii) CT scans has high X-ray dose and high exposure time.
16) Outline four advantages of using an MR scanner to scan a patient‟s 20) a) i) Describe briefly how X-rays are produced in an X-ray tube.
brain as compared with a CT scanner. ii) Describe the operation of a computerised axial tomography (CAT)
Solution scanner. State one of the advantages of a CAT scan image over a
a) MR non-ionising radiation while ionising radiation in CT more conventional X-ray image.
danger to living cells b) i) A magnetic resonance imaging (MRI) scanner is a valuable item of
MR can give multi-plane images from same scan whereas CT needs diagnostic equipment found in most modern hospitals. It is capable of
new scan for each image generating a three-dimensional image of the patient.
MR gives better resolution between tissue types, better resolution The following terms are used in the description of MRI scanners.
picture than CT • Larmor frequency of the protons
MR gives real time image but CT scan needs to rotate to produce • resonance of the protons
final image. • relaxation times of the protons
17) Both MRI and CT scans can be used in diagnostic medicine. Describe the operation of the MRI scanner with particular reference to
i) To which part of the electromagnet spectrum does each belong? these terms.
ii) Give tow advantages and two disadvantages (other than cost) of ii) An MRI scan can take a long time and it does produce an unpleasant
using MRI scans over CT scans. loud noise. State one other disadvantage and one advantage of an
Solution MRI scan.
i) CT is found in the X-ray region and MRI in the radio wave region. Solution
ii) Advantages: - better soft tissue contrast and no exposure to ionising a) i) Fast-moving electrons hit an anode and the kinetic energy of the
radiation. electrons is transferred into photons of X-rays.
Disadvantage: - Not use in patients with a metallic pacemaker  and ii) X-ray beam passes through the patient at different angles as X-ray
not good for imaging bone. tube rotates around the patient. A narrow, fan-shaped,
18) A simple model of one section of a CT scan is shown in monoenergetic X-ray beam passes through the body at different
Fig.O4.148. orientations, and an array of detectors which also rotates records the
A B intensity transmitted through the patient at each position. The results
D C are digitised and the images of „slices‟ through the patient in one
Fig.O4.148 plane are generated by computer and combine to form a 3-D image.
The model consists of four voxels with pixel numbers A, B, C and D. The image in CAT is three dimensional with better contrast between
In this model, the voxels are viewed in turn along four different different soft tissues
directions D1, D2, D3 and D4 as shown in Fig.O4.149. b) i) Protons spin and, because they are charged, they generate their
D3 own magnetic field and act like tiny magnets. When an external
D2 D4 strong magnetic field is applied, the protons align themselves with
3
3
3 the field, so that their spin axes precess about the direction of the
D1 A B applied field. The frequency of the precession is called the Larmor
D C frequency, and this motion produces a very small electromagnetic
Fig.O4.149 signal at the Larmor frequency. A pulse of radio-frequency (RF)
The pixel readings in each of the four directions are noted. The total energy at the Larmor frequency is then directed at the patient. The
pixel reading for any one direction is 19. The pixel readings for all protons absorb this energy and resonance occurs, causing them to
of the directions are summed to give the pattern of readings shown become excited to higher energy states.
in Fig.O4.150. When the radio pulse is stopped, the protons de-excite, return to their
25 34 original states and emit RF signals. The strength of the RF signal
28 46 depends on the proton density in different regions of the body, which
Fig.O4.150 is itself linked to the amount of water in the tissue.
a) State the background reading in this model. The relaxation time is the average time taken for the protons to
b) Determine each of the pixel readings. return back to their low energy state. This relaxation time depends
c) Use your answers in (b) to determine the pixel readings along the on the tissues.
directions D3 and D4
Solution
587
 The RF signals from tissues are picked up by receiver coils and are
used by a computer to reconstruct an image of a section through the
patient‟s body.
ii) Disadvantage: Patient with metallic objects cannot be scanned;
patient has to remain still for a long time, difficult for patient
suffering from claustrophobia.
Advantage: Non-ionising, non-invasive, better contrast, between soft
tissues.
21) a) Describe the main principles of how a CT scan image is
produced and compare this with the formation of an X-ray shadow
image.
b) A CT image is sometimes superimposed on an image from an MRI
scan. Explain the advantages of using this dual approach.
Solution
a) The patient lies in a vertical ring of X-ray detectors and the X-ray
tube rotates around the ring. The body part is split up into tiny cubes
called voxels. A voxel is a unit of graphic information that defines a
point in three-dimensional space. Slices through the body are
viewed. The computer combines slices to build up a three-
dimensional image of the patient. Images of „slices‟ through the
patient are shown on the computer screen.
A traditional X-ray picture is formed by absorption. Denser materials
absorb more than less dense materials, producing a shadow image.
b) CAT gives a better contrast of soft tissues. MRI gives better image
of dense tissue such as bone.
22) a) The human eye is able to accommodate. Explain what is meant
by accommodation.
b) The range of distinct vision of an elderly person is 1.2 m to 4.0 m.
i) State the range of distinct vision for a person with normal vision.
ii) In order to correct the elderly person‟s vision, two pairs of
spectacles are required. Calculate the power of the lenses in each
pair of spectacles.
iii) Suggest how the inconvenience of changing spectacles for distant
vision and then close-up vision may be overcome.
Solution
a) This is the ability of the eye to form focused images of objects at
different distances from the eye.
b)i) From 25 cm to infinity
1 1 1 1 1
ii) P1       3.17 D (near)
f u v 0.25 1.2
1 1 1 1 1 the functions and metabolic processes of the body rather than providing
P2       0.25 D (far)
f u v  4.0
iii) By the use of a bifocal lens.
NUCLEAR MEDICATOIN
Nuclear medicine is the branch of medicine that uses radioisotopes for
research diagnosis and treatment of disease. Sometimes, after its
emission of an alpha, beta or positron particle, the nucleus is still in an
excited state, called a metastable state. In order to get to a lower energy
state it emits a quantum of energy in the form of a gamma ray. No
matter is emitted from the nucleus therefore the nucleon number and the
proton number remain the same. Before and after emission of the
gamma ray they are the same isotope of the element but they are
different nuclide because the term nuclide incorporates nuclear energy
states as well basic structure. Metastable state is an excited state of an
atom with a longer lifetime than the other excited states. A nuclear
isomer is a metastable state of an atomic nucleus caused by the
excitation of one or more of its nucleons (protons or neutrons).
All isotopes of technetium are radioactive.Technetium-99m, symbolized
as 99m Tc, is a metastable isotope of the element technetium. The 'm' in
its name stands for metastable. That means it has an excited nucleus. In
order for the nucleus to de-excite to a more stable state, it emits a
gamma ray, of photon energy 140.5 keV, and has a half-life of 6 hours.
Technetium-99m is ideal for medical tracer because it emits only
gamma rays of sufficiently low energy and has a short physical half-life.
This energy can easily be detected by a gamma camera. The gamma
radiation it emits allows the medical practitioner to image internal body
organs causing hardly any radiation damage to the patient.
43Tc   9943Tc  
99m
For gamma ray emission to occur the nucleus must be in an excited
state after emitting an alpha, beta or positron particle. Sometimes it
stays like that for quite a while before the gamma ray is emitted,
sometimes it is instantaneous.
Technetium-99m has an ideal half-life (six hours) which is long enough
for diagnostic procedures to take place but short enough for the patient
not to be inconvenienced unduly by remaining „radioactive‟ for too long
a period after the investigation. It's short half-life means that it is not
588
found in any abundance naturally and therefore it has to be produced in
a nuclear reactor. It is suitable not only for use alone but also for
attachment to a wide range of compounds for tracer experiments. It can
easily be produced „in situ‟ using a „cow‟ as it is the daughter nucleus of
the decay of Molybdenum 99 and is easily separated from the parent
(more hazardous b-emitter) by a saline flush. Molybdenum-99 has a
half-life of 66 hours, allowing it to be transported over fairly long
distances. A fresh supply is brought to the hospital fortnightly and then
the „cow‟ is „milked‟ as and when required.
A Technetium-99m - antimony sulphide colloid can be used as a
radioactive marker to examine the function of the lymph nodes.
Technetium 99m is injected into the drainage areas to be visualised
using 'butterfly' needle to ensure that an injection of radioactive material
is inserted into the correct site. The radionuclide in the syringe is
shielded to protect the person giving the injection. The gamma ray
output is then fed into a gamma camera. Cancerous cells divide more
frequently than non-cancerous ones and therefore a 'hot-spot' of high
activity results from cancerous growth.
The operator has to take into account not only its six hour half-life but
also the rate at which it will be flushed biologically out of the body.
This will depend upon the chemical compound to which it is attached
and the way an individual‟s metabolism copes with that compound.
Technetium-99m is also used to image the skeleton and heart muscle in
particular, but also for brain, thyroid, lungs, liver, spleen, kidney, gall
bladder, bone marrow, salivary and lachrymal glands, heart blood pool,
infection and numerous specialized medical studies.
Radionuclides imaging technique
A gamma emitting radiopharmaceutical of suitable half-life is injected
into the patient‟s bloodstream. The gamma radiation is transported to
the targeted area. A gamma camera connected to a monitor is used to
detect the radiation from a gamma-emitting tracer introduced into the
patient‟s body as it moves over the surface of the targeted area as shown
in Fig.O4.154.
The image formed is display on the screen of a monitor for medical
analysis.
Radionuclide imaging exposes patients to less radiation than X-ray.
Gamma cameras can provide diagnostic images of the brain, thyroid,
liver, kidneys and other major organs and structures in the body.
Gamma scans differ from X-ray imaging techniques in that they map
simply structural images. The tracer‟s progress through the body can be
tracked by the camera. Typical scans take about 30 minutes to
complete.
Fig.O4.154
The detectors used in thermography are often cooled in liquid nitrogen
to reduced unwanted signal. This is important in thermography as
current from the detectors is low. If the surroundings are cooled, they
produce less noise.
Physical, biological and effective half-life
The physical half-life, TR of a radioactive nuclide is the time taken for
half the nuclei present to disintegrate radioactively. If a radioactive
nuclide is administered to a patient, not only is it disintegrating within
the body but it is also being removed from the body by biological
processes such as respiration, urination and defaecation. Therefore, the
activity of the radioactive nuclide within the body will be considerably
less than the physical half-life due to pure radioactive decay. It has been
found that the amount of the radioactive substance administered often
decreases exponentially with time. In order to take this factor into
account, the quantity called biological half-life is used. The biological
half-life, TB of a material is the time taken for half the radioactive
substance to be removed from the body by biological processes. That
is, the time taken for half of the radionuclide being expelled from the
body by natural biological processes such as excretion, sweating and
respiration. Biological half-life varies with the individual and the target
organ for the radionuclide as it is dependent on metabolic processes.
Therefore, the effective half-life, TE of a radionuclide is the time taken
for the activity of the sample to reduce to one half of its value in the
body of a patient. This will be less than the physical half-life due to the 6) Technetium-99m is an artificial isotope which is frequently used to
biological half-life component. obtain a scan of the human body. Fig.O4.155 shows it decay graph.
If λR and λB are the fractions of the radioisotope removed per second by
physical decay and biological processes respectively, then the total

% of sample remaining
fraction removed per unit time λE is given by: 100
E  R  B
The effective decay constant is related to the effective half-life by: 80
ln 2
E  60
TE
and it then follows that:
ln 2 ln 2 ln 2 1 1 1 40
    
TE TR TB TE TR TB
20
This means that when Technetium 99m is used as a radioactive tracer
and is studied with the gamma camera the operator has to take into
account not only its 6 hour half-life but also the rate at which it will be 0
2 4 6 8 10 12 14
flushed biologically out of the body. This will depend upon the Time (hours)
chemical compound to which it is attached and the way an individual‟s Fig.O4.155
metabolism copes with that compound. i) Using the graph, determine the half-life of technetium-99m.
ii) A patient is given an injection containing 6.0 × 10−18 kg of
Worked Examples technetium-99m. The scan is taken four hours after the injection.
1) Explain why the isotope of technetium, Tc– 99m, is often chosen as How much technetium-99m remains undecayed when the scan is
a suitable source of radiation for use in medical diagnosis. taken?
Solution iii) Propose reasons why scans are best taken between two and five
• Technicium-99m may be prepared on site within the hospital. hours after injection of this radioisotope.
• It only emits γ rays as the metastable nucleus moves to a stable state. Solution
• There is no chain of decay associated with it, therefore no residual ii) From the graph, T  6 hours 1
daughter radioactive nuclei will remain active in the body after use. 2

• As is only emits gamma rays that means that any ionisation of tissue iii) 64  100%  67% .
that does occur will be widely spaced and the body's defence Approximately 67% of the sample is present.
mechanisms will be better able to cope with any damage. 67% of 6.0 × 10−18 kg = 4.0 × 10−18 kg remains undecayed after four
• It is easy to detect the emission sites of the gamma rays using a hours.
gamma camera so that diagnosis can be made. iv) After 6 hours, half of the technetium-99m had decay, therefore half
• It has a short enough half-life to not make the patient radioactive for of the information gone too. Obviously, the scan must be done before
too long and yet the half-life is long enough for the medical tests to be then. A physician should wait about 2 hours after the injection though,
able to be carried out. as the radiopharmaceutical has to be given enough time to reach the
• The substance itself has a toxicity that can be tolerated by the body. particular area that is to be scanned. Therefore, a range of 2 to 5 hours
2) The human serum, albumin can be labelled with atoms of the is when a scan should be done.
radioactive isotope iodine 131. This has a physical half-life of 8 days
and a biological half-life of 21 days. Find the effective half-life. RADIATION IN MEDICINE
Solution
Dosimetry
1 1 1 1 1
     0.1726 Dosimetry is the study of radiation. Radiation can be transmitted in the
TE TR TB 8 21 form of electromagnetic waves or as energetic particles, and when
TE  6 days sufficient energy is absorbed by an atom, it can cause the release of
3) a) A box gives information about the radioactive isotope technetium- electrons and the formation of positive ions. When radiation causes ions
99. What is meant by the term half-life? to form it is called ionising radiation. Ionising radiation is produced by
b) To study the blood flow in a patient's lungs, a doctor injects a small X-rays, CAT, radioactive tracers and radiopharmaceuticals.
quantity of a technetium-99 compound into the patient. The radiation When ionising radiation penetrates living cells at the surface or within
emitted by the technetium-99 atoms is detected outside the patient's the body, it may transfer its energy to atoms and molecules through a
body. Explain why a doctor would not use a radioactive isotope with series of random collisions. The most acute damage is caused when a
a very short half-life, such as 2 seconds, as a medical tracer. large functioning molecule such as DNA is ionised leading to mutations
Solution in its chemical structure. If the DNA is damaged it can cause premature
a) It is the time taken for number of radioactive nuclei in the sample to cell death, prevention or delay of cell division, or permanent genetic
halve. modification. If genetic modification occurs, the mutated genes pass the
b) If the half-life was very short there would not be enough time to take information on to daughter cells. If genetic modification occurs in
measurements or observations before level of radiation became sperm or egg cells, the mutated genes may be passed on to offspring.
insignificant. Since the body is 65% water by weight, most of the radiation energy is
4) Why are high-energy X-rays used for X-ray therapy rather than low- absorbed by the water content. This energy can produce ions (H+, OH-,
energy ones? H3O+) and electrically neutral free radicals of water. These ions and free
Solution radicals can cause chemical reactions with other chemical constituents
Low-energy X-rays are absorbed preferentially by bone, so bones of the cell. For example, OH ions and OH free radicals that forms the
would be damaged more than surrounding tissue. High-energy X- strong oxidising reagent hydrogen peroxide (H2O2), which can interfere
rays are not absorbed preferentially by bone or tissue. with the carbon-carbon double bonds within the DNA molecule causing
5) The isotope iodine-131 can be used to treat malignant growths in the rupture of the double helical strands. Free radicals may also cause
thyroid gland. The isotope has a physical half-life of 8 days and a damage to enzymes that are required for the metabolism of the cell or
biological half-life of 21 days. Calculate its effective half-life and they can affect the membranes that are vital for the transport of
determine the time it would take the activity to decrease to 18 of its materials within the cell.
Ionising radiation appears to affect different cells in different ways.
initial activity. Cells of the reproductive organs are very radiation, sensitive and
Solution sterility is a common outcome after radiation exposure. Bone and nerve
1 1 1 1 1 cells are relatively radiation-resistant. However, radiation of bone
     0.1726
TE TR TB 8 21 marrow leads to a rapid depletion of stem cells that can then induce
anaemia or even leukemia.
TE  5.8 days Exposure to radiation results in a range of symptoms including skin
1
8  1
23
is 3 effective half-lives. burns, radiation sickness (nausea, vomiting, diarrhoea, loss of hair, loss
So the time is 3 × 5.8 days = 17.4 days. of taste, fever, loss of hair) and cancer, leukemia and death.
External exposure to alpha particles is fairly harmless as they will be
absorbed by a few microns of skin. Internal exposure after ingestion is
589
very damaging as the α-particles are very ionising and they can interact
with body fluids and gases. Beta particles are more penetrating but
because of their irregular paths upon entering body tissue they are
considered to have low ionising ability. X-rays and γ-radiation have
high ionising ability (but not as high as ingested α-particles), and are a
common cause of disruption to normal cellular metabolism and
function.
Younger cells are more sensitive radiation than older cells. Simple cells
are more sensitive radiation than highly complex cells. Cells that use
energy rapidly are more sensitive than those with a slower metabolism.
Cells that divide and multiply rapidly are more sensitive to radiation
than those that replicate slowly.
All living things are being exposed to cosmic radiation from the Sun
and space, and terrestrial radiation from the lithosphere (uranium and
thorium series and isotopes of radon). It is important that we have
measures in place to monitor both this background and artificial
radiation produced in medicine and the nuclear industry.
Exposure
It has been found that when X-rays and γ-radiation pass through matter,
a measurement of their ionising ability gives a good indication of the
total energy absorbed. It is also known that the energy absorbed per
kilogram in air and tissue is similar because the average atomic number
of air (Z = 7.6) and living tissue (Z for muscle = 7.4) is similar.
The term exposure, X is defined for X-radiation and γ-radiation as the
total charge, Q , of ions of one sign (either electrons or positrons)
produced in air when all the β- particles liberated by photons in a
volume of air of mass, m are completely stopped in air
Q months.
X 
m that is less sensitive to exposure. If the radiation exposure causes the
It can be seen that the units for exposure are C kg-1. The measurement
of exposure has limited applications because it only applies to X-rays
and γ-radiation, and it only refers to ionisation in air and not to
absorption in body materials. It would be better to have a monitoring
quantity that applies to all forms of radiation in all material.
Absorbed Dose
A more useful quantity is absorbed dose D. It is defined as the amount
of energy, E, transferred to a particular unit mass, m. That is,
E to products. The radioisotopes used in imaging technique are called
D
m isotope scanning, nuclear scanning or nuclear imaging.
The S.I. unit of absorbed dose is J kg-1 otherwise known as the Gray
(Gy). The absorbed dose is difficult to measure directly and as a result it
is usually calculated from measurements of exposure. The relationship
between exposure and absorbed dose can be determined for X-rays and
γ-radiation.
The energy absorbed per kilogram for other biological materials will
depend on the type of material and the photon interactions (scattering,
photoelectric effect and Compton scattering). Therefore, each medium
will have its own absorption property and identical exposure will lead to
different absorbed doses in different materials.
D = ( f ×X)
for other media. Where f is a factor dependant on the material involved
and the types of photon interactions involved.
Dose equivalent and quality factor
Although the different types of ionising radiation may all be measured
in units of absorbed dose, equal quantities of different types of radiation
measured in grays, may not have identical biological effects. Neutrons
and α-particles dissipate their energy more densely causing more
cellular damage than less densely ionising radiations like β-particles, X-
rays and γ-radiation even when the absorbed dose is the same. For this
reason, a further quantity called dose equivalent H has been introduced.
H  QDN
where Q is a dimensionless quantity called the quality factor of the
radiation which depends on the ionisation ability of the radiation, and N
is another dimensionless quantity that is the product of all other
modifying factors that might alter the potentially harmful biological
effects of the absorbed dose (currently assigned a value of 1). The unit
of dose equivalent is the sievert (Sv) and 1 Sv = 1 J kg-1.
Relative biological effectiveness (RBE)
Neutrons, protons and heavy charged particles interact with matter.
These particles whereas X-rays and γ-radiation photons. These particles
laid down energy more densely along their tracks (more energy per unit
length) than electrons, and more energy per unit length was laid down
by 250 keV X-rays than was by X-rays generated in the megavolt range.
These differences were expressed as a ratio called the relative
590
biological effectiveness. The relative biological effectiveness is defined
as:

absorbed dose of 250 keV
X-rays for a given effect 
 
RBE 
absorbed dose of another X-ray
magnitude to produce the same
The biological effect of radiation exposure varies according to the type
and energy of radiation. Because equal doses of various types of
radiation do not necessarily result in equal biological effects. Therefore,
the terms quality factor and relative biological effectiveness can be
taken to mean the same thing.
Protections and Precautions in radiation situations
The exposure time to the radioactive source has to be carefully
monitored.
• As the intensity of the radiation obeys the inverse square law for
distance from the source, keeping a safe distance from the source is the
best means of protection.
• Shielding materials are always used. For example, a suitable thickness
of perspex sheet will stop beta rays, and lead, concrete and water will
absorb gamma and X-rays. Lead aprons are often used on patients to
stop any stray radiation.
• All radioactive sources must be completely contained to prevent the
spread of contamination.
• The β-dose is monitored by comparing the blackening through the
open window and different thicknesses of plastic.
• The badges are assessed every two to four weeks and the TLD every 3
• The other side of the film is coated with a fine grain, slow emulsion
fast emulsion in the processed film to be darkened to a degree that it
cannot be interpreted, the fast emulsion is removed and the dose is
computed using the slow emulsion.
Radioactive Tracers (Radioisotopes)
A radioactive tracer is a chemical compound in which one or more
atoms have been replaced by a radioisotope so by virtue of its
radioactive decay it can be used to explore the mechanism of chemical
reactions by tracing the path that the radioisotope follows from reactants
• The stable isotopes of chemicals in the body carry out their
physiological processes in a normal fashion on most occasions.
However, when these normal functions are disrupted various illnesses
are generated at both the cellular and organ level. If a specific
radioisotope is introduced into the body, generally by intravenous
injection, it should behave in the same manner as the equivalent stable
isotope of the same element. The path or accumulation of the
radioactive tracer can then be pinpointed with the use of a detecting
device.
• If the radioactive tracer is of the preferred gamma-emitter type, its
path can be detected by a gamma camera, that is, traced over the body
system or an organ and the activity of the tracer can be „imaged‟. For
example, a gamma camera scan of the heart could be taken and
abnormalities in heart function could be analysed on the lack of
uptake (a cold spot) or the excessive uptake (a hot spot) of the
radioactive tracer.
• α-radiation and β- radiation do not pass far enough through the body
to be easily detected. However, blood and fluid samples can be taken
and the radioactive tracer activity can be detected and measured with
other radiation detectors.
• There are a number of organ specific chemicals. Certain stable
isotopes tend to accumulate in particular parts of the body. Some
examples include iodine in the thyroid gland, calcium and strontium
isotopes in the bone or potassium and rubidium in the muscles. By
attaching radioisotopes to these chemicals, the tracer can be directed
to the organ of interest.
• It is important that any radioactive tracer used has a short half-life in
the order of minutes, hours or a day as long half-life radioisotopes
would emit potentially dangerous radiation for a long time period.
• One of the most popular radiopharmaceuticals is technetium-99m. It
has a short half-life of 6 hours and it is considered to be non-toxic. It
can be manufactured instantly in major hospitals from its parent
nuclide molybdenum-99 with a half-life of 66 hours. This means it
can produce 99m Tc for over a week before it needs to be replenished.
It is an excellent tracer for many diagnostic purposes as discussed
before.
 Radiation Carcinogenesis in Humans
Genetic and proliferative alterations of cells require years to many
lifetimes to develop.
• Tumor development: Ionizing radiation in large amounts is an effective
carcinogenic agent.
• Sterility: Temporary sterility can be induced at exposure levels of
approximately 150 rem. Females are more often permanently affected
than males.
• Cataracts: Due to the high sensitivity of the lens of the eye, opaque
areas of the lens develop after exposure of 200-600 rem.
• Life-shortening: The aging process is increased. Nutrition to the cell
appears to be impaired. The total cell number is decreased and there is a
modification of the composition of cellular material.
• Fetal damage: The fetus is highly radiosensitive due to the rapid
division of cells. No measurable fetal damage has been seen at
exposures less than one rem.
• Chromosomal damage: Detection of chromosomal damage requires
many generations.
Reasons why gamma rays equipment are preferable
over X-ray equipment
• X-ray equipment needs high voltage supply for its operation while this
high voltage is not needed by gamma ray equipment.
• Gamma ray equipment is much more potable than X-ray equipment.
• Gamma ray equipment can be controlled by remote but this is difficult
with X-ray equipment.
MEDICAL APPLICATION OF LASER
LASERS (light amplification by stimulated emission of radiation) have
many applications in both the diagnostic and therapeutic areas of
medicine. Firstly, LASERS are a collimated, coherent, monochromatic
source of photons with the same energy. Secondly, from their source,
they can be continuous or pulsed. Although their average power is the
same, the pulsed laser at the peak of its pulse has greater power than the
continuous models.
Highly collimated beam of a LASER can be focused to a microscopic
dot of extremely high energy density. This makes it useful as a cutting
and cauterizing instrument.
Laser light
Fig.O4.161
LASERS have been used to make incisions half a micron wide,
compared to about 80 microns for the diameter of a human hair. A
focused laser can act as an extremely sharp scalpel for delicate
surgery, cauterizing as it cuts. „Cauterizing’ refers to long-standing
medical practices of using a hot instrument or a high frequency
electrical probe to singe the tissue around an incision, sealing off tiny
blood vessels to stop bleeding. The cauterizing action is particularly
important for surgical procedures in blood-rich tissue such as the liver.
Because heat from lasers cauterizes blood vessels, there is less
bleeding compared to scalpel use. The instrument that produces
LASER light is called laser.
Uses of LASERS
• LASERS are commonly used in conjunction with endoscopy which
uses optical fibres to look inside the body. An endoscope consists of
two basic parts – a flexible tube fitted with a camera and a bright light
that can be inserted through a small incision and a viewing monitor
that magnifies the transmitted image of the part of the body being
examined. The endoscope is used as the viewing device for the
surgical instruments being used. Because lasers are highly collimated
they can be for transmission along optical fibres. For example, the
neodymium YAG laser can be used with the endoscope to help to
destroy cancers in parts of the gut, the colon and airways. It can also
be used to treat blood clots in the legs and coagulate bleeding ulcers
of the stomach.
• LASERS are also used in pulse oximetry which is a non-invasive
technique used to monitor the oxygen content of haemoglobin. It is
critical that intensive care patients and patients being taken to hospital
in an ambulance after a trauma are monitored. A small clip is attached
to a part of the body that is transparent to laser light. A laser light
source with two different wavelengths – one in the infrared and one in
the red region – is partially absorbed by the haemoglobin by different
amounts depending upon the amount of saturated or unsaturated
oxygen that is present.
591
• Carbon dioxide lasers cannot be used in optical fibres because they
operate in the far infra-red region and their energy is absorbed by the
fibre. However, they have become a major laser in operations for
cutting the skin and surface tissue, cauterizing bleeding blood vessels,
doing fine surgery of the brain and fallopian tubes and treating
cervical cancer.
• Argon LASERS that produce blue-green light are used to remove red
birthmarks and some tattoos. It is also used to treat eye diseases in
diabetic patients and re-attaching detached retinas.
• The excimer LASER is commonly used to correct eye defects by
vaporising excess tissue in the reshaping of the corneal surface.
Worked Examples
1) Potassium-42 decays with a half-life of 12 hours. When potassium-
42 decays, it emits β–particles and gamma rays. One freshly prepared
source has an activity of 3.0 × 107 Bq.
a) To determine the radiation dose absorbed by the scientist working
with the source, the number of gamma rays photons incident on each
cm2 of the body has to be known. One in every five of the decaying
nuclei produces a gamma ray photon. A scientist is initially working
1.50 m from the fresh source with no shielding. Show that at this time
approximately 21 gamma photons per second are incident on each cm2
of the scientist's body.
b) The scientist returns 6 hours later and works at the same distance
from the source.
i) Calculate the new number of gamma ray photons incident per
second on each cm2 of the scientist's body
ii) Explain why it is not necessary to consider the beta particle
emissions when determining the radiation dose the scientist receives.
Solution
3.0  107  0.2
a) γ-rays per cm  2
 21
4(1.5  102 ) 2
b) i) 6 hours is 0.5 half-lives
The source activity decreases to 2–0.5 of initial activity in this time
So, the new number of gamma photons per second per cm2 = 21.2
× 2–0.5= 15
ii) Beta particle range in air is less than 1.5 m, they are absorbed by air,
they lose energy in air much more rapidly than gamma photons and
ionise the air much more than gamma photons.
2) a) Alpha particles (α), beta particles (β) and gamma rays (γ) are
types of nuclear radiation.
i) Which of the nuclear radiations is the most hazardous to human
health?
ii) What two effects do nuclear radiations have on living cells?
Solution
i) When outside the body is gamma because it can penetrate and
damage cells of internal organs.
Alpha is ingested into the body because the high ionisation power
results in highly localised damage to tissue near to the source.
ii) It may causes genes mutations or causes cancer
3) Calculate the absorbed dose in air when the exposure is 1 unit. If the
average ionisation energy in air = 34 eV.
Solution
Exposure of one unit = 1 C kg -1
34e
Energy absorbed =  34 J kg-1
e
E 34 J
Absorbed dose =   34 Gy
m 1 kg
4) Discuss the dangers of exposing the human body to a source of α-
radiation. In particular compare the dangers when the α-source is held
outside, but in contact with the body, with those when the source is
placed inside the body.
Solution
Alpha radiation is highly ionising, it therefore causes highly localised
damage to cells and/or DNA. Damage to DNA can result in mutated
cells or cancer. Cell damage can result in cell death.
If the alpha source is outside the body and in contact with the skin,
emitted alpha particles will be emitted in all directions therefore half
will be directed away from the body and ionise the air. Those directed
towards the body will be absorbed by dead skin cells on the skin
surface. They would therefore not result in damaged living tissue or
cell mutation. An alpha source would only cause skin damage if it had
a very high activity, then some skin burns would occur.
If the alpha source was inside the body it would be much more
dangerous. All of the emitted alpha particles would be absorbed by
living body tissue and cause possible cell mutations in a highly
localised area. This would probably result in cancerous growth. If the
alpha source was near to vital organs mutations would be even more
 dangerous as cancerous growths in such organs can easily lead to
death.  If the activity of the source was high, internal tissue damage
(burns) would occur, if this was within an important vital organ the
result would be very hazardous.
5) a) Describe in simple terms how X-ray photons are produced in a
hospital X-ray machine.
b)i) In the treatment of patients, explain what is meant by a non-
invasive technique. State one of its advantages.
ii) Explain what is meant by a medical tracer. Name a medical tracer
commonly used to diagnose the function of organs
c) Fig.O4.156 shows an ultrasound transducer placed above an artery.
gel
patient‟s skin transducer
direction of artery
red blood
cells blood flow
Fig.O4.156
i) Explain what is mean by piezoelectric materials.
ii) The speed of ultrasound in blood is 1500 m s–1. Calculate the
wavelength of the ultrasound of frequency 2.0 × 106 Hz.
iii) Describe how the ultrasound is used to determine the speed of the
blood in the artery.
Solution
c) Electrons are accelerated through high voltage. These high speed
electrons hit metal target and the kinetic energy of the electrons
„produces‟ X-ray photons.
d) i) It means no surgery and as a result lower risk of infection and less
trauma.
ii) A radioactive substance that is enjected into a patient‟s body. For
example, technetium-99m (iodine-131 or fluorine-18 will also be
suitable).
e) i) Are crystalline solids that deform when a potential difference is
applied across them.
v 1500
ii)     7.5  104 m
f 2.0  106
iii) Ultrasound is reflected by moving blood cells. The frequency of the
ultrasound is changed. The change of frequency is directly
proportional to the speed of blood.
6) α- radiation and γ- radiation has different quality factors. State which
type of radiation has the largest quality factor, and explain why the
radiations have different effects for the same absorbed dose.
Solution
Alpha particles have the largest quality factor because they cause
more ionisation per unit length of their track.
7) How much energy is absorbed when a person of mass 70 kg receives
an effective dose equivalent to 30 mSv, half the dose equivalent being
acquired from radiation of quality factor 1 and half from radiation of
quality factor 3?
Solution
H  DQ and H  H1  H 2  30 mSv
H1 15 mSv
D1    15 mJ kg 1
Q1 1
H2 15 mSv
D2    5 mJ kg 1
Q2 3 higher, lower or the same Q factor as alpha particles? Explain your
D  D1  D2  5  15  20 mJ kg 1
Therefore, energy absorbed by 70 kg = 70 kg × 20 mJ kg-1 = 1400
mJ = 1.4 J
8) i) Explain the difference between radiation exposure and absorbed
dose.
ii) Explain why, for the same absorbed dose, the dose equivalent would
be different for exposure to alpha particles than for gamma rays.
Solution
i)Exposure is the amount of radiation incident on the body whereas
absorbed dose is the energy absorbed per unit mass of the body.
ii) Dose equivalent is the product of the absorbed dose and quality
factor. The quality factor depends on ionization of the radiation
which is 20 for alpha and one for gamma. Hence, dose equivalent
greater for alpha-particles than gamma-rays.
9) Polonium is an alpha source with long half-life. News reports are
saying that careful handling of polonium is not a threat to careful
handlers but it is deadly as a poison if administered as such. Explain
why this is true as fully as you can.
Solution
Alpha sources are not dangerous outside the body as they cannot
penetrate through the skin to reach sensitive organs but if ingested it is
592
very dangerous as alpha particles have low penetrating power which
involves very concentrated damage due to intense ionisation in a small
locality. This is made worse by the relatively short half-life of
Polonium which means that a small sample will have a high activity.
10) A person is accidentally exposed for a short time to ionising
radiation.
a) Explain
i) what is meant by absorbed dose,
ii) why the effect of the exposure depends on the type of radiation.
b) Suggest why the effects of the exposure cannot be fully assessed
within a few weeks of the exposure.
Solution
a)i) This is the energy deposited in body per unit mass of the body
tissue
(ii) The effects depend on density of deposition of ionizing energy.
Some radiations cause greater density of ionisation than other.
b) Radiation has long-term effects and as a result shortens life, cause
gene mutation and may result to cancer.
11) (a) Describe what is meant by the term quality factor (relative
biological effectiveness).
A person of mass 75 kg has his whole body exposed to
monochromatic X-rays of energy 250 keV. Because of this exposure,
he receives a dose equivalent of 0.50 mSv in 2.0 minutes.
(b) Deduce that the person absorbs approximately 109 photons per
second.
Solution
(a) The quality factor compares the relative biological effectiveness of
different types of radiation to that of X-rays that are given a quality
factor of 1.
(b) D = 0.5 mSv = 5 × 10-4 Jkg-1.
E = m × D = 75 kg × 5.0 × 10-4 J kg-1= 3.75 × 10-3 J.
W = qV = 250 × 103 eV × 1.6 × 10-19 C = 4.0 × 10-14 J.
3.75  103
Number per second = 14
 7.8 108 photons s 1
120  4.0  10
12) a) Describe the mechanism by which radiation causes damage to
the cells of living matter. Hence explain the probable effects on a cell
of such damage.
b) On the basis of your account in (a), explain why the extent of
radiation damage depends on:
i) the type of radiation to which the cells are exposed,
ii) the total dose of radiation
iii) the dose rate of the radiation.
Solution
a) Radiation causes disruptions in the DNA molecules, ionisation of
water molecules and ions may react with the DNA molecules result
to death, shortens life expectancy or genes mutation.
b) i) Damage depends on the density of ionisation per unit length and
the track density depends on the type of radiation, hence alpha
radiation causes more ionisation and more damage than the beta and
gamma.
ii) Greater dose gives greater ionisation per unit volme and so damage
increase with increasing dose.
iii) Rapair mechanism requires time to operate. The higher the dose
rate, the lesser the repairing time and so damage increases with
increasing does rate.
13) When using ionising radiation in medicine the different types of
radiation are given a Quality, or Q factor. Do beta particles have a
answer.
Solution
Lower  because alpha-particles are more ionising  to tissue.
14) A student complains that she is not able to see clearly any object
unless it is 75 cm from her eyes. The normal near point is taken as
being 25 cm.
a) i) Name the student‟s eye defect.
ii) State what is meant by the near point of the eye.
b) Fig.O4.157 is a simple diagram of the eye.
Fig.O4.157
i) Copy the figure on to your answer booklet. On this, draw a ray
diagram to illustrate the paths of two rays of light from a point object
at the normal near point, showing how they would reach the retina of
the student‟s eye.
ii) On another copy of the figure, draw a second ray diagram to show
how a named lens may be used to correct the defect for an object set
at the near point from the student‟s eye.
 iii) Calculate the power of this correcting lens. 80  9.81  60  0.2
c) Some animals are able to change the curvature of the cornea so that they b) P   1712 W
5.5
are able to see clearly both in air and in water. Explain why a change in
This is unlikely unless he is an athlete because the rate is usually 1 kW.
curvature is necessary.
80  9.81  60  0.2  83
Solution c) i) Ew   45980 W
• i) Long sight (hypermetropia) 17
ii) The closest point to the eye at which the eye can focus on an object on to 45980
the retina. ii) m  = 1.09  102 kg
• i) See Fig.O4.158. 4200  103
iii) Likely to be more because some of the sweat will not be lost by evaporate
near point image as some of the heat is lost by convection, respiration and radiation and
will reduced the mass to be excreted

 4) a) Give a difference between the probe used in an A-scan and that used in a
B-scan.
Fig.O4.158 b) How is a piezoelectric crystal used to generate wave of ultrasound?
ii) See Fig.O4.159. c) In order to make the crystal pulses short, short voltage pulses are applied.
However the assembly must have an additional modification if the crystals
near point are to emit short pulses. Explain the modification used and why it is
necessary?
  Solution
a) B-scan uses a multi -transducer whereas A-scan uses a single transducer
convex lens  probe.
b) The surfaces of a thin slice of crystal are used as electrodes. These
Fig.O4.159 electrodes are connected to a very high frequency e.m.f. The applied e.m.f.
0.25  0.75 causes a rapidly alternating electric field across the crystal between the
iii) f   0.375 m electrodes. The crystal expands and contracts at the same frequency as the
0.75  0.25
e.m.f. which is applied. The vibrations of the faces of the crystal produces
1 1
Power   = 2.67 D ultrasound pressure waves.
f 0.375 c) A sheet of vibration-absorbing backing material is applied behind the
• Focusing depends to great extent on the refraction at cornea.  for water- crystal to stop the vibrations continuing after each electrical signal is
stopped.
cornea boundary is less than  for air-cornea boundary, so less refraction 5) Fig.O4.162 shows the spectrum of X-rays produced from an X-ray source.
when in water and greater curvature in water to compensate.
15) Explain the difference between absorbed dose and dose equivalent and
explain how the dose equivalent would be different for exposure to alpha
particles and gamma rays.
Solution
Absorbed dose is energy absorbed per unit mass while the dose equivalent is
the product absorbed dose and quality factor. The dose equivalent of alpha
particle is higher than that of gamma radiation because the quality factor of
alpha is higher than that gamma since alpha is far more ionising than gamma.

Worked Examples
1) (a) State four applications of laser radiation in medicine.
(b) For one of the applications which you have given, describe how the
LASER radiation is applied and state any safety features needed.
c) Why is gel used during ultrasound scan?
Solution
a) It is used for the treatment of defects of vision, welding of detached retina,
removal of birthmarks, treatment of tumours and used as cutting
instrument
b) Method: it produces pulsed beams, delivered via optical fibres and specific
wavelength of radiation needed
Safety: it lack of reflective surfaces, short focal length lens used at point of
application, use of goggles. and keep patient still.
c) The greater the difference in acoustic impedance, the greater is the percent
reflection. The difference in impedance between the air and skin is very
large, so to prevent almost all the ultrasound being reflected before it enters
the body, the gap between the transmitter and skin is filled with a gel. This is
normally smeared over the body or the probe before the scan begins.
2) Which laser would you use for the following procedures? Give a reason for
each one:
a) removing a tumour from the brain;
b) spot welding a detached retina.
6) a) Describe the differences in the production of a CT-scan image with the
Solution
a) A carbon dioxide laser as its penetration is very small, making it suitable to
b) (i) Describe the advantages of an MRI scan compared with a CT scan.
operate on delicate tissues.
b) An argon laser, as the light in the visible range can pass into the eye and
causes photocoagulation
3) a) i) What do you understand by basal metabolic rate (BMR)?
ii) Why is the BMR of a child greater than that of an adult?
b) A flight of stairs consists of 50 steps each of height 20.0 cm. A man of mass
80 kg claims to be able to run up the steps in 5.5 s. Make suitable
calculations so that you can decide whether the claim is justified.
c) When climbing the steps in (b), the body muscles are able to work with an
efficiency of 17%.
i) Calculate the amount of energy „wasted‟
ii) Given that the specific latent heat of vaporization of sweat is 2400 kJ kg–1,
what mass of sweat must evaporate in order to dissipate this „waste‟
energy?
iii) Discuss why, in practice, the mass of sweat excreted is likely to differ from
that calculated.
Solution
a) i) The time rate per unit mass to maintain the body at rate functions.
ii) Greater energy is required by the child for growth.
Fig.O4.162
c) Describe the process by which:
i) the three sharp peaks of high-intensity X-rays are produced
ii) the broad band of X-rays is produced.
d) The X-rays in the shaded region, labelled A, are filtered out using an
aluminium filter. Explain:
i) why it is advantageous to filter these X-rays out
ii) why aluminium is a suitable material to filter them out
e) Calculate the maximum frequency of X-rays produced by this tube.
Solution
a) i) Peaks are formed by excitation of an inner electron in an atom to a higher
level. Energy is given out when it drops back to ground state.
ii) Band is produced by many interactions, each absorbing different energies.
b) i) Low-energy X-rays are absorbed by flesh so do not contribute to the
overall picture. Filtering these rays reduces the patient‟s overall exposure
to radiation.
ii) Aluminium absorbs these low-energy X-rays.
E 115  103  1.6  1019
c) f   34
 2.78×1018 Hz
h 6.63  10
production of a traditional X-ray image.
(ii) Explain why it is sometimes useful to produce a combined image from a
CT scan and an MRI scan.
Solution
a) An X-ray image is a shadow image caused by the differing absorption of
the different body tissues as a single beam of X-rays is passed through the
patient.
In a CT scan the patient is in the centre of a ring and the X-ray source
rotates around the patient taking a series of images through a slice. The
information gained is sent to a computer which builds up a picture of the
slice. The patient is moved slowly through the machine so that this is
repeated to make images of many slices. These images are then put together
by the computer to form a three-dimensional image, which can be viewed
from different angles.
b) i) MRI scans do not rely on ionising radiation, unlike CT scans. This makes
it safer for both patient and medical staff. MRI scans give a better contrast
between soft tissues than CT scans.
c) ii)While MRI scans give a better contrast between soft tissues, CT scans
give better contrast with bony tissue. The combination allows the doctors
to relate the soft tissue to the bony tissue.

593
 7) a) Explain what is meant by acoustic impedance and outline its role in the
use of ultrasound scans.
b) Brain tissue has a density of 1.04 × 103 kg m−3 and ultrasound travels at
1.58 × 103 m s−1 through it. Calculate the acoustic impedance of brain
tissue.
c) Fig. O4.163 shows the trace formed on the screen of an oscilloscope when
ultrasound is reflected from the front and rear surfaces of the head of a fetus.
The time-base of the oscilloscope is set at 10 µs per division.
12) a) State two physical properties of human tissue which determine its
Fig. O4.163
i) Explain why the second peak is lower than the first.
ii) Calculate the diameter of the head of the fetus.
Solution
a) Acoustic impedance of a material = density × speed of sound in the
material. When ultrasound goes from one material to another, some
reflects and some transmitted. The proportion of the signal reflected is
determined by the acoustic impedance of the two materials.
2 –1
b) Z   v  1.04 10 1.58 10  1.64 10 kg m s
3 3 6
c) i) Some energy is reflected at the first surface, so incident energy is lower at
the second surface.
ii) Time between pulses = 3.5 × 10 × 10–6 s
Distance, x, of travel of pulse = vt
x = 1.58 × 103 × 3.5 × 10 × 10–6 s
Diameter of head =  1
x  2.76 10–2 m
2
8) a) Give three hazards to a patient which could be associated with MRI and
for each, describe an associated safety precaution.
b) State two advantages of X-ray imaging compared to MRI
c) Name the region of the electromagnetic spectrum used in MRI scans.
d) The commonest elements present in the human body are oxygen-16, carbon-
12 and hydrogen-1. Explain why it is justifiable to say that the nuclei
imaged in an MRI scan are those of hydrogen.
Solution
a) Wearing ear plug reduces noise hazard and ear damage.
Removing earrings, watches, etc. reduces magnetic effects.
Counselling help confined space and claustrophobia.
b) X-rays are cheaper, quicker, relatively portable, can be used if patients have
metal implants and better images of bones.
c) Radio waves
d) The nucleons in carbon and oxygen are paired and so the tiny magnet
moments due to spin cancel out. Thus resonant signals are only emitted
from nuclei of odd nucleon number. Hydrogen has a single proton.
9) Describe and explain two uses of a laser in clinical therapy.
Solution
- Lasers are also used in pulse oximetry which is a non-invasive technique
used to monitor the oxygen content of haemoglobin. A small clip is attached
to a part of the body that is transparent to laser light. A laser light source
with two different wavelengths, one in the infrared and one in the red region,
is partially absorbed by the hemoglobin by different amounts depending
upon the amount of saturated or unsaturated oxygen that is present. A
processor connected to the laser probe determines the proportion of the
hemoglobin that is oxygenated.
- Laser is used in repairing the retina (pneumatic retinopexy). In this
procedure, a gas bubble is injected into the eye. The bubble presses
against the detached retina and pushes it back into place. A laser or
cryotherapy is then used to reattach the retina firmly into place.
10) State
a) the cause of astigmatism,
b) the effect of astigmatism on vision,
c) the type of lens needed to correct astigmatism,
d) two parameters that must be determined for the correcting lens.
Solution
a) Due to non-spherical cornea.
b) When one plane is in focus, the plane at 90° is out of focus.
c) Cylindrical lens.
d) The power and angle of alignment.
11) a) With reference to nuclear magnetic resonance, explain what is
meant by the gyromagnetic ratio.
b) A doctor is conducting an MRI scan on a patient. There is a steady
magnetic field of 1.8 T and superimposed on this is a much weaker
field which oscillates at an RF of 48 MHz.
i) Assuming the RF causes resonance of the protons, calculate their
gyromagnetic ratio.
ii) Explain what resonance means in this application.
iii) Describe what happens when the RF field is removed and how this
leads to information about the internal organs of the patient.
594
Solution
a) The ratio of the Larmor frequency to the applied magnetic field
strength.
b) i) 0  2 f  48  106  3.01 108 rad s1
0 3.01 106
γ   1.67  108 rad s 1 T 1
B0 1.8
ii) The frequency of the RF signal is equal to the natural frequency of
the proton precession, so the proton absorbs the energy.
iii) Protons fall back to a lower energy state, emitting (RF) radiation as
they do so. The different relaxation times (or words to that effect)
from different tissues enable a picture to be built up.
acoustic impedance
b) What are the conditions under which ultrasound is strongly reflected
at a boundary between two different types of tissue.
c) Why is a gel used between the patient body and the transducer when
an ultrasound scan is taken?
Solution
a) The density of the tissue and the speed of sound in the tissue.
b) Large different in acoustic impedance.
The gel excludes air. Air has a very different acoustic impedance to soft
tissue and so most of the ultrasound would be reflected. Gel has a
similar acoustic impedance to soft tissue and so maximised the
transmission of ultrasound.
REVISION QUESTIONS
1) A diverging spectacle lens of power –3.0 D is used to correct a
defect of vision. When used to view a real object, the image is
formed 0.21 m from the lens.
a) State the defect of vision.
b) Calculate the distance of the object from the lens
2) Screening for breast cancer is normally carried out by directing low
dose X-rays into
breast tissue. Researchers have investigated using thermography to
screen for breast cancer.
a) Why are X-rays able to detect breast cancer?
b) (i) What is thermography?
(ii) Suggest why thermography can detect breast cancer.
c) Using thermography is a much safer way of detecting breast cancer
than using X-rays.
(i) Explain why thermography is safer.
(ii) Suggest why doctors prefer to use X-rays rather than thermography,
even though
thermography is safer.
3) CAT and MRI scanners produce tomographic images of parts of the
body in diagnostic tests.
a) Describe what is meant by the term tomography.
b) Outline the method by which CAT scans are collected.
c) Give two diagnostic applications that CAT scans are used for.
d) Discuss the advantages that a CAT scan has when compared to
conventional X-ray techniques.
4) Both ultrasound and lasers can be used to treat gallstones. Sound
waves travel through air at a speed of 330 m s –1.
(a) (i) Calculate the frequency of a sound wave which has a wavelength
of 0.2 m when
travelling through air. State the correct unit in your answer.
(ii) Explain why this sound wave cannot be described as „ultrasound‟.
(b) When lasers are used to treat gallstones, the laser light is sent along
optical fibres.
(i) Explain why these optical fibres must be made of glass of high
refractive index.
(ii) One type of glass used to make optical fibres has a refractive index
of 1.3. Calculate the critical angle for this type of glass.
(iii) Explain what would happen to a ray of light that, when travelling
from this glass into the
air, hits the glass/air boundary at an angle of incidence of 25°.
c) A patient has been given the choice of having his gallstones treated
either by using
ultrasound or a laser. Critically evaluate the advantages and
disadvantages of each of these methods in order to help the patient
make his choice.
5) A sample of blood is placed in a centrifuge of radius 15.0 cm. The
mass of a red corpuscle is 3.0×10-16 kg, and the magnitude of the
centripetal force required to make it settle out of the plasma is
 4.0×10-11 N. At how many revolutions per second should the
centrifuge operate?
6) The human ear canal is about 2.8 cm long. If it is regarded as a tube
open at one end and closed at the eardrum, what is the fundamental
frequency around which we would expect hearing to be best? Speed
of sound, use: v = 340 m s–1.
7) A doctor has ordered some medical tests for four sisters, A, B, C
and D, who have a family history of heart disease. Test 1 is an
electrocardiogram (ECG) test. Each sister‟s ECG trace is shown in
Fig.O4.164.
Fig.O4.164
State with reason which sister, A, B, C or D, has the following
condition:
(a) (i) bradycardia
(ii) ventricular fibrillation.
(b) Test 2 measures blood pressure.
i) What is the normal value of blood pressure for a healthy young
female adult?
ii) Describe how a nurse would use the equipment shown in Fig.O4.165
to measure the sisters‟ blood pressures.
stethoscope
sphygmomanometer
Fig.O4.165
c) Blood pressure can be measured using either invasive or non-invasive
methods.
i) State and explain one reason why non-invasive methods are usually
used to measure
blood pressure even though invasive measurements give more
accurate readings.
ii) Why are invasive methods likely to produce more accurate readings
of blood pressure than non-invasive methods?
d) The doctor also measured the sisters‟ pulse rates.
i) What is the normal resting pulse rate range for a healthy young adult?
ii) Describe briefly how the doctor would measure the sisters‟ resting
pulse rates.
8) a) Describe the properties that make a radioactive isotope useful
for medical imaging. Include a specific example of a radioactive
isotope in your answer.
b) A cancer specialist has access to ultrasound, CAT and NMR
scanners. Which of these technologies is the most appropriate to
detect a 3 mm brain tumour? Justify your choice.
c) Why does the target material in X-ray need to have high values of
595
i) thermal conductivity
ii) specific heat capacity
iii) melting point?
9) a) Explain the difference between incoherent and coherent bundles
of optical fibres.
b) Compare, given reasons, the use of CT and ultrasound scans in
terms of patient safety, convenience and diagnostic information.
c) i) Explain the difference between effective half-life, physical half-
life and biological half-life when using radioactive materials for
diagnostic imaging in medicine.
ii) Why is the effective half-life always less than the physical half-
life?
10) a) A radiopharmaceutical contains a tracer with a half-life of 14
days and is injected into a patient. The corrected count from a
specific part of the body was initially 3500 counts s−1. Seven days
later, the corrected count from the same part of the body is measured
at 1800 counts s−1. What is the biological half-life of the tracer?
b) i) What controls the intensity of an X-ray beam?
ii) An X-ray tube has a current of 50 mA and potential difference of
140 kV between its anode and cathode. The X-ray photons are
produced from the tungsten target with an efficiency of 0.7%. What
is the power of the X-ray beam?
c) Describe how a magnetic resonance scanner produces an image of
the body.
11) a) State and explain how, in an X-ray tube, the hardness of the X-
ray beam is controlled.
b) The de-excitation energy E (measured in joule) of a proton in
magnetic resonance imaging is given by the expression: E = 2.82 ×
10−26 B
where B is the magnetic flux density measured in tesla. The energy E
is emitted as a photon of electromagnetic radiation in the radio-
frequency range. Calculate the magnetic flux density required for the
radio frequency to be 42 MHz.
12) a) What do the letters CT stand for in a CT scan?
b) State one similarity and one difference between the radiation used in
producing a conventional X-ray photograph and that used in carrying
out a CT scan.
c) State one example of a person who would be unsuitable for diagnosis
using CT scanning and explain why they would be unsuitable.
d) What is the role of the computer in the production of a CT scan?
13) a) What do the letters CT stand for in a CT scan?
b) State one similarity and one difference between the radiation used in
producing a conventional X-ray photograph and that used in carrying
out a CT scan.
c) State one example of a person who would be unsuitable for diagnosis
using CT scanning and explain why they would be unsuitable.
d) What is the role of the computer in the production of a CT scan?
14) a) Distinguish between the images produced by CT scanning and
X-ray imaging.
b) By reference to the principles of CT scanning, suggest why CT
scanning could not be developed before powerful computers were
available.
15) a) Estimate the pulse rate of the patient whose ECG is shown in
Fig.O4.166.
Fig.O4.166
b) How would the ECG trace differ for a patient with?
i) high pulse rate ii) low pulse rate?
c) A patient is diagnosed with „ventricular standstill‟. There is no
contraction of the ventricles. Sketch the likely ECG trace from this
patient. Include a scale on the potential axis.
d) Exposure to X-rays can be dangerous for patients receiving a
diagnosis or treatment and for radiographers who use the X-ray
equipment. Explain the precautions that are taken to ensure the
safety of both patients and radiographers exposed to radiation.