NOTES AND DISCUSSIONS

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Using physics to investigate blood ow in arteries: A case study for premed students
Michael A. Waxmana
Department of Natural Sciences, University of WisconsinSuperior, Superior, Wisconsin 54880

Received 24 December 2009; accepted 14 March 2010 Concepts from magnetism, hydrodynamics, and electrical circuits are used to investigate blood circulation and motivate premed students in their physics studies. 2010 American Association of Physics
Teachers.

DOI: 10.1119/1.3379292

Most premed students dont like physics. Almost all of the authors physicians over the years, having learned what subjects he teaches, have conded how challenging they found their undergraduate courses in physics and physical chemistry and how irrelevant those subjects seemed at the time. This attitude is not helpful, both in regard to the students short-term goals physics is an important component of the MCAT and in regard to their later professional success because physics is important for understanding the functioning of living organisms. The challenges and importance of effectively teaching physics to premed students have long been recognized see, for example, Refs. 14. I will describe a case study that increases the motivation of these students in introductory physics. I have also designed a series of activities where students need to integrate their knowledge from different branches of physics and beyond and apply their knowledge in an unfamiliar context. These skills are crucial for their success on the MCAT.3 It will be shown that in the study of blood circulation, concepts from magnetism, hydrodynamics, and electrical circuits are necessary and interconnected. My starting point is a textbook problem5 on using a magnetic eld to determine the velocity of blood ow in an artery. Before I assign the problem, I ask my students if they think that our blood contains any particles that can be strongly affected by a magnetic eld. After some thought, a few students particularly those who have already taken biochemistry recall that there are ions in blood. We briey discuss their nature, particularly the fact that proteins are charged particles, and that the buffer that stabilizes the pH of blood at nearly 7.35 contains bicarbonate ions, HCO3 . Monoatomic ions, such as Na+ and K+, are contained in blood as well. After this discussion, problem 1 is assigned: A heart surgeon examines the ow rate of blood through an artery using an electromagnetic ow meter see Fig. 1. Electrodes A and B make contact with the outer surface of the blood vessel, which has interior diameter 3.00 mm. For a magnetic eld magnitude of 0.0400 T, an emf of 160 V appears between the electrodes. Calculate the speed of the blood.5 To solve the problem, it is necessary to understand that the resulting
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emf is essentially the motional emf. As usual, the balance condition between the magnetic and electric forces yields

= V/Bd ,

giving = 1.33 m / s, where is the speed of the blood ow, V is the emf, B is the magnetic eld, and d is the inner diameter of the artery. This problem is simple enough for some of students to proudly produce the solution. An interesting question to ask at this point is whether the effect would be diminished by the presence in blood of both negative and positive charges. The answer is negative because the magnetic eld will deect the positive and negative ions in opposite directions positive ions upward, toward electrode A, and negative ions downward, toward B, with the corresponding electric elds adding up. It might seem to the students that the described device is highly invasive because the electrodes in Fig. 1 appear to penetrate the artery. Actually, the electromagnetic ow meters are implemented as catheters with the external diameter as small as 0.5 mm.69 Interestingly, the described instrument is used to measure the velocity of uxes not only in blood but also in various other conductive liquids, such as waste water and slurry.10 True to my usual routine,11 the next step is to assign a follow-up problem for extra credit in a test: A heart surgeon examines the condition of an artery using two devices considered in your recent homework problem. One device, at a point X along the artery, has magnetic eld magnitude of 0.040 T, and an emf of 250 V appeared between its electrodes. Another device, at another point Y along the same artery, has magnetic eld magnitude of 0.060 T, and an emf of 475 V appeared between its electrodes. What quantitative conclusions, if any, can be reached about the condition of the artery at points X and Y , if there is no blood vessel branching between points X and Y ? A basic understanding of uid ow has been cited as the knowledge most lacking in medical students,2 and the solutions given by students to this bonus problem usually conrm their lack of knowledge convincingly. Some students, for example, suggest that there is an unequal quantity of blood owing through points X and Y . In actuality for blood
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Fig. 2. Flow of blood in artery. The drag forces shown act on the cylinder with surface area 2rL.

Fig. 1. Geometry of Problem 1 from Ref. 5. Reproduced with permission, www.cengage.com/permissions.

treated as an incompressible uid, the volume ow rates must be equal due to the lack of branching between points X and Y , which leads to the equality see Ref. 5, p. 477
2 X d X /4 = Y d2 Y /4 .

the artery wall and therefore slower. Here is the viscosity,13 and is the velocity of the blood ow at the distance r from the center of the artery. We use Newtons rst law to equate these two forces for the stationary ow of blood and obtain

2 3

r2 PA PB = 2rL

d . dr

Equation 2 yields Xd X d X = Y d Y d Y , and thus

We integrate from r to R where R = d / 2, the artery inner radius, use the no-slip boundary condition at the artery walls, R = 0, and nd PA PB 2L

Xd X d Y = . Y dY dX
According to Eq. 1, at each point, X and Y ,

rdr =

d .

id i = V i/ B i ,
dY VX BY = . dX VY BX

Equation 8 yields the following expression for the velocity prole across the arterys cross-section:

where i = X or Y . We substitute Eq. 5 into Eq. 4 and nd 6

r =

1 P 2 2 R r , 4 z

According to Eq. 6, dY / dX = 0.79, that is, the artery is narrowed by about 21% at point Y . When discussing the test problems during the next class meeting and after presenting the solution, I ask students if they believe that having plaque blocking the artery at some point so that its diameter is decreased by 21% seems very signicant. Many students answer negatively, which makes them quite surprised when I announce that the ability of the artery to support the blood ow is decreased by 61%. Indeed, in reality the velocity of blood across the cross-section of the artery is not constant because the blood speed is attenuated by the walls. Because of the cylindrical symmetry of the artery, the resulting ow consists of a series of concentric, telescoping layers, with the central portion owing most rapidly and with the outermost layer stationary at the arterys wall. To determine the exact shape of this ow, let us consider12 a cylinder of blood with a length L and a radius r centered on the arterys axis see Fig. 2. The pressure difference, PA PB caused by the pumping action of the heart, drives the blood, whose motion is opposed by the drag force, 2rLd / dr, which acts on the surface of the cylinder of radius r in the center of the artery slowing it down through friction from the adjacent layer of blood which is closer to
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where P / z = PB PA / L is the blood pressure gradient along the artery. The negative sign in Eq. 9 indicates that the direction of the ow is opposite to that of the blood pressure gradient. Students can integrate the result of Eq. 9 for all the circular layers of thickness dr to nd the resulting volume ow rate13 of the blood, = =

2rrdr

P 2 z

rR2 r3dr 10

P 4 R , 8 z

which is the famous relation derived experimentally by the French physician Jean Lonard Marie Poiseuille.1214 Equation 10 has several aspects worthy of discussion. First, the blood ow rate depends very strongly on the inner radius of the artery,15 R4, which yields a drastic decrease in the arterys ability to pass blood even for a relatively small decrease in its diameter 61% decrease in the blood ow rate for 21% reduction in the arterys diameter in our example. To pump the same amount of blood through the artery, our body would need to, according to Eq. 10, increase the
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Fig. 3. Blood pressure in various blood vessels of the circulation system Ref. 16. Reproduced with permission.

blood pressure gradient P / z along the artery, which suggests a connection between the deposits of plaque in arteries atherosclerosis and hypertension. A series of questions can be discussed at this point. How much leeway is there for the pressure differential, and thus how much constriction can be compensated? What does the pressure differential P along the artery have to do with the blood pressure measured in the doctors ofce? To fully answer the latter question, students need a simple introduction to the physiology and physics of circulation see, for example, Refs. 13, 14, and 16. Because the heart pumps blood in pulses, the pressure in arteries varies between the maximal and minimal values see Fig. 3. An interesting aspect of blood pressure measurements is the use of turbulence.13,14

Constriction introduced by the inatable cuff makes the blood ow become turbulent full of eddies, swirls, and ripples and thus audible through a stethoscope unlike the laminar, smooth, and quiet ow,13 which is quantitatively described by Eq. 10. When the applied pressure from the cuff exceeds the hearts output pressure, the artery collapses, and no noise of the owing blood can be heard through the stethoscope. The corresponding pressure is called systolic pressure. Then the pressure in the cuff is slowly lowered until the sound of the turbulent blood ow becomes audible again as the ow resumes and then disappears as the ow becomes laminar to yield the diastolic pressure.13 The average of the systolic and diastolic pressures, the mean arterial pressure,16 is the pressure that propels the blood to the tissues see Fig. 3. We can see from Fig. 3 that in accord with these arguments, the most rapid decline in blood pressure in the human body occurs in the arterioles, not the aorta or arteries, because the arterioles smaller diameters increase the resistance to blood ow. We now discuss the nal part of our case study, namely, electrical circuits. When my premed students learn particularly, from the introduction to the textbook5 that this topic is one of the most important items for the physics section of the MCAT, they become upset. In their minds, knowledge of electrical circuits is important only for people who design or repair instrumentation. In reality, many important aspects of blood circulation such as the functioning of pacemaker tissue in the heart17 and the entire human circulation system18,19 can be successfully modeled using electrical circuits. In these models, the current, voltage, charge, resistance, and capacitance of the electrical circuit correspond to the ow rate, blood pressure, volume, resistance, and capaci-

Fig. 4. Electronic circuit used to model blood circulation in human body Ref. 19. Reproduced with permission. 972 Am. J. Phys., Vol. 78, No. 9, September 2010 Notes and Discussions 972

tance of the cardiovascular system19 see Fig. 4. The resistance of the cardiovascular system is caused by the blood viscosity, elasticity of the blood-vessel walls produces capacitance, and, in some models, inertia of the blood ow yields the inductance see Ref. 18, pp. 4177. The parameters of any element of the electrical circuit can be determined, and this analogy allows modeling of pathological conditions such as left ventricular failure, aortic stenosis, or hypertension by adjusting the parameters of the circuit components.19 Although a full-scale description of the entire model is not appropriate here, we can offer students a simple problem conveying the spirit of this model. Problem 3. A portion of a certain artery in the human body can be normally represented in an electrical-circuit model as a 4.5 resistor. As a result of atherosclerosis, the inner diameter of this artery has decreased from 6.0 to 4.0 mm, and a by-pass has been made, which is 5.0 mm in diameter. Assuming that the blood ow remains laminar, what should the resistance of the corresponding element in the electricalcircuit model be changed to? It should be clear to students that the resistance of a blood vessel is inversely proportional to R4 or d4.18 Therefore, the resistance of the analog to the original artery increased to 4.5 6.0 mm / 4.0 mm4 = 23 , resistance of the by-pass should be 4.5 6.0 mm / 5.0 mm4 = 9.3 , and the combined resistance of those two is 1 / 1 / 23 + 1 / 9.3 = 6.6 . The fact that the combined resistance of the damaged artery plus by-pass 6.6 is still signicantly higher than the original resistance of the healthy artery 4.5 , even though there are now two vessels working in parallel instead of the single one originally, with the diameter of each of the two in the new system 5 and 4 mm almost the same as that of the original healthy artery 6 mm, again illustrates the strong dependence of the rate of blood ow on the diameter of the vessel, d4. I emphasize that my goal was not to introduce a rigorous description of blood ow in a magnetic eld or a full-scale model using electrical circuits. Such a description requires sophistication much higher than can be expected from an average premed student for a more sophisticated discussion, see Refs. 1720. Rather, my goal was to motivate these students by demonstrating the relevance of the principles of physics to understanding how the human body works and to show how important it is to integrate knowledge from different areas of physics to probe a single function of an organism.

ACKNOWLEDGMENTS The author is grateful to Jim Lane and Myron Schneiderwent, as well as to the reviewers, for comments that were useful in improving the clarity and the overall quality of the manuscript.
Electronic mail: mwaxman@uwsuper.edu Abraham R. Liboff and Michael Chopp, Should the premed requirements in physics be changed?, Am. J. Phys. 47 4, 331336 1979. 2 Sue Broadston Nichparenko, Pre-med physics: What and why, J. Coll. Sci. Teach. 14, 391394 1985. 3 Gardo Garnet Blado, The MCAT physics test, Phys. Teach. 38, 364 366 2000. 4 Gerd Kortemeyer, The challenge of teaching introductory physics to premedical students, Phys. Teach. 45, 552557 2007. 5 Raymond A. Serway and John W. Jewett, Jr., Principles of Physics. A Calculus-Based Text, 4th ed. Thomson, Brooks/Cole, Belmont, 2006, p. 763. 6 Alexander Kolin, An electromagnetic catheter blood ow meter of minimal lateral dimensions, Proc. Natl. Acad. Sci. U.S.A. 66, 5356 1970. 7 Some noninvasive tools for measuring the velocity of blood ow have been developed as well. Those include nuclear magnetic resonance ow meters Ref. 8 and ultrasonic instruments Ref. 9. 8 J. H. Battocletti et al., Nuclear magnetic resonance blood owmeter, U.S. Patent No. 4,613,818, issued September 23, 1986. 9 R. Lombardi, G. Danese, and F. Leporati, Flow rate proler: An instrument to measure blood velocity proles, Ultrasonics 39, 143150 2001. 10 Introduction to magnetic ow meters, Omega Engineering technical reference, www.omega.com/prodinfo/magmeter.html. 11 Michael A. Waxman, Exploring rotations due to radiation pressure: 2-D to 3-D transition is interesting!, Phys. Teach. 48, 3031 2010. 12 Jerry B. Marion and William F. Hornyak, Principles of Physics Saunders, Philadelphia, 1984, pp. 269270. 13 Paul Peter Urone, Physics with Health Science Applications Harper & Row, New York, 1986, pp. 193203. 14 Carl R. Nave and Brenda C. Nave, Physics for the Health Sciences, 3rd ed. Saunders, Philadelphia, 1985, pp. 8286, 117126. 15 Qualitatively, the fourth power of R in the Poiseuille law occurs due to the combination of two factors. First, in the vessels of larger diameter, the walls are far from most of the blood. Thus the blood is free to ow more rapidly, yielding a greater average speed av. Second, due to the greater cross-section of the larger vessels and because the total ow rate av cross-section, the difference between the ow rates for large and small vessels becomes even greater. 16 Elaine N. Marieb and Katja Hoehn, Human Anatomy and Physiology, 7th ed. Pearson/Benjamin Cummings, San Francisco, 2007, p. 725. 17 Theory of Heart, edited by Leon Glass, Peter Hunter, and Andrew McCulloch Springer-Verlag, New York, 1991, pp. 239248, 255283. 18 M. Zamir, The Physics of Coronary Blood Flow Springer, New York, 2005, pp. 35254. 19 D. J. Tsalikakis, D. I. Fotiadis, and D. Sideris, Simulation of cardiovascular diseases using electronic circuits, Comput. Cardiol. 30, 445448 2003. 20 E. E. Tzirtzilakis, A mathematical model for blood ow in magnetic eld, Phys. Fluids 17, 077103 2005.
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