Medical Physics Chapter 4 Heat and Cold in Medicine

Chapter 4 Heat and Cold in Medicine

4.1 Physical Basis of Heat and Temperature

m Matter is composed of molecules in motion

Ÿ Kinetic energy (K.E.) is related with temperature (T)
Ÿ K.E. ↑ ⇔ T ↑
m Heat
Ÿ Energy transferred to molecules to increase T
Ÿ Solid + heat ⇒ liquid
Ÿ Liquid + heat ⇒ gas
Ÿ Gas + heat ⇒ ions

4.2 Thermometry and Temperature Scales

m Thermometry: indirect measurement of T

m Temperature scales
ŸFahrenheit (°F) scale
ù Water freezes at 32°F and boils at 212°F
ù Normal body T (rectal) is about 98.6°F
Ÿ Celsius (°C) scale
ù Water freezes at 0°C and boils at 100°C
ù Normal body T (rectal) is about 37°C
Ÿ Absolute (°K) scale
ù Water freezes at 273.15°K and boils at 373.15°K
ù Normal body T (rectal) is about 310°K
ù Absolute zero (0°K) is –273.15°C
m Glass thermometer
Ÿ Increase in T of different materials ⇒ expansion by different amounts
Ÿ Mercury or alcohol in a glass capillary
ù Mercury or alcohol expands more than glass as T ↑
Ÿ Mercury fever thermometer
ù T change from 0 to 100°C in 1cm3 mercury ⇒ 1.8% change in volume
ù Capillary with smaller diameter (0.1 mm) ⇒ high sensitivity

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Medical Physics Chapter 4 Heat and Cold in Medicine

ù Magnifying glass and opaque white backing ⇒ improved visibility (Fig.

4.2)
Restriction just above the bulb ⇒ hold the maximum T
ù
ù
T measurement underneath the tong or in the rectum requires several
minutes for stabilization (why?)
m Thermistor
Ÿ Resistor with negative T coefficient (-5%/°C)
Ÿ Bridge circuit in Fig. 4.3
Ÿ Highly sensitive to detect T change of 0.01°C
Ÿ Small mass and fast response
Ÿ Application to pneumograph (respiration monitoring)
m Thermocouple
Ÿ Two junctions of two different metals (copper-constantan) in Fig. 4.4
Ÿ T difference between two junctions ⇒ voltage of 4 mV/100°C ⇒ needs
amplification
Ÿ Cold junction at 0°C using ice bath or semiconductor circuit
Ÿ Wide T range: -190 to 300°C
Ÿ Very small

4.3 Thermography – Mapping the Body’s Temperature

m Body surface T
Ÿ External physical factors
Ÿ Internal metabolic and circulatory processes near the skin (blood flow near the
skin dominates)
m Thermogram: surface T map
Ÿ Surface T above tumor is about 1°C higher ⇒ breast cancer detection ⇒ not
successful
Ÿ Radiation emitted by body
ù W = eσ T4 : Stefan-Boltzmann law (Example 4.1)
2898
ù λmax = : Wien’s displacement law
T
ù T = 300°K ⇒ λmax = 9.66µm (infrared region, not visible)
Ÿ Basic thermographic unit (Fig. 4.5) and commercial instrument (Fig. 4.6)
ù Detect T difference of 0.2 or 0.1°C
ù Frame time of 2 s

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Medical Physics Chapter 4 Heat and Cold in Medicine

ù 20 min stabilization period at 21°C

ù Clothing must be removed
Ÿ Breast cancer detection
ù Thermography: high false positive and false negative
ù Palpation: difficult to detect a small tumor (less than 1 cm in diameter)
ù Mammography (low energy x-ray): successful but radiation hazard
ù Biopsy: invasive, some cancer tissue may be missed
Ÿ Circulation of blood in the head
Ÿ Detection of circulatory problem in the foot of diabetics

4.4 Heat Therapy

m Heating of tissue may be beneficial to damaged tissue

Ÿ Increase in metabolism ⇒ relaxation of the capillary system (vasodilation)
Ÿ Increase in blood flow since blood moves to cool the heated area
m Heating methods
Ÿ Heat conduction: hot bath, hot pack, electric heating pad, hot paraffin, etc.
ù Contact area
ù T difference
ù Duration
ù Thermal conductivity
Ÿ Radiant (IR) heat: glowing wire coil, incandescent lamp, sun, etc.
ù IR wavelength: 800 to 40,000 nm
ù Waves penetrate the skin by 3 mm and increase the surface T
ù Excessive exposure ⇒ reddening (erythema), swelling (edema), browning
and hardening of the skin
Ÿ Electrical heating: electric currents through resistive tissues produce joule
heating
ù Short-wave diathermy: radio frequency (500 kHz), muscle spasm, pain,
degenerative joint disease, bursitis, use of electrodes (Fig. 4.9) and use of
magnetic induction (Fig.4.10)
ù Microwave diathermy: radar frequency (900 MHz), fractures, sprains and
strains, bursitis, injuries to tendons, arthritis
ù Internal heating is possible ⇒ treatment of inflammation of the skeleton,
bursitis, neuralgia
Ÿ Ultrasonic diathermy: ultrasonic waves vibrate tissues producing heat

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Medical Physics Chapter 4 Heat and Cold in Medicine

m Treatment of cancer by heat is promising (tumor heated to about 42°C for 20 to 30

min)

4.5 Use of Cold in Medicine

m Cryogenics: science and technology of producing and using very low temperature
m Cryobiology: study of low-temperature effects in biology and medicine
m Cryogenic fluids
Ÿ Liquid helium: -269°C
Ÿ Liquid nitrogen: -196°C
m Container: Dewar vessels (Fig. 4.11)
Ÿ Glass or thin stainless steel: minimize conductive heat loss
Ÿ Vacuum space: minimize convective heat loss
Ÿ Silvered or polished surface: reflect radiation
m Transfer of cryogenic fluids: two polished concentric metal pipes with vacuum
between walls
m Cryogenic methods in medicine
Ÿ Long-term preservation of blood, sperm, bone marrow, and tissues
Ÿ Cryonics: preservation and revival of living tissues at low T
Ÿ Survival behavior as a function of cooling rate (Fig. 4.12): different tissues
show different behavior
m Storage of blood
Ÿ Thin-walled container (Fig.4.13)
Ÿ Blood-sand method

4.6 Cryosurgery

m Cryosurgery: cryogenic methods to destroy cells

Ÿ Less amount of bleeding
Ÿ Volume of tissue destroyed can be controlled by T
Ÿ Little pain sensation since low T desensitize nerves
m Cryoknife or Cooper cryosurgery system (Fig. 4.14)
Ÿ Treatment of Parkinson’s disease
Ÿ Destroy a part of the thalamus in the brain
m Treatment of tumors and warts
m Eye surgery

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Medical Physics Chapter 4 Heat and Cold in Medicine

Ÿ Repair of a detached retina

Ÿ Cataract surgery (removal of a darkened lens)

4.7 Safety with Cryogenics

Ÿ Containers must be securely fixed

Ÿ Pressure-reducing regulator must be used
Ÿ Cryogenic fluid causes “freeze burns”
Ÿ Adequate ventilation is required
Ÿ Open flame and smoking are prohibited
Ÿ Special care for oxygen since it is highly flammable

l Homework
m Review questions: #3, #10

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