Basic Physics and Measurement
in Anaesthesia
Presented by:-DR.KALYAN REGMI
Moderator: DR. ANIL PRASAD NEUPANE
Assistant professor,Department of
anesthesiology,PAHS,Pokhara
•Flows: Definition, types, clinical aspects
•Hagen-Poiseuillie equation
•Surface tension
•Laplaces law
•Bernoulli effect
•Viscosity
•Venturi effect
•Entrainment ratio
•Coanda effect
OBJECTIVE
• Flow is defined as the quantity of a fluid, i.e. a
gas or a liquid, passing a point in unit time
• where F = mean flow
• Q = quantity (mass or volume)
• t = time
FLOW
TYPES OF FLOW
LAMINAR FLOW
• Fluid moves in a steady manner and there are no
eddies or turbulence.
• Laminar flow normally present in smooth tubes
at low rates of flow.
• The velocity of flow is highest in the centre.
• Flow is directly proportional to pressure under
conditions of laminar flow
The ratio of pressure to flow is a constant
known as resistance R of the apparatus or tube
concerned
Measurement of flow resistance
TURBULENT FLOW
• Flow in which fluid is no longer flows in a
smooth fashion but swirls in eddies.
• Laminar flow may change to turbulent flow if
a constriction is reached which results in the
increasing fluid velocity.
• In turbulent flow the resistance is higher for
the same laminar flow
• For turbulent flow in tubes that are rough on the
inside it is found that the flow is approximately
proportional to the square root of the pressure
•The factors affecting turbulent flow are :-
1.Vicosity of fluid
2.Diameter of tube
3.Density of fluid and
4. Linear velocity of fluid
• These factors may all be combined to give an index
known as Reynolds number, which is calculated as
follows
•If Reynolds number exceeds about 2000, then
turbulent flow is likely to be present.
•If Reynolds number is below 2000, the flow is likely
to be laminar.
Clinical aspects of flow
•Changes between laminar and turbulent flow
depends on the velocity of gases,which in turn
depends on the volume flow and thus on the
diameter of tubing and airways.
•In patients airway,gases are humidified, warmed (34-
37ᵒ C) and contains carbondioxide. The overall effect
of these is reduction in density of gases and rises in
critical flow.
Critical flows for anesthetic gaseous
mixture of 60% nitrous oxide, oxygen
and air (20ᵒ C and patients airway)
•As breathing is cyclical, with peak flows over 50 lit
per min(turbulent flow during peak flow), laminar
flow at other times in respiratory cycles
•Bronchi and smaller air passages in lungs: slower
flow and laminar in lower respiratory tract.
Hegan- Poissuilles equation:
•Represents relationship between flow and
factors affecting flow.
• Applied for laminar flow.
Qᵒ = πPd4/128 ηl
Where, Qᵒ = flow
P = pressure across the tube
d = diameter of the tube
η = viscosity
l = length of the tube
π/128 = constant
Flow Rate (ml/min) 270ml 180ml 80ml 54ml 33ml 20ml
Length(mm) 45mm 45mm 45mm 32mm 25mm 19mm
Fig. Central venous catheter Fig . Peripheral venous catheter
SURFACE TENSION
• Surface tension is a result of the attraction
between molecules across the surface of a
liquid.
• In the surface water molecules are attracted
downwards and sidewise only.(air fluid
interface)
LAPLACES LAW
•surfactants are compounds that lower the surface
tension of a liquid.
•Surfactant molecules are synthesized by type II
pneumocytes (cuboidal cells lining alveoli) and kept in
clusters called lamilar bodies and secreted as tubular
myelin.
•The alveoli in the lungs are lined with fluid
which,comprising mainly water, has a significant
surface tension.
Surfactant
• Alveoli collapse
• Smaller sized alveoli collapses into large
sized alveoli causing ventillation perfusion
mismatch
• Tendency of edema formation in alveoli
• Surface area for gaseous exchange
decreases
Major problems with surface tension in
lungs
VISCOCITY
•Viscosity is a measure of the frictional forces
acting between the layers of the fluid as it flows
along the tube.
•Flow and viscosity are inversely proportional.
Higher
viscosity
Lower flow
Increased
risk of
vascular
occlusion
BERNOULLI’S PRINCIPLE :
States that when a gas flowing through a tube,
encounters a constriction, at that point, the pressure
drops and velocity increases.
VENTURI EFFECT :
•consequence of the Bernoulli’s principle
•The entrainment of the air from the surroundings due
to fall in the pressure at the point of constriction is
called venturi effect.
•Suction: injectors working on this venturi effect may
be used to provide suction, either water or gases
being used as the driving fluid.
•Nebulisers
•Venturi masks
Uses of venturi effect
• A Venturi is a simple design of valve that provide control
oxygen supplied through a narrow port which allows room
air to be drawn in from atmosphere
• The rate of flow generated by this Venturi principle and
Venturi mask may be equal to peak inspiratory flow of
patient.
Venturi masks
ENTRAINMENT RATIO
The entrainment ratio is defined as the ratio of
entrained flow to driving flow.
COANDA EFFECT
:
•If a constriction occurs at a bifurcation, due to
increase in velocity and reduction of pressure, the
fluid/air tends to stick to the side of the branch
causing maldistribution.
APPLICATION:
• Mucus plug at the branching of tracheo-bronchial
tree may cause maldistribution of respiratory gases.
•Unequal flow may result because of atherosclerotic
plaques in the vascular tree
TAKE HOME MESSAGE
• Reynold number less than 2000 indicate laminar flow
• Fluid resuscitation is done via wide bored peripheral
catheter
• Surfactant helps to prevent alveoli collapses
• Gas/fluid flow from higher pressure to low pressure area
• Gas/ fluid following through tube when encounter
constriction at that point pressure drop and velocity
increases.
THANKYOU

FLOW, physics, laminar, turbulant, physics

  • 1.
    Basic Physics andMeasurement in Anaesthesia Presented by:-DR.KALYAN REGMI Moderator: DR. ANIL PRASAD NEUPANE Assistant professor,Department of anesthesiology,PAHS,Pokhara
  • 2.
    •Flows: Definition, types,clinical aspects •Hagen-Poiseuillie equation •Surface tension •Laplaces law •Bernoulli effect •Viscosity •Venturi effect •Entrainment ratio •Coanda effect OBJECTIVE
  • 3.
    • Flow isdefined as the quantity of a fluid, i.e. a gas or a liquid, passing a point in unit time • where F = mean flow • Q = quantity (mass or volume) • t = time FLOW
  • 4.
  • 5.
    LAMINAR FLOW • Fluidmoves in a steady manner and there are no eddies or turbulence. • Laminar flow normally present in smooth tubes at low rates of flow. • The velocity of flow is highest in the centre.
  • 7.
    • Flow isdirectly proportional to pressure under conditions of laminar flow The ratio of pressure to flow is a constant known as resistance R of the apparatus or tube concerned
  • 8.
  • 9.
    TURBULENT FLOW • Flowin which fluid is no longer flows in a smooth fashion but swirls in eddies. • Laminar flow may change to turbulent flow if a constriction is reached which results in the increasing fluid velocity. • In turbulent flow the resistance is higher for the same laminar flow
  • 11.
    • For turbulentflow in tubes that are rough on the inside it is found that the flow is approximately proportional to the square root of the pressure
  • 12.
    •The factors affectingturbulent flow are :- 1.Vicosity of fluid 2.Diameter of tube 3.Density of fluid and 4. Linear velocity of fluid
  • 13.
    • These factorsmay all be combined to give an index known as Reynolds number, which is calculated as follows
  • 14.
    •If Reynolds numberexceeds about 2000, then turbulent flow is likely to be present. •If Reynolds number is below 2000, the flow is likely to be laminar.
  • 15.
    Clinical aspects offlow •Changes between laminar and turbulent flow depends on the velocity of gases,which in turn depends on the volume flow and thus on the diameter of tubing and airways. •In patients airway,gases are humidified, warmed (34- 37ᵒ C) and contains carbondioxide. The overall effect of these is reduction in density of gases and rises in critical flow.
  • 16.
    Critical flows foranesthetic gaseous mixture of 60% nitrous oxide, oxygen and air (20ᵒ C and patients airway)
  • 17.
    •As breathing iscyclical, with peak flows over 50 lit per min(turbulent flow during peak flow), laminar flow at other times in respiratory cycles •Bronchi and smaller air passages in lungs: slower flow and laminar in lower respiratory tract.
  • 18.
    Hegan- Poissuilles equation: •Representsrelationship between flow and factors affecting flow. • Applied for laminar flow. Qᵒ = πPd4/128 ηl Where, Qᵒ = flow P = pressure across the tube d = diameter of the tube η = viscosity l = length of the tube π/128 = constant
  • 20.
    Flow Rate (ml/min)270ml 180ml 80ml 54ml 33ml 20ml Length(mm) 45mm 45mm 45mm 32mm 25mm 19mm
  • 22.
    Fig. Central venouscatheter Fig . Peripheral venous catheter
  • 23.
    SURFACE TENSION • Surfacetension is a result of the attraction between molecules across the surface of a liquid. • In the surface water molecules are attracted downwards and sidewise only.(air fluid interface)
  • 25.
  • 26.
    •surfactants are compoundsthat lower the surface tension of a liquid. •Surfactant molecules are synthesized by type II pneumocytes (cuboidal cells lining alveoli) and kept in clusters called lamilar bodies and secreted as tubular myelin. •The alveoli in the lungs are lined with fluid which,comprising mainly water, has a significant surface tension. Surfactant
  • 27.
    • Alveoli collapse •Smaller sized alveoli collapses into large sized alveoli causing ventillation perfusion mismatch • Tendency of edema formation in alveoli • Surface area for gaseous exchange decreases Major problems with surface tension in lungs
  • 29.
    VISCOCITY •Viscosity is ameasure of the frictional forces acting between the layers of the fluid as it flows along the tube. •Flow and viscosity are inversely proportional.
  • 30.
  • 31.
    BERNOULLI’S PRINCIPLE : Statesthat when a gas flowing through a tube, encounters a constriction, at that point, the pressure drops and velocity increases.
  • 32.
    VENTURI EFFECT : •consequenceof the Bernoulli’s principle •The entrainment of the air from the surroundings due to fall in the pressure at the point of constriction is called venturi effect.
  • 33.
    •Suction: injectors workingon this venturi effect may be used to provide suction, either water or gases being used as the driving fluid. •Nebulisers •Venturi masks Uses of venturi effect
  • 34.
    • A Venturiis a simple design of valve that provide control oxygen supplied through a narrow port which allows room air to be drawn in from atmosphere • The rate of flow generated by this Venturi principle and Venturi mask may be equal to peak inspiratory flow of patient. Venturi masks
  • 37.
    ENTRAINMENT RATIO The entrainmentratio is defined as the ratio of entrained flow to driving flow.
  • 38.
    COANDA EFFECT : •If aconstriction occurs at a bifurcation, due to increase in velocity and reduction of pressure, the fluid/air tends to stick to the side of the branch causing maldistribution.
  • 39.
    APPLICATION: • Mucus plugat the branching of tracheo-bronchial tree may cause maldistribution of respiratory gases. •Unequal flow may result because of atherosclerotic plaques in the vascular tree
  • 40.
    TAKE HOME MESSAGE •Reynold number less than 2000 indicate laminar flow • Fluid resuscitation is done via wide bored peripheral catheter • Surfactant helps to prevent alveoli collapses • Gas/fluid flow from higher pressure to low pressure area • Gas/ fluid following through tube when encounter constriction at that point pressure drop and velocity increases.
  • 41.

Editor's Notes

  • #9 A known constant flow Qᵒ is passed through the apparatus concerned and differences in pressures P1-P2 between ends of the apparatus is measured. If flow is laminar ,resistance can be measured by dividing the pressure differences by rate of flow.
  • #15 Whenever there is narrowing or sharp bend in tubing, velocity of fluid increases leading to turbulent flow. Since density plays important role in turbulent flow, helium in oxygen can be used in patient with airway obstruction to reduce extent of turbulent flow (oxygen density— 1.3, helium density—0.16).
  • #16 Critical flow is a flow in which specfic energy is minimum Froude number =velocity /square root of gravity and depth (froude number =1 . Velocity of fluid = critical velocity)
  • #17 Internal diameter = critical flow litre for min , increased temperture decrease density The flow of anesthetic gases in 9mm internal diameter endotracheal tube becomes turbulent when flow exceeds about 9 liter per min. Trachea which is approx 15 mm in internal diameter, flow becomes turbulent at flow 15 lit per min.
  • #18 Quite breathing: laminar flow Coughing, speaking, taking deep breath: turbulent flow.
  • #20 the flow is proportional to the fourth power of the diameter. fluid flows rapidly through 16 G cannula compared to 22 G small size ETT may cause a tremendous decrease in the flow of gases
  • #22 -fluid flows slowly through central line compared to peripheral cannula -
  • #23 For Fluid resuscitation a wide bored pheripheral venous catheter is best
  • #27 Components of surfactant molecules: Di-palmitoyl-phosphatidyl choline,phophatidyl glycerol surfactant-protein A, B, C,D hydrophobic-b and c IgA, Albumin
  • #31 Increased viscosity seen in incresed blood cell like thrombocytosis polycythemia leukemia , increases immnoglobin like multiple myeloma
  • #36 Green 65% fio2 at 12-15l/min Red 40% fio2 at 10-12l/min Yellow 35% fio2 at 8-10l/min White 28% fio2 at 4-6 l/min Blue 24% fio2 at 2-4l/m
  • #40 This phenomenon is also called as wall attachment there be unequal gas flow to the alveoli where there has been a slight narrowing of the bronchiole before it divides.It may also explain some cases of Myocardial Infraction, where there may be some narrowing, before the branching of the coronaries. Unequal flow may result because of atherosclerotic plaques in the vascular tree