Medical Physics

IB 12

The Ear and Hearing

1. Distinguish among the:
a) outer ear

b) middle ear

c) inner ear

2. Describe the function of the:

a) ear canal

b) eardrum (tympanic membrane)

c) Eustachian tube

ossicles (consisting of . . .

d) cochlea

e) auditory nerves
1

IB 12

3. What is a sound wave?

Pressure:

Formula:

Units:

Air pressure:

4. What is the range of audible frequencies experienced by a person with normal hearing?

5. What frequency is a normal ear most sensitive to?

6. How are sound pressure variations in air changed to larger pressure

variations in the cochlear fluid?
a) Lever action of ossicles

b) Different areas -

Result:

7. Why is the middle ear necessary? Why not have the sound waves vibrate the oval window directly?

Intensity and Loudness

Power:

Formula:

Units:

Intensity:

Formula:

Units:

IB 12

Total area of sound energy:

As distance from source doubles . . .
Area of eardrum (or oval window) where sound is received:
1. The power output of a speaker is 100 W.
a) Determine the intensity of the sound heard by a person 3.0 m away from the speaker.

b) Determine the energy delivered to the persons eardrum each second. (The total area of the
eardrum is approximately 60 mm2.)

Loudness:
NOTE:

2. What is the difference between intensity and loudness?

3. Why discuss intensity rather than loudness?

Intensity Level

Intensity Level (IL):

IB 12

Units:

3. Calculate the intensity level of a 100 W speaker at a

distance of 6.50 meters.

4. A sound meter placed 0.5 meter from a circular saw measures 92 dB.
a) What is the intensity of the sound that corresponds to this intensity level?

b) How much sound power does the saw produce?

Changing sound
intensity levels:

IB 12

5. If the intensity of a sound doubles, by how much does the intensity level change?

6. What is the difference in the readings on the two sound meters at right?

7. Discomfort is experienced by a person with normal hearing when the intensity is approximately 1.0 W/m2.
a) What is the corresponding intensity level for this intensity?

b) Compare the intensity at this intensity level to the threshold of hearing.

8. What are the effects of short-term and long-term exposure to noise?

a)
b)
c)

IL versus frequency diagram for a person with normal hearing

IB 12

Scale on frequency axis:

Curve:
a)
b)
c)
1. a) Can a 100 Hz note from a piano be heard by a person sitting in the audience at such a distance that
the intensity level of the sound is 20 dB? Explain.

b) What is the minimum intensity and intensity level that the listener could hear for this note?

c) What is the lowest frequency note that the listener could hear at 20dB?
2. Sketch on the graph the results of a hearing test for an elderly person.

Medical Imaging

IB 12

Various imaging techniques are used for diagnostic purposes:

1) X-rays
2) Computed Tomography (CT)
3) Ultrasound
4) Nuclear Magnetic Resonance (NMR)
5) Lasers

X-Rays
Production of X-rays:
a)
b)
c)
d)

Imaging technique:
a)

b)

Increasing sharpness:

Increasing contrast:

IB 12

Attenuation:
a)
b)

The graph at right shows data for the intensity of the X-rays transmitted through a muscle versus the thickness of
the muscle. What is the relationship between the two?

Intensity
Equation:

Half-value Thickness:

Symbol:

Units:

Relationship between Half-value thickness and

attenuation coefficient

Attenuation coefficient:

Symbol:

Units:

1. The graph at right shows the transmitted intensity of a parallel

beam of X-rays versus the thickness of a certain type of tissue.
Determine the:

IB 12

a) half-value thickness of this tissue

b) attenuation coefficient of this tissue

2. Outline the basis for the formation of X-ray image of a limb.

a)

b)

c)

3. Analyze the intensity graph at right by straightening it.

IB 12
4. The half-value thickness of a 30 keV X-ray photon in aluminum is 2.4 mm. The initial intensity of
the X-ray beam is 4.0 x 102 kW/m2.
a) What is the beam intensity after passing through 9.6 mm of aluminum?

b) What is the beam intensity after passing through 1.5 mm of aluminum?

5. A parallel beam of X-rays passes through muscle and reduces to one-eighth of its initial intensity.
Determine the fraction of the intensity of this beam when it is transmitted through the same thickness of
fatty tissue. The half-value thickness of muscle is 4.0 mm and the half-value thickness of fatty tissue is
6.0 mm.

6. The half-value thickness for soft tissue (muscle) is about 20 cm and for bone is 150 times less than this.
Determine the attenuation coefficient for bone and for soft tissue.

10

Computed Tomography (CT)

IB 12

CT or CAT scan: Computer-Assisted Tomography or Computerized Axial Tomography

Outline the basis of CT scanning

X-ray image of target taken at different angles (many
different directions)
- computer produces detailed image of slice (these images are
combined using computers to form a two-dimensional image of
section)
images of many sections/slices can be obtained
combined to build up a 3D image so image can be rotated for
viewing from any angle
Compare X-ray imaging and CT scans
X-ray imaging
1)
2)
3)
4)
CT scanning
1)
2)
3)
4)
Why/how are barium meals used to assist X-ray imaging of stomach or intestinal tract?
a) All tissues in the abdominal cavity have approximately the same attenuation coefficient so there
is little to no contrast on photographic film.
b) The attenuation coefficient for barium is greater than for the tissues in the abdominal cavity.
c) Barium meal lines the stomach.
d) Outline of stomach becomes clearer (greater contrast).
11

IB 12
Biological Effects of Ionizing Radiation (short-term and long-term)
a) Radiation causes direct damage to DNA by removing electrons
b) Damages cells indirectly via ionization of water (removing electrons)
c) Short-terms effects include death of cell/failure to replicate
d) Short-term effects include production of toxins/failure of immune system
e) Long-term effects include mutations or cancers caused by faulty repairs or changes to DNA,
sterility, and shortening of life expectancy
Why would patients accept an increased health risk from exposure to X-ray radiation?

Balanced Risk:

Precautions for reducing exposure to ionizing radiation for both patients and health-care workers:
1) Shielding: lead, leaded glass
Purpose:
a) material absorbs energy before it reaches worker,
b) prevents energy from going to other body parts of patient other than target area
2) Distance: maximize distance from source eg. Controls remote from source
Purpose: reduces intensity of energy worker receives
3) Time-of-Exposure: minimize time of exposure to radiation
Purpose: reduces intensity of energy worker or patient receives
Codes of Practice (Protocols): standard procedures for working with each type of radiation to reduce risk
of accidents
Monitoring of exposure can be done using a Film Badge.
a) Photographic film sealed in a plastic container so not
exposed to light.
b) Any ionizing radiation that passes through film badge
darkens part of photographic film (exposes film).
c) Different filters are placed on either side of the film to
determine the type of ionizing radiation worker was
exposed to.

12

Ultrasound

IB 12

Type of energy used:

Advantage:

Typical operating frequencies of ultrasound waves:

Operating principles: High frequency sound waves are
transmitted from a probe into the patients body and are reflected
at each boundary between different types of tissue and bone. The
same probe both transmits and receives the ultrasound waves.
By measuring the time between transmission and reception, the
distance to each boundary can be calculated using the speed of
sound and thus the location and surface of each organ can be
mapped.
Production and detection of ultrasound waves
Piezoelectric crystal:

Production:

Detection:

Factors affecting choice of diagnostic frequency:

a) Resolution:

Favors:
b) Attenuation:

Favors:
Compromise:

13

IB 12
1. The time delay for an ultrasound pulse going through body fat to reach and be reflected from the liver
is 0.133 ms. The speed of the ultrasound through fat at the chosen frequency is 1450 m/s.
a) Calculate how far from the probe the liver is.

b) What are some assumptions made in this calculation?

Acoustic Impedance:

Symbol:

Formula:

Units:

2. Calculate the acoustic impedance of room temperature air.

Reflection at a boundary:

3. Based on the table above, from what boundary will most of the energy of the ultrasound waves be
reflected?
4. What is the purpose of putting gel on probe and the patients skin?

14

IB 12
Types of ultrasound scans
1) A-scan:

Presentation:

The diagram above shows an ultrasound transducer (probe) in contact with the skin in an effort to
determine the depth and width of the organ shown. An A-scan of the results is shown also. The
average speed of the ultrasound used in tissue and muscle is 2.0 x 103 m/s.
a) Identify the source of each reflection labeled A, B, C, and D.
b) Calculate the depth of the organ.

c) Calculate the width of the organ.

2) B-scan:

Presentation:

15

NMR

IB 12

NMR:
MRI:
Type of energy used:
1)
2)
Uses:
1)
2)
3)
Operating Principles:
a) Large constant uniform magnetic field causes hydrogen atoms to line up (align their spin axes)
act like tiny magnets
b) Small non-uniform magnetic field is superimposed on top of larger field localized magnetic
field weak oscillating field in the form of pulses of radio waves
c) If frequency of radio waves matches that of the hydrogen atoms (resonance) then the smaller
field makes some hydrogen atoms realign
d) When small non-uniform field is removed, atoms relax back to original alignment
e) As they relax they emit radio-waves
f) Time it takes to relax is measured
g) Frequency of emitted radio waves and relaxation times are processed to produce the NMR
image
Advantages:
1) Any situation where detailed tomography/slicing/imaging is required
2) Large scale investigations where dose of ionizing radiation would be too great

16

Comparisons of Diagnostic Imaging Techniques

IB 12

1. What are the advantages and disadvantages of using

ultrasound instead of X-rays?
Advantage: not as harmful since no ionizing radiation
And so can be used for pregnant women
Disadvantages:
Small depth of penetration
Limit to size of objects that can be imaged
Blurring of images due to reflection at boundaries
2. Why are X-rays preferred over ultrasound for bone fractures?
Nearly all ultrasound is reflected by bone (at bone/tissue
boundary) but x-rays can penetrate bone therefore X-rays
show up internal structures.

3. What are the main advantages of each of the following imaging

techniques?
X-rays:
To detect broken bones because bone and tissue show different
attenuation/good distinction between bones and flesh
Ultrasound:
Any soft tissue analysis takes advantage of reflections off organ
boundaries
Pre-natal scans because there is no risk from ionizing radiation
NMR:
Any situation where detailed tomography/slicing/imaging is
required
Large scale investigations where dose of ionizing radiation would
be too great

4. Apart from health hazards, why are different means of diagnosis needed?
a)
b)
c)
d)
e)
f)
g)

Different types of tissues and bone have different absorption/attenuation properties

Some are better at distinguishing boundaries of organs
Some provide two dimensional slice imaging some provide complete three dimensional images
Some are better at monitoring static or dynamic conditions
Some are better to investigate at large or small scales
Some can be used to study concentrations of specific types of tissue or pharmaceuticals
Some are better at monitoring specific organ functions
17

Lasers

IB 12

1) Pulse Oximetry
Red and infrared laser light is shone through a thin part of a patients anatomy, for example an
earlobe or fingertip. The amount of absorbance of each wavelength will depend on many factors but a
changing relative absorbance between two wavelengths can be used to determine the ratio of blood
cells with oxygen (which are bright red) and those without oxygen (which are dark red). This allows
the overall oxygen content of the blood to be determined without having to take a sample of blood.

2) Endoscopes
An endoscope provides the ability to look inside the human body without invasive surgery. A
tube is inserted into the body, usually through the mouth or anus. Within the tube there is a collection
of optical fibers that allows illumination from an outside source to reach the end of the tube and
illuminate the region under investigation (stomach, lungs, colon, intestines). Reflected light is
collected using a lens system and further optical fibers are used to allow an image to be viewed.

Total internal reflection of a laser

beam in a fiber optic cable

3) Scalpel
A laser focused on a small region can increase its temperature so high that it cuts through
tissue like a scalpel. The laser heating ensures the site is kept free of germs and thus the risk of
infection is reduced. In addition, vessels and nerves are automatically sealed off.

4) Coagulator
A defocused laser beam can stop bleeding by stimulating the blood to form a clot.

18

Therapeutic Radiation

IB 12

Diagnostic radiation:
Therapeutic radiation:
Radiation dosimetry:

1. Exposure

Symbol:

Formula:

Units:

Formula:

rad
Units:

Significance:

2. Absorbed Dose

Symbol:

Significance:

What are three factors that affect the absorbed dose?

3. Quality Factor (Relative Biological Effectiveness)

Symbol:

Units:

Significance:

4. Dose Equivalent

Symbol:

Formula:

Units:

Significance:
19

1. Why do radiations have different effects for same absorbed dose?

IB 12

2. Why use the dose equivalent rather than the absorbed dose when assessing
biological effects of radiation?

3. So what is this quality factor(RBE)?

It is a factor that compares the effectiveness of different types of radiation to that of X-rays
because different types of radiation of the same intensity produce different amounts of ionizing
radiation and can cause different amounts of damage.
Thus Q = 1 for X-rays.
4. Radiation from a gamma source creates an exposure of 4.3 x 10-3 C/kg. The average energy to singly
ionize an atom in human tissue is approximately 40 eV and the quality factor for gamma radiation is
1. What is the absorbed dose and dose equivalent of this exposure?

5. A person of mass 75 kg is exposed to monochromatic X-rays of energy 250 keV. As a result of this
exposure, the person receives a dose equivalent of 0.50 mSv in 2.0 minutes. Approximately how
many photons per second does the person absorb?

20

Radiation Therapy

IB 12

Aim of radiotherapy:
To target malignant cells in preference to normal healthy cells. Malignant cells are slightly more
susceptible to damage from radiation than healthy cells.

Balanced risk:
If the dose is too high, too many healthy cells are killed. If the dose if too low, cancer is not
destroyed. The dose needs to be as high as possible in the region of the cancer and as low as
possible everywhere else.
Types of treatments:
1) A radioactive source can be placed within the tumor itself, either physically or chemically.
2) Overlapping beams of radiation can be used. Where they overlap the dose will be high (at the
tumor site) while elsewhere the does will be low.
Types of sources:
1) A radioactive element
2) High energy X-rays, gamma rays or protons from
particle accelerators
Example of therapy technique using X-rays to kill cancer cells in a tumor:
a) X-rays are much higher intensity than those used to take chest X-rays
b) Cancer cells are targeted to receive a high dose by irradiating region from different angles with
tumor in overlap region
c) Aim is to minimize danger to other healthy cells while killing cancerous ones since malignant
cells are preferentially susceptible to x-rays.
Example of therapy technique using iodine-131 to treat thyroid cancer:
a) Iodine-131 decays with beta-minus and gamma particle
b) Iodine readily absorbed by thyroid so will localize in target area
c) Beta-particles are absorbed over small volume so dose is localized (whereas alpha-particles are
absorbed over large volume more indiscriminate and therefore dangerous)
d) Gamma will escape from body so can be monitored
e) Effective half-life is about six days so patient will receive effective dose for a reasonable
period of time but not too long to cause other damage

21

Half-Life

IB 12

Physical Half-life (TP) (same as T1/2)

a. the time taken for the number of radioactive nuclei in sample to decay
b. the time taken for the activity of a sample to decrease to its initial value
Biological Half-life (TB)

Effective Half-life (TE)

Half-Life
Relationship
1. If the physical half-life of a radioisotope is 10 days and the
biological half-life is 15 days, what fraction will remain after 30
days?

2. a) The isotope iodine-131 can be used to treat malignant growths in the thyroid gland. The isotope has a
radioactive half-life of 8 days and a biological half-life of 21 days. Calculate its effective half-life and
determine the time it would take for its activity to decrease to 1/8th of its initial activity.

b) The isotope technetium-99 is also readily absorbed by the thyroid but has a radioactive half-life of
only six hours. Comment on which of these two isotopes is preferable to use for:
i)

diagnostic purposes

ii)

therapeutic (treatment) purposes.

22