7States of MatterSolids – have a high degree of internal order; their atoms have a strong mutual attractive forceLiquids – atoms exhibit less degree of mutual attraction compared with solids, they take the shape of their container, are difficult to compress, exhibit the phenomenon of flowGases – weak molecular attractive forces; gas molecules exhibit rapid, random motion with frequent collisions, gases are easily compressible, expand to fill their container, exhibit the phenomenon of flow
8The energy of position, and the energy of motion. States of MatterAll matter possesses energy. There are 2 types of internal energy:The energy of position, and the energy of motion.Internal energy of matterPotential energy (Position) The strong attractive forces between molecules that cause rigidity in solidsKinetic energy (Motion) Gases have weak attractive forces that allow the molecules to move about more freely, interacting with other objects that they come in contact withInternal energy and temperatureThe two are closely related: internal energy can be increased by heating or by performing work on it.Absolute zero = no kinetic energy
9Potential energy is stored energy. Kinetic energy is the energy that an object possesses when it is in motion.
10Physical properties of a solid: Possess the least amount of KEMostly Potential Energy in intermolecular forces holding particles togetherCan maintain their volume & shape
11Physical properties of a liquid: Intermolecular, cohesive forces are not as strongThey exhibit fluidity (particles slidingThey exhibit a buoyant forceEssentially incompressibleAssume the shape of their container
12Physical properties of a gas: Extremely weak – if any – cohesive forcesPossess the greatest amount of KE & the least amount of Potential EnergyMotion of atoms & molecules is randomDo not maintain their shapes & volumes but expand to fill the available spaceExhibit the phenomenon of flowExhibits the least thermal conductivityUses: Gas therapy (Oxygen, Heliox, Nitrous oxide…HHN/SVN…)
13Change of State Liquid-solid phase changes (melting and freezing) Melting = changeover from the solid to the liquid stateMelting point = the temperature at which melting occur.Freezing = the opposite of meltingFreezing point = the temperature at which the substance freezes; same as its melting point
14Fahrenheit Scale the freezing point of water at 32 degrees and the boiling point at 212 degrees. These two points formed the anchors for his scale.Celcius Scale the freezing temperature for water to be 0 degree and the boiling temperature 100 degrees. The Celsius scale is known as a Universal System Unit. It is used throughout science and in most countries.Kelvin Scale There is a limit to how cold something can be. The Kelvin scale is designed to go to zero at this minimum temperature. At a temperature of Absolute Zero there is no motion and no heat. Absolute zero is where all atomic and molecular motion stops and is the lowest temperature possible. Absolute Zero occurs at 0 degrees Kelvin or degrees Celsius or at -460 degrees Farenheit.
15Change of State (cont.) Properties of liquids Pressure – depends on the height and weight density.Buoyancy – occurs because the pressure below a submerged object always exceeds the pressure above itViscosity – the force opposing a fluid’s flow. The greater the viscosity of a fluid, the greater the resistance to flow.Blood has a viscosity five times greater than that of water
16Pressure Pressure is measured in cmH2O, mmHg or PSI Atmospheric pressure is the force per unit area exerted into a surface by the weight of air above that surface in the atmosphere of Earth (or that of another planet). In most circumstances atmospheric pressure is closely approximated by the hydrostatic pressure caused by the mass of air above the measurement point.
17PressureMany techniques have been developed for the measurement of pressure and vacuum. Instruments used to measure pressure are called pressure gauges or vacuum gauges.A manometer could also refer to a pressure measuring instrument, usually limited to measuring pressures near to atmospheric. The term manometer is often used to refer specifically to liquid column hydrostatic instruments.
18PressureStatic pressure is uniform in all directions, so pressure measurements are independent of direction in an immovable (static) fluid. Flow, however, applies additional pressure on surfaces perpendicular to the flow direction, while having little impact on surfaces parallel to the flow direction. This directional component of pressure in a moving (dynamic) fluid is called dynamic pressure.
19Change of State (cont.) Heat transfer Conduction – transfers heat in solidsConvection – transfers heat in liquids and gases(Example: heating homes or infant incubators)Radiation – occurs without direct contact between two substances - example: microwave ovenEvaporation/Condensation: requires heat energy to occurSublimation - change from a solid to a gas without an intermediate change to a liquid - example dry ice turning into CO2
20Heat Transfer Conduction: http://www.youtube.com/watch?v=9UxU0ELgYO A Convection&feature=relmfuRadiation&feature=relmfuCondensation/evaporationfeature=related
21Change of State (cont.)Pascal’s Principle. Liquid pressure depends only on the height and weight density of the liquid and not the shape of the vessel or total volume of a liquid.
22Pascal's lawPascal's law states that pressure exerted anywhere in a confined incompressible fluid is transmitted equally in all directions throughout the fluid such that the pressure ratio (initial difference) remains the same.Pascal’s Law states that when you apply pressure to confined fluids (contained in a flexible yet leak-proof enclosure so that it can’t flow out), the fluids will then transmit that same pressure in all directions within the container, at the same rate. The simplest instance of this is stepping on a balloon; the balloon bulges out on all sides under the foot and not just on one side. This is precisely what Pascal’s Law is all about – the air which is the fluid in this case, was confined by the balloon, and you applied pressure with your foot causing it to get displaced uniformly.
23Change of State (cont.) Cohesion and adhesion The attractive force between like molecules is cohesion.The attractive force between unlike molecules is adhesion.The shape of the meniscus depends on the relative strengths of adhesion and cohesion.H20: Adhesion > CohesionMercury: Cohesion > AdhesionMercuryH20
24Cohesion and AdhesionCohesion: Water is attracted to water Adhesion: Water is attracted to other substancesAdhesion and cohesion are water properties that affect every water molecule on earth and also the interaction of water molecules with molecules of other substances. Essentially, cohesion and adhesion are the "stickiness" that water molecules have for each other and for other substances.The water drop is composed of water molecules that like to stick together, an example of the property of cohesion. The water drop is stuck to the end of the pine needles, which is an example of the property of adhesion. Notice I also threw in the all-important property of gravity, which is causing the water drops to roll along the pine needle, attempting to fall downwards. It is lucky for the drops that adhesion is holding them, at least for now, to the pine needle.
25Change of State (cont.) Liquid to vapor phase changes Boiling – heating a liquid to a temperature at which its vapor pressure equals atmospheric pressure.Saturation – equilibrium condition in which a gas holds all the water vapor molecules that it can.Dew point – temperature at which the water vapor in a gas begins to condense back into a liquid.Evaporation – when water enters its gaseous state at a temperature below its boiling point.
26Evaporation: Heat is taken from the surrounding air by the liquid via convection thereby cooling the airThis heat transfer increases the KE in the liquid thus more molecules will have sufficient energy to escape from a liquid to a gaseous state, and vaporize.If air temperature increases, KE increases and more evaporation occurs.
27Condensation (conversion from a gas to a liquid) is the opposite of evaporation The hygroscopic humidifier (artificial nose)traps the condensation from the patient’sexhaled gas and re-humidifies the dryincoming air on inhalation
28Vapor pressureVaporization: the change of matter from a liquid to a gaseous formWater vapor pressure – the direct measure of the kinetic activity of water vapor moleculesReducing the pressure above a liquid lowers its boiling point. Ex. water boiling in mountains
29Water Vapor PressureWhen a gas is in contact with a liquid, and is in equilibrium (saturated) with the liquid, the partial pressure of the gas is a function of temperature. The one gas to which this applies in a normal respiration is water. The lungs and airways are always moist, and inspired gas is rapidly saturated with water vapor in the upper segments of the respiratory system. The temperature in the airways and lungs is almost identical with deep body temperature (approximately 37°C); at this temperature water vapor has a partial pressure of 47 mmHg. (Note that the gaseous form of a liquid frequently is termed a "vapor").Using the value of 47 mmHg, we can calculate partial pressure of oxygen and nitrogen in inspired air, after the gas mixture becomes saturated with water vapor in the upper airway (so-called tracheal air):Ptotal = 760 mmHg PH20 = 47 mmHg mmHg for remaining inspired gases (21% O2 and 79% N2)PO2 = 0.21 · 713 = 150 mmHg PN2 = 0.79 · 713 = 563 mmHg
30Water Vapor PressureThat is, since water vapor partial pressure must be 47 mmHg in a saturated gas mixture at 37°C, the total pressure remaining for the inspired gases is only or 713 mmHg. The composition of this remaining gas is 21% O2 and 79% N2, giving the partial pressures indicated above which is then substrated by the partial pressure of PaCO2 (PACO2, is a product of the amount of CO2 diffused into the lung)PAO2 = FIO2 (Pb-PH2O) – (PaCO2/0.8)
32HumidificationAbsolute humidity: the actual content or water vapor present in a given volume of airRelative humidity: the actual water vapor present in a gas compared with the capacity of that gas to hold the vapor at a given temperatureIf the water vapor content of a volume of gas equals its capacity, the relative humidity of the gas equals 100%Both are essential in effective ventilation.Prevents drying of airway mucosa and irritation.Various respiratory care devices are used to ensure adequate humidification of inspired gases.wKUXc
33HumidityThe NOSE is the bodies natural humidifier and filter, when bypassed we must use a artificial humidifier
34Humidity TermsVapor pressure – Pressure water as a vapor or gas exerts and is part of the total atmospheric pressure. Water vapor pressure in the lungs exert 47 mmHgAbsolute Humidity – the actual amount (in mg./l) of water vapor in the atmosphereRelative Humidity – the percent of water vapor in the air as compared to the amount necessary to cause saturation at the same temperature.% Body Humidity – the relative humidity at 37 degrees CelsiusHumidity Deficit – the amount of water vapor needed to achieve full saturation at body temperature (44 mg/l - A.H)Isothermic Saturation Boundary – At or just below carina (end of trachea) The point at which inspired gases are fully 100% saturated and warmed to body temperature (44 mg/L at 37oC)
35Humidity Uses of Humidity therapy Humidification of inspired gases Thinning of bronchial secretionsSputum inductionSolutions UsedSterile water used in humidifiers and continuous nebulizers (Hypotonic)(Normal) Isotonic saline (.9% Na) with (Aerosol / Medicine) TreatmentsHypertonic saline (10%) (for sputum induction)
36ExampleA gas is flowing thru a ventilator circuit at 50 C with a relative humidity of 100%. As it flows thru the tubing it is cooled to 37 C by the surrounding ambient temperature of the room.What effects will occur within the tubing? What will occur to the ambient temperature of the air surrounding the tubing?Condensation will occur on the inside surface of the tubing as the water vapor reaches its dew pointThere will be visible droplet formation when dew point is reachedThere will be warming of the adjacent air due to convection
37Critical temperature: The temperature reached in which gaseous molecules cannot be converted back to a liquid, no matter what pressure is exerted on them.The highest temperature at which a substance can exist in a liquid state.Critical pressure:The critical pressure of a substance is the pressure required to liquefy a gas at its critical temperature.
39Critical TemperatureGases can be converted to liquids by compressing the gas at a suitable temperature.Gases become more difficult to liquefy as the temperature increases because the kinetic energies of the particles that make up the gas also increasGasLiquid
40critical temperature (oC) The critical temperature of a substance is the temperature at and above which vapor of the substance cannot be liquefied, no matter how much pressure is applied.Every substance has a critical temperature.substancecritical temperature (oC)NH3132O2-119CO231.2H2O374
41Tubes containing water at several temperatures Tubes containing water at several temperatures. Note that at or above 374oC (the critical temperature for water), only water vapor exists in the tube.
42critical pressure (atm) The critical pressure of a substance is the pressure required to liquefy a gas at its critical temperature. Some examples are shown below.substancecritical pressure (atm)NH3111.5O249.7CO273.0H2O217.7
43Critical temperature & critical pressure examples Water boils at 100 C and has a critical temperature of 374 C.Oxygen has a boiling point of -183 C and a critical temperature of about -119 CBelow -183 C, oxygen can exist as a liquid.Above – 183 C, liquid oxygen becomes a gas.Above 217 atm, and a temperature of 374 C gaseous water cannot be converted back to a liquid no matter how much pressure is added
44Bulk Oxygen SystemHere, the liquid O2 is allowed to exceed its critical temp & convert to gas.
45Temperature Adding heat to a thermometer changes its physical properties.A mercury (nonelectrical thermometer) expands or contracts as temp. changes.A thermistor (electrical thermometer) operates by the electrical resistance of metal changingwith changes in temp. As the temp.increases, resistance to current flowdecreases and is shown as an increasedtemp. reading
46ViscosityThe internal force that opposes the flow of fluids (equivalent to the frictional forces between solid substances)The greater the viscosity, the greater the opposition to flowThe stronger the cohesive forces, the greater the viscosity
47Surface Tension A force exerted by like molecules at a liquids surface For a given liquid, surface tension varies inversely with temperatureSurface tension, like a fist compressing a ball, increases the pressure inside a liquid drop or bubbleThe smaller the bubble, the greater the inflation pressureInflation pressure can be lowered if surface tension is loweredThe smaller the bubble, the greater the surface tensionWhen connected, small bubbles tend to empty into larger bubblesETOH has a low surface tension and is used to treat pulmonary edema
48Surface Tension http://www.youtube.com/watch?v=u5AxlJSiE Es The pressure difference between the inside and outside of a bubble depends upon the surface tension and the radius of the bubble. The relationship can be obtained by visualizing the bubble as two hemispheres and noting that the internal pressure which tends to push the hemispheres apart is counteracted by the surface tension acting around the circumference of the circle.
49Surface tensionThe amount of net pressure required for inflation is dictated by the surface tension and radii of the tiny balloon-like alveoli.
51Capillary ActionA phenomenon in which a liquid in a small tube moves upward, against gravityInvolves both adhesive and surface tension forcesSmall capillary tubes create a more concave meniscus and thus create a greater area of contact with the liquid along its glass surface.The strong adhesive force of the liquid to the glass coupled with the surface tension properties of the liquid combine to cause the liquid be pulled upward.Liquid will rise higher in tubes with smaller cross-sectional areas
52Temperature Temperature Scale Calculations: Conversion of Celsius to Kelvin: °K = °C +273Conversion of Fahrenheit to Kelvin: °K = °F + 460Conversion of Celsius to Fahrenheit: °F = (9/5 x °C) + 32(°C x 1.8 ) + 32Conversion of Fahrenheit to Celsius: °C = 5/9(°F – 32)(°F – 32) divided by 1.8
53Temperature Temperature Scale Calculations: Conversion of Celsius to Kelvin: °K = °C +273Conversion of Fahrenheit to Kelvin: °K = °F + 460Conversion of Celsius to Fahrenheit: °F = (9/5 x °C) + 32(°C x 1.8 ) + 32Conversion of Fahrenheit to Celsius: °C = 5/9(°F – 32)(°F – 32) divided by 1.8
54First-year students at Med School were receiving their first Anatomy class with a real dead human body. They all gathered around the surgery table with the body covered with a white sheet.The professor started the class by telling them: "In medicine, it is necessary to have 2 important qualities as a doctor. The first is that you not be disgusted by anything involving the human body." For an example, the professor pulled back the sheet, stuck his finger in the EYE of the corpse, withdrew it and stuck his finger in his mouth." “Go ahead and do the same thing," he told his students. The students freaked out, hesitated for several minutes, but eventually took turns sticking a finger in the EYE of the dead body and sucking on it. When everyone had finished, the Professor looked at them and told them, "The second most important quality is observation. I stuck in my Middle finger and sucked on my index finger. Now learn to pay attention to yourpatients, their life may depend upon it."
56Gas Laws (why?)During mechanical ventilation, volumes, pressures, flows & the temperature of delivered gas are routinely manipulated to better match the patient’s condition.
57Pressure=ForceAreaCaused by collision of gas molecules with solid or liquid surfaces.Measurements reported in psi, mmHg, torr, cmH2O, and kPa.
58Properties of GasesGaseous diffusion – the movement of molecules from areas of high concentration to areas of lower concentrationGas pressureAll gases exert a pressure.Gas pressure in a liquid is known as gas “tension.”Atmospheric pressure is measured with a barometer.
59Properties of Gases (cont.) Components of a mercury barometer
60Properties of Gases (cont.) Gas pressure (cont.)Partial pressure = the pressure exerted by a single gas in a gas mixtureDalton’s law – the partial pressure of a gas in a mixture, is proportional to its percentage in the mixture. So the greater percentage that a gas occupies in a mixture, the greater its partial pressureSolubility of gases in liquids (Henry’s law)The volume of a gas dissolved in a liquid is a function of its solubility coefficient and its partial pressure.Solubility coefficient: The volume of gas dissolved per unit volume of liquid at standard atmospheric pressure and at a specified temperature
61Boyle’s Law: The volume that a gas occupies when it is maintained at a constant temp. is inversely proportional to the absolute pressure exerted on it.Body box plethesmography uses Boyle’s law to determine the volume of air remaining in the lungs after a full expiration. This is used to determine Residual Voume, Total Lung Capacity and Functional Residual Capacity
62A factor in breathing:For inhalation to occur,1. Diaphragm muscle flattens/moves down2. Increases the volume of the chest cavity3. Pressure within the chest decreases4. Air pressure within the lung is now less than atmospheric air pressure5. Air flows into your lungs.
64Charles Law: If pressure remains constant, the volume of a gas varies directly with the temperature, expressed in Kelvin.As the temperature increases, thevolume of the gas will increase.As the temp. decreases, the volume will also decrease.
65In both parts of this diagram the gas is at the same pressure, as the temperature increases, the volume of the gas also increasesIf the gas expands exponentially, the kinetic energy will also increase to the same degree
66APPLIED IMPORTANCE:Temperature also plays a role in the solubility of a gas in a liquid. As the temperature is increased the solubility of a dissolved gas is actually decreased.Clinical example:When an ABG is iced, the temperature of the plasma decreases. This decreases the amount of oxygen that can be displaced off the RBC and dissolved into the solution
67Gay-Lussac’s Law: “With volume remaining constant, pressure and temperature are directly related”
68Gay-Lussac’s LawExample:Drive to Las Vegas what happens to tire pressure? What is constant? What varies?
69COMBINED GAS LAW = P1 x V1 T1 P2 x V2 T2 States: “The state of an amount of gas is determined by its pressure, volume, and temperature”The absolute pressure of a gas is inversely related to the volume it occupies & directly related to its absolute temp.=
70COMBINED GAS LAWIt describes the macroscopic behavior of gases when any or all of the variables change simultaneously.It is useful in determining pressure, volume or temperature corrections in arterial blood-gas measurements and during PFTs.mM&feature=related
71DALTON’S LAW OF PARTIAL PRESSURE States: “The sum of the partial pressures of a gas mixture equals the total pressure of the system and that the partial pressure of any gas within a gas mixture is proportional to its % of the mixture”.Example:OXYGEN = 21%NITROGEN = 78%TRACE GASES = 1%100% AtmosphericAt 100% atmospheric,these gases exert a pressureof 760mmHg at sea level
72DALTON’S LAW OF PARTIAL PRESSURE Denver, CO640 mm Hg x 21%= 134 mm HgSeattle, WA760 mm Hg x 21 %= 152 mm Hg
73PO2 = (PB – PH2O) (FIO2)PO2 = (760 mm Hg – 47 mm Hg) (0.21)PO2 = 150 mm Hg
74Graham’s Law Molecular weight of Oxygen = 31.99 States “the rate of diffusion of a gas through a liquid is directly proportional to its solubility coefficient and inversely proportional to the square root of its density”.Describes the diffusion rate of one gas into another gas.Gram molecular weight equals the number of particles in a given amount of matter.Molecular weight of CO2 = 44.01Molecular weight of Oxygen = 31.99CO2 diffuses 20x faster than O2
75Henry’s LawDescribes the diffusion rate, or dissolving of a gas molecules into liquid.It states “For a given temperature, the rate of a gas’s diffusion into a liquid is proportional to the partial pressure of that gas and its solubility coefficient”.
76Henry’s Law in Respiratory Care? Relates to the solubility of gases, such as oxygen into and carbon dioxide out of the blood.It is known that mL of oxygen dissolve in every milliliter of blood at a temp. of 37 C and 1 atm of pressure.
77Henry’s LawOxygen and Carbon Dioxide transport can change significantly with changes in body temperature.The normal Pa02 at 37°C is approx torr. As a patient’s temperature rises from 37°C to 39°C, Pa02 increases to 110 torr due to the increased solubility. Likewise PCO2 increases 10% from 40 to 44 torr.
78Fick’s LawStates: The flow of a gas across a semi-permeable membrane into a membrane fluid phase is directly proportional to:The surface area available for diffusion,the partial pressure gradient between the two compartments &The solubility of the gas.
79Fick’s Law in Respiratory Care? AlveolusA/C membraneCO2O2O2O2CO2PulmonarycapillaryO2
81The Bernoulli Principle When a fluid flows through a tube of uniform diameter, pressure decreases progressively over the tube length.As fluid passes thru a constriction, the pressure drop is much greater
82The Bernoulli Principle Jet EntrainmentSource GasArea of negative pressure
83The Venturi PrincipleStates: “The pressure drop that occurs as the fluid flows thru a constriction in the tube can be restored to the preconstriction pressure if there is a gradual dilation of the tube”.lated
84The Venturi Principle Va = Flow before restriction. Vc = Flow from entrainment plus driving flow.Pa = Original lateral pressurePb = Falling lateral pressure at the restriction.Pc = Restored lateral pressure passed the restriction.
85Venturi MaskThe reduced pressure within the restriction may be used to introduce gases (usually air) into a low-pressure region of gas flow.
86POISEUILLE’S LAWFluid viscosity, tube length and radius determine resistance to flow.As the radius of a tube decreases by ½, resistance increases 16 times.Increased resistance to flow can be caused by a decreased airway size secondary to an increase in airway secretions, bronchospasm, intubation, etc.
87Poiseuille’s Law:Poiseuille’s Law: the law that the velocity of a liquid flowing through a capillary is directly proportional to the presence of the liquid and the fourth power of the radius of the capillary and is inversely proportional to the viscosity of the liquid and the length of the capillary.The variables in Poiseuille’s Law are:The driving pressure gradient (the heart pumping)Viscosity of the fluid (a person who is anemic can affect the viscosity of his/her blood)Tube length (the veins and arteries)Fluid flow (depending on the pressure and viscosity)Tube radius (can be affected by clogged arteries)And the constants (8 and 3.14)
88POISEUILLE’S LAWMucous plug removed from a patient’s airway.
89Reynolds NumberThe changeover from laminar to turbulent flow depends on several factors including:Fluid densityViscosityLinear velocityTubing lengthIn a smooth bore tube, laminar flow becomes turbulent when the Reynolds Number > 2000Factors that favor turbulent flow include:High gas velocityHigh gas densityLow gas viscosityLarge tube diameter
90Fluid Dynamics (cont.) Fluidics and the Coanda effect Fluidics is a branch of engineering that applies hydrodynamics principles in flow circuits.The Coanda effect (wall attachment) is observed when fluid flows through a small orifice with properly contoured downstream surfaces.