Chapter 12              

Introduction Definitions Physics of ear and hearing General properties of a Sound Reflection and transmission of sound waves Inverse square relationship Speed of Sound Characteristic of sound waves The body as a drum (Percussion in Medicine) Stethoscope Ultrasound Pictures of the Body Diagram of the outer, middle and inner ear Blood velocity determination by ultrasound Production of speech (phonation) The Acoustic Buzzer.
References:1- Medical Physics textbook by Cameron 2- Physics in Biology and Medicine, Third Edition by Paul Davidovits 3- Physics of the Human Body, by Irving P. Herman

Sound in Medicine

Introduction
Sense of hearing involves: (1) Mechanical system to stimulate the hair cells in the cochlea (real hearing organ); (2) Sensors that produce the action potentials in the auditory nerves and (3) The auditory cortex, the part of brain that decodes and interprets the signals from the auditory nerves. Deafness or hearing loss results if any of these parts malfunction. Ear is designed to convert very weak waves in air into electrical pulses in the auditory nerve. Ear is divided into three areas: outer, middle and inner ear. Physics of sound waves is called acoustics, because speaking is creating sound and hearing is detecting sound. Acoustics is the study of sound, mechanical waves in gases, liquids, and solids. A scientist who works in the field of acoustics is an acoustician. The medical specialists concerned with the function, diseases of the ear and hearing are called Otologist.
Wave is a periodic disturbance that travels in space, It is periodic in time, which means that at any given position the disturbance is periodic with time t.

These applications range from the use of the stethoscope (study heart valve motion) to the use of the modern ultrasonic techniques. Sound is a mechanical disturbance that propagates as a longitudinal wave through solid, liquid or gas. The molecules of the conducting liquid move back and forth producing bands of compression and rarefaction. Each cycle repetition of this back and forth motion is called cycle, and each produce a new wave. The length of the wave is the distance between two bands of compression and rarefaction. There are two types of waves: 1) Longitudinal are the waves in which the particles of the medium oscillate (change in pressure) in the same direction of the wave propagation. 2) Transverse are the waves in which the particles of the medium oscillate in a direction perpendicular to the direction of the wave propagation.

Longitudinal Waves The animation below shows a one-dimensional longitudinal plane wave propagating down a tube. The particles simply oscillate back and forth about their individual equilibrium positions. The wave is seen as the motion of the compressed region (it is a pressure wave), which moves from left to right.
Direction of the wave propagation

Transverse Waves The animation below shows a one-dimensional transverse plane wave propagating from left to right. The particles simply oscillate up and down about their individual equilibrium positions as the wave passes by. If you pluck a string, the wave propagates along the string, but the actual disturbance of the string is perpendicular to it.

Sound wave is travelling in this direction

compression

rarefaction

Vibrating object

These pressure and density variations are in phase with each other, meaning that they both increase (compression) or decrease (rarefaction) from the ambient values together. A sound wave is generated by a vibrating object. The vibrations disturb air around and cause local increases and decreases in pressure relative to atmospheric pressure, which cause alternating compressions (regions of crowding) and rarefactions (regions of scarcity) in the particles of the medium.

(Air pressure)
Maximum

crest Amplitude

Normal Minimum

(x)
trough

Figure shows the pressure relative to atmospheric pressure versus distance. P is the maximum pressure varied from atmospheric, -P is the minimum pressure and is the wavelength of the sound wave

Compression and rarefaction can be described by density changes and by displacement of the atoms and molecules from their equilibrium positions. Sound is really tiny fluctuations of air pressure thats why it is considered as a pressure wave. The audible range of hearing in young people is within 20 to 20000 Hz (20 KHz). However, relatively few people can hear over this entire range. Older people often lose the ability to hear the frequencies above 10 KHz. Compression = Rarefaction =

Sound pollution or noise of undesirable levels is a growing problem in modern society. Federal regulations now limit the permissible noise levels caused by cars and trucks on the highways. Typical limits of noise are 70 decibels (dB) for areas adjacent to highways and 55 (dB) for inside work areas. Noises (unwanted sounds) which are about 175 (dB) can kill. [Decibel (dB) is the common unit of sound pressure or intensity]. Safety organizations recommend that exposure to sound levels above 85 dB SPL are considered harmful, those above the pain threshold of sound pressure level (SPL) are unsafe, and those above 150 dB SPL cause physical damage to the human body.

The sensitivity of the ear is remarkable due to the mechanical construction of the ear, which amplifies the sound pressure. At the threshold of hearing, in the range of 2000-3000 Hz, the ear can detect a sound intensity of 1016 W/cm2.

The frequency range above 20 (KHz) is called ultrasound. Ultrasound is a form of energy transmitted in beams and can be used to scan different organs of the body successfully in a number of specialties. It is used by obstetricians to examine the unborn child. It often gives more information than x-ray, and it is less hazardous for the fetus. Infrasound refers to sound frequencies below the normal hearing range or less than 20 (Hz). It is produced by natural phenomena like earthquake waves and atmospheric pressure changes. It can also be produced mechanically. Frequencies of about 10 (Hz) cannot be heard but, they can cause headaches and physiological disturbances.

Sound is a form of energy produced and trasmitted by vibrating matter, it travels outward from the source with definite velocity. Sound waves travels more quickly through solid than liquids or gases since, solid atoms are hooked up by springs (bonds). Loudness, pitch, and quality are some of the terms we use to describe the sounds we hear.

Sound (change in pressure) waves Tuning fork

Definitions: 1- Loudness (L): Energy passing through the unit area during the second [Watt/m2]. Loudness is determined by the amount of pressure produced by a wave, it is measured in Bell, dB or phon. [Decibels measure the ratio of a given intensity (I) to the threshold of hearing intensity (Io)]. Loudness of sound wave depends on the pressure. L = log (I/Io) = 2 log (P/Po) Bell = 2 log (P/Po) x 10 dB = 20 log (P/Po) (P & Po are two compressions and 1 bel = 10 dB)
I is referenced to Io = 1012 W/m2; Io is a sound intensity that is barely audible at 3,000 Hz

dB

Bel Is the scale of sound waves that has been developed for comparing the intensities of two sound waves and to measure the intensity level of the sound waves.
= Pitch

2- Frequency (f): Number of cycles per second [cycles/second = cps]. It is measured in Hertz (Hz= s-1). Frequency is determined by how often the compressions and rarefactions take place. It determines the pitch of a sound. The sensation of pitch is related to the frequency of the sound. Pitch increases with frequency. 3- Period: Time duration of one wave cycle, and period is equal to 1/f where f is expressed in cycles/sec, hence the unit of period is second. 4- Angular frequency ( ) : Is a measure of how fast an object is rotating (spinning) around its axis ( ) = 2 f = d /dt. It is measured in radians per second, with units (s1) since radians are unitless.
( is the angle of rotation on the circular axis)
=2 f

5- Wavelength of a sine wave, , can be measured between any two points with the same phase, such as between crests, or troughs, or corresponding zero crossings. Wavelength is decreased in a medium with higher refractive index.
crest
Zero crossings

trough

6- Half-value thickness (HVT): Is the tissue thickness need to decrease the incident intensity (Io) of sound wave into half its value = Io/2 7- Acoustic Impedance (Z) = v [Kg/(m2. s)] = Rayls Acoustic impedance is a fundamental property of matter, is the density of the

medium (Kg/m3). The concept of impedance is more generally used to assess the characteristics of a medium that opposes energy flow in a system. the reciprocal of the impedance Z, is called the admittance(Y): Y = 1/Z = 1/ v, which describes the ease of energy flow.

8- Amplitude of a sound wave is most commonly characterized by its sound pressure. In a normal working environment, a very wide range of pressure can occur. Sound pressure is measured on a logarithmic scale using decibel. The sound pressure level (SPL) is defined as 20 times the logarithm of the ratio of the pressure to some reference pressure. The reference sound pressure is called the threshold of hearing.

Example: Find the value of angular frequency ( ) of a sound wave whose frequency is 850 Hz (s-1). Knowing that Answer: = 2 f = 2 x 3.14 x 850 = 5338 (s-1) = 22/7 = 3.14

Physics of ear and hearing

(Tympanic cavity), the hollow space of the middle ear middle ear communicate with the cochlea via a flexible membrane (the oval window)

Naso-

1- Outer ear: Protects inner ear and amplifies sound. It consists of (1) pinna (external auricle) it aids slightly in funnelling sound waves into the canal, (2) external auditory canal (critical part of outer ear which is closed on one side by the eardrum and (3) eardrum (thickness of tympanic membrane 0.1 mm). Eardrum couples the vibrations in the air to the small bones in the middle ear. Therefore, incoming acoustic waves of certain frequency can resonate. The regular route of receiving sound from the outer ear to the inner ear is called air-conduction.

x 2- Middle ear: Is an air - filled (hollow) cavity that contains a linkage of three bones called ossicles which connect the eardrum to the inner ear. These bones are full adult size before birth. Ossicles act as a lever, they amplify the pressure of the sound waves at the entrance to the inner ear and play an important role in matching the impedance of the sound waves at the eardrum to the liquid-filled chambers of the inner ear. And ossicles are arranged to efficiently transmit vibrations from the eardrum to the inner ear. Middle ear is the portion of the ear internal to the eardrum, and external to the oval window of the cochlea. The hollow space of the middle ear has also been called the tympanic cavity, or cavum tympani.

Eustachian tube connects the middle ear to the upper part of the throat, allowing pressure to equalize between the middle ear and throat. The movement of air through the Eustachian tube is aided by swallowing. The primary function of the middle ear is to efficiently transfer acoustic energy from compression waves in air to fluid - membrane waves within the cochlea. Middle ear contains three tiny bones are named after the objects they resemble: malleus (Hammer), incus (Anvil) and stapes (Stirrup). Ossicles directly couple sound energy from the eardrum to the oval window of the cochlea. Middle ear improves the transmission of sound from the outer ear to the inner ear. The outer and middle ear are collectively called the conductive system, which conducts the sound to the inner ear.

If the animal moves to a high-altitude environment, or dives into the water, there will be a pressure difference between the middle ear and the outside environment. This pressure will cause a risk of bursting or otherwise damaging the tympanum if it is not relieved. This is one of the functions of the Eustachian tubes. The Eustachian tubes are normally pinched off at the nose end, to prevent being clogged with mucus, but Eustachian tubes may be opened by lowering and protruding the jaw; this is why yawning or chewing helps relieve the pressure felt in the ears when on board of an aircraft. 3- Inner ear: It consists of cochlea and three semicircular canals which are all filled with fluid. Inner ear is hidden with the hard bone of the skull. Consists of a small spiral-shaped, fluid - filled structure called cochlea (real hearing organ). The vibration transmitted to the stapes (stirrup) is transmitted to the fluid in the cochlea by being in contact with a flexible membrane (the oval window) Chemical transmitters are released in the inner ear which cause impulses in auditory nerve. This transmitter excites nerve cells that are connected to the brain.

(external flap) 1) Pinna acts as collecting device that funnels the sound waves into the ear canal. 2) Ear canal increases the intensity of the sound by reducing the area. 3) Sound causes the tympanic membrane (eardrum) to vibrate (thickness~0.5 mm) 4) This vibrates the ossicles (the three small bones) 5) Which in turn strike the oval window of the cochlea 6) Cochlea has nerve cells that detect sound to convert it into electrical impulses for processing by the brain.

(eardrum)

Cochlea: Inside the cochlea there is fluid and tiny hairs (cilia). When a sound wave is made, cilia makes vibrations. These vibrations reach the fluid in the cochlea and press on the cilia. Higher sounds cause the fluid to press on more hairs than lower sounds. Brain receives this message and knows what kind of sound is being made. In older people the hair in the cochlea are gradually lost when ones gets older thats why they can hear sounds of frequencies up to 10000-12000 Hz while, young people can hear sounds ranging from 20-20000 Hz.

General properties of a Sound

Sound wave to be produced needs: 1- An original source of the wave, some vibrating object capable of disturbing the first particle of the medium. 2- A medium which carries the disturbance from one location to another. We can use a loudspeaker vibrating back and forth in air at a frequency f to demonstrate the behavior of sound. Sound spread outward as a longitudinal wave, that is a wave in which the pressure changes occur in the same direction the wave travels.

Nature of a Sound Wave

Velocity of propagation Vibrating object Disturbance transmitted through the medium

Sound is a Pressure Wave

Since a sound wave consists of a repeating pattern of high pressure (compression) and low pressure (rarefaction) regions moving through a medium, it is sometimes referred to as a pressure wave. Increased pressure

Compression

Rarefaction

Tuning fork

Compression Pressure

Rarefaction

Sinusoidal sound wave produced by a vibrating tuning fork

This figure shows a pure tone, which propagates through air, the pressure variations due to the compressions and rarefactions are sinusoidal in form. The total pressure in the path of a sinusoidal sound wave is: P = Pa + Po sin 2 ft Where, Pa is the ambient air pressure, Po is the maximum pressure change due to the sound wave, and f is the frequency of the sound in Hertz. = Ambient

Sound frequency
The speed (velocity) of sound wave in conducting media (v) is independent of frequency, and it depends on the material through which the sound will propagates. In air at temperature 20 C, the speed of sound is about 3.3 104 (cm/sec), and in water it is about 1.4 105 (cm/sec) [i.e., the speed of sound in water is larger than in air]. The relationship between the velocity (v) of sound propagation in (m/sec), wavelength ( ) in meter and the frequency of vibration (f) of the sound wave in (Hz) is given by this equation:

v=

(m/sec)

The frequency of a wave (f) = v/ (Hz) refers to how often the particles of the medium vibrate when a wave passes through them.

The ear responds to an enormous range of intensities. At frequency of 3000 Hz, the lowest intensity that the human ear can detect is about 1016 (W/cm2). The loudest tolerable sound has an intensity of about 104 (W/cm2). These two extremes of the intensity range are called the threshold of hearing and the threshold of pain, respectively. Sound intensities above the threshold of pain may cause permanent damage to the eardrum and the ossicles.

Frequency in cycles per second is expressed in (Hz). It can be expressed as: f = 1/T Where f = frequency (s-1 = Hz), T = time for completing one wave cycle = Period Octave Octave is the interval between two points where the frequency at the second point is twice the frequency of the first (Doubling the frequency). Example: For a sound wave with a frequency of 1000 (Hz), the velocity of sound wave v= 344 (m/sec). Calculate the value of wavelength. Answer: v= f hence, =v/f

= 344/1000= 0.344 (m)

High pitch = Tension ( Low pitch = Less tension

Period [Time duration of one wave cycle]

+P
Low Frequency = Low Pitch = Large wavelength

0 -P

Pressure

Amplitude = ~Loudness

Atmospheric (normal) pressure

Period

Pressure

High Frequency = High Pitch= Small wavelength

The height (amplitude) corresponds to loudness and the wavelength to frequency

The intensity (I) of a sound wave or loudness is the energy carried by the wave per unit area and per unit time (in units of J/m2.s or W/m2). Sound intensity is determined by the length of oscillation of the particles conducting the waves, the greater the amplitude of oscillation, the more intense the sound is [i.e., energy passing through 1(m2/s)]. Many sound intensity measurements are made relative to a standard threshold of hearing intensity Io [hence, Intensity (in dB) = 10 log10 I/Io].

[I= Po2/2 v] = Po is the maximum pressure change due to the sound wave, the medium, and v is the speed of sound propagation.

(dB)

is the density of

I = ( v)A2(2 f)2 = ZA2

The intensity can also be expressed as I=

2 =Z(A

)2
[I Po2]

Po2/2Z = Po2/2 v (Watt/m2)

Where, is the density of the medium (Kg/m3); v is the velocity of sound (m/sec); f is the frequency in Hz; is the angular frequency=2 f (s-1) and z is the impedance. Note: Intensity level for sound barely perceptible, human with good ears (reference sound) is 10-12 (W/m2) while, intensity level is 0 in dB SPL

A is maximum displacement amplitude of the atoms or molecules from the equilibrium position; Z = v [Kg/(m2.s)] and Po is the maximum change in pressure [Po= (A )]. I Po2 i.e., sound intensity is directly proportional to Po2.

Because of the nonlinear response of the ear and the large range of intensities involved in the process of hearing, it is convenient to express sound intensity on a logarithmic scale. On this scale, the sound intensity is measured relative to a reference level of 1016 W/cm2 (which is approximately the lowest audible sound intensity at frequency of 3000 Hz). The logarithmic intensity is measured in units of decibel (dB) and is defined as: Logarithmic intensity = 10 log10 Sound intensity in (W/cm2) 1016 (W/cm2) Example: Find the logarithmic intensity of a sound wave with an intensity of 1012 (W/cm2). Answer: Logarithmic intensity = 10 log10 10-12/10-16 = 10 log10104 = 10 x 4 = 40 (dB)

Example: What is the maximum displacement (A) in air corresponding to

the intensity 1 (W/m2). Knowing that the frequency = 1 (KHz) and the acoustic impedance is 430 [Kg/(m2.s)]

Solution:
Intensity (I) =1 (W/m2), f =1(KHz) =103 (Hz) and Z = 430 [Kg/(m2.s)] Intensity (I) = Z(A )2 = Z(A2 f)2 1= 430 (A x 2 x 3.14 x 103)2 = 215 (A x 6280)2 = 215 (39438400 A2) A2 =1/(8.47925 x 109) = 1.179349 x10-10 A =1.08597 x 10-5 (m) 1.1 x10-5 (m)

Classification of sound frequencies

Sound can be classified according to its frequency into 3 categories: 1- Infrasound (Frequency less than 20 Hz)

2- Audible sound (Frequency 20 Hz to 20000 Hz) 3- Ultrasound (Frequency more than 20000 Hz )

Threshold of hearing (TOH): The (softest) faintest audible sound which the typical human ear can detect has an intensity of 10-12 [Watt/m2]. Sound level measurements in decibels are generally referenced to a standard threshold of sound intensity: Io= 10-12 Watt/m2 = 10-16 Watt/cm2 or in terms of hearing sound pressure: Po= 2 x 10-5 (Newton/m2)= 2 x 10-4 (Dyne/cm2). Note that the I/Io= P2/Po2 and that the threshold of pain is about 120 dB SPL.

This value has wide acceptance as a nominal standard threshold. It represents a pressure change of less than one billionth (1/1010 =10-10) of standard atmospheric pressure. This is indicative of the incredible sensitivity of human hearing. The actual average threshold of hearing at 1000 (Hz) is 2.5 x 10-12 (Watts/m2) or about 4 (dB), but zero decibels is a convenient reference. Threshold of hearing varies with frequency. A special unit called Bell = 10 decibel (dB) has been developed for comparing the intensities of two sound waves (I/Io). Sound intensity level (SIL) = log10(I/Io) Bell
dB [Bell=10 dB]

(SIL) = 10 log10 (I/Io)

Normal background noise is 50-60 dB SPL (sound pressure level). Normal conversation is 60-70 dB SPL. Example: If I = 10-8 (W/m2) and Io= 10-12(W/m2) Sound intensity level (SIL) = log10(10-8/10-12) = log10104 = 4 Since I (Bell)

P2 then the sound pressure level (SPI) can be expressed as follow: Intensity (in dB SPL) SPI = 10 log10(P/Po)2 = 20 log10 (P/Po) dB

Example; For an incident ultrasound beam of intensity (Io) of 1 (W/cm2) is reflected with an intensity 0.1 (mW/cm2). Express the sound intensity level (SIL) in dB. Io= 1(W/cm2), I = 0.1 (mW/cm2) = 0.1 x 10-3 = 0.0001 (W/cm2) SIL= 10 log10 I/Io SIL = 10 log10 0.0001/1 = 10 x - 4 = - 40 (dB)

Example: If the sound intensity level (SIL) = 20 dB and the reference sound intensity (Io) = 1012 (W/m2). Calculate the value of I? Answer: SIL= 20 (dB), I = ? Io = 10-12 (W/m2) SIL = 10 log10 I/Io 20 =10 log10 I/10-12 20/10 = 2 = log10 I/10-12 log-1 (2) = I/10-12 100 = I/10-12 I =100 x 10-12 = 10-10 (W/m2)

Sound intensity and the Decibel Scale

Sound waves requires energy for pushing the atoms of a medium through a distance, and therefore exert power. Energy in joule is carried by sound waves (E) as Kinetic energy and Potential energy. When potential energy equals zero, then the total energy (E) = Kinetic energy (K.E.) = mv2 (Joule)

Note: Total energy = Potential energy + Kinetic energy

Reflection and transmission of sound waves at the eardrum

When a sound wave hits the eardrum, part of the wave is reflected (R) and part is transmitted into the body (T). The fraction of incident energy that is reflected (R) is given by: R = [(Z2 - Z1)/(Z2 + Z! )]2. To optimize the hearing sensitivity reflection should be minimized and transmission maximized. The ratio of the reflected pressure amplitude (R) to the incident pressure amplitude Ao depends on the acoustic impedances of the two media, Z1 and Z2: R/Ao = (Z2 - Z1)/(Z1+ Z2) The ratio of the transmitted pressure amplitude (T) to the incident amplitude (Ao) is T/Ao= 2Z2/(Z1+ Z2) The ratio of the reflected (R) and transmitted (T) intensities are: (R2/2Z1)/(Ao2/2Z1) = (R/Ao)2 (T2/2Z2)/Ao2/2Z1) = Z1/Z2 (T/Ao)2
Density

(Ao)

(T)

(R)

Speed Acoustic Impedance Frequency Wavelength

Example Calculate the ratios of the pressure amplitudes and the intensities of the reflected and transmitted sound waves from air to muscle. Knowing that Z1 = 430 (Kg.m-2.s-1) and Z2=1.64 x 106 (Kg.m-2.s-1). Solution (R/Ao) =(Z2 - Z1)/(Z1+ Z2) = [(1.64 x 106) 430]/[(1.64 x 106) + 430] = 0.9995 (T/Ao) = 2Z2/(Z1+ Z2) = [2 x 1.64 x 106]/[(1.64 x 106) + 430] = 1.9995 The ratio of the reflected and transmitted intensities are: (R/Ao)2 = (0.9995)2 = 0.9990 Z1/ Z2 (T/Ao)2 = [430/(1.64 x 106)] . (1.9995)2 = 0.0010

Inverse square relationship

(dB)

Source of sound waves

A,B & C are different measuring points away from source of sound

r (m)

(m)
Inverse square law is applied for sound waves: It is found that the intensity of sound waves (I) decreases as the wave diverge or spread out the source [ I 1/r2 ] where, r is the distance between source and the measuring point.

Speed of Sound
Sound waves move at a speed vs that is determined by the properties of the medium. The speed of sound depends on the (1) medium through which the sound travels, (2) temperature and (3) the air pressure. The speed of sound (v) is about 343 m/s in air (at 20C) [which is 15 times slower than that in steel as for steel vs = 5,960 m/s]. Sound speed in water is 1482 m/s. Sound travels at 1540 (m/s) everywhere in body.

vsolids > vliquids > vgases

The wavelength, frequency and speed of a wave are interrelated by this equation:

Speed (v) = distance/time = f = =

K is the elastic modulus describing the stiffness of the material and [ = v/f (m)] hence, f is the mass density.

= v/

So, low-frequency waves have long wavelengths, while high frequency waves have short wavelengths as frequency (f) is inversely proportional to wavelength ( ). Example: If the frequency of sound wave in muscle =1(MHz) and its speed is 400 (m/s). Calculate the wavelength of this sound wave. Answer f = 1 (MHz) = 1 x 106 (Hz), v = 400 (m/s)

= v/f

= 400/106 = 400 x 10-6 = 4 x10-4 (m)

Characteristic of sound waves

The geometric laws involving the reflection and refraction are the same as for light.This means that 1 (incident angle) = (reflected angle) and the angle of refracted sound wave 2 is, in general a function of the properties of the two media. 2 is determined by the velocities of sound in the two media v1 and v2 from the equation of Snells law:

sin

1/v1 = sin

2/v2

When sound waves with amplitude Ao (at x=0) pass through tissues, the transmitted waves will have less amplitude (A).There is some loss of energy due to frictional forces. Absorption of energy in tissue causes a reduction in the amplitude (A) of sound wave. X in (cm) is the thickness of the medium. Through which the waves are transmitted. A is related to Ao by the exponential equation:

Normal line perpendicular on the interface found between two media

Interface

A = Ao e
Knowing that

Illustration of reflection and refraction A

Ao

(cm-1) is absorption coefficient

for medium. Xh is the half value thickness.

Ao/2 0

xh

X (cm)

Since intensity (I) is directly proportional to A2 [I

A2] then if I is the intensity at depth x x

A

in the absorber and Io is the intensity of incident beam at x = zero.

I = Ioe-2

x Then

I/Io = e-2

x Then

ln I/Io= -2 x =2 x

Ao

The attenuation of sound intensity will be calculated using: ln Io/I

The half value thickness (HVT) is defined as The tissue thickness required to decrease the intensity of the incident sound waves (Io at x = 0) to its half value (Io/2). Sound intensity decreases with the distance according to the inverse square law Note: Absorption increases as the frequency of the sound waves increases. And intensity decrease more rapidly than the amplitude with depth. Example: If a sound wave of incident intensity 65 (dB) and attenuated intensity 40 (dB) after passing through a medium of thickness 3 (cm). Calculate the value of absorption coefficient. Answer: ln Io/I = 2 x and ln (65/40)= 6 ln1.625 = 6 = 0.4855 =0.0809(cm-1)

The sensation of hearing is produced by the response of the nerves in the ear to pressure variations in the sound wave. The nerves in the ear are not the only ones that respond to pressure, as most of the skin contains nerves that are pressure-sensitive. However, the ear is much more sensitive to pressure variations than any other part of the body. Sensory cells convert sound to nerve impulses are located in the liquid-filled inner ear. The main purpose of the outer and middle ears is to conduct the sound into the inner ear. When sound waves produce vibrations in the eardrum, the vibrations are transmitted by the ossicles to the oval window, which in turn sets up pressure variations in the fluid of the inner ear. The ossicles are connected to the walls of the middle ear by muscles that also act as a volume control. If the sound is excessively loud, these muscles as well as the muscles around the eardrum stiffen and reduce the transmission of sound to the inner ear.

Hearing and the Ear

The process of hearing cannot be fully explained by the mechanical construction of the ear. The brain itself plays an important role in our perception of sound. For example, the brain can effectively filter out ambient noise and allow us to separate meaningful sounds from a relatively loud background din. (This feature of the brain permits us to have a private conversation in the midst of a loud party). The brain can also completely suppress sounds that appear to be meaningless. Thus, we may lose awareness of a sound even though it still produces vibrations in our ear. The exact mechanism of interaction between the brain and the sensory organs is not yet fully understood. The most familiar clinical use of sound is in the analysis of body sounds with a stethoscope

The body as a drum (Percussion in Medicine)

Percussion (tapping) on the human body is used as a means of diagnosis since the 18th century with ear directly on the chest. When chests of patients are striking in various places different sounds are produced. These sounds are related to specified disease. Stethoscope is a simple hearing aid that permits a physician or nurse to listen to sounds made inside the patients body, primarily in the heart and lungs. The act of listening to these sounds using a stethoscope is called mediate auscultation or usually just auscultation. The main parts of a modern stethoscope are: (1) Bell, which is either open or closed by a thin diaphragm, (2) Tubing and earpiece as shown in the following figure. A closed bell is merely a bell with a diaphragm of high resonant frequency, that tunes out low-frequency sounds. Factors affecting the best hearing through the stethoscope: - Placing the earpieces in the ear let the eardrum act as the closed end of the system besides, eardrum is very sensitive to pressure changes. - To have high pressure change the volume of air inside the stethoscope must be small (volume of the bell, length and diameter of the tube must be small). - If the volume of the tube is small friction loss will be high.

[20-200]Hz

[200-2000]Hz

Open bell is an impedance matcher between the skin and the air, it accumulates sounds from the contacted area. Skin under the open bell behaves like a diaphragm that has a natural resonant frequency fres at which it most effectively transmits sounds. fres depends on (1) the bell diameter (d) and (2) tension of the diaphragm under which the skin is stretched (T). [where, is the area density (Kg/m2)]. Factors controlling the resonant frequency fres are: 1-The tighter the skin is pulled the higher fres. 2-The larger the bell diameter, the lower the skins fres Thus it is possible to enhance the sound range by changing the bell diameter and varying the pressure of the bell (skin tension) against the skin. Closed bell has a diaphragm of known resonant frequency fres that can be controlled. The closed bell is used for listening to lung sounds, which are of higher frequency than heart sounds.
[Resonant = return of echo]

fres

(1/2d) (T/ )

Hearing Tests
The basic principle of hearing aids is simple. A microphone converts sound to an electrical signal. The electrical signal is amplified and converted back into sound using a speaker-type device. The net result is an amplification of the sound that enters the ear. A hearing (audiometric) test is part of an ear examination that evaluates a person's ability to hear by measuring the ability of sound to reach the brain. Hearing tests help determine what kind of hearing loss you have by measuring (1) the ability to hear sounds that reach the inner ear through the ear canal (air-conducted sounds) and (2) sounds transmitted through the skull (bone-conducted sounds). Most hearing tests ask you to respond to a series of tones or words, but there are some hearing tests that do not require a response. An audiometer hearing test is usually administered to a person sitting in a soundproof booth (small room) wearing a set of headphones which is connected to an audiometer (generates pure tones over a wide range of pitch).

The audiometer produces tones at specific frequencies and set volume levels to each ear independently. The audiologist or licensed hearing aid specialist plots the loudness, in decibels, on an audiogram. People having their hearing tested will convey that they have heard the tone by either raising a hand or pressing a button. As the test progresses, the audiologist, plots points on a graph where the frequency in Hertz is on the x-axis and the loudness (hearing level in dB) on the y-axis. Once each frequency of hearing ability is tested and plotted, the points are joined by a line to identify the degree of hearing loss that may be present. Normal hearing at any frequency is a sound pressure of 20 dB.

Hearing test chart showing hearing loss

The audiogram is a physical representation of your hearing capabilities that shows the range of pitches or frequencies that youre able to hear with each ear, and at what intensity level youre able to hear them. Frequency is measured in Hertz, which we feel as pitch. Intensity is measured in decibels, and is perceived as loudness.

Ultrasound Imaging
Monitor

Transducer (hand held probe)

Diagnostic sonography (ultrasonography) is an ultrasound-based diagnostic imaging technique used for visualizing subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions. Obstetric sonography is commonly used during pregnancy. An ultrasound technician moves the transducer unit over the abdomen of a pregnant woman while adjusting the brightness of the image on the monitor. The frequencies used in diagnostic ultrasound are between 2 and18 (MHz).

Sonography is effective for imaging soft tissues of the body. Superficial structures such as muscles, tendons, testes, breast and the neonatal brain are imaged at a higher frequency (7-18 MHz), which provides better axial and lateral resolution. Deeper structures such as liver and kidney are imaged at a lower frequency (1- 6 MHz) with lower axial and lateral resolution but greater penetration. Ultrasound Pictures of the Body: Ultrasound is used to help physicians diagnosing a variety of conditions and to assess organ damage following illness. Basically an ultrasound source sends a beam of pulses of 1-5 MHz (106 Hz) sound into the body. The time required for sound pulses to be reflected gives information on the distances to the various structures or organs in the path of the ultrasound beam. Ultrasound is a mechanical, longitudinal wave with a frequency exceeding the upper limit of human hearing (20 KHz). Medical ultrasound is within the range of 2-16 (MHz).

Ultrasound is produced by passing an alternating voltage (AC) electrical current through piezoelectrical crystal [naturally occurring (quartz)] which causes it to expand and contract to generate ultrasound [i.e. voltage generated when certain materials are deformed by pressure]. What is piezoelectricity? When certain types of crystals are mechanically deformed, the charges in them are displaced; as a result, they develop voltages along the surface. This phenomenon is called the piezoelectric effect.

AC causes: - Alternating dimensional changes - Alternating pressure changes Then pressure propagates as sound wave

A device that converts electrical energy into mechanical energy or vice versa is called transducer. Ultrasound transducer is used to convert electrical signal into ultrasound wave which can be transmitted through the tissues. Waves reflected back from the tissue and incident on the crystal will be converted by the crystal to electrical charge. The most important component is a thin piezoelectric crystal located near the face of the transducer. Each transducer has a natural resonant frequency (fres) of vibration. Ultrasound imaging is also called ultrasound scanning or sonography which involves exposing part of the body to high frequency sound waves in order to produce pictures of the inside of the body. To obtain diagnostic information about the depth of structures in the body, we send pulses of ultrasound into the body by placing the vibrating crystal in close contact with the skin, using water or jelly paste in order to eliminate air.

This gives a good coupling at the skin and greatly increases the transmission of the ultrasound into the body and measure the time required to receive the reflected sound (echoes) from the various surfaces. This procedure is called the A scan method of ultrasound diagnosis. Pulses for A scan are typically a few microseconds long, and they are usually emitted at 400-1000 pulses/sec. The frequency of the ultrasound waves increase with decreasing the thickness of the crystal (i.e. The thinner the crystal the higher the frequency at which it will oscillate). Ultrasound image is an electronic representation of data generated from returning echoes and displayed on TV monitor, such image can provide valuable information regarding the size, location, displacement or velocity of a given structure without the necessity of surgery or using harmful radiation. The sonographic scanner must determine three things from each received echo: 1- How long it took the echo to be received since the sound was transmitted. 2- From this the focal length for the phased array is deduced, enabling a sharp image of that echo at that depth. 3- How strong the echo was. It could be noted that sound wave is not a click, but a pulse with a specific carrier frequency. Moving objects change this frequency on reflection.

Many of the applications of ultrasound in medicine are based on the principles of sonar. In sonar a sound wave pulse is incident through any medium and is reflected from an object; from the time (t) required to receive the echo and the known velocity (v) of sound, the distance (d) between the source of sound waves and the object can be determined by: d = vt The amount of the reflected beam from the tissue depends on: (1) Difference between the acoustic impedance between two mediums. (2) The angle of incidence between the ultrasound beam and the reflecting surface, when angle increases the reflection will decrease.
of sound object (d) Echoencephalography(EEG)measures potentials along the surface of the scalp. EEG signal is a complex irregular wave containing several frequencies and amplitudes. It is used to detect brain tumors using A scan. Where pulses are sent into a thin region of the skull slightly above the ear and echoes from different structures within the head are displayed on an oscilloscope. The usual procedure is to compare the echoes from the left side of the head to those from the right side and to look for a shift in the midline structure . A tumor on one side of the brain tends to shift the midline toward the other side.

Medium

Applications of A scans in ophthalmology can be divided into two areas: one is concerned with obtaining information for use in the diagnosis of eye diseases; the second involve measuring the distances in the eye. For many scans clinical purposes A scan have been largely replaced by the B (Brightness Mode). The B scan method is a series of gray shade dots which is used to obtain two-dimensional views of parts of the body. Dot position ideally indicates source of echo. The principles of B scan are the same as for the A scan except that the transducer is moving. Each echo produces a dot on the oscilloscope at a position corresponding to the location of the reflecting surface. B scans provide information about the internal structure of the body. They have been used in diagnostic studies of the eye, liver, breast, heart and fetus. B scan can detect pregnancy as early as the 5th week. In many cases scans can provide more information than x-rays and they present less risk.

Ultrasound Display

B-scan (Brightness Mode) Image series of gray shade dots (echoes). For each dot, scanner must calculate: Position & Gray shade Loud echo = bright dot Soft echo = dim dot 1- A-mode (A-scan, 1D) 2- B-mode (Gray scale, 2D, moving transducers) 3- M-mode (motion in the body) e.g., heart valves

In B scan all the echoes are displayed on the CRT (cathode ray tube) were the same brightness. Operator could exclude echoes of low magnitude by setting an electronic control this is called leading-edge display, The improved gray-scale display electronically changes the brightness on the CRT so that the large echoes appear brighter than weak ones. The success of the gray-scale display has led to the development of color display that shows a greater range of echoes.

Ultrasound to measure motion

Two methods are used to obtain information about motion in the body with ultrasound; the M (motion) scan, which is used to study motion such as that of the heart valves, and the Doppler technique, which is used to measure the blood flow.

M-scan combines certain features of A scan and the B scan. The transducer is held stationary as in A scan and the echoes appear as dots as in the B scan.

M-scans are used to obtain diagnostic information about the heart. By putting the probe it is possible to obtain information about the behavior of a particular valve or section of the heart.

The Speed of Sound

The speed of a sound wave in air depends upon the properties of the air, namely the temperature and the pressure Pressure of air (like any gas) will effect the mass density of the air and the temperature will effect the strength of the particle interactions. At normal atmospheric pressure, the temperature dependence of the speed of a sound wave through air is approximated by the following equation:

v = 331 (m/s) + (0.6 m/s/C) x T

At a temperature of 20C v = 331 m/s + (0.6 m/s/C) x 20 v = 331 m/s + 12 m/s v = 343 m/s
T= temperature in C

Physics of ear and hearing

Sense of hearing involves: 1- The mechanical system that stimulates the tiny hair cells in the inner ear (Cochlea). 2- The sensors that produce the action potential in the auditory nerves. 3- The auditory cortex (part of the brain) that interprets (explain) the signals coming from the auditory nerves. If any of these parts malfunction hear loss (deafness) will be obtained. There are two common causes of reduced hearing: A- Conduction hearing loss: In which sound waves do not reach the inner ear which is due to something wrong in the outer and middle ear such as a plug of wax which block the eardrum. Or a fluid in the middle ear or a solidification of the small bones in the middle ear. If conduction hearing loss is not curable a hearing aid can be used to transmit the sound through the bones of the skull into the inner ear. B- Nerve hearing loss: In which sound waves reaches the inner ear but not nerve signals are sent to the brain and this may be due to nerve damage. An electronic hearing aid consists of a microphone to detect sound, an amplifier to increase the sound energy and a loudspeaker to deliver the sound waves with high energy into the ear.

There are four steps in the hearing process within the ear: (1) The sound wave enters the outer ear through the pinna into ear canal (Acoustic filter) (2) The movement of the tympanic membrane is transferred by conduction through the ossicles to the oval window of the cochlea (Mechanical transformer). (3) The movement of the oval window generates a compressional (sound) wave in the fluid of the cochlea. (4) This wave moves the basilar membrane upon which the primary auditory receptors (the hair cells) are located, and the electrical signals generated by the hair cells are sent to the brain. This conversion of sound into electrical signals is called mechanoelectrical transduction.

Properties of Sound
When a wave enters one medium from another, part of the wave is reflected at the interface, and part of it enters the medium. Reflection: (bouncing back) or (mirror-like) of sound waves off of surfaces can lead to one of two phenomena-an echo or reverberation: Incident angle ( i)= Reflected angle ( r) Diffraction: When a wave encounters an obstacle , it spreads into the region behind the obstacle. This phenomenon is called diffraction. The amount of diffraction depends on the wavelength: The longer the wavelength, the greater is the spreading of the wave. Diffraction involves a change in direction of waves as they pass around a barrier in their path. Refraction: of waves involves a change in their direction as they pass from one medium to another. The degree of refraction depends on the properties of the two Normal line media and the angle of incidence ( i). - Using specialized techniques called ultrasound imaging, it is possible to form visible images of ultrasonic reflections and absorptions. The frequency of sound detected by an observer depends on the relative motion between the source of sound and the observer. This phenomenon is called the Doppler effect.
1st medium Interface

2nd medium

Doppler Effect
Doppler effect is a phenomenon observed whenever the source of sound waves is moving with respect to a stationary (not moving) observer. It can be used to measure the speed of moving objects or fluids within the body, such as blood. It can be shown that if the observer is stationary and the source of waves is in motion, the frequency of the sound f ' detected by the observer is given by: f ' = f v v vs where f is the frequency in the absence of motion, v is the speed of sound, and vs is the speed of the source.

(Sound source moving away from stationary listener standing behind it)

(Sound source approaching stationary listener standing in front of it)

Change in frequency is called Doppler shift

Doppler shift
The shifting of the acoustic frequency when the ultrasound reflects from a moving target (the Doppler effect) is the basis for measuring blood flow direction, turbulence, and speed (Doppler ultrasonography). A moving sound source compress (push together) the sound waves in front of the object in the motion direction. Motion direction RBCs moving toward sound waves

Source of sound waves

RBCs moving away from the sound waves

Blood velocity determination by ultrasound

Laminar and Turbulent flow of blood

If the velocity of a blood exceeds a specific critical value, the flow becomes turbulent. Through most of the circulatory system, the blood flow is laminar. Only in the aorta (the main artery arising out of the left ventricle of the heart), the flow occasionally become turbulent.

Blood velocity determination

Moving RBCs inside an artery from the left to right side

Artery

V cos is the velocity of blood in the same direction of the velocity of incident sound waves. And c is the velocity of the sound wave that are transmitted from transducer through skin and tissue to red blood cells (RBCs) in an artery and fo is frequency of continuous incident sound wave

Echolocation by bats

Prey
Bats and porpoises (kind of fish) use sonar principle for navigating and finding food. Blind humans use the same principle when they listen to echoes from the tap of a cane to help avoid large objects.

Echolocation by dolphin

Prey
Dolphin

Sound returning

[Echoes of sound tell size, shape and distance of prey

Production of speech (phonation)

Human speech is made by air from the lungs as it passes through the trachea, larynx (which houses the vocal folds or cords), and pharynx through the mouth and nasal cavities, and then out of the (throat), mouth and nose [The vocal folds (or vocal cords) are folds of ligament extending on either side of the larynx, with the space in between them called the glottis]. The structure above the larynx is called the vocal tract. Adjusting the vocal tract to produce speech sounds is called articulation. The basic elements of speech are classified as: (1) phonemes (the basic sounds), (2) phonetic features (how the sounds are made), and (3) the acoustic signal (the acoustic nature of the sounds). Phonemes are the shortest segments of speech, Each phoneme is produced by distinctive movements of the vocal tract, which are the phonetic features of speech.
Distinctive = Phonetic =

The Acoustic Buzzer

During speaking, air rushing through vocal folds in the larynx from the trachea to the pharynx causes the vocal folds to vibrate, which in turn leads to a modulation of the air flowing into the trachea. Initially the folds are apart and the pressure in the trachea and pharynx are equal to each other, and to the atmospheric pressure. Because of the separation between folds, the pressure is the same before and after the folds, even with air flowing from the lungs. Muscle contractions cause the folds to move to the midline of the tube (as shown in figure). Because of this constricted air flow, the pressure before the glottis [sub glottis pressure (Psub glottis)] exceeds the oral pressure (Poral). This pressure difference forces the folds to separate rapidly, leading to a rapid burst of air. This produces an overpressure above the glottis and an acoustic shockwave that moves up the vocal tract. The folds then rebound back to their initial positions because of their elastic recoil properties and the pressure gradient.

Speech communication is the study of how speech is produced, the analysis of speech signals and the properties of speech transmission, storage, recognition and enhancement. Normal speech sounds are produced by modulating an outward flow of air. Sound modulation are produced by changing volume of resonating cavities. For most sounds the lung furnish the stream of air, which flows through the vocal folds [located within the larynx or Adams apple inside the trachea or windpipe], and several vocal cavities and exits from the body through the mouth and to a slight degree through the nostrils. Speech sounds produced in this way are called voiced sounds [5 vowels: a, e, I, o & u] which rely on changing resonator volume only. Some sounds are produced in the oral portion of the vocal tract without the use of vocal folds and these are called unvoiced sounds which, require supporting movement of tongue and/or lips [s, f, th] and are called frictive sounds. These sounds involve air flow through constructions or past edges formed by the tongue, teeth, lips and palate (roof of the mouth). Sounds which rely on build-up and sudden release of pressure in the oral cavities are called explosive sounds (p, t, k, q). There is a combination of the two types such as ch.