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[English Language] The Advances
Volume 1: Biofluid Dynamics in Bioengineering
Volume 1: ofBiofluid
Human DynamicsResearch
Body Systems and
of Applications
Human Body Systems Book Series
______________________________________________________________________
Megh R. Goyal, PhD, PE Megh R. Goyal, PhD, PE
Senior Editor-in-Chief: Volume 2:Megh R. Goyal, of
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Volume 3: Dictionary of Technical Terms: Biotechnology and Bioengineering
Volume 3: Dictionary
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Megh R. PhD, PE
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Terms: Biotechnology and Bioengineering
VolumePhD,
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Volume 1: BiofluidMegh Dynamics R. Goyal, of Human
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Vijay K. Goyal, PhD
Megh R. Goyal, PhD, PE ISBN: 978-1-926895-84-0
Volume 3: Dictionary of Technical Terms: Biotechnology ISBN: 978-1-926895-84-0 and Bioengineering 9 0 0 0 0
Volume 2: Biomechanics Megh R.ofGoyal, Artificial
PhD, Organs
PE and Prostheses 90000
Megh R. Goyal, PhD, PE, and Vijay K. Goyal, PhD
ISBN: 978-1-926895-84-0
Volume 3: Dictionary of Technical Terms: Biotechnology and Bioengineering
Megh R. Goyal, PhD, PE 90000
9 781926 895840
ISBN: 978-1-926895-84-0
9 781 926 89 584 0
90000
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CONTENTS
I have been teaching fluid mechanics to undergraduate and graduate students since
1971. I decided to apply principles of fluid mechanics to human body systems: When
my respiratory system collapsed in 1989 and I had three strokes in 2002 and my vagus
nerve failed in 1999; my mother broke her hips and orthopedic surgeon did “Total Hip
Replacement (THR)” and my mother survived 12 more years; my elder brother had
a heart mitral valve replaced in 2003 and he feels perfectly fine; my mother-in-law
passed away in 2010 with three heart valves damaged (she did not want to have a heart
operation and she lived for next 4 years after diagnosis of heart disease); our neighbor
in Puerto Rico had “Total Knee Replacement (TKR)” for both knees and now she
can do her daily activities. I thought why would this happen to a human body, and I
was able to understand that Almighty Supreme God grants serenity and knowledge to
physicians so that we can live longer and happier. I also know a friend of mine with
amputation of both legs and he does his daily activities using a wheel chair. All this
fascinates my soul. Let us all keep our spirits high so that our life is always dynamic
to be happier today/tomorrow and forever. This is how idea for this book was born.
Engineering mechanics deals with response of bodies at rest or in motion due
to applied external forces/couples/torques/rotation/and moments. Biomechanics deals
with living organisms: Agricultural plants, animals and humans. In this book, I will
consider only human body systems. One is interested in variation of velocity, pres-
sure, density, volume, momentum, heat, mass, nutrient or other parameter throughout
the body. In the human body, I will consider only continuous bodies (i.e., there is no
discontinuity at any point for a specific body part). Biomechanics and Computational
Fluid Dynamics (CFD) is one of the specialty areas of biomedical engineering. Bio-
mechanics applies classical mechanics (bodies at rest or in motion, thermodynamics,
and continuum mechanics) to biological or medical problems. It includes the study
of motion flow within our body and in medical devices, and transport of chemical
constituents across biological and synthetic media and membranes. Progress in bio-
mechanics has led to the development of the artificial organs and prostheses: Heart
valves, stents, TKR, THR, etc.
Biomechanics is widely used in orthopedic industry to design orthopedic implants
for human joints, dental parts, external fixations and other medical purposes. It also
includes study of the performance and function of biomaterials used for orthopedic
implants. It plays a vital role in improving the design and producing successful bioma-
terials for medical and clinical purposes.
The mission of this compendium is to serve as a textbook or a reference manual
for graduate and undergraduate students of biomedical engineering, biotechnology,
nanotechnology, nursing, and medicine and health sciences. I hope that it will be a
valuable reference for professionals that work with medicine and health sciences, for
nursing institutes, and other agencies that work with human health.
My book complements other similar books in the market and is unique because it
is complete, simple, one-stop manual worldwide on Biomechanics of Artificial Organs
and Prostheses. This textbook includes basic principles and applications of mechanics
and materials for human body. This book is a must for physicians, scientists, educa-
tors, and students.
This book on Biomechanics of Artificial Organs and Prostheses consists of 12
chapters consisting of: Introduction on artificial organs; biofluid dynamics of cardio-
pulmonary bypass surgery; biomechanics of the artificial heart; biomaterials for an
artificial pacemaker; biomechanics of the angioplasty: ballooning and stenting; bio-
mechanics of carotid stenting; biomechanics of an artificial lung; biomechanics of the
human kidney system and artificial kidney; biomechanics of the arthritis and human
body pain; biomechanics of orthopedic fixations; biomechanics of total knee replace-
ment; and biomechanics of dental prostheses. Each chapter includes an introduction,
body of the chapter, conclusions, summary, key words and a bibliography. Book also
includes a glossary of terms. This book is Volume 2 for the AAP series titled Advances
in Bioengineering Research and Applications.
The chapters in this book are based on my research and teaching materials and
special projects by my students in the courses on fluid mechanics/engineering me-
chanics/and mechanics of materials at University of Puerto Rico at Mayagüez and the
course on biofluid mechanics at Florida International University. The contribution by
my students at University of Puerto Rico at Mayagüez and Florida International Uni-
versity has been most valuable in the compilation of this compendium. Their names
are mentioned in each chapter. In July of 2001, students of my course (INGE4015)
in Fluid Mechanics conducted the first congress on “Biofluid Dynamics of Human
Body Systems.” The purpose of this congress was to show and learn how the bioflu-
ids of the many body systems function and help to maintain a great physical state.
In this congress, student groups discussed Biofluid Dynamics of: Brain system; Ear/
throat/nose system; Circulatory system; Reproductive system; Digestive system; Re-
spiratory system; Urinary system; Arthritis; Instrumentation and measurements for
the human body; Challenges in Biofluid dynamics of human body systems. In July of
2002, students conducted second congress on “Biofluid Dynamics and Engineering
of Artificial Organs.” The purpose of this congress was to learn biofluid dynamics
of Bioheat Transfer in a Human Body, Biomass Transfer in a Human Body, Biofluid
Mechanics of Artificial heart, Biofluid Mechanics of Artificial lung, and Biofluid Me-
chanics of Artificial kidneys. In April of 2003, students of my course on – BME4999
Human Body Systems – conducted third congress on “Biofluid Dynamics of Human
Body Systems” to discuss: Circulatory System; Artificial Heart; Cardiovascular Bypass
Surgery; Respiratory System; Kinetics of Drug Transport; Digestive System; Mater-
nal Fetal System; Stenting of Intracranial Arteries as Endovascular Bypass of Berry
Aneurysms (Baruch Barry Lieber, PhD, PE, University of Miami). In July of 2004, we
conducted fourth congress on Biofluid Dynamics of Human Body Systems to discuss:
Our Body Fluids; Properties of body fluids; Ear/nose and throat system; Balloning and
stenting; Urinary system; Artificial kidney; Advances in human body fluids; dimen-
sional analysis; Biomass transfer; Body pain; Instrumentation and measurements. It
has been an excellent learning experience for me. I thank all of them at University of
Puerto Rico at Mayagüez and at Florida International University who have enriched
my knowledge in Biomedical Engineering.
This book would not have been written without the valuable cooperation of a group
of engineers and physicians at the University of Puerto Rico at Mayagüez (UPRM)
and Florida International University (FIU). I am grateful to my colleagues: Paul Sun-
daram, Ricky Valentin, Carlos Rinaldi, David Suleiman, Madeline Torres, Eduardo
Juan, Alejandro Acevedo, and Ivette Ríos Lamberty. Dr. Vijay K. Goyal, an associate
professor of the Department of Mechanical Engineering at the University of Puerto
Rico at Mayagüez with over 17 years of experience in advanced computational meth-
ods applied to structures, joins me as coauthor for this volume. He has been exploring
and researching this field for a couple of years as he tried to develop a toolkit to predict
bone regeneration. His insights and collaboration was invaluable for this volume. The
reader will not have this edition in front of you without his offer without his profes-
sional contribution.
I owe special gratitude to Anthony McGoron at FIU and Richard Schoephoerster,
now Dean of the College of Engineering at the University of Texas at El Paso – Texas,
who taught me to love biomedical engineering during my sabbatical leave in 2003 at
FIU. I had the opportunity to work closely with all of them including other faculty
members. The author also thanks executive officers at UPRM Campus to initiate re-
search in biomedical engineering and nanotechnology.
I would like to thank Ashish Kumar, Publisher and President, and Sandra Jones
Sickels, VP, at Apple Academic Press, Inc., for making every effort to publish the book
when the human health is a major issue worldwide. Special thanks are due to AAP
Production Staff for typesetting the entire manuscript and for the quality production
of this book.
I request the reader to offer me your constructive suggestions that may help to
improve the next edition. The reader can order the copy of this book for the library, the
institute or gift from www.appleacademicpress.com.
Finally, a river of thanks flows from my heart and soul to my wife Subhadra for
the understanding and collaboration of sharing the responsibility, time and devotion
necessary to prepare this book. With my whole heart and best affection, I dedicate this
book to our youngest son Vinay Goyal and his wife Stacey Carpenter. They always
motivate me to live longer and happier to serve the world community. I also dedicate
this book to “those who want to live happily” by making personal health as first pri-
ority. One should not hesitate to discuss any personal health issues with a physician
who are dedicated and blessed by Almighty Supreme God to do the maximum for al-
leviating our body pain. Good health not only makes us happy but also makes happy
everyone around us.
— Megh R. Goyal, PhD, PE
December 31st 2013
In 1994, Dr. Megh R. Goyal taught me courses on soil and water management and
farm machinery when I was an undergraduate student at the University of Puerto Rico
– Mayaguez Campus. He was one of my favorite professors. After receiving my BSc
degree in agriculture sciences, I decided to enter the medical school to become a spe-
cialist in internal medicine and respiratory mechanics. After reading and editing this
manuscript, I feel honored to write a foreword for this book, thus paying tributes to
my professor.
I want to share with the readers what I learnt from textbooks on medical physiol-
ogy by Arthur Guyton and other authors. The human body is a fascinating job of our
Almighty God. It is made up of a head, neck, torso, two arms and two legs. The human
body is made to stand erect, walk on two feet, use the arms to carry and lift, and has
opposable thumbs (able to grasp). The adult body is made up of 100 trillion cells, 206
bones, 600 muscles, and 22 internal organs. Every square inch of the human body has
about 19 million skin cells. Every hour about 1 billion cells in the human body must
be replaced. The average human head has about 100,000 hairs. The arteries, veins and
capillaries are about 100,000 kilometers long. The heart beats more than 2.5 billion
times in an average lifetime. The human heart creates enough pressure to squirt the
blood 30 feet high. It takes about 20 seconds for a red blood cell to circle the whole
body.
The human body has nine major systems: circulatory system; respiratory system;
musculoskeletal system; nervous system; reproductive system; digestive system; uri-
nary system; lymphatic system; integumentary (dermal) system. Five minor systems
are: immune system; excretory system; endocannabinoid system; endocrine system
and vestibular (sensory) system. Each system plays a vital part in the health and well-
being of the entire body.
The circulatory system pumps and channels blood to and from the body and lungs
with heart, blood, and blood vessels. Blood is a medium that transports oxygen, from
the respiratory system to the cells. Blood also transports sugars, chemicals, proteins,
hormones and many other substances around the body for use and elimination. As the
heart pumps blood, a pulse beat can be felt at various locations in the body and each
pulse beat corresponds to one heartbeat. The heart rate of the average adult at rest is
between 80 to 120 beats per minute, depending on age, medical conditions and general
fitness.
The respiratory system is composed of the airway (mouth, nose, trachea, larynx,
bronchi and bronchioles) and the lungs (including the small air sacs called alveoli).
The respiratory system provides oxygen to the blood and takes away the waste product
called carbon dioxide. Oxygen is extracted from air inhaled through the airway and
goes into the blood stream through the membranes of the lungs. For the first aider,
maintaining a casualty’s airway is of primary importance.
who are deaf. As this device becomes less expensive and more available, it is thought
that the worldwide incidence of deafness will decrease dramatically. One case of a
survival situation where an artificial organ will make the difference between life and
death is in a heart transplant. If a patient is awaiting a new heart, an artificial heart can
be temporarily used to keep the person alive until the new heart becomes available. In
recent times, models have been created that can stand alone and provide a permanent
replacement for a heart that has functional impairment. This new type of artificial heart
is currently in the process of being evaluated and it is thought that it will be ready for
widespread live use beginning in the year 2013. The availability of artificial organs can
do much to improve a person’s life, from providing the essential bodily functions for
survival to improving sensory capabilities, such as sight and hearing.
I hope that this concise textbook by Dr. Megh R. Goyal and Apple Academic Press
Inc. will be definitely appealing and valuable to the health sciences community. It is
unique, user-friendly and introductory, focusing on essential aspects of Biomechanics
of Artificial Organs and Prostheses. I will like to see more books on such topics.
READ CAREFULLY
This textbook guides the world community on Biomechanics of Artificial Organs and
Prostheses for better health. The reader must be aware that the dedication, commit-
ment, honesty, and sincerity are most important factors in a dynamic manner for a
complete success. It is not a one-time reading of this manual. Read and follow every
time; it is needed. To err is human. However, we must do our best. Always, there is a
space for learning new experiences.
The editor, the contributing authors, the publisher and the printing company have
made every effort to make this book as complete and as accurate as possible. How-
ever, there still may be grammatical errors or mistakes in the content or typography.
Therefore, the contents in this book should be considered as a general guide and not
a complete solution to address any specific situation in the human body. For example,
all humans are not same and behave differently.
The authors, the publisher and the printing company shall have neither liability nor
responsibility to any person, any organization or entity with respect to any loss or dam-
age caused, or alleged to have caused, directly or indirectly, by information or advice
contained in this book. Therefore, the purchaser/reader must assume full responsibility
for the use of the book or the information therein.
The mentioning of commercial brands and trade names are only for technical pur-
poses. It does not mean that a particular product is endorsed over to another product or
equipment not mentioned. Author, cooperating authors, educational institutions, and
the publisher Apple Academic Press Inc. do not have any preference for a particular
product.
All weblinks that are mentioned in this book were active on December 31st 2013.
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“I am enthusiastic to know that Apple Academic Press Inc. and Dr. Megh R. Goyal
(whom have I known since 1979) have published this textbook that is user-friendly
and easy-to-read. The book includes key aspects of Biomechanics of Artificial Organs
and Prostheses.”
— Miguel A. Muñoz Muñoz, PhD, President of University of Puerto Rico, USA
“I hope that this concise textbook on artificial organs and prostheses by Dr. Goyal
and Apple Academic Press Inc. will be definitely appealing and valuable to the health
sciences community. It is unique and introductory focusing on essential aspects of
Biomechanics of Artificial Organs and Prostheses. I will like to see more books on
such topics.”
— Jesús Manuel Román Vélez, M.D., Practicing Physician, Specialist in Internal
Medicine and Pulmonary Mechanics, Fellow of American Society of Pulmonary
Medicine, Mayaguez, PR, USA.
“What a gem, with simple language and vivid illustrations! The photos and data deep-
ened my understanding on biomechanics and biomaterials of artificial organs and
prostheses the way it applies to our daily life. Before I sat down to read this book,
I was not sure how much I would understand the content. But each chapter builds
understanding on the content and shows the author’s mastery on the subject. I firmly
believe that this book is a must read for all with interest in bioengineering and readers
who want to make their health as their first priority.”
— Prof. Raj Bansal, New Jersey, USA
and EEGs, regenerative tissue growth, and pharmaceutical and therapeutic drugs. In
BME there is continual change and creation of new areas due to rapid advancement
in technology. However, some of the well-established specialty areas of BME are:
bioelectricity; bioheat transfer; bioinformatics; bioinstrumentation; biomass trans-
port; biomaterials; biomechanics; biotechnology/bionanotechnology; biosensors;
cellular, tissue, genetic engineering, and transport phenomena; clinical engineering;
medical imaging; orthopedic surgery; physiologic modeling; prosthetic devices and
artificial organs; rehabilitation engineering; and systems physiology. These special-
ty areas frequently depend on each other. BMES has been the lead society to define
some of these areas as below:
Bioinstrumentation is the application of electronics and measurement techniques
to develop devices used in diagnosis and treatment of disease. Computers are an essen-
tial part of bioinstrumentation, from the microprocessor in a single-purpose instrument
used to do a variety of small tasks to the microcomputer needed to process the large
amount of information in a medical imaging system.
Biomaterials include both living tissue and artificial materials used for implanta-
tion. Understanding the properties and behavior of living material is vital in the design
of implant materials. The selection of an appropriate material to place in the human
body may be one of the most difficult tasks faced by the biomedical engineer. Cer-
tain metal alloys, ceramics, polymers, and composites have been used as implantable
materials. Biomaterials must be nontoxic, noncarcinogenic, chemically inert, stable,
and mechanically strong enough to withstand the repeated forces of a lifetime. Newer
biomaterials even incorporate living cells in order to provide a true biological and
mechanical match for the living tissue.
Biomechanics applies classical mechanics (statics, dynamics, fluids, solids, ther-
modynamics, and continuum mechanics) to biological or medical problems. It in-
cludes the study of motion, material deformation, flow within the body and in de-
vices, and transport of chemical constituents across biological and synthetic media
and membranes. Progress in biomechanics has led to the development of the artificial
heart and heart valves, artificial joint replacements, as well as a better understanding
of the function of the heart and lung, blood vessels and capillaries, and bone, cartilage,
intervertebral discs, ligaments and tendons of the musculoskeletal systems.
Cellular, tissue and genetic engineering involve more recent attempts to solve
biomedical problems at the microscopic level. These areas use the anatomy, biochem-
istry, and mechanics of cellular and subcellular structures in order to understand dis-
ease processes and to be able to intervene at very specific sites. With these capabilities,
miniature devices deliver compounds that can stimulate or inhibit cellular processes at
precise target locations to promote healing or inhibit disease formation and progres-
sion.
Clinical engineering is the application of technology to health care in hospitals.
The clinical engineer is a member of the health care team along with physicians,
nurses and other hospital staff. Clinical engineers are responsible for developing and
maintaining computer databases of medical instrumentation and equipment records
and for the purchase and use of sophisticated medical instruments. They may also
work with physicians to adapt instrumentation to the specific needs of the physician
and the hospital. This often involves the interface of instruments with computer
systems and customized software for instrument control and data acquisition and
analysis. Clinical engineers are involved with the application of the latest technol-
ogy to health care.
Medical imaging combines knowledge of a unique physical phenomenon (sound,
radiation, magnetism, etc.) with high-speed electronic data processing, analysis and
display to generate an image. Often, these images can be obtained with minimal or
completely noninvasive procedures, making them less painful and more readily re-
peatable than invasive techniques.
Orthopaedic bioengineering is the specialty where methods of engineering and
computational mechanics have been applied for the understanding of the function of
bones, joints and muscles, and for the design of artificial joint replacements. Orthopae-
dic bioengineers analyze the friction, lubrication and wear characteristics of natural
and artificial joints; they perform stress analysis of the musculoskeletal system; and
they develop artificial biomaterials (biologic and synthetic) for replacement of bones,
cartilages, ligaments, tendons, meniscus and intervertebral discs. They often perform
gait and motion analyzes for sports performance and patient outcome following surgi-
cal procedures. Orthopaedic bioengineers also pursue fundamental studies on cellular
function, and mechano-signal transduction.
Rehabilitation engineering is a growing specialty area of BME. Rehabilitation
engineers enhance the capabilities and improve the quality of life for individuals with
physical and cognitive impairments. They are involved in prosthetics, the develop-
ment of home, workplace and transportation modifications and the design of assistive
technology that enhance seating and positioning, mobility, and communication. Reha-
bilitation engineers are also developing hardware and software computer adaptations
and cognitive aids to assist people with cognitive difficulties.
Systems physiology is a term used to describe that aspect of BME in which engi-
neering strategies, techniques and tools are used to gain a comprehensive and integrat-
ed understanding of the function of living organisms ranging from bacteria to humans.
Computer modeling is used in the analysis of experimental data and in formulating
mathematical descriptions of physiological events. In research, predictor models are
used in designing new experiments to refine our knowledge. Living systems have
highly regulated feedback control systems that can be examined with state-of-the-
art techniques. Examples are the biochemistry of metabolism and the control of limb
movements.
Biotechnology, nanotechnology and bionanotechnology are sometimes used in-
terchangeably with BME in general. Biotechnology is the use of biological processes,
organisms, or systems to manufacture products intended to improve the quality of hu-
man life. The United Nations Convention on Biological Diversity defines biotechnol-
ogy as any technological application that uses biological systems, living organisms, or
derivatives thereof, to make or modify products or processes for specific use. Nano-
technology is a study and use of structures between 1 nanometer and 100 nanometers
in size. For example a width of a human hair is equivalent to eight hundred 100-nano-
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