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VSA SCHOOL OF ENGINEERING DEPT OF ECE
MEDICAL ELECTRONICS
UNIT – 1: RECORDING & MONITORING INSTRUMENTS Bio electric signals and Electrodes – Biomedical Recorders – Medical display systems – monitoring systems. CLASS – 1 Topic: Medical Electronics Introduction Medical Electronics: Def: A branch of electronics in which electronic instruments and equipment are used for such medical applications as diagnosis, therapy, research, anesthesia control, cardiac control, and surgery. Cell & its Structure:

Fig: Structure of Cell The cell was discovered by Robert Hooke in 1665. The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing (except virus, which consists only
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from DNA/RNA covered by protein and lipids), and is often called the building block of life. Organisms can be classified as unicellular (consisting of a single cell; including most bacteria) or multicellular (including plants and animals). Humans contain about 10 trillion (1013) cells. The different substances that make up the cell are collectively known as PROTOPLASM. It is composed of 1. Water 2. Electrolyte 3. Protein 4. Lipids 5. Carbohydrates 6. Cytoplasm 7. Ribosome 8. Lysosomes 9. Mitochondria A cell consists of a plasma membrane, a nucleus and cytoplasm. Plasma membrane: The cell membrane or plasma membrane is a biological membrane that separates the interior of all cells from the outside environment. The cell membrane is selectively permeable to ions and organic molecules and controls the movement of substances in and out of cells. The basic function of the cell membrane is to protect the cell from its surroundings. It consists of the lipid bilayer with embedded proteins. Nucleus: The nucleus is the largest cellular organelle in humans. In mammalian cells, the average diameter of the nucleus is approximately 6 micrometers (μm), which occupies about 10% of the total cell volume. The viscous liquid within it is called nucleoplasm, and is similar in composition to the cytosol found outside the nucleus.[7] It appears as a dense, roughly spherical organelle.

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Cytoplasm: The cytoplasm is the gel-like substance residing within the cell membrane holding all the cell's internal sub-structures (called organelles), outside the nucleus. All the contents of the cells of prokaryote organisms (such as bacteria, which lack a cell nucleus) are contained within the cytoplasm. Within the cells of eukaryote organisms the contents of the cell nucleus are separated from the cytoplasm, and are then called the nucleoplasm. The cytoplasm is about 70% to 90% water and usually colorless.

Hints:

Possible Questions: 1. Draw the structure of cell. [2] 2. Define protoplasm. [2] 3. Define ICF & ECF. [2] 4. Describe the structure of cell in detail. [8]

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Resting and Action potential:

Resting Potential: Dictionary Meaning: The electrical potential of a neuron or other excitable cell relative to its surroundings when at rest. Technical Meaning: The potential difference between the two sides of the membrane of a nerve cell when the cell is not conducting an impulse.

Fig: Resting Potential
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Action Potential: Dictionary Meaning: The change in electrical potential associated with the passage of an impulse along the membrane of a muscle cell or nerve cell. Technical Meaning: A momentary change in electrical potential on the surface of a cell, especially of a nerve or muscle cell, that occurs when it is stimulated, resulting in the transmission of an electrical impulse. Characteristics of Resting Potential: The characteristics of the resting potential are maintained as a constant until some kind of the disturbances will upset the equilibrium. It strongly depends on the temperature. The permeability of different cell types should vary. Hence the corresponding resting potential also vary. The range of resting potential is -60 to -100 mV. The resting potential can be calculated with the Goldman-Hodgkin-Katz voltage equation using the concentrations of ions as for the equilibrium potential while also including the relative permeabilities, or conductances, of each ionic species. Under normal conditions, it is safe to assume that only potassium, sodium (Na+) and chloride (Cl-) ions play large roles for the resting potential:

VR = (-kT/q)ln{ PK[K+]i+PNa[Na+]i+PCl[Cl-]o / PK[K+]o+PNa[Na+]o+PCl[Cl-]i }
Where the subscript o the subscript i VR K T q PK outside the cell inside the cell resting potential Boltzman constant Absolute temperature in Kelvin Charge of an electron Permeability of potassium ion

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Absolute & Relative Refractory Period: Absolute Refractory Period: It is the time duration in which the cell cannot respond to any new stimulus. Generally it is about 1ms in nerve cells. Relative Refractory Period: It is one during which another action potential can be triggered but a higher stimulus is required to reinitiate the action potential and the subsequent contraction of muscles.

Fig: Absolute and Relative Refractory Period. All Or Nothing Law: It states that regardless of the method of excitation of cells or by the intensity of the stimulus, the action potential is always the same for any given cell.

Possible Questions: 1. Define All or Nothing law. [2m] 2. Define resting & action potential. [2m]

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3. What are the characteristics of resting potential? [2m] or [4m] or [8m] 4. State Goldman’s equation of resting potential. [2m] 5. Differentiate absolute & relative refractory period. [2m] 6. Discuss in detail about origin of bioelectric potentials with necessary diagrams. [16]

HINTS:

Books Reffered: 1. Medical Electronics – R.L.Rekha [Pg:No: 1.1 to 1.6] 2. Handbook of biomedical instrumentation – R.S.Khandpur

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CLASS – 2 TOPIC: Bioelectric Signals & Electrodes Definition: Electrical biosignals ("bio-electrical" signals) are usually taken to be (changes in) electric currents produced by the sum of electrical potential differences across a specialized tissue, organ or cell system like the nervous system. Thus, among the best-known bio-electrical signals are the Electroencephalogram (EEG) Magneto encephalogram (MEG) Galvanic skin response (GSR) Electrocardiogram (ECG) Electromyogram (EMG) Heart Rate Variability (HRV) 1. Electrocardiogram [ECG]: ECG is the record of electrical activity of the heart. Typical bandwidth: 0.5 – 125 Hz Typical waveform: Rhythmic waveform Typical amplitude: 1 – 10 mV

Fig: ECG Waveform
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Characteristic waves of ECG: P wave – Atrial depolarization PQ segment – AV nodal delay QRS complex – ventricular depolarization (atrial repolarization) ST segment – ventricular ejection period T wave – ventricular repolarization TP segment – ventricular filling period Clinical significance: ECG record helps in the diagnosis of various heart arrhythmias such as tachycardia, bradycardia, heart block etc. 2.ElectroEncephaloGram [ EEG]: EEG is the record of sum of biopotentials generated by individual neurons or electrical activities of the brain. Typical bandwidth: 0.1 – 100 Hz Typical amplitude: 10 – 100 mV Typical waveform: Highly random

Fig: EEG Waveform
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Subdivided into five bands namely 1. 2. 3. 4. 5. Delta (d): 01 – 4 Hz; found in children; if found in alert adult it is abnormal Theta (q): 4 – 8 Hz; found in children of 2-5 year old; if found in alert adult it is abnormal Alpha (a): 8 – 13 Hz; found in alert adult with eyes closed (under relaxed conditions) Beta (b): 13 – 22 Hz; found in alert adult with eyes open (under active conditions) Gamma (g): >22 Hz.

Clinical Significance: EEG record helps in the diagnosis of brain asymmetry, epilepsy, mental disorders etc and in the study of sleep patterns. PhonoCardioGram [PCG]: Record of heart sounds – 1st and 2nd heart sounds are heard well but 3rd and 4th are not. Heart sounds are generally used for diagnosis of valve related diseases. Such abnormal heart sounds are called murmurs. 1st heart sound: due to closure of AV valves – long, soft & low-pitched sound – sounds like ‘lubb’ – 0.14-0.2 sec – 30-40 Hz. 2nd heart sound: due to closure of semilunar valves – short, sharp & high-pitched sound – sounds like ‘dub’ – 0.08-0.1 sec – 50-70 Hz. 3rd heart sound: due to ventricular vibrations resulting from on-rush of blood immediately after the opening of AV valves – very short – 0.04 sec. 4th heart sound: due to atrial contraction.

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Fig: PCG Waveform ElectroOculoGram [EOG]: Steady corneal-retinal potential – used to record eye movements in sleep and dream to evaluate reading ability and visual fatigue – eye movements less than 10 and greater than 300 is difficult to record because of lack of accuracy and lack of proportion.

Fig: EOG Waveform

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Electromyogram [EMG]: EMG is the record of electrical activity of muscles. Typical bandwidth: 300-3000 Hz Typical amplitude: 10-100 mV

Fig: EMG Waveform ELECTRODES: Electrodes are generally used to pick up the electric signals of the body. There are various electrodes that are used in instrumentation system. They are 1. Surface electrode 2. Micro electrode 3. Depth electrode 4. Needle electrode 5. Chemical electrode

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TYPES OF ELECTRODES: 1. Micro-Electrodes: They are normally used to measure the potential within a single cell. The microelectrodes are very small in diameter and so it will not damage the human cell. Microelectrodes are classified into Metallic & Non-Metallic. Metallic Electrode: The metal microelectrodes are formed by electrolytically etching the tip of fine tungsten filament into a minute structure. The final potential within the cell is the difference between the microelectrode potential and reference potential. Final potential = EA-ER

Micropipet: It is used to measure the potential within a single cell, but instead of metal electrolyte non-metallic material is used.

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2. Depth Electrode: Depth electrodes are used to measure the oxygen tension. These are used to study the electrical activity of neuron of superficial layers of brain. In some depth electrode, the supporting element is in the form of capillary tube, which is used to inject medicine into the brain. 3. Needle Electrode: Needle electrodes are used to record the peripheral nerve action potential. The needle electrode will resemble a medicine dropper. There are two types: 1. 2. Monopolar needle electrode. Bipolar needle electrode.

4. Surface Electrode: The surface electrodes are used to measure the potential available from the surface of the skin and used to sense the potential from heart, brain and nerves.

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The smaller area surface electrodes are used to measure EEG,EMG potentials and the larger area surface electrodes are used to measure ECG potentials. Depends on construction, the surface electrodes are classified into 1. Metal plate electrode 2. Suction cup electrode 3. Adhesive tape electrode 4. Multipoint electrode 5. Floating electrode 1. Metal plate electrode: It is made up of Ag-AgCl (Silver-Silver Chloride). It is used to pick up ECG from the limb lead positions. It is fixed to the skin surface by means of conductive gel & rubber belt.

Fig: Metal plate electrode. 2. Metal disc electrode: It is made up of Ag-AgCl. It is used to pick up EEG from the scalp. It is fixed to the scalp by means of adhesive tape.

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Fig: Metal disc electrode. 3. Metallic suction electrode: It is made up of Ag-AgCl. It is used to pick up ECG from chest lead positions and EMG from muscular areas such as calf, thigh etc. It does not require adhesive tapes or rubber bands. It is fixed to the skin surface by means of air suction.

Fig: Metal suction electrode. 4. Disposable foam-pad electrode: It is made up of Ag-AgCl. It is used to pick up ECG or EEG for those patients with contagious skin diseases. It is fixed to the skin surface by means of adhesive tapes attached to the electrode.

Fig: Disposable foam-pad electrode. 5. Floating electrode: This type of electrode is used to prevent the motion-artifact from being picked up.
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Fig: Floating electrode. 5. Chemical electrodes: The chemical electrodes are used to measure the pH content and pO 2 of blood. It is also used to determine the oxygen content & CO 2 content in blood. Various types of chemical electrodes are 1. Hydrogen electrode. 2. Practical reference electrode. 3. pH electrode. 4. pO2 electrode. 5. pCO2 electrode.

Possible Questions: 1. Define the process of depolarization & repolarization.[2m] 2. What is the specific usage of signal average? [2m] 3. What is ERP? [2m] 4. Write down the Nernst equation. [2m] 5. What is a PCG? [2m] 6. Write a detail note on electrodes. [16m] Books Reffered: 1. Medical Electronics – R.L.Rekha [Pg:No: 1.18 to 1.] 2. Handbook of biomedical instrumentation – R.S.Khandpur
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CLASS – 3 TOPIC: Bio Amplifiers BASIC COMPONENTS OF BIOMEDICAL SYSTEM:

Fig: Basic Components Of Bio-medical System SYSTEM: The measurements are made on the subject. i.e.: Human being. STIMULUS: The response to external stimulus is necessary in many biomedical instrument systems. TRANSDUCER: It is used to convert biosignals to electrical signal. SIGNAL CONDITIONING EQUIPMENT: The electrical output from the transducer is amplified and modified by using this block. MEASUREMENT (or) DISPLAY (or) RECORDING UNIT: The output can be displayed using CRT display (or) DSO. CONTROL FEEDBACK: The output of control feedback block is connected with stimulus block the input applied to the subject.

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BIO-AMPLIFIER: DEF: A Bioamplifier is a device used to gather and increase the signal integrity of human neurophysiologic electrical activity for output to various sources. BASIC REQUIREMENT FOR BIOLOGICAL AMPLIFIERS: Bio-Amplifiers must have high input impedance. It must have isolation and protection circuits. Voltage gain of bio-amplifiers should be more than 100db. Constant gain should be maintained throughout the required bandwidth. Drift free amplifiers can acts as good bio-amplifiers. CMRR of bio-amplifiers should be more than 80db. TYPES OF BIO-AMPLIFIERS: 1. Differential amplifier. 2. Operational amplifier. 3. Instrumentation amplifier. 4. Chopper amplifier. 5. Isolation amplifier. 1. Differential amplifier:

Fig: Single ended amplifier.
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Fig: Differential amplifier

Fig: Input and Output Waveforms of differential amplifier. 2. OPERATIONAL AMPLIFIER:

Fig: Operational amplifier If the input is applied to inverting input terminal (-), then the output can be obtained with 1800 phase shift. This is known as “INVERSION OF THE SIGNAL”.

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Ideal Op-Amp Properties: 1. Infinite input impedance 2. Zero output impedance 3. Infinite open loop voltage gain 4. Zero noise level 5. Infinite frequency response. Configurations of Op-Amp: 1. Inverting amplifier:

Fig: Inverting amplifier

AV=Vo/Vin= -Rf/Rin
2. Non-Inverting amplifier:

Fig: Non-Inverting amplifier

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AV=Vo/Vin= 1+(Rf/R1)

3.

Instrumentation amplifier:

Fig: Instrumentation amplifier

Advantages: 1. High gain 2. Extremely high input impedance 3. CMRR is good.

4.

CHOPPER AMPLIFIERS: Analog signal is sampled in this amplifier circuit. Hence this circuit is known as chopper amplifier. Chopper amplifiers are classified into mechanical and non-mechanical choppers.

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Advantages: 1. Stable gain 2. Provides low noise operation. 5. ISOLATION AMPLIFIER:

Fig: Symbol of isolation amplifier

Fig: Isolation amplifier Advantages: 1. Isolation amplifiers withstand high voltage. 2. It amplifies the signals while passing only low leakage current to prevent shock.

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HINTS:

Books Reffered: 1. Medical Electronics – R.L.Rekha [Pg:No: 2.2 to 2.14] 2. Handbook of biomedical instrumentation – R.S.Khandpur

POSSIBLE QUESTIONS: 1. What are the ideal op-amp characteristics? [2m] 2. Define chopper amplifier. [2m] 3. Explain the various types of amplifiers with a neat diagram. [16 m]

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CLASS – 4 TOPIC: ELECTROCARDIOGRAPHY DEF: ECG shows the electrical activity of the heart muscles. The recorded ECG waveform is known as electrocardiograph & the instrument is termed as electrocardiogram. It gives the valuable information about the cardiac disorders. Cross Section Of Heart:

Fig: Cross section of heart Heart is divided into four chambers. The 4 chambers are 1. Left atrium 2. Right atrium

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3. Left ventricle 4. Right ventricle TRICUSPID VALVE [Right Atrio Ventricular Valve]: It is located in between the right atrium and right ventricle. It is located in between the right atrium and right ventricle. It prevents backward blood flow from right ventricle to right atrium. BICUSPID VALVE [Left Atrio Ventricular Valve]: It is located in between left atrium and left ventricle. It prevents backward blood from left ventricle to left atrium. PULMONARY VALVE: It is located at the right ventricle. It has half moon shaped cusps. It does not allow blood to come back to the right ventricle. AORTIC VALVE: It is located between left ventricle and aorta. It does not allow the blood to come back to the left ventricle. Heart consists of 3 layers namely, 1. Peri cardium 2. Endo cardium 3. Myo cardium Pericardium: It is the outer layer of heart. It keeps the outer surface and prevents the heart from friction. Endocardium: It is the inner layer of the heart. It provides smooth path for blood flow. Myocardium: It is the middle layer of the heart. It acts as the main muscle of the heart and it is made up of short cylindrical fibers.

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ECG LEAD SYSTEMS: Types of ECG lead systems are (i) Limb lead systems and (ii) Chest lead systems (i) Limb lead systems: (a) Bipolar limb lead systems (b) Unipolar or augmented limb lead systems. (a)Bipolar limb lead systems: Potential between any two limb leads is measured with RL grounded.

(i)Lead I: Potential between LA & RA with RL grounded.

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(ii) Lead II: Potential between RA & LL with LA tied to RL & RL grounded.

(iii) Lead III: Potential between LA & LL with RA tied to RL & RL grounded.

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EINTHOVAN TRIANGLE: An imaginary equilateral triangle having the heart at its center and formed by lines that represent the three standard limb leads of the electrocardiogram.

Fig: Einthovan’s Triangle

(b) Unipolar or augmented limb lead systems: Potential at a particular limb lead with other two limb leads augmented. This increases the amplitude of the ECG signal without changing its waveform. (i)Lead aVR: Potential at RA with LA & LL augmented & RL grounded.

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(ii)Lead aVL: Potential at LA with RA & LL augmented & RL grounded.

(iii)Lead aVF: Potential at LL with RA & LA augmented & RL grounded.

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(ii) Chest leads systems: Potential at one of six chest leads with RA, LA & LL augmented and RL grounded.

CHEST LEAD POSITIONS:

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V1 – Fourth intercostals space at right sternal margin V2 – Fourth intercostals space at left sternal margin V3 – midway between V2 and V4 V4 – Fifth intercostals space at mid-clavicular line V5 – Same level as V4 on anterior auxiliary line V6 – Same level as V4 on mid auxiliary line ECG WAVEFORM:

ECG RECORDING METHOD: Electrode system: Metal plate electrodes made of Ag/AgCl are placed at desired limb positions. Good contact between electrodes & skin is ensured with the help of gel and belts. Lead fault detect: The function of this block is to detect the improper connection of the electrodes on to the skin by continually measuring the contact resistance and to warn the operator of this via either an audible tone or a visual indication. Amplifier protection circuitry: The function of this block is to protect the remaining part of the circuit from large electrical discharges resulting from defibrillation process. Lead selector: The function of this block is to select a desired lead system from 12 possible lead systems. This can be carried out either manually by an operator or automatically by microprocessor or microcontroller or microcomputer.
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Fig: ECG recording system Preamplifier: The function of this block is to eliminate noise such as other biopotentials and various electromagnetic interferences resulting from nearby communication links etc. Generally a differential amplifier with high input impedance and CMRR is used for this purpose. Calibration signal: The function of this block is to calibrate the display or the recorder for predetermined amplitude. A sine wave of 1 mV is generally used for this purpose. Baseline restoration: The function of this block is to restore any baseline shift resulting from the low operating frequency of the amplifier. Right leg driven system: The function of this block is to provide a reference point on the patient generally at ground potential. Isolation circuitry: The function of this block is to provide electrical isolation between the high power section that is generally driven by 230 V 50 Hz ac mains and the low power patient section that is generally driven by a low power battery. This is required to protect the patient from any electrical hazards resulting from leakage currents. Driver amplifier: The function of this block is to amplify the ECG signal sufficiently to level required for the display or the recorder.

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ADC & memory: The ECG signal can be digitized and stored for future analysis. Microcomputer: A microcomputer along with a user-friendly software package developed on a high-level language such as VC++ can be used (i) to control the entire process of acquiring the ECG and (ii) to analyze it automatically for various parameters such as heart rate, PR interval, QRS interval etc using sophisticated digital signal processing techniques. Recorder-printer/display: A heat sensitive paper can be used to get a hard copy of the ECG signal obtained or a CRO can be used to display the ECG signal obtained for visual analysis. HINTS:

POSSIBLE QUESTIONS: 1. 2. 3. 4. 5. 6. 7. Define the terms systole & diastole in heart activity.[2m] Define cardiac output. [2m] Define Einthovan’s triangle. [2m] Draw ECG Waveform. [2m] Name the four valves of heart and define it. [2m] Write a short notes on ECG lead system and its types. [8m] Describe in detail about ECG recording system with neat block diagram. [16m]

Books Reffered: 1. Medical Electronics – R.L.Rekha [Pg:No: 2.14 to 2.22] 2. Handbook of biomedical instrumentation – R.S.Khandpur
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CLASS – 5 TOPIC: ELECTROENCEPHALOGRAPHY [EEG] DEF: Electroencephalography is the study of electrical activity of the brain. In EEG measurement, electrical activity of brain is measured from electrodes which are placed on scalp. ACTION POTENTIAL OF THE BRAIN: Inhibitory Post Synaptic Potential: If the transmitter substance is inhibitory, then the membrane potential of the receptor neuron increases in a negative direction. So that it is less likely to discharge. This induced potential change is called as Inhibitory Post Synaptic Potential. Excitatory Post Synaptic Potential: If the transmitter substance is excitatory, then the receptor membrane potential will increase in a positive direction. So that it is more likely to discharge and produces a spike potential. This induced potential change is called as Excitatory Post Synaptic Potential. EVOKED POTENTIAL: These are the potentials developed in the brain as the responses to external stimuli like sound, light etc. PLACEMENT OF ELECTRODES IN EEG MEASUREMENT: The distance between the Nasion and Inion over the head is divided into 5 points: 1. Frontal Pole (FP): 10% of Nasion & Inion distance above Nasion. 2. Frontal (F): 20% of Nasion & Inion distance from FP. 3. Central (C): 20% of Nasion & Inion distance from F.

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4. Parietal (P): 20% of Nasion & Inion distance from C (Central Point). 5. Occipital (O): 10% of Nasion & Inion distance from Inion.

Fig: Anterior – Posterior Measurement

Fig: Lateral Measurement.

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EEG RECORDING SETUP:

Fig: Block diagram of EEG Electrode system: Metal disc electrodes made of Ag/AgCl are placed at scalp positions. Good contact between electrodes & skin is ensured with the help of gel and adhesive tapes. Channel selector: The function of this block is to select a desired combination of 19 possible electrodes. This can be carried out either manually by an operator or automatically by microprocessor or microcontroller or microcomputer.

Preamplifier: The function of this block is to eliminate noise such as other biopotentials and various electromagnetic interferences resulting from nearby communication links etc. Generally a differential amplifier with high input impedance and CMRR is used for this purpose. A minimum gain of 1000 is required as typical amplitude range of EEG is from 1 to few microvolts.

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Calibration signal: The function of this block is to calibrate the display or the recorder for predetermined amplitude. A sine wave of 1 mV is generally used for this purpose. Isolation circuitry: The function of this block is to provide electrical isolation between the high power section that is generally driven by 230 V 50 Hz ac mains and the low power patient section that is generally driven by a low power battery. This is required to protect the patient from any electrical hazards resulting from leakage currents.

Driver amplifier: The function of this block is to amplify the EEG signal sufficiently to level required for the display or the recorder.

ADC & memory: The EEG signal can be digitized and stored for future analysis.

Microcomputer: A microcomputer along with a user-friendly software package developed on a high-level language such as VC++ can be used (i) to control the entire process of acquiring the EEG and (ii) to analyze it automatically for various parameters using sophisticated digital signal processing techniques. Recorder-printer/display: A heat sensitive paper can be used to get a hard copy of the EEG signal obtained or a CRO can be used to display the EEG signal obtained for visual analysis.

POSSIBLE QUESTIONS: 1. 2. 3. 4. Define EEG.[2m] What is meant by Evoked potential? [2m] Draw EEG lead placement for anterior – posterior measurement. [2m] Write a detail note on EEG recording setup with neat sketch. [16m]

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CLASS – 6 TOPIC: EMG, EOG, ERG & PCG ELECTROMYOGRAPH: Def: Electromyograph is an instrument used for recording the electrical activity of the muscles to determine whether the muscle is contracting or not. Surface and needle electrodes are generally used for EMG. EMG RECORDING SYSTEM:

Fig: EMG Recording system APPLICATIONS: 1. Electrophysiology testing 2. Clinical neurophysiology 3. Neurology 4. Psychiatry

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ELECTROOCULOGRAM [EOG]: DEF: EOG is the recording of the biopotentials generated by the movement of eyes. Surface electrodes are used to measure EOG.

EOG ELECTRODES:

Fig: EOG Electrodes

Fig: EOG Measurement system

APPLICATIONS: 1. It is used to analyze the state of semicircular canals. 2. Diagnoses of the neurologic disorders are possible. 3. The level of anesthesia can be indicated by the characteristics of eye movement.

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ELECTRORETINOGRAPH [ERG]: DEF: Electro Retinography is the method of recording and interpreting the electrical activity of the eye. The process of recording the change in potential when light falls on the eye is known as electroretinography. ERG RECORDING SYSTEM:

ERG WAVEFORM:

Fig: Electroretinogram a – Due to Early Receptor Potential generated by light. b – Due to Late Receptor Potential. c- Obtained at the offset of the light stimulus. d- Due to the off response of ERP and LRP.

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PHONOCARDIOGRAM: DEF: The device which is used to measure heart sound is known as Phonocardiogram. These heart sounds are due to the vibrations set up in the blood inside the heart by the sudden closure of valves. AUSCULTATION: The technique of listening sound produced by organs and vessels of the body is known as Auscultation. CLASSIFICATION OF HEART SOUND: 1. Valve closure sound 2. Ventricular filling sound 3. Valve opening sound 4. Extra cardiac sound. PCG RECORDING SYSTEM:

Fig: PCG Recording System Types Of Microphones Used in PCG: 1. Air-Coupled Microphone 2. Contact Microphone

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VSA GROUP OF INSTITUTIONS-2013

PCG WAVEFORM: Relationship between blood pressure & heart sound & ECG Waveform

HINTS:

POSSIBLE QUESTIONS: 1. Define Auscultation.[2m] 2. Name the microphones used in PCG. [2m] 3. Differentiate ERG and EOG. [2m] 4. Give EMG signal characteristics. [2m] 5. How is the pulse rate is measured? [2m] 6. What is the advantage of instrumentation amplifier over differential amplifier? [2m] 7. What are the frequency range of ECG, EEG and EMG waves? [2m] 8. Compare the signal characteristics of ECG and PCG. [2m] 9. How the PCG signals are generated? Explain the measurement of PCG. [8m] 10. Draw the 12 lead system used in ECG. [8m]

MEDICAL ELECTRONICS LECTURE NOTES

© Ms.V.Ezhilya

44

VSA GROUP OF INSTITUTIONS-2013

CLASS – 7 TOPIC: MONITORING SYSTEMS MONITORING SYSTEM: DEF: A quantitative assessment of the important physiological variables of the patients during critical periods of their biological functions. Types Of Monitoring System: 1. Cardiac Monitor 2. Bedside patient monitoring system 3. Central monitors. MEASUREMENT OF HEART RATE: Heart rate is derived by the amplification of the ECG signal and by measuring either the average or instantaneous time intervals between two successive R peaks. Techniques used to calculate heart rate include: 1. Average calculation – Oldest and most popular technique. An average rate is calculated by counting the number of pulses in a given time. 2. Beat-to-beat calculation – This is done by measuring the time in seconds, between two consecutive pulses and converting this time into beats/min., using the formula beats/min = 60/T. 3. Combination of beat-to-beat calculation with averaging: This is based on a four or six beats average. MEASUREMENT OF PULSE RATE: The pulse pressure and waveform are indicators for blood pressure and flow. Instruments used to detect the arterial pulse and pulse pressure waveforms in the extremities are called Plethysmographs.

MEDICAL ELECTRONICS LECTURE NOTES

© Ms.V.Ezhilya

45

VSA GROUP OF INSTITUTIONS-2013

The method used for the detection of pulse changes due to blood flow are: 1. Electrical impedance changes 2. Strain Gauge or microphone 3. Optical changes The most commonly used method to measure pulsatile blood volume changes is by the photoelectric method. Two methods are common: 1. Reflectance method 2. Transmittance method. BLOOD PRESSURE MEASUREMENT: Blood pressure is the most often measured and the most intensively studied parameter in medical practice. The most frequently monitored pressures, which have clinical usefulness in medium and long term patient monitoring, are arterial and venous pressure. The two basic method for measuring blood pressure are 1. Direct 2. Indirect. Books Reffered: 1. Medical Electronics – R.L.Rekha [Pg:No: 2.15 to 2.42] 2. Handbook of biomedical instrumentation – R.S.Khandpur [Pg:No:186]

POSSIBLE QUESTIONS: 1. How partial pressure of blood can be measured and explain the measurement techniques.[6m] 2. Why conducting gel is applied during biosignal recording?[8m] 3. Describe in detail about basic component of biomedical system.[16m]

MEDICAL ELECTRONICS LECTURE NOTES

© Ms.V.Ezhilya

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