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College, Perumalpattu EC1006 MEDICAL ELECTRONICS 3 0 0 100
AIM To make students to understand the applications of electronics in diagnostic and therapeutic area. OBJECTIVE • To study the methods of recording various biopotentials • To study how to measure biochemical and various physiological information • To understand the working of units which will help to restore normal functioning • To understand the use of radiation for diagnostic and therapy • To understand the need and technique of electrical safety in Hospitals UNIT I ELECTRO-PHYSIOLOGY AND BIO-POTENTIAL RECORDING 9 The origin of Bio-potentials; biopotential electrodes, biological amplifiers, ECG, EEG, EMG, PCG, EOG, lead systems and recording methods, typical waveforms and signal characteristics. UNIT II BIO-CHEMICAL AND NON ELECTRICAL PARAMETER MEASUREMENT 9 PH, PO2, PCO2, PHCO3, Electrophoresis, colorimeter, photometer, Auto analyzer, Blood flow meter, cardiac output, respiratory measurement, Blood pressure, temperature, pulse, Blood cell counters. UNIT III ASSIST DEVICES AND BIO-TELEMETRY 9 Cardiac pacemakers, DC Defibrillator, Telemetry principles, frequency selection, Biotelemetry, radio-pill and tele-stimulation. UNIT IV RADIOLOGICAL EQUIPMENTS 9 Ionosing radiation, Diagnostic x-ray equipments, use of Radio Isotope in diagnosis, Radiation Therapy. UNIT V RECENT TRENDS IN MEDICAL INSTRUMENTATION 9 Thermograph, endoscopy unit, Laser in medicine, Diathermy units, Electrical safety in medical equipment. TOTAL: 45 TEXTBOOKS 1. Leislie Cromwell, “Biomedical instrumentation and measurement”, Prentice Hall of India, New Delhi, 2002. REFERENCES 1. Khandpur, R.S., “Handbook of Biomedical Instrumentation”, TATA McGraw-Hill, New Delhi, 1997. 2. Joseph J.Carr and John M.Brown, “Introduction to Biomedical equipment Technology”, John Wiley and Sons, New York, 1997.
SRIRAM ENGINEERING COLLEGE Perumalpattu – 602 024 STAFF LESSON PLAN Name Department Branch Semester : V. Salai Selvam : ECE : ECE ‘A’ : VI Subject code : EC1006 Subject : Medical Electronics Schedule of completion Unit Description The origin of Biopotentials (1) Biopotential electrodes (1) Biological amplifiers (1) ECG, EEG, EMG, PCG & EOG typical waveforms and signal characteristics (1) ECG lead systems and recording methods (1) EEG lead systems and recording methods (1) EMG recording methods (1) PCG recording methods (1) EOG recording methods (1) pH, pO2, pCO2, pHCO3 (1) Electrophoresis (1) Colorimeter (1) Photometer (1) Auto analyzer (1) Blood flow meter (1) Cardiac output measurement (1) Respiratory measurement (1) Blood pressure measurement (1) Temperature measurement (1) Pulse measurement (1) Blood cell counters (1) Cardiac pacemakers (2) DC Defibrillators (2) Telemetry principles & frequency selection Bio-telemetry (2) Radio-pill and tele-stimulation (2) From To No. of hours required Date of Assnmnt. Designation : Assistant Professor & HOD
Signature of the staff
Head of the Department
SRIRAM ENGINEERING COLLEGE Perumalpattu – 602 024 STAFF LESSON PLAN Name Department Branch Semester : V. Salai Selvam : ECE : ECE ‘A’ : VI Subject code : EC1006 Subject : Medical Electronics Schedule of completion Unit Description Ionizing and Non-ionizing Radiations (1) Generation of Ionizing radiation: Generation of X-rays (1) Diagnostic x-ray equipment (2) Special Techniques (1) Use of Radio Isotope in diagnosis: Radioisotopes (1) Use of Radio Isotope in diagnosis: Detection (1) Radiation Therapy (1) Adverse Effects (1) Thermograph (2) Endoscopy unit (2) V Laser in medicine (2) Surgical diathermy (2) Electrical safety (2) 10 From To No. of hours required Date of Assnmnt. Designation : Assistant Professor & HOD
Signature of the staff
Head of the Department
It is a distinct spherical or oval structure located near the center of the cell. ECE. This has a value of −70mV to −90mV. AP & HOD. K+ and intracellular anions. (ii) When the cell is at rest. a nucleus and cytoplasm. This leads to a potential difference across the cell membrane called the resting membrane potential (RMP). College. Cytoplasm: It is a gel-like mass with membrane-bound structures suspending in it. the inside of the cell membrane is more negative than its outside. The fluid inside the plasma membrane called the intracellular fluid (ICF). The fluid outside the plasma membrane is called the extracellular fluid (ECF). The plasma membrane separates the cell’s contents from its surroundings. Sriram Engg. Nucleus: It is the largest single organized cellular component. It is covered by a double-layered membranous structure. Plasma membrane: It is selectively permeable to (various ions such as) Na+. (iii) Due to these facts. Action potential: 1 . Resting membrane potential: (i) Na+ is large in the ECF while K+ is large in the ICF.V SALAI SELVAM. Perumalpattu MEDICAL ELECTRONICS UNIT I Origin of biopotential: Cell is the basic building unit of human body. Structure of a cell: Nuclear envelope Selectively permeable plasma membrane Outflow of K+ (large) Nucleus K+ Na+ Inflow of Na+ (small) Selective permeable plasma membrane Organells +++++ ++ −−−− − −+ + + K + − − − + − ICF +A − ECF + − − + ECF + − − − Na − + ++ + + − − − + + + ++ Cl− A cell consists of a plasma membrane. the inflow of Na+ is very small but the outflow of K+ is large.
During this period. This positive shoot over the neutral level (0mV) is called the action potential. Typical bandwidth: 0. Some important biopotentials & their signal characteristics: ECG: ElectroCardioGram: ECG is the record of electrical activity of the heart. Refractory period: Absolute and relative: Absolute refractory period: During a short period after the generation of an action potential. After certain (very short) period. As the inflow of Na+ exceeds the outflow of K+ by several times. However. the cell responds to a stimulus but less strongly than usual. Relative refractory period: It is the time period between the instant when the membrane potential becomes negative again and the instant when the membrane potential returns to RMP. the membrane potential does not immediately return to the resting value rather it goes more negative than the RMP.. the membrane potential returns to the resting value.5 – 125 Hz Typical amplitude: 1 – 10 mV Typical waveform: Rhythmic waveform R PG seg m en t P S Tseg m ent T P Q T P se g m en t S 2 . the membrane potential suddenly decreases from −70mV to zero and then shoots up to +40mV. Sriram Engg.V SALAI SELVAM. After a very short period. the permeability of the plasma membrane to Na+ suddenly increases 600 times greater than that to K+ & a sudden large inflow of Na+ takes place. ECE. RMP value. This period is known as the absolute refractory period. Once generated. Perumalpattu When cell is excited. this cools the cell membrane that has become hot due to the generation of the action potential. the permeability of the plasma membrane returns to equilibrium conditions causing the membrane potential to return to the resting value i. the cell does not respond to any stimulus at all. College. the action potential travels down the nerve for a long distance. AP & HOD.e.
found in children.1 sec – 50-70 Hz. found in children of 2-5 year old. 2nd heart sound: due to closure of semilunar valves – short. AP & HOD. mental disorders etc and in the study of sleep patterns. Such abnormal heart sounds are called murmurs. heart block etc.1 – 100 Hz Typical amplitude: 10 – 100 µV Typical waveform: Highly random Subdivided into five bands namely Delta (δ): 01 – 4 Hz. epilepsy. Perumalpattu 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. Typical bandwidth: 0. College.08-0. bradycardia. found in alert adult with eyes open (under active conditions) Gamma (γ): >22 Hz. 1st heart sound: due to closure of AV valves – long. PCG: PhonoCardioGram: Record of heart sounds – 1st and 2nd heart sounds are heard well but 3rd and 4th are not.04 sec. found in alert adult with eyes closed (under relaxed conditions) Beta (β): 13 – 22 Hz. if found in alert adult it is abnormal Alpha (α): 8 – 13 Hz. Sriram Engg. sharp & high-pitched sound – sounds like ‘dub’ – 0.14-0. EEG: ElectroEncephaloGram: EEG is the record of sum of biopotentials generated by individual neurons or electrical activities of the brain. Heart sounds are generally used for diagnosis of valverelated diseases. 4th heart sound: due to atrial contraction. if found in alert adult it is abnormal Theta (θ): 4 – 8 Hz. soft & low-pitched sound – sounds like ‘lubb’ – 0. ECE. Clinical Significance: EEG record helps in the diagnosis of brain asymmetry.V SALAI SELVAM. Typical bandwidth: 300-3000 Hz Typical amplitude: 10-100 mV 3 . 3rd heart sound: due to ventricular vibrations resulting from on-rush of blood immediately after the opening of AV valves – very short – 0.2 sec – 30-40 Hz. EMG: ElectroMyoGram: EMG is the record of electrical activity of muscles. EOG: ElectroOculoGram: Steady corneal-retinal potential – used to record eye movements in sleep and dream to evaluate reading ability and visual fatigue – eye movements less than 1o and greater than 30o is difficult to record because of lack of accuracy and lack of proportion.
Sriram Engg. (a)Bipolar limb lead systems: Potential between any two limb leads is measured with RL grounded. LA RA − + LL Buffer RL CM AMPL – Common mode amplifier 4 . ECG lead systems: (i) Limb lead systems and (ii) Chest lead systems (i) Limb lead systems: (a) Bipolar limb lead systems and (b) Unipolar or augmented limb lead systems. ECE. AP & HOD.V SALAI SELVAM. Perumalpattu Typical waveform: Highly random. − RA LA + Buffer RL LL CM AMPL (ii)Lead II: Potential between RA & LL with LA tied to RL & RL grounded. College. (i)Lead I: Potential between LA & RA with RL grounded.
RA LA − + Buffer RL LL CM AMPL CM AMPL – Common mode amplifier Lead I.V SALAI SELVAM. ECE. RA − Lead I + LA − Lead II − Lead III + LL + (b) Unipolar or augmented limb lead systems: Potential at a particular limb lead with other two limb leads augmented. AP & HOD. Perumalpattu (iii) Lead III: Potential between LA & LL with RA tied to RL & RL grounded. This increases the amplitude of the ECG signal without changing its waveform. II and III together form a triangle known as Einthoven triangle. (i)Lead aVR: Potential at RA with LA & LL augmented & RL grounded. College. Sriram Engg. + Buffer RA LA − RL LL CM AMPL CM AMPL – Common mode amplifier 5 .
Perumalpattu (ii)Lead aVL: Potential at LA with RA & LL augmented & RL grounded + RA LA − Buffer RL LL CM AMPL CM AMPL – Common mode amplifier (iii)Lead aVF: Potential at LL with RA & LA augmented & RL grounded − RA LA + Buffer RL LL CM AMPL CM AMPL – Common mode amplifier (ii) Chest lead systems: Potential at one of six chest leads with RA. ECE. (i)Lead V: + RA CH LA Buffer − RL LL CM AMPL CM AMPL – Common mode amplifier 6 .V SALAI SELVAM. AP & HOD. Sriram Engg. College. LA & LL augmented and RL grounded.
AP & HOD. ECE. 7 . 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. Sriram Engg. Perumalpattu CH positions: V1 V2 V3 VE V4 V5 V6 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-davicular line V5 – Same level as V4 on anterior axillary line V6 – Same level as V4 on mid axillary line Block diagram of a ECG recording system: Right leg driven circuit Lead fault detect Electrode system Amplifier production circuit Lead selector Isolation circuit Driver amplifier Recorder – printer/ display ADC & memory Pre-amplifier Baseline restoration Power supply To all units Calibration signal Microcomputer Electrode system: Metal plate electrodes made of Ag/AgCl are placed at desired limb positions.V SALAI SELVAM. College. 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.
Sriram Engg. (2) Saturation or cutoff distortion: High offset voltages at the electrodes or amplifier produce saturation or cutoff distortion – peaks of QRS complex are cut off due to this. Preamplifier: The function of this block is to eliminate noise such as other biopotentials and various electromagnetic interferences resulting from nearby communication links etc. AP & HOD. Generally a differential amplifier with high input impedance and CMRR is used for this purpose. This can be carried out either manually by an operator or automatically by microprocessor or microcontroller or microcomputer. This is required to protect the patient from any electrical hazards resulting from leakage currents. PR interval. Low frequency distortion shifts the base line causing monophasic waves in ECG to be biphasic. ECE. QRS interval etc using sophisticated digital signal processing techniques. This leads to a current from one ground through the patient to another ground as shown below. Right leg driven system: The function of this block is to provide a reference point on the patient generally at ground potential. 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. there may exist a potential difference among these grounds. (3) Ground loop: When two or more equipments are grounded via different outlets. Baseline restoration: The function of this block is to restore any baseline shift resulting from the low operating frequency of the amplifier. 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.V SALAI SELVAM. College. Perumalpattu Lead selector: The function of this block is to select a desired lead system from 12 possible lead systems. Driver amplifier: The function of this block is to amplify the ECG signal sufficiently to level required for the display or the recorder. 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. Problems frequently encountered during ECG recording: (1) Frequency distortion: High frequency distortion rounds off sharp corners of ECG waveforms and reduces the amplitude of QRS complex. ADC & memory: The ECG signal can be digitized and stored for future analysis. This can be fatal. A sine wave of 1 mV is generally used for this purpose. Calibration signal: The function of this block is to calibrate the display or the recorder for predetermined amplitude. Holter ECG: Continuous recording of ECG at a stretch up to 24 hour and playing it in as minimum as 12 minutes – used to diagnose certain arrhythmias which occur under certain physiological conditions such as emotional stress. 8 .
Sriram Engg. the 50 Hz power supply interference shown below is quite common. College. AP & HOD. Of these. (6) Electromagnetic interferences: Electromagnetic interferences from ac mains power supply. It is normally eliminated by a notch filter. This leads to invalid signals. serious artifacts are produced in the recorded ECG signal. 9 . other electrical equipments and large communication equipments produces noise in the recorded ECG signal. V1 V1> V2 2nd Machine Grounding of 2nd machine Ground electrode of 2nd machine At some potential. Perumalpattu Current from 1st ground electrode through patient to 2nd ground electrode 1st Machine Grounding of 1st machine Ground electrode of 1st machine At some potential. V2 (4) Open lead wires: Due to rough handling or bad wiring. one or more lead wire may become disconnected from the electrodes. say. (5) Artifacts: Due to large electrical discharges from defibrillation process or patient’s large movements. ECE.V SALAI SELVAM. say.
bizarre QRS complexes (6) Ventricular fibrillation – irregular. the shaved head is mapped by four points: (i) nasion. Perumalpattu Heart arrhythmias and clinical significance of ECG: ECG record helps in the diagnosis of various heart arrhythmias – abnormal cardiac rhythm . 20%. Sriram Engg. heart block etc. 20%. (ii) inion. Thus there are 19 electrodes on the scalp plus one electrode for grounding the subject (usually at ear lobes).V SALAI SELVAM. (iii) left preauricular point and (iv) right preauricular point as shown below. C3 P2 P3 20% 20% C2 20% A1 10 . In this scheme. bradycardia. high frequency ECG waveform EEG lead system: The most popular scheme of placing the surface electrodes (usually Ag/AgCl discs) on the scalp is the 10-20 electrode placement system suggested by the International Federation of EEG Societies. 2 in temporal lobe and 1 in occipital lobe) by measuring the nasion-inion distance via the temporal lobes and marking points on the shaved head at 10%.such as tachycardia. This makes the popular 10-20 EEG electrode system. 20%. 20%. (1) Tachycardia – fast heart rate (>100 bpm) – shorter R-R interval (2) Bradycardia – slow heart rate (<60 bpm) – longer R-R interval (3) Atrial flutter – saw-toothed P-wave (4) Atrial fibrillation – unrecognizable P-wave and irregular R-R interval (5) Ventricular tachycardia – wide. The remaining six electrodes (2 in frontal lobe. AP & HOD. ECE. 2 in central lobe and 2 in parietal lobe) are placed on the peripheries of the circles joining these electrodes. 1 in central lobe and 1 in parietal lobe) by measuring the nasion-inion distance via the vertex and marking points on the shaved head at 10%. 20%. College. For example. 20% and 10% of this length on either side. 20% and 10% of this length. Similarly five electrodes are placed on either side (2 in frontal lobe. 20%. F2 20% F3 10% Fp1 F1 Nasion Eye orbit T1 Left ear lobe T5 O1 10% Inion Left head side view Three electrodes are placed (1 in frontal lobe.
Preamplifier: The function of this block is to eliminate noise such as other biopotentials and various electromagnetic interferences resulting from nearby communication links etc. Channel selector: The function of this block is to select a desired combination of 19 possible electrodes. Generally a differential amplifier with high input impedance and CMRR is used for 11 . This can be carried out either manually by an operator or automatically by microprocessor or microcontroller or microcomputer. AP & HOD. Perumalpattu Nasion Fp1 F1 F3 F2 Fp2 F4 F8 Left ear T3 C3 C2 C4 T4 Right ear T5 P3 O1 P2 P4 O2 T6 Inion Block diagram of a EEG recording system: ADC & memory Lead fault detect Electrode system Amplifier production circuit Channel selector Isolation circuit Driver amplifier Recorder – printer/ display Pre-amplifier Power supply To all units Calibration signal Microcomputer Electrode system: Metal disc electrodes made of Ag/AgCl are placed at scalp positions. Sriram Engg. College.V SALAI SELVAM. ECE. Good contact between electrodes & skin is ensured with the help of gel and adhesive tapes.
ADC & memory: The EEG signal can be digitized and stored for future analysis. College. Sriram Engg. it becomes ionized at the vicinity of contact with a cloud of electrons inside and an adsorbed layer of positive ions at the bar’s surface. A sine wave of 1 µV is generally used for this purpose. Metal bar Electrical double layer Solution When an ac signal is applied. AP & HOD. When a dc signal is applied. ECE.e. the double layer behaves like a resistor called Faradic resistor. the double layer behaves like an ideal capacitor. This forms a diffused mobile layer of negative ions near the bar’s surface. This adsorbed fixed layer of positive ions attracts nearby negative ions drifting around in the solution.V SALAI SELVAM. 12 . Microcomputer: A microcomputer along with a user-friendly software package developed on a high-level language such as VC++ can be used (iii) to control the entire process of acquiring the EEG and (iv) to analyze it automatically for various parameters using sophisticated digital signal processing techniques. 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.. A minimum gain of 1000 is required as typical amplitude range of EEG is from 1 to few microvolts. an ideal capacitor in parallel with a resistor. Biopotential electrodes: Electrode behaviour & circuit model: When a bar of metal is immersed in a solution. Perumalpattu this purpose. Calibration signal: The function of this block is to calibrate the display or the recorder for predetermined amplitude. 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. Thus an electrode in a solution (under the influence of ac & dc signals) can be modeled as a leaky capacitor i. Driver amplifier: The function of this block is to amplify the EEG signal sufficiently to level required for the display or the recorder. This is required to protect the patient from any electrical hazards resulting from leakage currents. These two layers form the electrical double layer.
Different materials generate different half-cell potential.8 V Cu: +0.34 V H: 0 V (reference) Thus the circuit model of an electrode-gel interface can be a leaky capacitor in series with a half-cell as shown below.V SALAI SELVAM. Equivalence of an electrical double layer under the application ac as well as dc to a leaky capacitor 13 . This potential is known as the electrode or half-cell potential. Perumalpattu ac Behaviour of electrical double layer under the application of ac & its equivalence to an ideal capacitor dc Behaviour of electrical double layer under the application of dc & its equivalence to a resistor A potential difference is developed across the electrode-solution interface due to the formation of the double layer.66 V Fe: −0.44 V Ag: +0. ECE. AP & HOD. College. Sriram Engg. Al: −1.
Perumalpattu Circuit model of surface electrode: B A Electrodes Gel Skin Gel Double layer Ea − Rt Body tissues & fluids Half cell potential + A Electrode A Es Bioelectric generator Rft Cft Electrode B − Eb Double layer + Half cell potential B Circuit model of surface electrodes where Ea. Rft – effective double layer formed by body tissues and fluids 14 . Eb – half-cell potentials of electrodes A & B respectively at the electrode-gel interface Cda. Sriram Engg. College.V SALAI SELVAM. AP & HOD. Rfb – double layers of electrodes A & B respectively at the electrodegel interface Rt – total series resistance offered by skin. Rfa & Cdb. ECE. massive tissues & gel Es – biopotential to be measured Cdt.
AP & HOD. Cda. Perumalpattu Circuit model of a micro electrode: A Skin Insulation Metal rod B Cell membrane ++++++ + + + −− − − − − − − + −+ + −− −+ +− + − ICF + + − − − +− − −++ −+ +− − − − − + − + − ++++++ − − −− + ++++ Rs Reference electrode ECF Ce2 Ea Rfa Ci Ce1 A Cw B Cda Cdr Er Ri Re Rfr where Rs – series resistance offered by metal rod Ea. Rfr – half-cell potential & double layer at the reference electrode-ECF interface Ci – distributed capacitance between metal and ICF Ri – series resistance offered by ICF Ce – distributed capacitance between metal and ECF Re – series resistance offered by ECF Cw – distributed wiring capacitance 15 . Rfa – half-cell potential & double layer at the microelectrode-ICF interface Er.V SALAI SELVAM. Cdr. College. Sriram Engg. ECE.
It is used to pick up ECG from chest lead positions and EMG from muscular areas such as calf. It is used to pick up EEG from the scalp. ECE. (I) Surface electrodes: The surface electrodes are used to pick up bio-potentials non-invasively from the surface of the skin.V SALAI SELVAM. Lead wire Lead wire terminal Rubber belt support Contact surface (ii) Metal disc electrode: It is made up of Ag-AgCl. College. It is fixed to the skin surface by means of air suction. Sriram Engg. Lead wire Contact surface (iii) Metallic suction electrode: It is made up of Ag-AgCl. This provides sufficient information for most of the clinical purposes. There is a variety of surface electrodes intended for variety of clinical purposes. It is used to pick up ECG from the limb lead positions. It does not require adhesive tapes or rubber bands. It is fixed to the skin surface by means of conductive gel & rubber belt. thigh etc. Here are some of them. Squeezable rubber bulb Contact surface Lead wire 16 . Perumalpattu Types of Electrodes: The major categories are the (I) Surface electrodes. It is fixed to the scalp by means of adhesive tape. AP & HOD. (II) Internal or subcutaneous electrodes and (III) Micro electrodes. (i) Metal plate electrode: It is made up of Ag-AgCl (Silver-Silver Chloride).
Contact surface Adhesive tape Top view Bottom view (v) Floating electrode: This type of electrode is used to prevent the motion-artifact from being picked up. AP & HOD. Metallic disc Lead wire Electrolyte gel (vi) Flexible electrode: It is used to pick up bio-potentials from irregular body surface like back. The most commonly used internal electrodes are the needle and wire electrodes. The investigator studying a particular bioelectric phenomenon by using internal electrodes often designs his/her. The wire electrodes are used for chronic recordings. There are many different designs for internal electrodes. ECE.V SALAI SELVAM. It is also used as indifferent electrode in electrosurgery. own electrodes. Mylar film with a gel coat Lead wire (II) Internal or sub-cutaneous electrodes: The internal or sub-cutaneous electrodes are used to make measurements at subcutaneous level. The needle electrodes are used for acute recordings as their stiffness and size make them uncomfortable for long term implantation. Perumalpattu (iv) Disposable foam-pad electrode: It is made up of Ag-AgCl. 17 . College. Sriram Engg. 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.
The most commonly used micro electrodes are the metal micro electrodes. AP & HOD. Perumalpattu The following figures show three needle electrodes (a. micropipette electrodes and microelectronically fabricated micro electrodes. Sriram Engg. Metal tip (shank) Metal needle (shaft) Insulation (film of some polymer) Metal microelectrode 18 .V SALAI SELVAM. supported-metal micro electrodes. b and c) and a wire electrode (d). College. Some are shown below. Exposed metal tip Insulation a) Needle electrode Central electrode Lead wire Hypodermic needle b) Coaxial needle electrode Lead wire Hypodermic needle c) Bipolar needle electrode Lead wire Un-insulated barb Hypodermic needle d) Wire electrode Lead wire (III) Micro electrodes: The micro electrodes are used to make measurements at cellular level. ECE. They have different designs to meet different needs.
College. AP & HOD.V SALAI SELVAM. Perumalpattu Tip Metal filled glass pipette Glass Tip Glass Insulation Metal film Cap Glass pipette with electrolyte Supported-metal microelectrodes Exposed metal surface Silicon base Connector pad Microelectronically fabricated microelectrode 19 . ECE. Sriram Engg.
ECE. blood vessel and hemoglobin abnormalities. Hypercapnia: Increase in pCO2 due to cardiac arrest. The blood gas analyzer consists of three types of electrode systems for the measurement of pH.45 Alkalosis: Increase in pH due to increase in bicarbonates (HCO3-) Acidosis: Decrease in pH due to decrease in bicarbonates (HCO3-) Blood gas analyzer: The blood gas analyzer measures the pH value i..e. College. Sriram Engg. (iii) pH: Normal range: 7.35-7. The electrode systems and the sample chamber are located inside a temperature-controlled block maintained at 37oC (human body temperature). pO2 and pCO2 respectively and a sample chamber. pH=log10[1/(H+)]= − log10(H+) 1 . Hypoxemia: Lack of O2 i. Perumalpattu MEDICAL ELECTRONICS UNIT II Blood gases and their clinical significance: (i) pO2: Normal range: 80-100 mm Hg. chronic obstructive lung disease. H+ ion concentration. (ii) pCO2: Normal range: 35-45 mm Hg. AP & HOD. reduction in pO2 due to bronchial obstruction.e. The blood sample is first injected into the sample chamber where it undergoes a temperature equilibration before measurement. the partial pressure of oxygen (pO2) and the partial pressure of carbon dioxide (pCO2) in an arterial blood sample.V SALAI SELVAM. pH measurement: Glass membrane sensitive to H+ Ag-AgCl measuring electrode Solution of constant pH Calomel or Ag-AgCl reference electrode Sample path KCl solution Leaky membrane pH value is a measure of H+ ion concentration. chronic metabolic acid-base disturbances.
the difference in H+ ion concentration on either side of the glass membrane changes the potential at the measuring electrode whereas the reference electrode produces a constant potential irrespective of H+ concentration in the sample. ECE. pCO2 measurement: CO2 permeable membrane Ag-AgCl reference electrode Ag-AgCl electrode Electrolyte Sample path Spacer 2 . The current generated by the system is the measure of pO2 in that sample. A potential of 0. AP & HOD. The change in the potential at the measuring electrode is detected by a voltmeter. Perumalpattu Two electrodes are used: (i) a calomel or Ag/AgCl reference electrode immersed in a Kcl solution and closed by a leaky membrane that permits a current flow from the reference electrode via the sample in the sample chamber to the measuring electrode and (ii) a Ag/AgCl measuring electrode immersed in a solution of constant pH and closed by a glass membrane that is sensitive to H+. Sriram Engg. College. As the sample passes through the chamber.7V is applied between these electrodes. which has been calibrated in pH units.V SALAI SELVAM. pO2 measurement: O2 permeable membrane Ag-AgCl reference electrode (anode) Electrolyte Sample path Platinum wire (cathode) 4Ag → 2Ag+ + 4e− O2 + 2H2O + 4e− → 4OH− A polarographic electrode system consisting of (i) a Ag/Agcl reference electrode (anode) and (ii) a thin platinum wire (cathode) both immersed in an electrolyte (H2O) and separated from the sample by a O2 permeable membrane.
Diffusion of CO2 alters the pH of the electrolyte thereby changing potential output of this modified pH electrode. Electrodes are placed in the buffer solutions as anode and cathode. (iii) ionic strength of the buffer. agar gel. College. Cellulose acetate is the most commonly used solid medium. (iii) temperature. Colorimeter: The colorimeter (filter-photometer) is an optical electronic device that measures the color concentration of a substance in a solution. AP & HOD. A plot of density versus migration distance is made from this measurement. A voltage of 250V with an initial current of 4-6mA is applied across the medium through the buffer solution for 15-20 min. A fixative and a dye are used to fix and stain the migrated particles on the medium. etc. starch gel. The buffer solution is supported by a solid substance called the medium. 3 . Then the electric voltage is removed. This results in separation of particles into zones on the solid medium. Electrophoresis: Cathode Cellulose accetate Anode Buffer − + Movement of a solid phase with respect to a liquid called the “buffer solution” under the influence of an electric current. Buffer solution is taken in two beakers. groups of particles that are similar in charge. size and shape migrate at similar rates. The purpose of the buffer solution is to carry the current and the purpose of the solid medium is to provide a base for the migration of particles. Finally a densitometer is used to measure the densities of the migrated particles on the medium. Other possible mediums are paper. ECE. sucrose. This gives the pCO2 in the sample. Perumalpattu H2O + CO2 → H+ + HCO3− A Severinghans pCO2 electrode consisting of (i) a Ag/Agcl reference electrode and (ii) a glass pH electrode both immersed in an electrolyte and separated from the sample by a CO2 permeable membrane and a spacer which acts as a support for the aqueous HCO3− layer. (iv) time and (v) type of support medium. A strip of cellulose acetate is placed as a bridge between the buffer solutions.V SALAI SELVAM. Under the influence of electric current. The factors that affect the speed of migration are (i) magnitude of charge. Sriram Engg.
College.V SALAI SELVAM. the light from a light source is passed through an optical filter. Io is initial light intensity. which filters out a particular wavelength or color. C is concentration of absorbing substance and L is cuvette path length. a is absorbtivity. I1 is the light intensity after attenuation and T is transmittance. AP & HOD. The absorbance is defined as A = − log(I1/Io) = log(1/T) where A is absorbance. ECE. Hence. Sriram Engg. The absorbance increases and the transmittance decreases as the path length or the concentration increases. Perumalpattu Principle: Light of a specific wavelength or color when passed through a solution of a substance of certain concentration is absorbed by an amount proportional to the length of the passage via the solution and the concentration of the substance. Photo detector 1 Optical filter Lens 1 Cuvette 1 Reference Sample A R1 R2 R3 Lens 2 − Cuvette 2 Light source Photo detector 2 + To meter R4 In a basic colorimeter. This particular wavelength or color is 4 . the absorbance in terms of the path length and the concentration is given by the Beer’s law A = aCL where A is absorbance.
The difference between these two voltages is amplified by a dc amplifier and applied to a meter. The calibration procedure is as follows: (1) Ground the amplifier input and adjust the potentiometer (R4) for a zero reading on the meter. ECE. which convert their intensities into voltages. which has been calibrated in transmittance or absorbance units. College. Perumalpattu focused by lenses on to a reference cuvette with a solution containing a substance of known (standard) concentration and absorbance and onto a sample cuvette with the sample solution. (2) Read the difference voltage on the meter. The light waves coming off the cuvettes fall on photo-detectors.V SALAI SELVAM. which has been calibrated to yield this voltage difference directly in transmittance or absorbance unit. (2) Fill both the cuvettes with the reference solution and adjust the potentiometer (R1) for a zero reading on the meter. Sriram Engg. Flame photometer: Photo detector 1 Lens 1 Flame Ref optical filter A R1 R2 R3 Lens 2 − + Photo detector 2 R4 To meter Ref gas Sample optical filter O2 Sample solution 5 . AP & HOD. The measurement is made as follows: (1) Fill the cuvette 1 with the same reference solution and the cuvette 2 with the sample solution.
This technique determines the unknown constituents of a solution or the concentrations of the known substances in a solution. 6 . The monochromatic light (i. The difference in the voltages generated by the photo detectors is amplified by a dc amplifier and applied to a meter. which converts the intensity of the incident monochromatic light into voltage. ECE. Na.V SALAI SELVAM. Yellow color by the sodium or violet color by the potassium).. K. Ex. which separates the light from a point source ( a light source and a slit) into its spectral components. The flame is supported by air and a reference substance (Ex. The monochromator consists of a rotating diffracting grating or prism. which has been calibrated in concentration units. This voltage signal is then amplified by a dc amplifier and applied to a meter display. Sriram Engg. AP & HOD. a specific wavelength or color) from the diffracting grating is reflected through a slit and a cuvette containing the sample solution onto a photodetector. Perumalpattu The flame photometer is an optical photometer that measures the color intensity of a substance. The reference optical filter separates the wavelength or color produced by the reference substance (Ex. Lithium) in addition to the sample substance (Ex. Red color by lithium) whereas the sample optical filter separates the wavelength or color produced by the sample substance (Ex. College.e. Spectro photometer: Slit 1 Mirror Light source Diffracting grating Monochromator Photo detector Slit 2 R1 R2 Cuvette with sample solution − + To meter R3 The spectro photometer is an optical electronic device that measures the light absorption in a solution at various wavelengths. Sodium and potassium). These filtered light waves are then focused onto photo detectors. which can be aspired into a flame. The spectrophotometer consists of a monochromator.
e. College. As these air-separated sample-reagent mixtures traverse through the coil of mixing tube the process of mixing is performed. The following figure shows the block diagram of a typical autoanalyzer. standards and wash solutions to the autoanalyzer system. The recording system. (v)Colorimeter: It measures the color intensities of the substances in the samples. stores or displays or prints the data provided by the electrical signals from the colorimeter. Sriram Engg. (ii) mixing or proportioning pump and manifold. ECE. Perumalpattu Autoanalyzer: The autoanalyzer sequentially performs the biochemical tests and displays the records. introduces air bubbles that separate sample-reagent mixtures from one another and from cleaning fluid and pumps this row through the mixing tube at a specific rate.V SALAI SELVAM. (iv) heating bath. 37oC). Colorimeter Heating Bath Dialyzer Mixing or Proportioning Pump and Manifold Sampler Reagent Cleaner Graphic Recorder The autoanalyzer shown in the figure consists of (i) sampler. Heating is critical for the color development. (v) a colorimeter followed by a recorder. 7 . which follows the colorimeter.. (iv) Heating bath: It heats the sample-reagent mixtures to an exact temperature (typically the normal human body temperature i. Adds reagents to samples. which provide the substance concentrations in the samples. (ii) Mixing or proportioning pump and manifold: It consists of a peristaltic (occluding roller) pump and a mixing tube. Problem-1: Identification of samples Problem-2: Periodic sterilization of the sample passages and other parts that are contaminated with infections is required. (iii)Dializer: It separates the interfacing substances from the samples by passing the sample components selectively through a semi-permeable membrane. AP & HOD. (i)Sampler: It aspirates samples. (iii) dializer.
V SALAI SELVAM. ECE. Uniform magnetic flux density a emf Flow Conductive fluid i. blood with velocity normal to the paper E/ Electrode B E Magnetic field coil E/ Vessel wall Core magnet High gain amp Gate Pulse stretcher Magnet core Flow probe Oscillator Phase shifter Sample pulse generator LPF Magnet current drive Integrator Total flow Phasic flow 8 . College.. Sriram Engg. Perumalpattu Blood flow (& Cardiac output) measurement: (I) Electromagnetic method: Electrode E Vessel wall field flow B. AP & HOD.e.
Perumalpattu Magnet current Transformer (artifact) emf Flow emf Sampling signal Sampled signal Negative flow Zero flow Positive flow Principle: A voltage is created when a moving conductor “cuts” the flux of a magnetic field. If that conductor is a blood carrying vessel of diameter ‘a’. Sriram Engg. Hence. then the voltage generated is given by E=(QB)/(50 a) !V where Q is volumetric flow rate in cm3/sec.e. 9 . The use of a changing magnetic field with ac excitation however causes the transducer to act like a transformer producing artifacts of magnitudes several order greater than the magnitude of the desired signal. Since the induced transformer artifact emf is 90o out of phase with the excitation signal i. the induced transformer artifact emf is zero when the excitation signal is maximum. the use of a full-wave synchronous phase-sensitive detector. eliminates this problem.. AP & HOD. a changing magnetic field with ac excitation is used. B is magnetic flux density in Gauss and A is radius of the vessel in cm. Hence Q= va2 where v is the average flow.V SALAI SELVAM. velocity over the region from the center of the vessel to the vessel wall. which samples the amplified electrode signal when the induced transformer artifact emf is nearly zero. ECE. College. The use of a constant magnetic field with dc excitation produces artifacts that proved difficult to be eliminated.
e. Peak Exponential decay 85% Peak Concentration 36% Peak Recirculation artifact Ideal curve t0 t1 t2 Time t3 Blood flow rate = K VI [ ] / [" Cdt] ml/min where K is a constant (20 to 150) depending on injectate. College. A good approximation is achieved if the rectangular is chosen to have a height equal to the peak value of the exponential curve i. Problem: Recirculation artifact. Perumalpattu (II) Dye dilution technique: Dye used: Optical dye like Indocyanine green or a radioactive dye. To rectify this problem. (2) The technique of geometric integration is used to approximate the ideal exponential decay curve. Detector used: (i) light densitometer or (ii) scintillation counter or gamma camera. In this technique. Sriram Engg. the time required for the dilution curve to drop from 85% of its peak value to 36% of its peak value. 85% of the peak value of the dilution curve and a base equal to the time constant of the exponential curve i.. which changes the ideal exponential decay curve shape between t2 and t3. the following two techniques are commonly used: (1) The portion of the curve prior to the appearance of the recirculation artifact is used to approximate the ideal exponential decay curve. 10 .e. VI is the volume of injectate in ml and C is concentration in mg/ml. AP & HOD. the input of the integrator stage is connected to the thermistor or the dye transducer from t1 to t2 and then switched over to another source equal to 85 percent of the peak value of the dilution curve from t2 to t3.V SALAI SELVAM. ECE..
VI is volume of injectate in liters. CO= KGBGIVI(TB – TI) [ ]/[U U "T B I 1 B dt liters/min ] where K is a constant (20 to 150). Perumalpattu (III) Thermodilution technique: Cardiac output computer: An ordinary intravenous solution like saline or 5 percent dextrose in water. Simplified formula for the cardiac output is CO= (60)(1. AP & HOD.V SALAI SELVAM. TB is pre-injection temperature of blood in oC. Sriram Engg. College. UB is the energy content of blood in joules. UI is the energy content of injectate in joules and TB1 is post injection temperature of the blood. R1 + − R3 Balance Thermistor R4 R2 + − Isolation amp Input circuit for Cardiac output computer Balance vx Bridge Preamp Integrator vy Divider vo=K(vy/vx) Start Control Logic TB-TI and constants Over-range indicator Cardiac output computer Digital Panel Meter Filter 11 .08)(TB – TI) [ ]/["T 1 B dt liters/min ] Thermodilution cardiac computer: The input circuit & the block diagram of the thermodilution cardiac computer is shown below. GI is density of injectate in Kg/m3. ECE. GB is density of blood in Kg/m3. Cardiac output. TI is pre-injection temperature of injectate in oC.
and the balance adjustment is made. which are produced by thoracic movements during respiration activity. AP & HOD. After injection of the saline or D5W. The highlevel output signal is passed through an isolator to the remainder of the circuit. The integrator output is supplied to the denominator of the equation. The numerator input of the divider is obtained from a stage that multiplies together the constants and a signal entered by the operator or. Part of the signal goes to an output jack so that it may be recorded on a strip-chart recorder. Ag or Platinum. Sriram Engg. 10k! R2 ac amp A1 Sync Detector LPF R2 10k! Thorax R R A2 dc amp R1 100k! 100k! output R1 Carrier Oscillator 250kHz 12 . taken from another electronic temperature measurement circuit that indicates the differences between blood and injectate temperature. The bridge produces zero output when the thermistor is at normal blood temperature. later mercury is replaced by copper sulphate which provides high resistance thereby reducing the current needed to produce readable output voltage. Two different techniques are commonly used: (i) The time period before the appearance of the artifact is used to predict the path of the ideal curve. • Measurement of respiration rate by measuring changes. Perumalpattu Figure shows the block diagram of one popular CO computer. the bridge produces an output potential of 1. in more sophisticated models. A control logic circuit is required to time the operation of the CO measurement cycle. The CO computers have a circuit to compensate for the recirculation artifact. (ii) The technique of geometric integration is used to approximate the ideal curve. Impedance pneumography: • Measurement of respiration rate by measuring changes in thoracic impedance during respiration activity via electrodes placed across the chest. This signal is amplified in the preamplifier stage to a level of 1 V/o C. Respiratory measurements: Respiration rate measurement: 1.8 mV/oC. in impedance of a piezoresistive device via a strain gauge placed across the chest. It is simultaneously applied to the input of an operational amplifier electronic integrator stage.V SALAI SELVAM. ECE. The following figure shows a schematic diagram of the technique. (ii) Wire or Foil or Semiconductor strain gauge. College. Piezoresistive devices used are: (i) Mercury strain gauge: It is an elastic tube filled with mercury and fitted on both ends with amalgamated Cu.
in impedance of a thermistor placed either near nostrils or in endotracheal tube. Sriram Engg. Tee piece • The following figures show these techniques: Flow RT Bead thermistor To wheatstone bridge Nostril Thermistor R1 + E R2 R3 Respiratory flow volume measurement: Spirometer: String Bulleys Air space Bell jar +E Tank Water Pot Rotating drum with paper E0 Weight E0 Kymograph -E Mouth piece Tubing 13 . AP & HOD. College. Perumalpattu Thoracic or transducer impedance change amplitude-modulates a high frequency carrier signal. Thoracic or transducer impedance change waveform representing the respiration activity is extracted by a synchronous detector. Low pass filter removes the residual carrier signal.V SALAI SELVAM. ECE. which are produced by temperature difference between inspiratory and expiratory air. 2. Thermistor detector: • Measurement of respiration rate by measuring changes.
a bell-jar immersed upside down into the water and a tube extending into the air space inside the bell-jar. Otherwise the third arm of a potentiometer may be attached to the weight to obtain an electrical signal corresponding to the movement of the weight. (ii) a rubber squeeze ball pump and valve assembly and (iii) a manometer. The weight attached to the other end of the string moves up and down accordingly. Sriram Engg. The subject is asked to breathe into the tube via the mouth piece. During every cycle of inspiration and expiration. Systolic Cuff pressure Blood pressure waveform (dicortic notch) Diastolic 110 Pressure in mmHg Squeeze-ball pump-valve assembly Stethoscope Arm 20 Hg (Mercury) Inflating cuff Brachial artery 14 . A pen may be attached to the weight to make a graph on a paper attached to a rotating drum. Perumalpattu The spirometer consists of a water tank. College. One end of a string is attached to the bell-jar and the other to a weight via two bulleys. the bell-jar moves up and down depending on the volume of air inspired or expired into or from the air space inside the jar. The resultant graph is called the Kymograph. Blood pressure measurement: Indirect method: (Sphygmomanometer): The sphygmomanometer consists of (i) an inflatable rubber bladder called the “cuff”.V SALAI SELVAM. ECE. AP & HOD.
e.V SALAI SELVAM. (ii) When the cuff pressure drops slightly below the diastolic pressure. This causes “occlusion” that stops the blood flow in the vessel. This pressure compresses the artery against the underlying bone.. AP & HOD. (2) The cuff is inflated so that the cuff pressure becomes slightly greater than the anticipated systolic pressure. College. The pressure indicated by the monometer on the onset of these Korotkoff sounds is the systolic pressure and the pressure indicated by the manometer on the disappearance of these sounds is the diastolic pressure. This causes crashing and snapping sounds called the “Korotkoff sounds” in the stethoscope. these sounds disappear. The onset of the Korotkoff sounds in the stethoscope indicates the systolic pressure and the disappearance of these sounds in the stethoscope indicates the diastolic pressure. Vent to atmosphere To cuff V3 V2 V1 . ECE. (i) When the cuff pressure drops slightly below the systolic pressure. downstream) to the cuff. a sudden rush of blood flow (through the occlusion in the artery) takes place. A stethoscope is placed over a brachial artery distal (i. (3) The cuff is then slowly deflated so that the cuff pressure drops slowly. Perumalpattu Procedure for measurement of blood pressure: (1) The cuff is wrapped around the patient’s upper arm (at a point midway between the elbow and shoulder). Indirect method: Ultrasonic method: Ultrasound transmitter Ultrasound receiver To audio amplifier & electronic control system fs fs ± ∆f Cuff Skin Piezoelectric crystals Artery Pump Mano meters Systolic Diastolic V4. Sriram Engg. Bleed valve Electronic Control system RF & audio amp To From piezoelectric crystals 15 .
(i) Conductive method: The following figure shows the schematic diagram: To suction pump Mercury Orifice Electrodes Conductivity Circuit Threshold Circuit Diluted blood Gate Control Logic Counter 16 . high frequency Doppler shifts corresponding to the opening event from a heart beat are detected. When the cuff pressure drops to the diastolic pressure. AP & HOD. College. Then the cuff is deflated slowly at a fixed rate. Low frequ4ency Doppler shifts corresponding to the closing event from the same heartbeat are not detected as they overlap with the high frequency Doppler shifts at this point. The blood pressure is measured by measuring the Doppler shift caused in the incident ultrasonic wave by a moving wall of a brachial artery. When the cuff pressure drops further. Initially the cuff pressure is increased slightly above the anticipated systolic pressure. Perumalpattu The ultrasonic blood pressure measurement system consists of (i) an inflatable rubber bladder called the “cuff” (ii) piezoelectric crystals for the transmission and reception of ultrasonic waves (iii) a pump and valve assembly to inflate and deflate the cuff and (iv) an electronic control system to coordinate all events. Sriram Engg. Piezoelectric crystals are placed between the patient’s arm and the cuff. At this point the reading on the systolic manometer is the systolic pressure value.V SALAI SELVAM. When the cuff pressure drops to the systolic pressure. ECE. Blood cell counter: Two methods: (i) conductive method and (ii) dark field method. the opening and closing events from a heartbeat start to separate and hence high and low frequency Doppler shifts detected alternatively. At this point the reading on the diastolic manometer is the diastolic pressure value. Generally 2 or 8MHz ultrasonic waves are used. The valve v2 is closed to fix the manometer on this value. The valve v3 is closed to fix the manometer on this value. the closing event from a heartbeat coincides with the opening event from the next heartbeat and hence once again only the high frequency Doppler shifts are detected.
V SALAI SELVAM. ECE. This facilitates the counting process to be performed for a known volume of the solution passing through the orifice. As long as there is a zero resistance conductivity. Perumalpattu Construction details: A beaker with diluted blood.. the glass tube is connected to a suction pump via a U-tube with a column of mercury. The suction pump draws the diluted blood in the beaker along with the blood cells into the glass tube through the orifice. The following figure shows the schematic diagram of the threshold circuit: +E Upper limit set Pulses from conductivity circuit −E Lower limit set To counter 17 . Working principle: As long as the orifice is left open. The following figure shows the schematic diagram of the conductivity circuit block: Output Pulses From Electrodes + RA E0 Constant Current Source As long as the orifice is left open. the zero-resistance conductivity between the electrodes is altered resulting in a pulse at the output of the conductivity circuit. it obstructs the conductivity between the electrodes. to be counted. there is a zero-resistance conductivity between the electrodes via the solutions. When a blood cell crosses the orifice. the output of the conductivity circuit is zero. conductance between the solution in the glass tube and that in the beaker is measured by two electrodes. one in the glass tube and the other in the beaker. a glass tube with a small orifice of few !m diameter dipped into it. College. AP & HOD. Whenever a blood cell obstructs the orifice. This results in a pulse at the output of the conductivity circuit. The degree of obstruction depends on the size of the blood cell. Eo is zero due to the zero resistance conduction path between the electrodes through the solutions. The amplitude of the pulse depends on the degree of obstruction in the conductivity i.e. The threshold circuit allows only those pulses that exceeds a threshold. on the size of the blood cell. Sriram Engg. The control logic opens the gate thereby starting the counting process when the mercury column reaches the point labeled as “start” and closes the gate thereby stopping the counting process when the Hg column reaches the point labeled as “stop”.
(ii) Dark field method: The following figure shows the schematic diagram: 1 2 3 4 6 5 7 The diluted blood flows through a thin cuvette (4). AP & HOD. College. When the amplitude of the input pulse falls outside the window limit. the outputs of the comparators are positive thereby pulling the output of the AND gate “high” and allowing that pulse to be counted. Perumalpattu Threshold circuit allows only those pulses. the output of the respective comparator goes negative thereby pulling the output of the AND gate “low” and preventing that pulse from being counted. to be counted. Sriram Engg. u D B 18 . The cuvette is illuminated by a cone-shaped light beam obtained from a lamb (1) through a ring aperture (3) and an optical system (2). When the amplitude of the input pulse falls within the window limit. ECE. Ultrasonic blood flow meters: Two types: (i) Transit Time Ultrasonic Blood Flow Meter (ii) Doppler Shift Ultrasonic Blood Flow Meter. Normally no light reaches the phototube until a blood cell passes through the cuvette and reflects a flash of light on the phototube.V SALAI SELVAM. A θ Flow. The cuvette is imaged on the cathode of a phototube (7) by means of a lense (5) and an aperture (6). whose amplitudes fall within a window limit. (i) Transit Time Ultrasonic Blood Flow Meter: Two ultrasonic transducers (piezoelectric crystals) are placed on either side of the blood vessel at an oblique angle to the flow axis and at a distance D from each other.
≈ ------------------c2−u2 cos2θ c2 c2∆t ⇒u = -------------2Dcosθ (ii) Doppler Shift Ultrasonic Blood Flow Meter: Two ultrasonic transducers (piezoelectric crystals) are placed on the same side of the blood vessel with one transducer acting as transmitter and the other as receiver.= ----------------------------source frequency velocity of sound 19 . the Doppler effect i. respectively.& downstream transit times is 2Du cosθ 2Du cosθ ∆t = tup − tdown = ---------------------.V SALAI SELVAM. AP & HOD.= ---------------conduction velocity c−u cosθ D tdown = --------------c+u cosθ where càvelocity of sound uàaverage velocity of blood flow A c u c+u cosθ B u cosθ B A c u θ c−u cosθ u cosθ θ D D Upstream Downstream The difference in up. College.. Perumalpattu Up. change in frequency target velocity -------------------------. ECE.& downstream transit times are measured with B as transmitter and A as receiver and vice versa. as the name itself implies.e. Sriram Engg. They are given by distance D tup = ------------------------. Principle: The principal is.
Perumalpattu i.. ∆f u -----. fr. AP & HOD.= -----fs c The following figure shows the schematic diagram of the process. Sriram Engg.V SALAI SELVAM. College. fs RF Oscillator (10MHz) fs A θ φ Flow direction Blood vessel Meter indicating average blood flow Mixer fr fs. ECE. ∆f c u = ------------------fs(cosθ + cosφ) 20 .e. fs ± fr BPF fs − fr Zero Crossing Detector Frequency Discriminator RF amp fr B One Shot Multivibrator Flow signal Integrator Flow signal The Doppler shift is (fs − fr) = ∆f = ± fs(cosθ + cosφ) (u/c) where fsàtransmit frequency fràreceive frequency θàtransmit angle φàreceive angle uàaverage velocity of blood flow càvelocity of sound ∆fàdoppler shift Hence.
1 . Classification based on location of device: Two types namely (i) External and (ii) Internal. Electrodes: Types: (i) unipolar and (ii) bipolar electrodes. The ability to capture depends also on the contact of the electrodes. Ventricular programmed: Types: (a) R-wave inhibited (demand) and (b) R-wave triggered (standby). It is used on patients with permanent heart arrhythmias such as permanent heart block. less for children and 10 times higher for emergency cases. Atrial programmed: It is synchronized with natural P-wave to pace the ventricles in case of complete heart block in which case the natural pacing impulses are able to depolarize the atria but they fail to depolarize ventricles.. Unipolar type: There is one electrode in the heart and the other electrode is away from the heart.V SALAI SELVAM. Bipolar type: Both the electrodes are in the heart. the higher the amplitude is required to capture a heartbeat. College. R-wave triggered (standby) type pacemaker: It senses natural R-waves and discharges artificial pacing impulses either every time when it senses a natural R-wave or at a fixed rate in case of fall of intrinsic heart rate below a preset value. Types: (i) Ventricular programmed and (ii) Atrial programmed. Perumalpattu MEDICAL ELECTRONICS UNIT III Artificial pacemaker: A device consisting of a “pulse generator” to generate artificial pacing impulses and appropriate “electrodes” to deliver them to the heart.8 ms pulse requires 6 mA amplitude.g. Sriram Engg. AP & HOD. 2 ms pulse requires 3 mA amplitude while 0. The shorter the duration of the pulse. Competitive or fixed rate or asynchronous: It discharges artificial pacing impulses at a “fixed rate” “asynchronously” with the natural pacing impulses thereby “competing” with any natural cardiac activity. Non-competitive pacemaker: It discharges artificial pacing impulses synchronously with the natural pacing impulses thereby not competing with any natural cardiac activity.15-3 ms and amplitude 5-15 mA for adults. It is used on patients with temporary heart irregularities and on patients during and after a cardiac surgery for temporary management of certain heart arrhythmias. Signal characteristics of artificial pacing impulses: Rectangular pulse of duration 0. R-wave inhibited (demand) type pacemaker: R-waves discharges artificial pacing impulses at a fixed rate either in case of absence of natural R-waves or in case of fall of intrinsic heart rate below a preset value. Internal pacemaker: Pulse generator is placed inside the body in a surgically formed pocket and electrodes are introduced into the right ventricle or onto the surface of the myocardium. ECE. External pacemaker: Pulse generator is located outside the body and electrodes are introduced into the right ventricles via a catheter. e.
It determines the stimulating pulse duration.1A/hour capacity and a lifetime of 7 to 10 years with continuous pacing at 72 bpm.. Sensing circuit: It senses an intrinsic (natural) R-wave and resets the oscillator timing capacitor.e. Voltage monitor: It senses cell depletion and signals the rate slowdown circuit and energy compensation circuit of this event. Rate limit circuit: It is a RC network. a reference voltage source and a comparator. Energy compensation circuit: It causes pulse width to increase to maintain a constant stimulation energy when cell depletion occurs. Rate slowdown circuit: It slows down the pulse rate by 8±3 pulses per minute when cell depletion occurs. It determines the basic pacing rate of the pulse generator. ECE. Nuclear batteries with a lifetime of 10 years are also used. synchronous) pacemaker: Reversion Circuit Sensing Circuit Refraction Circuit Timing Circuit Pulse Width Circuit Rate Limit Circuit Output Circuit Rate Slowdown Circuit Voltage Monitor Energy Compensation Circuit Timing circuit: It consists of a RC network. AP & HOD. Block diagram of a (non-competitive i. It disables the comparator for a preset interval limiting the pacing rate to a maximum of 120 pulses per minute. Pulse width circuit: It is a RC network. Sriram Engg.V SALAI SELVAM.6V with 1. Refractory circuit: It provides a time period after an output pulse or a sensed (natural) R-wave during which the amplifier does not respond to outside signals. College. Output circuit: It provides a voltage pulse to stimulate the heart. Perumalpattu Power source: Hermetically sealed lithium iodine battery generally rated at 5. 2 .
a double-pole-double-throw (DPDT) relay. ac defibrillation is no longer used. Defibrillation: Momentary application of strong electrical stimulus to bring all the cardiac cells simultaneously into a refractory period thereby arresting their irregular. Fibrillation of atria is called the atrial fibrillation and that of ventricles is called the ventricular fibrillation. Defibrillator: Fibrillation: A condition in which the normal rhythmic contractions of atria or ventricles are replaced by rapid. As an attempt to correct the atrial fibrillation using ac often results in even more serious ventricular fibrillation.25 to 1 sec) burst of 60 Hz ac at an intensity of 6 A is applied to the chest of the patient. The resulting waveform is known as the monophasic Lown waveform. Ventricular fibrillation: During this. uncoordinated twitching is known as defibrillation. A typical dc defibrillator: The following figure shows a typical dc defibrillator circuit. The operator positions the paddle electrodes on the patient’s chest and presses the discharge button. This is achieved by a heavy momentary electrical stimulus applied directly to the chest muscles. The operation is as follows: The operator selects the desired level of electrical energy to be delivered to the patient via the set-energy-level switch and then presses the charge button. The dc defibrillation: Several volts of dc is momentarily applied across or through the chest – only fewer repetitions are required to correct ventricular fibrillation so less harm than ac defibrillation – successful in correcting atrial fibrillation. AP & HOD. Hence ventricular fibrillation needs to be arrested and the normal cardiac activity needs to be restored within few seconds. the ventricles suffer from irregular vibration or twitching of muscles and hence they are unable to pump blood. R and the paddle electrodes. College. Sriram Engg. the blood circulation is still maintained but less efficiently. C from the charging circuit and connects it to the patient circuit. Perumalpattu Reversion circuit: It causes the pacemaker to inhibit its operation in case of presence of a natural Rwave or to exhibit its operation in case of absence of a natural R-wave. Several other waveforms are also in use. irregular twitching of their muscular walls is known as fibrillation. The ac defibrillation: A brief (0. the patient circuit. a push button discharge switch and a set-energy-level switch. Loss of blood supply to the brain even for a period of few seconds is fatal (leads to death). The high voltage dc power supply generates dc voltage as high as 3000 volts. a capacitor. The magnetic field built up in L collapses during the last 5 ms producing the negative excursion of the waveform. The capacitor. They are (i) Tapered dc delay waveform and (ii) Trapezoidal waveform 3 . the ventricles can still function but they receive irregular non-rhythmic electrical stimulation from the fibrillating atria.V SALAI SELVAM. S1. Atrial fibrillation: During this. The negative excursion may be omitted by eliminating L. This disconnects the capacitor. C gets charged up to the supply voltage. a low-voltage dc power supply. Types: (i) ac defibrillation & (ii) dc defibrillation. Since most of the blood flows into the ventricles due to gravity even before atrial contraction. C now discharges its stored energy into the patient via L. This takes place in the first 4 to 6 ms producing the high voltage positive excursion of the waveform shown below. which consists of a high voltage dc power supply. The capacitor. S2. ECE. This waveform is known as the biphasic Lown waveform. This is known as defibrillation.
Sriram Engg.V SALAI SELVAM. AP & HOD. ECE. College. Perumalpattu S2 (charge) L R ac power mains High voltage dc power supply C Rp (patient) Set energy level + Low-voltage dc power supply − Lown dc defibrillator circuit S1 (discharge) volts 3000 at 20 A Biphasic Lown defibrillation waveform 0 volts 1200 t (ms) 10 15 Tapered dc delay defibrillation waveform 0 t (ms) 8 15 4 .
Perumalpattu volts 1500 800 Trapezoidal defibrillation waveform 0 20 t (ms) Paddle electrodes: The defibrillation electrical energy can be applied across the chest via anterioranterior paddle electrodes or through the chest via anterior-posterior paddle electrodes.V SALAI SELVAM. AP & HOD. ECE. Thumb switch Insulated handgrip Insulated handguard Electrode surface Electrode surface Standard anterior paddle electrode Insulated handgrip Posterior paddle electrode Electrode surface Insulated handgrip Thumb switch Internal paddle electrode 5 . Sriram Engg. College. The following figures show these electrodes.
care must be taken to ensure that the electrical stimulus is not applied during the vulnerable period (i. Generally the discharge process is synchronized with the ECG with the help of an electronic circuitry.V SALAI SELVAM.. ECE. Sriram Engg. 6 . Good contact is ensured with the help of gel and belt. The amplified ECG signal is then filtered and is fed to the threshold detector that detects the R wave. The threshold detector causes the delay circuitry to emit a 30ms pulse if an R wave is detected in the ECG signal.e. T wave) of the ECG cycle. College. Perumalpattu Cardioverter: While correcting certain other less serious arrhythmias such as atrial fibrillation (in which case the ventricles are still able to pump blood into the system) via a large electrical stimulus. otherwise it leads to even more serious arrhythmia such as ventricular fibrillation. Thus the defibrillation process is synchronized with the R wave eliminating the risk of resulting in a serous arrhythmia such as ventricular fibrillation. The ECG amplifier eliminates noise from the ECG signal and amplifies it to a level suitable for further processing. If the operator switch has been closed. Cardioscope ECG electrodes Analog switch ECG amplifier Trigger circuit AND 30-ms delay Threshold detector Filter Defibrillator Operator controlled switch Defibrillation electrodes Metal plate electrodes made of Ag/Agcl are placed at desired limb or chest positions. Such an equipment is called cardioverter and the process is called cardiovertion. and at the same time it closes the switch that discharges capacitor through the defibrillator electrodes to the patient. AP & HOD. then this opens the analog switch to prevent the ECG amplifier from receiving the defibrillation pulse. These electrodes pick up the ECG signal from the patient.
Thus. Radio pill: One of the earliest biotelemetry units was the endoradiosonde. developed by Mackay and Jacobson. Applications: (1) Monitoring physiological conditions of astronauts in space. The pressure-sensing endoradiosonde is a “radio pill” less than 1 cm3 in volume so that it can be swallowed by the patient.4 V C2 L Ferrite Core C1 Basically. R 1. workers in deep mines. AP & HOD.V SALAI SELVAM. (3) Monitoring physiological conditions of patients in an ambulance or in a location away from the hospital. Similar devices have also been built to sense temperature. (5) Monitoring animals for research in their natural habitat. which causes it to move in and out as a function of pressure and. Pressure is sensed by a variable inductance. pH. EEG & EMG and (ii) those that require transducer such as temperature & pressure. As it travels through the gastrointestinal tract. College. ECE. it is a transistorized Hartley oscillator having constant amplitude and variable frequency of oscillation. and oxygen tension values by the use of different sensors or transducers. it measures the various pressures it encounters. Physiological parameters adaptable to biotelemetry: Physiological parameters are classified into two based on adaptability to biotelemetry: (i) direct biopotentials such as ECG. therefore. Sriram Engg. varies the value of inductance in the coil. changes in pressure modulate the frequency. (4) Remote medical data collection from home or office. whereas temperature is sensed by a temperature-sensitive transducer. enzyme activity. This change in inductance produces a corresponding change in the frequency of oscillations. The oscillator 7 . (2) Monitoring physiological conditions of subjects during exercise or in a normal working environment. Perumalpattu Biotelemetry: Measurement of biological parameters over a distance is known as biotelemetry. The ferrite core of the coil is attached to a diaphragm.
College. Physiological signals are obtained from the subject by means of appropriate transducers. AP & HOD. The components of biotelemetry system: Direct biopotentials Subject Transducer Processor Exciter Amplifier Modulator Biotelemetry transmitter Carrier The stages of a typical biotelemetry system can be broken down into functional blocks. a demodulator to separate the signal from the carrier wave.V SALAI SELVAM. The signal is then passed through a stage of amplification and processing circuits that include generation of a subcarrier and a modulation stage for transmission. and a means of displaying or recording the signal. Chart recorder/ Oscilloscope Tuner Demodulator Carrier Biotelemetry receiver The receiver consists of a tuner to select the transmitting frequency. Sriram Engg. ECE. Perumalpattu resonator coil also acts as an antenna. The signal can also be stored in the modulated state by the use of a tape recorder. The transmitted signal is a composite of a positive synchronizing pulse and a series of negative signal pulses. can be picked up on any simple receiver. A typical biotelemetry system: Biolink PWM biotelemetry system: A typical example of biotelemetry system is a pulse-width modulation (PWM) system capable of simultaneously transmitting four channels of physiological data. ranging from about 100 kHz to about 100MHz. 8 . The transmitted frequencies. the transmitter and the receiver.
it turns the second channel MMV ON and so on. When it turns itself OFF. a mixing network and a FM transmitter. College.V SALAI SELVAM. Sriram Engg. Each channel block consists of a monostable multivibrator (MMV) and a differentiator. ECE. a sync generator. the resulting negative pulses are clipped and mixed with the positive sync pulses. Perumalpattu Signal conditioner Signal conditioner Signal conditioner Signal conditioner Ch1 Sync pulse generator Ch2 Mixing network Ch3 FM transmitter Ch4 Biolink PWM transmitter The biotelemetry transmitter consists of four signal conditioners. The resultant square waves are thus width-modulated by the input data. Its pulse turns the first channel MMV ON. Sync pulse amplifier Demint Ch1 Demint FM receiver Sync/Signal separator Demint Ch2 Ch3 Signal pulse amplifier Biolink PWM receiver Demint Ch4 9 . The sync pulse generator begins the action. four channel blocks. The square waves are then differentiated. AP & HOD. Depending on the level of the input data at that instant of time the MMV remains ON for some period of time.
a sync/signal separator. nearby telecommunication transmissions. ECE. the most commonly used multiplexing method is the Frequency Multiplexing (FM). College. The sync pulse turns the first channel flip-flop ON. The sync/signal separator separates the positive sync pulse from the negative signal pulses. Pulse Width Modulation (PWM) and Pulse Code Modulation (PCM) are the most commonly used digital modulation techniques in the biotelemetry. Sync pulses t1 t2 t3 t4 t1 t2 t3 t4 Ch1 Ch2 Ch3 Ch4 Sync pulses Signal pulses Frequency selection & modulation techniques: The radio frequency biotelemetry uses either the VHF or UHF band set aside by the Federal Communications Commission (FCC) exclusively for the medical telemetry or the unused television channels. Hence FM/FM denotes that sub-carriers frequency-modulate individual data channels and RF carrier frequency-modulates these sub-carriers. Pulse Amplitude Modulation (PAM). For example. AP & HOD. Perumalpattu The biotelemetry receiver consists of a FM receiver. Sriram Engg. Each channel block consists of a flip-flop and an integrator.V SALAI SELVAM. if sub-carriers frequency-modulate individual data channels and RF carrier amplitude-modulates these sub-carriers.or amplitude-modulated using separate sub-carrier and these sub-carriers are either frequencyor amplitude-modulated using a RF carrier. Each channel of data is either frequency. a signal pulse amplifier and four channel blocks. 10 . a sync pulse amplifier. then such system is termed as FM/AM. The square waves from these flip-flops are then integrated to give the actual data. While multiplexing many channels of data. When it turns OFF. Amplitude Modulation (AM) and Frequency Modulation (FM) are the most commonly used analog modulation techniques in the biotelemetry. The flip-flop remains ON until the next negative signal pulse occurs. it turns the second flip-flop ON and so on. It is often desired that the frequency and power considerations for the proposed telemetry system dose not affect the existing.
Among these ionizing radiations. each with its own distinct properties. The other radiations that do not ionize the gases are known as the non-ionizing radiations. The intensity of X rays depends on the current through the tube. ECE. These voltages are obtained from high-voltage transformers that are often mounted in oil-filled tanks to provide electrical insulation. (Otherwise high-voltage diodes. X-rays. radio waves Generation of ionizing radiations: Generation of X-rays: X-ray tube. When ac voltage is used. β-rays. gamma rays. AP & HOD. This in turn controls the cathode (heater) temperature. Sriram Engg. Perumalpattu MEDICAL ELECTRONICS UNIT IV 1 Ionizing and non-ionizing radiations: The radiation that ionizes the gases through which it travels is known as the ionizing radiation. infrared. They are (i) alpha rays: they are positively charged particles (helium nuclei) with low penetrating capacity (ii) beta rays: they are negatively charged particles (electrons) with moderate penetrating capacity and (iii) gamma rays & X-rays: they are electrically neutral particles (photons) with very high penetrating capacity. So the current through the tube does not depend on the applied anode voltage. Examples: α-rays. Examples: visible light. The wavelength of the X rays depends on the target material and the velocity of the electrons hitting the target. This current can be varied by varying the heater (cathode) current. the X-rays are widely used in the medial imaging for diagnosis. An X-ray tube is basically a high-vacuum diode with a heated cathode located opposite a target anode. X-ray equipment for diagnostic purposes uses target voltages in the range of 30 to 100 kV and the current is in the range of several hundred milliamperes. This diode is operated in the saturated mode with a low cathode (heater) temperature.V SALAI SELVAM. cosmic rays. the X-ray tube conducts only during one halfwave and acts as its own rectifier.) . principle of operation X rays are generated when fast-moving electrons are suddenly decelerated by a hard target. There are three different types of radiations. It can be varied by varying the target (anode) voltage of the tube. often in voltage-doubler or multiplier configurations. College. are used as rectifiers.
The sensitivity of this effect can be increased by the use of intensifying screens which are similar to the fluoroscopic screens. X-ray films. Collimators. are used to confine these X-rays into a fine beam. Because of these inconveniences. with or without intensifying screens. higher radiation energies are required and hence linear or circular particle accelerators such as cyclotron and magnetron have been used to obtain electrons with sufficiently high energy. direct fluoroscopy now has only limited use. has a high melting point. X-ray films and Image intensifiers. a shadow image is generated that corresponds to the X-ray density of the organs in the body section. only a small part of their energy is converted into X rays. a film that has been exposed to X rays shows an image of the X-ray intensity. The electron beam is concentrated to form a small spot on the target. most of it is dissipated as heat and the target. Perumalpattu For therapeutic X-ray equipment. therefore. Sriram Engg. The screen is brought into close contact with the film surface so that the film is exposed to the X rays as well as to the light from the fluorescence of the screen. are packaged in light-tight cassettes in which one side is made of thin plastic that can easily be penetrated by the X rays. usually made of tungsten. has a spatial intensity variation that is an image of the internal structure of the body. College. The radiation that leaves the body. When X rays from a point source penetrate a body section. The X rays emerge in all directions from this spot. this intensity distribution is visualized by a suitable device. Hence. made up of lead. the internal structure of the body absorbs varying amounts of the radiation. X-ray films: X rays react with photographic emulsions. it is either water-cooled or air-cooled or it is in the form of a motordriven rotating cone. Diagnostic X-ray equipments: The use of X rays as a diagnostic tool is based on the fact that various components of the body have different densities for the rays. Fluoroscopy: Certain metal salts glow in the dark when struck by the X-rays. The X-ray intensity necessary to obtain a fluoroscopic image is harmful to both the patient and the observer. When the electrons strike the target. X rays normally cannot be detected directly by the human senses. When. . AP & HOD. ECE. Therefore. After processing in a developing solution. and cardboard pieces or glass surfaces coated with such metal salts are used to visualize X-ray images. the fluoroscopic image becomes rather faint. If the X-ray intensity is reduced to a safer level.2 V SALAI SELVAM. Three different techniques are in common use: Fluoroscopy. indirect methods of visualization must be used to visualize X-ray images. The brightness of this fluorescence is a function of the radiation intensity. as shown in the following figure.
In order to prevent the grid from throwing its own shadow on the film. This effect can be reduced by the use of a grid or a Bucky diaphragm. In order to make them visible on the X-ray images. Contrast Media: While foreign bodies and bone absorb the X rays much more readily than soft tissue. (ii) The structures of the gastrointestinal tract are made visible with the help of barium sulfate. For this reason. as shown in the following figure. Grids: Some of the X rays entering the body of a patient are scattered and no longer travel in a straight line. it is moved by a motorized drive during the exposure of the film. a TV camera is now used frequently to pick up the intensified image. The electron image thus obtained is projected onto a phosphor screen at the other end of the tube by means of an electrostatic lens system. Perumalpattu 3 Image intensifiers: The faint image of a fluoroscopic screen can be made brighter with the help of an electronic image intensifier. The resulting brightness gain is due to the acceleration of the electrons in the lens system and the fact that the output image is smaller than the primary fluorescent image. The intensifying tube. Sriram Engg. Often special techniques are used to obtain usable images from certain body structures. the organs and soft tissue structures of the body do not show up well in the X-ray images. The grid absorbs the scattered X rays while those traveling in straight lines can pass. is rather heavy and requires a special suspension. College. and other conditions of the heart characterized by hemodynamic changes. however. they are filled with a contrast medium prior to taking the X-ray photo. This device consists of a grid-like structure made of thin lead strips that is placed directly in front of the X-ray film. given orally or as an enema. The scattered X rays can cause a blurring of the X-ray image. Cardiac Catheterization: Fluoroscopic techniques are used to assist the cardiac catheterization used primarily to diagnose valve deficiencies. AP & HOD. the outlines of blood vessels are made visible on the X-ray image by injecting a bolus of contrast medium directly into the bloodstream in the region to be investigated. The intensifier tube contains a fluorescent screen. ECE. Example: (i) In Pneumoencephalography. Its surface is coated with a suitable material to act as a photocathode.V SALAI SELVAM. . The gain can reach an overall value of several hundred. This TV picture can also^e recorded on a TV tape recorder. septal defects. (iii) In angiography. the ventricles of the brain are made visible by filling them with air.
This is because the gamma rays penetrate the surrounding tissues but the beta rays do not. For in-vivo determinations. radiation is emitted. The time after which half of the original number of radioisotope atoms have decayed is called the half-life. the path of the substance (isotope) can be traced and its concentration in various parts of the organism can be determined. Use of radioisotopes for diagnosis: Radioisotopes: Radioactive decay is the other source of nuclear radiation. two X-ray photos are taken from different angles. Each radioisotope has a characteristic half-life from a few seconds to thousands of years. For in-vivo (inside living body) diagnosis.7 days With the help of the emitted radiation. College. . The radioisotopes most frequently used for medical purposes are listed in the above table. (i) In stereoradiography. The scintillation detector consists of a suitable medium that emits light flashes on the incidence of radiation and a photomultiplier. Perumalpattu Three-Dimensional Visualization: A basic limitation of X-ray images is the fact that they are two-dimensional presentations of three-dimensional structures. and viewed in a stereo viewer to give a three-dimensional X-ray image. One organ located in front of or behind another organ therefore frequently obscures details in the image of the other organ.8 days 99m Tc Gamma 6 hours 131 I Gamma 8. is used. ECE.3 days 14 C Beta 5570 years 51 Cr Gamma 27.07 days 198 Au Gamma 2. Sriram Engg. This property of the scintillation detector is used to reduce the background noise (counts due to natural radioactivity) by means of a pulse-height analyzer. often through several intermediate forms. The unstable atom disintegrates after some time. an unstable form of the element is generated that is chemically equivalent to the original form (isotope). At the moment of the disintegration. AP & HOD. until it has assumed the form of another stable element. Artificial radioactivity can be induced in other elements by exposing them to high-velocity neutrons. the X-ray photo shows the structure of only a thin slice or section of the body.4 V SALAI SELVAM. (ii) In tomography. Detection methods: Radioisotope techniques are all based on actually counting the number of nuclear disintegrations that occur in a radioactive sample during a certain time interval or on counting the radiation quanta that emerge in a certain direction during this time. Several photos representing slices taken at different levels give three-dimensional visualization. By introducing a high-velocity neutron into the nucleus of the atom of an element. but only a very small number of chemical elements exhibit natural radioactivity. a scintillation detector with a collimator. known as collimated detector. Each radiation quantum passing the crystal causes an output pulse at the photomultiplier. the gamma-emitting isotopes must be used and the beta-emitting isotopes are used only for in-vitro (outside living body) diagnosis. Tomographic X-ray photos are obtained with a thin X-ray beam by moving the X-ray tube and the film cassette in opposite directions during the exposure of the film. The amplitude of this pulse is proportional to the energy of the radiation. Scintillation detectors or counters that utilize the light flashes caused by radiation in a suitable medium are used for the detection of radiation from isotopes. A collimator is a thick lead shield with holes for the passage of X-rays travelling in straight lines. The following figure shows the other building blocks that constitute a typical instrumentation system for medical radioisotope measurements. RADIOISOTOPES Isotope Radiation Half-Life 3 H Beta 12.
Changing the direction of entry of the beam in successive therapy sessions or rotating the patient during a session reduces the radiation damage to unaffected body parts while concentrating the radiation at the site of the tumor. A timer and gate allow the pulses that occur in a set time interval to be counted by means of a scaler (decimal counter with readout). on the other hand. and burns and (iii) death—destruction of vital physiological systems such as nervous. College. Sriram Engg. Radiation therapy: The ionizing effect of X rays is utilized in the treatment of certain diseases. headache. respiratory. . ECE. Adverse effects of radioactive diagnosis and therapy: The effects of cumulative X-ray dosage of ionizing radiation may result in (i) mutations—genetic changes resulting from damage to chromosomes (ii) physical illness— vomiting.V SALAI SELVAM. In the therapy of deep-seated tumors. dizziness. loss of hair. Sometimes linear accelerators or betatrons are used to obtain electrons with a very high voltage for this purpose. cardiovascular. very hard X rays generated using voltages much higher than those for diagnostic X rays are used. The radioactive diagnosis or therapy is not advised for pregnant females due to the above-said adverse effects of radiation. and digestive systems and tissues. AP & HOD. A rate meter (frequency meter) shows the rate of the pulses. especially of certain tumors. In dermatology very soft X rays (called the Grenz rays) that do not have enough penetration power are used for treatment of the skin. renal. Perumalpattu 5 The pulses from the photomultiplier tube are amplified and shortened before they pass through the pulse-height analyzer.
V SALAI SELVAM, AP & HOD, ECE, Sriram Engg. College, Perumalpattu MEDICAL ELECTRONICS UNIT V Thermograph: 105 104
Visible region 102 Human body radiation at 37o C 10 10−1 0.4 0.8 3 9.3 10 Wavelength in µrons 50
The human body absorbs infrared radiation almost without reflection. At the same time, it emits part of its own thermal energy in the form of infrared radiation. The intensity of this radiation depends on the temperature of the radiating part of the body. Therefore it is possible to measure the temperature of any part of the body from a distance by measuring the intensity of this radiation. The total infrared energy radiated by an object with a temperature T oK is given by the Stefen-Boltzman relation as W=#$T4 where W – total energy radiated % – Stefen-Boltzman constant $ – emissivity T – absolute temperature Infrared detectors:
CMT 10 Detectivity
6 12 Wavelength in µm
V SALAI SELVAM, AP & HOD, ECE, Sriram Engg. College, Perumalpattu
Indium Antimonide (InSb) and Cadmium Mercury Telluride (CMT) are the most commonly used infrared detectors. Thermography camera:
The camera consists of mirrors and lenses made of germanium and a prism made of silicon. A vertically oscillating mirror scans the scene vertically while a rotating silicon prism scans the scene horizontally. The optical rays after the scanning process are made to fall on an infrared detector such as InSb or CMT which converts these optical rays into electrical signals. The detector is cooled by liquid nitrogen. The electrical signals from the camera are then amplified and fed to a cathode ray tube. The CRT scanning process is synchronized with the mechanico-optical scanning process. Laser in medicine: Laser principle: E1 Incident photon E0 Incident photon Emitted photon
E0<E1 Lasing medium Fully reflecting mirror Pumping source Basic lasing system Laser beam Partially reflecting mirror
LASER – Light Amplification by Stimulated Emission of Radiation.
V SALAI SELVAM, AP & HOD, ECE, Sriram Engg. College, Perumalpattu
When an excited atom is impinged by a photon, the atom is brought to ground stage emitting a photon identical to the incident one. If a large number of such coherent photons were emitted, the intensity of such photonic beam would be very high. Such “Light Amplification” will be achieved by this “Stimulated Emission of Radiation” if a “population inversion” can be achieved. “Population inversion” means having a material with more number of atoms is the excited state than in the ground state. When the excited atoms in a material, which is in the population inversion, are brought to the ground state simultaneously either an enormous amount of heat or a beam of coherent photons is produced. Materials with later emission are known as “laser medium”. Population inversion in a lasing medium can be achieved by an external energy source such as a light source or an electric discharge. The process of obtaining population inversion is known as “pumping” and the respective external source as “pumping source”. The partially or fully reflecting mirrors enhance the process of stimulation by reflecting the photons back and forth. The photons that are incident on the partially reflecting mirror at a particular angle are sent out. Types of lasers: Classification based on physical status of lasing medium: (1) solid lasers, e.g., Ruby laser (2) gas lasers, e.g., CO2 laser (3) liquid lasers e.g., Acridine red in ethyl alcohol. Classification based on mode of emission: (1) pulsed mode lasers e.g., Ruby laser (2) Continuous wave lasers, e.g., CO2 laser. Examples of lasers: Ruby laser: Lasing medium: ruby crystal (AlO3 dopped with Cr3-) Pumping source: Xenon flash lamp Wave length (&): (i) 0.55 !m(Green), (ii) 0.42 !m (Violet) Uses: (i) tattoo and ports-wine removal, (ii) ophthalmology CO2 laser: Lasing medium: CO2 + N2 + He Pumping source: electrical discharge Wave length (&): 10.6 !m (IR) - Invisible Uses: Surgery Acridine red in ethyl alcohol: Lasing medium: Acridine red in ethyl alcohol Pumping source: flash lamp Laser applications in medicine: (1) Surgery with minimal or no loss of blood and with greater precision, e.g., CO2 laser with 50 – 500W output power. (2) Removal of tattoo and port-swine, e.g., pulsed ruby laser with 55-100 J/cm2 (3) Treating tumors, e.g., pulsed ruby laser with 1500-2000cm2
Coagulation waveform The cutting is achieved by a continuous sine wave of frequency from 500 to 2500 kHz and power 100 to 750 W shown in the following figure. Principle: The electrosurgical unit consists of two electrodes one being called the active electrode and other being called the passive or dispersive electrode or patient plate. argon and NdYAG lasers. A high-frequency electrical current is passed through these electrodes. the tissue underneath the active electrode is heated up to destruction. (6) Treatment of glaucoma (increase in eye-ball pressure due to a block) (7) Photodynamic therapy (PDT) – a treatment with a combination of a photosensistor and a light beam in the presence of molecular oxygen causing biological destruction (8) Would healing and pain relief using cold lasers (cold lasers-lasers of very low power in the range µW) Surgical diathermy: Electrosurgical unit: The electronic device used to assist the surgical procedures by providing cutting & hemostasis (stopping bleeding) is known as the electrosurgical unit. Cutting waveform .g. diabetic retinopathy. desiccation. Desiccation: Localized destruction of the deep-seated tissues through application of high-frequency current.4 V SALAI SELVAM. As a result of this.. The active electrode has a very small cross-sectional area whereas the passive electrode has a large surface area. cataract. AP & HOD. The desiccation & coagulation are achieved by damped sinusoidal pulses of frequency from 250 to 2000 kHz and power from 50 to 200 W shown in the following figure. Different current waveforms are used for different applications such as coagulation. Sriram Engg. Electrotomy: Process of cutting the tissues through application of high-frequency current. College. (5) Treatment of retinal holes/tears. Perumalpattu (4) Photocoagulation by red ruby laser or argon laser. retinal detachment.g.. Fulguration: Process of destructing the superficial tissues through application of high-frequency current without affecting the deep-seated tissues. the current density at the active electrode is far greater than that at the passive electrode. Due to far smaller cross-sectional area. ECE. “Photocoagulation” – process of clotting blood by laser beam. e. Coagulation: Clotting of blood through application of high-frequency current. pulsed ruby laser. cutting & ‘bloodless’ cutting. e.
The output of the modulator is amplified to desired power-level by a RF power amplifier. College. The electrodes used come in various sizes and shapes depending on the manufacture and application. 3. The output circuit couples the output of the RF amplifier to the active and passive electrodes. 2. which is amplified and modulated to produce the coagulation. Hazards in electrosurgical unit: 1. AP & HOD.V SALAI SELVAM. Bloodless cutting waveform The following figure shows the block diagram of a typical electrosurgical unit: RF oscillator Modulator Power amplifier Output circuit Electrodes Function generator Control circuit Power supply Mode selector Hand or foot switch The RF oscillator provides the basic high-frequency signal. The function generator produces the modulation waveforms according to the mode selected by the operator. ECE. cutting & blended waveforms. Electrocution: The electrocution of the patient occurs due to involuntary contact of the patient with the active electrode or leakage currents due to faulty ground. . Explosion hazards: The explosion occurs when the active electrode involuntarily comes in contact with the cleaning agents such as ethyl alcohol or with the tubes carrying anesthetic gases. Perumalpattu 5 The bloodless cutting is achieved by combining the above two waveforms. Burns: (i) The presence of moisture or the accumulation of prepping agent or blood or any other liquid in between the patient body and the dispersive electrode increases the conductivity and hence the current density at those points of contact leading mild or severe burns at those points. The RF power amplifier can be turned on or off by a hand switch on the active electrode or a foot switch. (iii) Burns occurs at the points of contact of monitoring electrodes due to ground loop (potential difference between earth points of various equipments). (ii) The improper contact of the dispersive electrode to the patient body due to bony areas leads to burns. The resulting waveform is known as blended waveform shown in the following figure. Sriram Engg.
Sustained myocardial contraction: Currents from 1 to 6 A can cause sustained myocardial contraction. Macroshock: Large currents applied to the heart via external surface of the body are called macroshocks. To avoid burns. Each of these two cables carries few hundreds of glass fibers. involuntary contact of the patient with the active electrode should be avoided and proper ground should be provided. College. To avoid explosion hazards. a perfect contact of the dispersive electrode to the patients should be ensured. The external part of the fiber cable for illumination consists of a high-power light source. Respiratory paralysis. Perumalpattu Safety aspects in electrosurgical unit: 1. ECE. The light incident on one end of these fibers is transmitted to the other end by total reflection. Endoscope: A tubular optical instrument inserted into natural or surgically created orifices to inspect the body cavities is known as endoscope. Common ground can be used to avoid ground loop. The internal part of the fiber cable for image transmission consists of an optical system. Range: 0. pain and fatigue: Currents from 18 to 25 mA can cause involuntary contraction of respiratory muscles (respiratory paralysis). The optical system comprises a prism and a positive lens to couple the reflected light rays to the fibers. To avoid electrocution. Let-go current: The maximal current at which an individual can withdraw voluntarily. involuntary contact of the active electrode with cleaning agents or tubes carrying the anesthetic agents should be avoided. The dispersive electrode should be properly cleaned off any strains. Electrical safety: Physiological effects of electricity: Threshold of perception: The minimal current that an individual can detect is known as the threshold of perception. Range: 6 to 15 mA. Sriram Engg. Each glass fiber consists of two transparent materials.6 V SALAI SELVAM. A pad electrode can be used to cover bony areas.5 to 1 mA at 50 Hz. 3. Modern endoscopes consist of two fiber optic cables one for illumination and the other for image transmission. physical injury and tear the muscle off the bone leading even to death. AP & HOD. pain and even fatigue. Burns & physical injury: Currents above 10 A can cause severe burns. The light from this source is transmitted down the fibers with low loss to illuminate the objects to be viewed. Ventricular fibrillation: Currents from 75 to 400 mA can cause ventricular fibrillation thereby even leading to death. 2 to 10 mA at dc. an internal core with a high refractive index and an external shell with a low refractive index. . 2.
V SALAI SELVAM. . Sriram Engg. (ii) poor grounding of the equipments via high-resistance grounds and broken grounds and (iii) involuntary contact with live wires. Catheter ac supply Microshock Microshocks result mainly from leakage currents due to (i) stray capacitances between live wires and conducting surfaces of the equipment chassis and (ii) ground loop due to difference in ground potentials of various equipments. Perumalpattu 7 ac supply Macroshock Macroshocks can result from (i) faulty electric equipments such as short-circuits between live wires and conducting surfaces of the equipment chassis. ECE. AP & HOD. × N P Short circuit Chassis Circuit Faulty equipment & ground Microshock: Small currents applied directly to the heart are called microshocks. Even 10 mA applied directly to the heart muscles can cause ventricular fibrillation leading to death. College.
affected tissues can alone be treated without affecting the neighbouring tissues.8 V SALAI SELVAM. Ground resistance should be checked periodically using a Ground Fault Circuit Interrupter (GFCI). ECE. Advantages of diathermy: 1.e.. This is achieved by the application of electrical energy through electrodes at high frequencies in order to avoid stimulation of motor or sensory nerves. Equipment design: Low-power designs: The equipments can be designed to operate at low voltage & current levels. Diathermy: Diathermy means ‘through heating’ or producing deep heating directly in the tissues of the body. AP & HOD. 3. a common ground point should be provided for all the equipments. To avoid ground loop. Equipment design: Stray capacitances: The equipments should be designed so that the leakage currents due to stray capacitances do not exceed 10 µA. 2. Isolation: The patient part of the equipment should be isolated from the highpower section via transformer coupling or optical isolation or carrier isolation. 5. Selective treatment is possible i.5Ω . 4. Perumalpattu Broken ground × N P Stray capacitances Chassis Leakage current Circuit Catheter Direct blood pressure measurement ECG recording system Ground 1 Ground 2 Ground loops Basic approaches to protection against shock: 1. GFCI disconnects the source of electrical power when the ground fault is greater than 6 mA. Equipment design: Double insulation: The live parts of the equipments should be double-insulated from the other conducting parts of the equipments. Grounding system: Ground resistance should be less than 0. Sriram Engg. . College.
. College. R F E C1 C2 D B T2 To patient electrodes . As the high frequency alternating current is used. Precise control over the heat produced is possible i. The intensity of the current applied to the patient can be controlled by (i) controlling the anode voltage or (ii) controlling the filament heating current or (iii) controlling the grid bias. the treatment can be controlled precisely. A LC tuned circuit formed by the coil AB along with the capacitor C1 is used to generate the short wave of desired frequency. Sriram Engg. Power tube A C Mains supply T1 The transformer T1 provides EHT to anode & heating current to the cathode. The coil CD generates the positive feedback for the oscillations to occur. Short wave diathermy: Alternating current of frequency 27. there will be no stimulation of motor or sensory nerves and hence no discomfort to the patient. The anode is driven at 4000 V. 3. The current through the patient is used to charge a capacitor to a voltage which is a measure of the detuning. 4. Perumalpattu 9 2. ECE. AP & HOD.12 MHz and wavelength 11 m is used. The coil EF along with the capacitor C2 forms the patient tuning circuit for coupling. Power supply High power tuned triode short wave oscillator Patient tuning circuit To patient electrodes The circuit of a typical short wave diathermy unit is shown in the following figure. This voltage operates a servomotor to adjust the tuning capacitor accordingly. As the body becomes part of the electrical circuit.e. Detuning may happen due to unavoidable & involuntary movements of the patient. Auto tuning: Maximum electrical energy is delivered to the patient only if the unit is correctly tuned to the electrical values of the object (part of the body). The intensity of the current applied to the patient is shown on an ammeter. the heat is not transferred through the skin. An electronic circuit is used to measure the polarity & magnitude of the detuning & to adjust the tuning capacitor accordingly.V SALAI SELVAM. The following figure shows the block diagram of a short wave diathermy unit. Upto 500 W of electrical energy is available from this circuit.
Electrodes Part of the body to be treated 2. Microwave oscillator e. an electric field is set up at its ends and a magnetic field at the center. This forms a capacitor. The magnetron requires (i) a delay circuit to incorporate a delay for the initial warm-up (ii) cooling facility using water or air for the anode & (iii) fuses to avoid damage due to excessive current flow (> 500 mA). Current carrying cable Part of the body to be treated Microwave diathermy: The tissues of the body are irradiated with very short wireless waves of frequency in the microwave region.25 cm. Much longer duration of irradiation may cause some discomfort such as skin burns. Ultrasonic diathermy: In ultrasonic diathermy. Typical frequency used is 2450 MHz corresponding to a wavelength of 12.10 V SALAI SELVAM. When a RF current is passed through the cable. Deep heating achieved via electrostatic field and superficial heating is achieved via magnetic field. AP & HOD. The microwaves are transmitted in wireless fashion towards the portion of the body to be treated.. Thus no tuning is required. Sriram Engg. The reflector antenna is used to direct the microwaves towards the portion of the body to be treated. magnetron High voltage power supply To transmitting antenna The microwaves are generated by a microwave oscillator like magnetron. . heating is produced due to absorption of ultrasounds by the tissues. College. The following figure shows the block diagram of a microwave diathermy. Perumalpattu Application techniques: 1.g. heat is produced in the intervening tissues. Heating is produced due to the absorption of microwaves by the tissues. Condenser type: The part of the body to be treated is placed between the electrodes called the pads without touching the skin. The following figure shows the block diagram of ultrasonic diathermy. Typical duration of irradiation is 15-20 min. Inductor type: A flexible cable is wound around the part of the body to be treated. Due to dielectric loss. ECE.
College. Air or bone completely obstructs the transmission of ultrasounds. the ultrasonic energy is reduced to 50 % at a depth of 1. the ultrasonic energy tends to diffuse and no efficient treatment can be done. AP & HOD. (ii) intensity of ultrasound and (iii) duration of exposure. At 1 MHz. ultrasonic pulses are used. ECE. continuous ultrasonic waveform is used while in the pulsed mode of operation. Dosage: The dosage is controlled by varying any of the following parameters: (i) frequency of ultrasound. But at frequencies less than 1 MHz. the ultrasonic energy is reduced to 50 % at a depth of 5 cm in the soft tissues while. Sriram Engg. The ultrasonic diathermy can be operated either in continuous or pulsed mode.5 cm. In the continuous mode of operation. These electrical oscillations are then converted into ultrasounds by piezoelectric crystal. Application techniques: Ultrasounds require medium to transmit.V SALAI SELVAM. Gel-like medium or water is used to transmit the ultrasounds through the tissues. Perumalpattu 11 Power supply Conventional oscillator Ultrasonic probe (piezoelectric crystal) The conventional oscillator produces sinusoids of frequency 800 kHz to 1 MHz. at 3 MHz. .
ELSEVIER. John G. Leslie Cromwell et al. Gordon and Breach. N. Bristol and Philadelphia. 9. 1991. 6. 12.. Churchill Livingstone. Brown. 10. “A Premier of ECG A Simple and Deductive Approach”. Pearson Education Asia. Prentice Hall of India. 2000. Science Publishers. W. Churchill Livingstone. “Biomedical Instrumentation and Measurements”. 5. 4. Isabel M Shirley et al.V SALAI SELVAM. “Medical Instrumentation Application and Design”. Robert B. K. 2005. ECE. 1988. Pitman Medical Publishing Co Ltd. “A User’s Guide to Diagnostic Ultrasound”. 1998. Adam Hilger. Pascal Verdonck et al. College.. AP & HOD. CRC PRESS. 1994. McDicken. . Apollo Hospitals. Construction. “Analysis and Application of Analog Electronic Circuits to Biomedical Instrumentation”. “Design and Development of Medical Electronic Instrumentation A Practical Perspective of the Design. 11. Leon Goldman and R. Perumalpattu References 1. James Rockwell Jr.. “Diagnostic Ultrasonics Principles and Use of Instruments”. Sriram Engg. “Therapeutic Lasers Theory and Practice”. John Wiley & Sons. Chennai. “Introduction to Biomedical Equipment Technology”. “The Physics of Medical Imaging”. Joseph J. 2001. David Baxter et al. Carr and John M. “Advances in Biomedical Engineering”. 2009. G. 2004. John Wiley & Sons. Steve Webb et al. 1971. Webster et al.. David Prutchi and Michael Norris. 7. 3... 2. P. 1978. 8. and Test of Medical Devices”.. “Lasers in Medicine”. Northrop. Misra. India.
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