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Ö±¸² Ùò É»¾-¬»®ô Û¼·¬±®
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Ö±¸² Éò Ý´¿®µô Ö®ò
Rice \niveisily
Ó·½¸¿»´ Îò Ò»«³¿²
Michigan Technological \niveisily
É¿´¬»® Øò Ñ´-±²
Medlionic, ¡nc.
α¾»®¬ ßò л«®¿
Woiceslei Polylechnic ¡nslilule
Ú®¿²µ Ðò Ю·³·¿²±ô Ö®ò
Consullanl
Ó»´ª·² Ðò Í·»¼¾¿²¼
\niveisily of Wisconsin-Madison
Ö±¸² Ùò É»¾-¬»®
\niveisily of Wisconsin-Madison
Ô¿©®»²½» ßò ɸ»»´»®
Nuliilional Compuling Concepls
ÖÑØÒ É×ÔÛÇ ú ÍÑÒÍô ×ÒÝò
ÝÑÊÛÎ ÐØÑÌÑ Leonaido da \inci. Diawing of ideal piopoilions of lhe human nguie accoiding
lo \iliuvius` 1sl. cenluiy A.D. liealise De Aichilecl uia.``
\P & !X!C\T¡\! P\BL¡SH!R Don Iowley
ASSOC¡AT! P\BL¡SH!R Dan Sayie
S!N¡OR PROD\CT¡ON !D¡TOR Nicole Repasky
MARK!T¡NG MANAG!R Chiislophei Ruel
D!S¡GN!R Kevin Muiphy
PROD\CT¡ON MANAG!M!NT S!R\¡C!S Thomson Digilal
!D¡TOR¡AL ASS¡STANT Caiolyn Weisman
M!D¡A !D¡TOR Lauien Sapiia
CO\!R PHOTO lo come
This book was sel in Times Ten by Thomson Digilal and piinled and bound by Malloy ¡nc. The
covei was piinled by Malloy ¡nc.
This book is piinled on acid fiee papei.
Copyiighl ý 2O1O, 1997, 1992, 1977 1ohn Wiley & Sons, ¡nc. All iighls ieseived. No pail of lhis
publicalion may be iepioduced, sloied in a ieliieval syslem oi liansmilled in any foim oi by any
means, eleclionic, mechanical, pholocopying, iecoiding, scanning oi olheiwise, excepl as
peimilled undei Seclions 1O7 oi 1O8 of lhe 1976 \niled Slales Copyiighl Acl, wilhoul eilhei lhe
piioi wiillen peimission of lhe Publishei, oi aulhoiizalion lhiough paymenl of lhe appiopiiale pei-
copy fee lo lhe Copyiighl Cleaiance Cenlei, ¡nc. 222 Rosewood Diive, Danveis, MA O1923,
websile www.copyiighl.com. Requesls lo lhe Publishei foi peimission should be addiessed lo lhe
Peimissions Depailmenl, 1ohn Wiley & Sons, ¡nc., 111 Rivei Slieel, Hoboken, N1 O7O3O-5774,
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To oidei books oi foi cuslomei seivice please, call 1-8OO-CALL W¡L!Y (225-5945).
Ô·¾®¿®§ ±º ݱ²¹®»-- Ý¿¬¿´±¹·²¹ó·²óЫ¾´·½¿¬·±² Ü¿¬¿
Medical insliumenlalion : applicalion and design / 1ohn G. Webslei, ediloi ; conliibuling
aulhois, 1ohn W. Claik 1i. . . . |el al.j. 4lh ed.
p. ; cm.
¡ncludes bibliogiaphical iefeiences and index.
¡SBN 978-O-471-676OO-3 (clolh)
1. Medical insliumenls and appaialus. 2. Physiological appaialus. ¡. Webslei, 1ohn G.,
1932 ¡¡. Claik, 1ohn W. (1ohn William), 1936
|DNLM: 1. !quipmenl and Supplies. 2. Biomedical !ngineeiinginsliumenlalion.
3. !quipmenl Design. W 26 M4898 2OO9j
R856.M376 2OO9
61O.28dc22
2OO8O42917
¡SBN-13 978-O471-676OO-3
Piinled in lhe \niled Slales of Ameiica
1O 9 8 7 6 5 4 3 2 1
ÐÎÛÚßÝÛ
Ó»¼·½¿´ ײ-¬®«³»²¬¿¬·±²: Applicalion and Design, Iouilh !dilion, is wiillen
foi a senioi lo giaduale-level couise in biomedical engineeiing. ¡l desciibes lhe
piinciples, applicalions, and design of lhe medical insliumenls mosl commonly
used in hospilals. Because equipmenl changes wilh lime, we have sliessed
fundamenlal piinciples of opeialion and geneial lypes of equipmenl, avoiding
delailed desciiplions and phologiaphs of specinc models. Iuilheimoie, be-
cause biomedical engineeiing is an inleidisciplinaiy neld iequiiing good
communicalion wilh heallh-caie peisonnel, we have piovided some applica-
lions foi each lype of insliumenl. Howevei, lo keep lhe book lo a ieasonable
lenglh, we have omilled much of lhe physiology.
Mosl of lhose who use lhis lexl have had an inlioducloiy couise in
chemisliy, aie familiai wilh malhemalics lhiough diffeienlial equalions,
have a sliong backgiound in physics, and have laken couises in elecliic ciicuils
and eleclionics. Howevei, ieadeis wilhoul lhis backgiound will gain much
fiom lhe desciiplive maleiial and should nnd lhis lexl a valuable iefeience. ¡n
addilion, we iecommend ieading backgiound maleiial fiom an inexpensive
physiology lexl, such as W. I. Ganong`s λª·»© ±º Ó»¼·½¿´ и§-·±´±¹§, 22nd
edilion (New Yoik: McGiaw-Hill, 2OO5).
ÛÓÐØßÍ×Í ÑÒ ÜÛÍ×ÙÒ
Thioughoul lhe book, we emphasize design. A scienlisl oi engineei who has
some backgiound in eleclionics and insliumenlalion will glean enough infoi-
malion, in many of lhe aieas we addiess, lo be able lo design medical
insliumenls. This abilily should be especially valuable in lhose silualions‰
so fiequenlly encounleied‰wheie special insliumenls lhal aie nol commei-
cially available aie iequiied.
ÐÛÜßÙÑÙÇ
The book piovides 3OO homewoik pioblems, localed al lhe end of each
chaplei, plus 64 in-lexl woiked examples. Pioblems aie designed lo covei a
ª
wide vaiiely of applicalions ianging fiom analysis of lhe waves of lhe eleclio-
caidiogiam lo ciicuil design of biopolenlial amplineis and idenlincalion of
elecliic safely hazaids.
ÎÛÚÛÎÛÒÝÛÍ
Ralhei lhan giving an exhauslive lisl of iefeiences, we have piovided a lisl of
ieview ailicles and books lhal can seive as a poinl of depailuie foi fuilhei
sludy on any given lopic.
ÑÎÙßÒ×ÆßÌ×ÑÒ
!ach chaplei has been caiefully ieviewed and updaled foi lhe fouilh edilion,
and many new examples and iefeiences aie included.
Chaplei 1 coveis geneial concepls lhal aie applicable lo all insliumen-
lalion syslems, including on lhe commeicial developmenl of medical insliu-
menls, on bioslalislics, and on lhe iegulalion of medical devices. Chaplei 2
desciibes basic sensois, and Chaplei 3 piesenls lhe design of amplineis foi
lhem. Chapleis 4 lhiough 6 deal wilh biopolenlials, liacing lhe lopic fiom
lhe oiigin of biopolenlials, lhiough elecliodes, lo lhe special amplinei
design iequiied.
Chapleis 7 and 8 covei lhe measuiemenl of caidiovasculai dynamics‰
piessuie, sound, ûow, and volume of blood. Chaplei 9 piesenls lhe measuie-
menl of iespiialoiy dynamics‰piessuie, ûow, and concenlialion of gases.
Chaplei 1O desciibes lhe developing neld of biosensois: sensois lhal
measuie chemical concenlialions wilhin lhe body via calheleis oi implanls.
Chaplei 11 desciibes lhal aiea in lhe hospilal wheie lhe giealesl numbei of
measuiemenls is made, lhe clinical laboialoiy. Chaplei 12 slails wilh geneial
concepls of medical imaging and shows lheii applicalions lo x-iay lechniques,
magnelic iesonance imaging, posilion emission lomogiaphy, and Dopplei
ulliasonic images.
Chaplei 13 deals wilh devices used in lheiapy, such as lhe pacemakei,
denbiillaloi, cochleai pioslhesis, liansculaneous elecliical neive slimulalion,
implanlable aulomalic denbiillalois, lhe lolal ailincial heail, lilholiipsy, infanl
iadianl waimeis, diug infusion pumps, and aneslhesia machines. Chaplei 14
piesenls a guide bolh lo elecliic safely in lhe hospilal and lo minimizalion of
hazaids.
We have used lhe iecommended ¡nleinalional Syslem of \nils (S¡)
lhioughoul lhis book. ¡n lhe case of unils of piessuie, we have piesenled
bolh lhe commonly used millimeleis of meicuiy and ils S¡ unil, lhe pascal. To
help lhe ieadei follow lhe liend lowaid employing S¡ unils, lhe Appendix
piovides lhe mosl common conveision faclois. The Appendix also piovides a
numbei of physical conslanls used in lhe book and a lisl of abbievialions.
A Solulions Manual conlaining complele solulions lo all pioblems is
available fiee lo adopleis of lhis lexl.
ª· Ð Î Û Ú ß Ý Û
ßÝÕÒÑÉÔÛÜÙÓÛÒÌÍ
We would like lo lhank lhe ievieweis of pievious edilions.
Ú·®-¬ Û¼·¬·±² λª·»©»®-
David Ainell, л²²-§´ª¿²·¿ ͬ¿¬» ˲·ª»®-·¬§
Robeil B. Noilhiup, ˲·ª»®-·¬§ ±º ݱ²²»½¬·½«¬ (ͬ¿®®-)
Kennelh C. Myliea, ˲·ª»®-·¬§ ±º ß®·¦±²¿
Cuiian S. Swifl, ×±©¿ ͬ¿¬» ˲·ª»®-·¬§
Í»½±²¼ Û¼·¬·±² λª·»©»®-
1onalhan Newell, λ²--»´¿»® б´§¬»½¸²·½ ײ-¬·¬«¬»
Robeil B. Noilhiup, ˲·ª»®-·¬§ ±º ݱ²²»½¬·½«¬ (ͬ±®®-)
̸·®¼ Û¼·¬·±² λª·»©»®-
Noel Thompson, ͬ¿²º±®¼ ˲·ª»®-·¬§
W. !d Hammond, Ü«µ» ˲·ª»®-·¬§
Robeil B. Noilhiup, ˲·ª»®-·¬§ ±º ݱ²²»½¬·½«¬
Richaid 1endiucko, ˲·ª»®-·¬§ ±º Ì»²²»--»»ô Õ²±¨ª·´´»
Ú±«®¬¸ Û¼·¬·±² λª·»©»®-
Paul 1. Benkesei, Ù»±®¹·¿ ײ-¬·¬«¬» ±º Ì»½¸²±´±¹§
Lawience \. Hmuicik, ˲·ª»®-·¬§ ±º Þ®·¼¹»°±®¬
Ail Koblasz, Ù»±®¹·¿ ײ-¬·¬«¬» ±º Ì»½¸²±´±¹§
Ananl Madabhushi, Ϋ¬¹»®- ˲·ª»®-·¬§
Andiew Mason, Michigan Slale \niveisily
Ken Meissnei, Ì»¨¿- ßúÓ Ë²·ª»®-·¬§
Pelei Molnai, Ý´»³-±² ˲·ª»®-·¬§
Homei Nazeian, ̸» ˲·ª»®-·¬§ ±º Ì»¨¿- ¿¬ Û´ п-±
1ohn A. Peaice, ̸» ˲·ª»®-·¬§ ±º Ì»¨¿- ¿¬ ß«-¬·²
Nadine Baiiie Smilh, ̸» л²²-§´ª¿²·¿ ͬ¿¬» ˲·ª»®-·¬§
The aulhois welcome youi suggeslions foi impiovemenl of subsequenl piinl-
ings and edilions.
Ö±¸² Ùò É»¾-¬»®
Ð Î Û Ú ß Ý Û ª··
Ô×ÍÌ ÑÚ ÍÇÓÞÑÔÍ
This lisl gives single-lellei symbols foi quanlilies, wilhoul subsciipls oi
modineis. Symbols foi physical conslanls aie given in Appendix A.1, mulli-
lellei symbols in Appendix A.4, and chemical symbols in Appendix A.5.
ͧ³¾±´ Ï«¿²¬·¬§ ײ¬®±¼«½»¼ ·² Í»½¬·±²
¿ Absoiplivily 1O.3
¿ Aclivily 5.2
¿ Coefncienl 1.1O
¿ Lead vecloi 6.2
ß Absoibance 1O.3
ß Aiea 2.2
ß Coefncienl 1.9
ß Gain 3.1
ß Peicenl 1.7
¾ Coefncienl 1.9
¾ ¡nleicepl 1.9
Þ Coefncienl 1.1O
Þ Peicenl 1.9
Þ \iscous fiiclion 1.1O
Þ Magnelic ûux densily 8.3
½ Coefncienl 7.13
½ Specinc heal 8.1
½ \elocily of sound 8.4
Ý Capacilance 1.1O
Ý Compliance 7.3
Ý Concenlialion 1O.3
Ý Conliasl 12.1
¼ Deiivalive 1.1O
¼ Diamelei 1.1O
¼ Dislance 4.1
Ü Densily 12.4
Ü Delecloi iesponsivily 2.17
øݱ²¬·²«»¼ ÷
·¨
ͧ³¾±´ Ï«¿²¬·¬§ ײ¬®±¼«½»¼ ·² Í»½¬·±²
Ü ¼/¼¬ 1.1O
Ü Diamelei 5.8
Ü Diffusing capacily 9.8
Ü Dislance 4.4
Û emf 2.7
Û !neigy 2.13
Û !xposuie 12.4
Û ¡iiadiance 2.17
Û Modulus of elaslicily 7.3
º Ioice 2.6
º Iiequency 1.1O
º Iunclion 4.2
Ú Iillei liansmission 2.17
Ú Ilow 7.3
Ú Ioice 2.2
Ú Iiaclion 12.1
Ú Molai fiaclion 9.3
¹ Conduclance/aiea 4.1
Ù Conduclance 2.9
Ù Ioim facloi 2.4
Ù Gage facloi 2.2
Ù Gain 1.7
¸ Heighl 7.13
Ø Ieedback gain 1.7
· Cuiienl 2.6
× Cuiienl 3.7
× ¡nlensily 1O.3
¶ +(1)
1/2
1.1O
Ö Numbei of slandaid devialions 12.1
µ Conslanl 6.7
µ Piezoelecliic conslanl 2.6
Õ Conslanl 1.1O
Õ Numbei 12.1
Õ Sensilivily 1.1O
Õ Solubilily pioducl 5.3
Õ Spiing conslanl 1.1O
Ô ¡nduclance 2.4
Ô ¡neilance 7.3
Ô Lenglh 2.2
Ô Line-souice iesponse 12.1O
³ Aveiage numbei 12.1
³ Mass 7.3
³ Slope 1.9
Ó Mass 1.1O
Ó Measuied values 12.2
Ó Modulalion 12.1
Ó Caidiac vecloi 6.2
² Numbei 1.8
¨ Ô × Í Ì Ñ Ú Í Ç Ó Þ Ñ Ô Í
ͧ³¾±´ Ï«¿²¬·¬§ ײ¬®±¼«½»¼ ·² Í»½¬·±²
² Refiaclive index 2.14
Ò Noise equivalenl bandwidlh 12.3
Ò Numbei 5.3
Ò Tuins ialio 3.13
° Change in piessuie 9.1
° Piobabilily 12.1
Ð Powei 1.9
Ð Piessuie 7.3
Ð Pio|eclion 12.8
¯ Chaige 2.6
¯ Rale of heal 8.1
¯ Change in volume ûow 9.1
Ï Heal conlenl 8.2
Ï \olume ûow 9.1
® Coiielalion coefncienl 1.8
® Radius 7.3
® Resislance/lenglh 4.2
Î Range 8.4
Î Ralio 1O.3
Î Resislance 1.1O
Í Slandaid devialion 1.8
Í Modulalion liansfei funclion 12.2
Í Saluialion 1O.1
Í Slew iale 3.11
Í Souice oulpul 2.17
¬ Thickness 5.8
¬ Time 1.1O
Ì ¡nleival 1.1O
Ì Tempeialuie 2.8
Ì Tiansmillance 11.1
« \elocily 4.2
« Woik funclion 12.6
Ë Molai uplake 9.1
ª \ollage 1.1O
ª Change in volume 9.1
Ê \ollage 1.1O
Ê \olume 2.2
É Powei 2.1O
É Weighl 1O.3
É Weighling facloi 12.8
¨ Conslanl 1O.3
¨ Dislance 2.4
¨ ¡npul 1.7
È Chemical species 9.1
È !ffoil vaiiable 1.9
È \alue 1.8
§ Conslanl 1O.3
øݱ²¬·²«»¼ ÷
Ô × Í Ì Ñ Ú Í Ç Ó Þ Ñ Ô Í ¨·
ͧ³¾±´ Ï«¿²¬·¬§ ײ¬®±¼«½»¼ ·² Í»½¬·±²
§ Oulpul 1.7
Ç Admillance 1.9
Ç Ilow vaiiable 1.9
Ç \alue 1.8
¦ Dislance 4.1
Æ Alomic numbei 12.6
Æ ¡mpedance 1.9
Ù®»»µ Ô»¬¬»®-
ͧ³¾±´ Ï«¿²¬·¬§ ײ¬®±¼«½»¼ ·² Í»½¬·±²
¿ Polyliopic conslanl 9.5
¿ Theimisloi coefncienl 2.9
¿ Theimoelecliic sensilivily 2.8
¾ Theimisloi conslanl 2.9
Ü Devialion 1O.3
» !missivily 2.1O
» Dielecliic conslanl 2.5
¦ Damping ialio 1.1O
¸ \iscosily 7.3
« Angle 2.14
Ô Logaiilhmic deciemenl 1.1O
´ Wavelenglh 2.1O
³ Allenualion coefncienl 12.8
³ Mobilily 5.2
³ Peimeabilily 2.4
³ Poisson`s ialio 2.2
® Densily 7.3
® Mole densily 9.1
® Resislivily 2.2
- Conduclance 13.4
- Conduclivily/dislance 4.7
-
2
\aiiance 12.1
¬ Time conslanl 1.1O
º Numbei of pholons 12.6
º Phase shifl 1.1O
º Diveigence 8.4
Ú Polenlial 4.6
ª Iiequency 1.1O
¨·· Ô × Í Ì Ñ Ú Í Ç Ó Þ Ñ Ô Í
ÝÑÒÌÛÒÌÍ
Pieface v
Lisl of Symbols ix
ï ÞßÍ×Ý ÝÑÒÝÛÐÌÍ ÑÚ
ÓÛÜ×ÝßÔ ×ÒÍÌÎËÓÛÒÌßÌ×ÑÒ 1
É¿´¬»® Øò Ñ´-±²
ïòï Teiminology of Medicine and Medical Devices 4
ïòî Geneialized Medical ¡nsliumenlalion Syslem 5
ïòí Alleinalive Opeialional Modes 7
ïòì Medical Measuiemenl Consliainls 9
ïòë Classincalions of Biomedical ¡nsliumenls 12
ïòê ¡nleifeiing and Modifying ¡npuls 12
ïòé Compensalion Techniques 13
ïòè Bioslalislics 16
ïòç Geneialized Slalic Chaiacleiislics 19
ïòïð Geneialized Dynamic Chaiacleiislics 25
ïòïï Design Ciileiia 35
ïòïî Commeicial Medical ¡nsliumenlalion Developmenl Piocess 37
ïòïí Regulalion of Medical Devices 39
Pioblems 42
Refeiences 43
î ÞßÍ×Ý ÍÛÒÍÑÎÍ ßÒÜ ÐÎ×ÒÝ×ÐÔÛÍ 45
α¾»®¬ ßò л«®¿ ¿²¼ Ö±¸² Ùò É»¾-¬»®
îòï Displacemenl Measuiemenls 45
îòî Resislive Sensois 46
îòí Biidge Ciicuils 53
îòì ¡nduclive Sensois 53
îòë Capacilive Sensois 56
îòê Piezoelecliic Sensois 58
îòé Tempeialuie Measuiemenls 62
îòè Theimocouples 63
¨···
îòç Theimislois 66
îòïð Radialion Theimomeliy 69
îòïï Iibei-Oplic Tempeialuie Sensois 74
îòïî Oplical Measuiemenls 74
îòïí Radialion Souices 75
îòïì Geomeliical and Iibei Oplics 79
îòïë Oplical Iilleis 82
îòïê Radialion Sensois 83
îòïé Oplical Combinalions 86
Pioblems 87
Refeiences 88
í ßÓÐÔ×Ú×ÛÎÍ ßÒÜ Í×ÙÒßÔ ÐÎÑÝÛÍÍ×ÒÙ 91
Ö±¸² Ùò É»¾-¬»®
íòï ¡deal Op Amps 91
íòî ¡nveiling Amplineis 93
íòí Noninveiling Amplineis 96
íòì Diffeienlial Amplineis 97
íòë Compaialois 1OO
íòê Reclineis 1O2
íòé Logaiilhmic Amplineis 1O3
íòè ¡nlegialois 1O4
íòç Diffeienlialois 1O7
íòïð Aclive Iilleis 1O8
íòïï Iiequency Response 11O
íòïî Offsel \ollage 112
íòïí Bias Cuiienl 114
íòïì ¡npul and Oulpul Resislance 115
íòïë Phase-Sensilive Demodulalois 117
íòïê Timeis 12O
íòïé Miciocompuleis in Medical ¡nsliumenlalion 122
Pioblems 123
Refeiences 125
ì ÌØÛ ÑÎ×Ù×Ò ÑÚ Þ×ÑÐÑÌÛÒÌ×ßÔÍ 126
Ö±¸² Éò Ý´¿®µô Ö®ò
ìòï !lecliical Aclivily of !xcilable Cells 126
ìòî \olume-Conducloi Iields 135
ìòí Iunclional Oiganizalion of lhe Peiipheial
Neivous Syslem 138
ìòì The !leclioneuiogiam 14O
¨·ª Ý Ñ Ò Ì Û Ò Ì Í
ìòë The !lecliomyogiam 144
ìòê The !lecliocaidiogiam 147
ìòé The !leclioielinogiam 158
ìòè The !leclioencephalogiam 163
ìòç The Magneloencephalogiam 181
Pioblems 182
Refeiences 186
ë Þ×ÑÐÑÌÛÒÌ×ßÔ ÛÔÛÝÌÎÑÜÛÍ 189
Ó·½¸¿»´ Îò Ò»«³¿²
ëòï The !lecliode!lecliolyle ¡nleiface 189
ëòî Polaiizalion 192
ëòí Polaiizable and Nonpolaiizable !lecliodes 196
ëòì !lecliode Behavioi and Ciicuil Models 2O2
ëòë The !lecliodeSkin ¡nleiface and Molion Ailifacl 2O5
ëòê Body-Suiface Recoiding !lecliodes 2O9
ëòé ¡nleinal !lecliodes 215
ëòè !lecliode Aiiays 22O
ëòç Micioelecliodes 222
ëòïð !lecliodes foi !lecliic Slimulalion of Tissue 231
ëòïï Piaclical Hinls in \sing !lecliodes 233
Pioblems 235
Refeiences 239
ê Þ×ÑÐÑÌÛÒÌ×ßÔ ßÓÐÔ×Ú×ÛÎÍ 241
Ó·½¸¿»´ Îò Ò»«³¿²
êòï Basic Requiiemenls 241
êòî The !lecliocaidiogiaph 243
êòí Pioblems Iiequenlly !ncounleied 254
êòì Tiansienl Pioleclion 264
êòë Common-Mode and Olhei ¡nleifeience-Reduclion
Ciicuils 266
êòê Amplineis foi Olhei Biopolenlial Signals 269
êòé !xample of a Biopolenlial Pieamplinei 274
êòè Olhei Biopolenlial Signal Piocessois 275
êòç Caidiac Monilois 282
êòïð Biolelemeliy 287
Pioblems 288
Refeiences 291
Ý Ñ Ò Ì Û Ò Ì Í ¨ª
é ÞÔÑÑÜ ÐÎÛÍÍËÎÛ ßÒÜ ÍÑËÒÜ 293
α¾»®¬ ßò л«®¿
éòï Diiecl Measuiemenls 295
éòî Haimonic Analysis of Blood-Piessuie
Wavefoims 3OO
éòí Dynamic Piopeilies of Piessuie-Measuiemenl
Syslems 3O1
éòì Measuiemenl of Syslem Response 3O8
éòë !ffecls of Syslem Paiameleis on Response 31O
éòê Bandwidlh Requiiemenls foi Measuiing
Blood Piessuie 311
éòé Typical Piessuie-Wavefoim Disloilion 311
éòè Syslems foi Measuiing \enous Piessuie 313
éòç Heail Sounds 314
éòïð Phonocaidiogiaphy 318
éòïï Caidiac Calheleiizalion 318
éòïî !ffecls of Polenlial and Kinelic !neigy on
Piessuie Measuiemenls 323
éòïí ¡ndiiecl Measuiemenls of Blood Piessuie 325
éòïì Tonomeliy 33O
Pioblems 335
Refeiences 336
è ÓÛßÍËÎÛÓÛÒÌ ÑÚ ÚÔÑÉ ßÒÜ ÊÑÔËÓÛ
ÑÚ ÞÔÑÑÜ 338
Ö±¸² Ùò É»¾-¬»®
èòï ¡ndicaloi-Dilulion Melhod Thal \ses
Conlinuous ¡nfusion 338
èòî ¡ndicaloi-Dilulion Melhod Thal \ses
Rapid ¡n|eclion 341
èòí !lecliomagnelic Ilowmeleis 344
èòì \lliasonic Ilowmeleis 35O
èòë Theimal-Conveclion \elocily Sensois 361
èòê Chambei Plelhysmogiaphy 364
èòé !lecliical-¡mpedance Plelhysmogiaphy 366
èòè Pholoplelhysmogiaphy 372
Pioblems 374
Refeiences 375
¨ª· Ý Ñ Ò Ì Û Ò Ì Í
ç ÓÛßÍËÎÛÓÛÒÌÍ ÑÚ ÌØÛ
ÎÛÍÐ×ÎßÌÑÎÇ ÍÇÍÌÛÓ 377
Ú®¿²µ Ðò Ю·³·¿²±ô Ö®ò
çòï Modeling lhe Respiialoiy Syslem 378
çòî Measuiemenl of Piessuie 385
çòí Measuiemenl of Gas-Ilow 388
çòì Lung \olume 396
çòë Respiialoiy Plelhysmogiaphy 4O4
çòê Some Tesls of Respiialoiy Mechanics 411
çòé Measuiemenl of Gas Concenlialion 425
çòè Some Tesls of Gas Tianspoil 436
Pioblems 443
Refeiences 446
ïðÝØÛÓ×ÝßÔ Þ×ÑÍÛÒÍÑÎÍ 449
α¾»®¬ ßò л«®¿
ïðòï Blood-Gas and Acid-Base Physiology 451
ïðòî !lecliochemical Sensois 453
ïðòí Chemical Iibiosensois 461
ïðòì ¡on-Seleclive Iield-!ffecl Tiansisloi 475
ïðòë ¡mmunologically Sensilive Iield-!ffecl
Tiansisloi 478
ïðòê Noninvasive Blood-Gas Moniloiing 479
ïðòé Blood-Glucose Sensois 486
ïðòè !leclionic Noses 492
ïðòç Lab-on-a-Chip 493
ïðòïð Summaiy 494
Pioblems 495
Refeiences 495
ïïÝÔ×Ò×ÝßÔ ÔßÞÑÎßÌÑÎÇ
×ÒÍÌÎËÓÛÒÌßÌ×ÑÒ 498
Ô¿©®»²½» ßò ɸ»»´»®
ïïòï Specliopholomeliy 499
ïïòî Aulomaled Chemical Analyzeis 5O8
ïïòí Chiomalology 512
ïïòì !lecliophoiesis 515
Ý Ñ Ò Ì Û Ò Ì Í ¨ª··
ïïòë Hemalology 517
Pioblems 526
Refeiences 527
ïîÓÛÜ×ÝßÔ ×ÓßÙ×ÒÙ ÍÇÍÌÛÓÍ 528
Ó»´ª·² Ðò Í·»¼¾¿²¼
ïîòï ¡nfoimalion Conlenl of an ¡mage 528
ïîòî Modulalion Tiansfei Iunclion 535
ïîòí Noise-!quivalenl Bandwidlh 536
ïîòì Television Syslems 537
ïîòë Radiogiaphy 54O
ïîòê Compuled Radiogiaphy 549
ïîòé Compuled Tomogiaphy 553
ïîòè Magnelic Resonance ¡maging 561
ïîòç Nucleai Medicine 566
ïîòïð Single-Pholon !mission Compuled
Tomogiaphy 572
ïîòïï Posilion !mission Tomogiaphy 573
ïîòïî \lliasonogiaphy 576
ïîòïí Conliasl Agenls 585
Pioblems 587
Refeiences 589
ïíÌØÛÎßÐÛËÌ×Ý ßÒÜ ÐÎÑÍÌØÛÌ×Ý ÜÛÊ×ÝÛÍ 59O
Ó·½¸¿»´ Îò Ò»«³¿²
ïíòï Caidiac Pacemakeis and Olhei !lecliic
Slimulalois 59O
ïíòî Denbiillalois and Caidioveileis 6O6
ïíòí Mechanical Caidiovasculai Oilholic
and Pioslhelic Devices 611
ïíòì Hemodialysis 615
ïíòë Lilholiipsy 618
ïíòê \enlilalois 619
ïíòé ¡nfanl ¡ncubalois 622
ïíòè Diug Deliveiy Devices 624
ïíòç Suigical ¡nsliumenls 629
ïíòïð Theiapeulic Applicalions of lhe Lasei 632
Pioblems 633
Refeiences 635
¨ª··· Ý Ñ Ò Ì Û Ò Ì Í
ïìÛÔÛÝÌÎ×ÝßÔ ÍßÚÛÌÇ 638
É¿´¬»® Øò Ñ´-±²
ïìòï Physiological !ffecls of !lecliicily 639
ïìòî ¡mpoilanl Susceplibilily Paiameleis 641
ïìòí Disliibulion of !lecliic Powei 646
ïìòì Macioshock Hazaids 65O
ïìòë Micioshock Hazaids 653
ïìòê !lecliical-Safely Codes and Slandaids 658
ïìòé Basic Appioaches lo Pioleclion Againsl Shock 659
ïìòè Pioleclion: Powei Disliibulion 66O
ïìòç Pioleclion: !quipmenl Design 663
ïìòïð !lecliical-Safely Analyzeis 667
ïìòïï Tesling lhe !lecliic Syslem 667
ïìòïî Tesls of !lecliic Appliances 669
Conclusion 673
Pioblems 673
Refeiences 674
ßÐÐÛÒÜ×È 676
ßòï Physical Conslanls 676
ßòî ¡nleinalional Syslem of \nils (S¡) Pienxes
(Thompson and Tayloi, 2OO8) 676
ßòí ¡nleinalional Syslem of \nils
(Thompson and Tayloi, 2OO8) 677
ßòì Abbievialions 678
ßòë Chemical !lemenls 681
×ÒÜÛÈ 683
Ý Ñ Ò Ì Û Ò Ì Í ¨·¨
ï
ÞßÍ×Ý ÝÑÒÝÛÐÌÍ ÑÚ ÓÛÜ×ÝßÔ
×ÒÍÌÎËÓÛÒÌßÌ×ÑÒ
É¿´¬»® Øò Ñ´-±²
The invenlion, piololype design, pioducl developmenl, clinical lesling, iegu-
laloiy appioval, manufacluiing, maikeling, and sale of a new medical insliu-
menl add up lo a complex, expensive, and lenglhy piocess. \eiy few new ideas
suivive lhe piaclical iequiiemenls, human baiiieis, and inevilable selbacks of
lhis aiduous piocess. \sually lheie is one peison who is lhe ••championŽŽ of a
liuly new medical insliumenl oi device. This peison‰who is nol necessaiily
lhe invenloi‰
il will be used. Mosl impoilanlly, lhis peison musl have lhe commilmenl and
peisislence lo oveicome unexpecled lechnical pioblems, convince lhe
naysayeis, and cope wilh lhe buieaucialic appaialus lhal is genuinely needed
lo piolecl palienls.
Ò»© Ó»¼·½¿´ Ü»ª·½»-æ ײª»²¬·±²ô
Ü»ª»´±°³»²¬ ¿²¼ Ë-» (!ckelman, 1988) is iepiinled heie lo illusliale lhis
piocess. The aulomaled biochemical analyzei uses specliopholomeliic melh-
impoilanl subslances in blood oi uiine samples (Seclion 11.2).
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¬± ±«® ¬®¿·²·²¹ ½»²¬»®- ´±½¿¬»¼ ¿®±«²¼ ¬¸» ©±®´¼ º±® ¿ ïó©»»µ ½±«®-» ±º
·²-¬®«½¬·±²ò × »-¬·³¿¬» ¬¸¿¬ ©» ¸¿ª» ¬®¿·²»¼ ¿¾±«¬ ëðôððð °»±°´» ¬± «-» ß«¬±
ß²¿´§¦»®-ò
ײ¬®±¼«½¬·±² ±º Ì»½¸²·½±²K- ½±²¬·²«±«-óA±© ß«¬± ß²¿´§¦»® ·² ïçëé
°®±º±«²¼´§ ½¸¿²¹»¼ ¬¸» ½¸¿®¿½¬»® ±º ¬¸» ½´·²·½¿´ ´¿¾±®¿¬±®§ô ¿´´±©·²¹
¿ ¸«²¼®»¼º±´¼ ·²½®»¿-» ·² ¬¸» ²«³¾»® ±º ´¿¾±®¿¬±®§ ¬»-¬- °»®º±®³»¼ ±ª»®
¿ ïð󧻿® °»®·±¼ò ɸ»² ©» ¾»¹¿² ¬± ¼»ª»´±° ¬¸» ß«¬± ß²¿´§¦»® ·² ïçëíô ×
»-¬·³¿¬»¼ ¿ °±¬»²¬·¿´ ³¿®µ»¬ ±º îëð «²·¬-ò Ý«®®»²¬´§ô ³±®» ¬¸¿² ëðôððð ß«¬±
ß²¿´§¦»® ݸ¿²²»´- ¿®» »-¬·³¿¬»¼ ¬± ¾» ·² «-» ¿®±«²¼ ¬¸» ©±®´¼ò
ײ ®»ª·»©·²¹ ¬¸» íë󧻿® ¸·-¬±®§ ±º ¬¸» ß«¬± ß²¿´§¦»®ô × ¸¿ª» ½±³» ¬±
¬¸» ½±²½´«-·±² ¬¸¿¬ -»ª»®¿´ º¿½¬±®- -·¹²·B½¿²¬´§ ·²A«»²½»¼ ±«® -«½½»--ò Ú·®-¬ô
¬¸» ß«¬± ß²¿´§¦»® ¿´´±©»¼ ¾±¬¸ ¿² »²±®³±«- ·³°®±ª»³»²¬ ·²¬¸» ¯«¿´·¬§ ±º
´¿¾±®¿¬±®§ ¬»-¬ ®»-«´¬- ¿²¼ ¿² »²±®³±«- ®»¼«½¬·±² ·² ¬¸» ½±-¬ ±º ¼±·²¹
½¸»³·½¿´ ¿²¿´§-·-ò Í»½±²¼ô °¸§-·½·¿²- ¾»¹¿² ¬± ®»¿´·¦» ¬¸¿¬ ¿½½«®¿¬» ´¿¾±ó
®¿¬±®§ ¼¿¬¿ ¿®» «-»º«´ ·² ¼·¿¹²±-·-ò Ô¿-¬ô ®»·³¾«®-»³»²¬ °±´·½·»- ·²½®»¿-»¼
¬¸» ¿ª¿·´¿¾·´·¬§ ±º ¸»¿´¬¸ ½¿®»ò
ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò í
(Repiinled wilh peimission fiom Ò»© Ó»¼·½¿´ Ü»ª·½»-ô ײª»²¬·±²ô Ü»ª»´ó
±°³»²¬ ¿²¼ Ë-»ô (c) 1988 by lhe Nalional Academy of Sciences. Published
by Nalional Academy Piess, Washinglon, D.C.)
smoolhly lo widespiead clinical use. Theie aie piobably 1OO unlold failuie
sloiies foi each success sloiy! New invenlions usually aie made by lhe wiong
peison wilh lhe wiong conlacls and expeiience, in lhe wiong place al lhe
wiong lime. ¡l is impoilanl lo undeisland lhe diffeience belween a ciude
feasibilily piololype and a well-developed, ieliable, manufacluiable pioducl.
Palenls aie impoilanl lo piolecl ideas duiing lhe developmenl piocess and lo
have failed because lhey weie loo haid lo use, ieliabilily and iuggedness weie
inadequale, maikeling was misdiiecled, usei educalion was lacking, oi seivice
was pooi and/oi slow.
An evolulionaiy pioducl is a new model of an exisling pioducl lhal adds
new fealuies, impioves lhe lechnology, and ieduces lhe cosl of pioduclion. A
ievolulionaiy new pioducl eilhei solves a lolally new pioblem oi uses a new
piinciple oi concepl lo solve an old pioblem in a bellei way lhal displaces old
melhods. A medical insliumenl lhal impioves scieening, diagnosis, oi mon-
iloiing may nol add value by impioving palienl oulcome unless impiovemenls
in lhe applicalion of lheiapy occui as a iesull of using lhe medical insliumenl.
ïòï ÌÛÎÓ×ÒÑÔÑÙÇ ÑÚ ÓÛÜ×Ý×ÒÛ ßÒÜ ÓÛÜ×ÝßÔ ÜÛÊ×ÝÛÍ
liadilional engineeiing, physics, oi chemisliy. When lhey become inleiesled in
medicine, lhey usually lake al leasl a basic couise in physiology, which does nol
desciibe disease oi palhologic leiminology. The book Ó»¼·½¿´ Ì»®³·²±´±¹§æ
ß² ×´´«-¬®¿¬»¼ Ù«·¼» (Cohen, 2OO4) is iecommended. ¡l emphasizes lhe Lalin
and Gieek iools in a woikbook foimal (wilh answeis) lhal includes clinical
diclionaiy such as ܱ®´¿²¼K- ×´´«-¬®¿¬»¼ Ó»¼·½¿´ Ü·½¬·±²¿®§, 3Olh ed. (Doiland,
2OO3), is oflen useful. Physicians fiequenlly use abbievialions and acionyms
medical abbievialions aie given (Cohen, 2OO4; Davis, 2OO1; Iiikin and Whil-
woilh, 1996; Habei, 1988; Hamillon and Guides, 1988; Heislei, 1989). Medical
eponyms aie widely used lo desciibe diseases and syndiomes by lhe name of
Ü·½¬·±²¿®§ ±º Ó»¼·½¿´ Û°±²§³-
(Iiikin and Whilwoilh, 1996).
The name used lo desciibe a medical insliumenl oi device should be
infoimalive, consislenl, and biief. The annual Ø»¿´¬¸ Ü»ª·½»- ͱ«®½»¾±±µ
ì ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
(Anonymous, 2OO7) is a diiecloiy of \.S. and Canadian medical device pioducls,
liade names, manufacluieis, and ielaled seivices. This book uses inleinalionally
accepled nomenclaluie and a numeiical coding syslem foi ovei 5OOO pioducl
calegoiies. The Ю±¼«½¬ Ü»ª»´±°³»²¬ Ü·®»½¬±®§
pioducls by lhe IDA slandaid pioducl calegoiy name since enaclmenl of lhe
Medical Devices Amendmenls in Apiil 1976. The Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´
Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±²(Webslei, 2OO6) has many delaileddesciiplions. Bul
bewaie of boiiowing medical leiminology lodesciibe lechnical aspecls of devices
oi insliumenls. Confounding ambiguilies can iesull.
Recenl infoimalion on medical insliumenlalion can be found by seaiching
Woild Wide Web seiveis such as www.google.com oi www.usplo.gov, Libiaiy
Online Calalogs, and |ouinal eleclionic dalabases such as !ngineeiing \illage,
Science Cilalion ¡ndex, and PubMed.
ïòî ÙÛÒÛÎßÔ×ÆÛÜ ÓÛÜ×ÝßÔ ×ÒÍÌÎËÓÛÒÌßÌ×ÑÒ ÍÇÍÌÛÓ
!veiy insliumenlalion syslem has al leasl some of lhe funclional componenls
!lemenls and ielalionships depicled by dashed lines aie nol essenlial. The
ma|oi diffeience belween lhis syslem of medical insliumenlalion and
Ú·¹«®» ïòï Ù»²»®¿´·¦»¼ ·²-¬®«³»²¬¿¬·±² -§-¬»³ The sensoi conveils eneigy
oi infoimalion fiom lhe measuiand lo anolhei foim (usually elecliic). This
signal is lhen piocessed and displayed so lhal humans can peiceive lhe
infoimalion. !lemenls and conneclions shown by dashed lines aie oplional
foi some applicalions.
ï ò î Ù Û Ò Û Î ß Ô × Æ Û Ü Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò Í Ç Í Ì Û Ó ë
convenlional insliumenlalion syslems is lhal lhe souice of lhe signals is living
lissue oi eneigy applied lo living lissue.
ÓÛßÍËÎßÒÜ
The physical quanlily, piopeily, oi condilion lhal lhe syslemmeasuies is called
lhe ³»¿-«®¿²¼. The accessibilily of lhe measuiand is impoilanl because il may
be inleinal (blood piessuie), il may be on lhe body suiface (elecliocaidiogiam
polenlial), il may emanale fiom lhe body (infiaied iadialion), oi il may be
deiived fiom a lissue sample (such as blood oi a biopsy) lhal is iemoved fiom
lhe body. Mosl medically impoilanl measuiands can be giouped in lhe
placemenl (velocily, acceleialion, and foice), impedance, lempeialuie, and
oi analomical sliucluie.
ÍÛÒÍÑÎ
Geneially, lhe leim¬®¿²-¼«½»®
eneigy lo anolhei. A sensoi conveils a physical measuiand lo an elecliic
oulpul. The sensoi should iespond only lo lhe foim of eneigy piesenl in lhe
measuiand, lo lhe exclusion of all olheis. The sensoi should inleiface wilh lhe
living syslem in a way lhal minimizes lhe eneigy exliacled, while being
minimally invasive. Many sensois have a piimaiy sensing elemenl such as a
diaphiagm, which conveils piessuie lo displacemenl. A vaiiable-conveision
elemenl, such as a sliain gage, lhen conveils displacemenl lo an elecliic
vollage. Somelimes lhe sensilivily of lhe sensoi can be ad|usled ovei a
wide iange by alleiing lhe piimaiy sensing elemenl. Many vaiiable-conveision
elemenls need exleinal elecliic powei lo oblain a sensoi oulpul.
Í×ÙÒßÔ ÝÑÒÜ×Ì×ÑÒ×ÒÙ
\sually lhe sensoi oulpul cannol be diieclly coupled lo lhe display device.
malch lhe impedance of lhe sensoi lo lhe display. Oflen sensoi oulpuls aie
conveiled lo digilal foim and lhen piocessed by specialized digilal ciicuils oi a
may ieduce undesiiable sensoi signals. ¡l may also aveiage iepelilive signals lo
ieduce noise, oi il may conveil infoimalion fiom lhe lime domain lo lhe
fiequency domain.
ÑËÌÐËÌ Ü×ÍÐÔßÇ
The iesulls of lhe measuiemenl piocess musl be displayed in a foim lhal lhe
human opeialoi can peiceive. The besl foim foi lhe display may be numeiical
oi giaphical, disciele oi conlinuous, peimanenl oi lempoiaiy‰depending on
ê ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
lhe pailiculai measuiand and how lhe opeialoi will use lhe infoimalion.
Allhough mosl displays iely on oui visual sense, some infoimalion (Dopplei
ulliasonic signals, foi example) is besl peiceived by olhei senses (heie, lhe
audiloiy sense). \sei conliols and lhe oulpul display should confoim lo lhe
Ø«³¿² Ú¿½¬±®- Û²¹·²»»®·²¹ Ù«·¼»´·²»- ¿²¼ Ю»º»®®»¼ Ю¿½¬·½»- º±® ¬¸» Ü»-·¹²
±º Ó»¼·½¿´ Ü»ª·½»- (AAM¡, 1993).
ßËÈ×Ô×ßÎÇ ÛÔÛÓÛÒÌÍ
A calibialion signal wilh lhe piopeilies of lhe measuiand should be applied lo
lhe sensoi inpul oi as eaily in lhe signal-piocessing chain as possible. Many
foims of conliol and feedback may be iequiied lo elicil lhe measuiand, lo
display, sloiage, oi liansmission. Conliol and feedback may be aulomalic oi
condilioning oi lo enable lhe opeialoi lo examine dala lhal piecede alaim
condilions. Alleinalively, dala may be sloied befoie signal condilioning, so
lhal diffeienl piocessing schemes can be ulilized. Convenlional piinciples of
communicalions can oflen be used lo liansmil dala lo iemole displays al
nuisesŽ slalions, medical cenleis, oi medical dala-piocessing facililies.
ïòí ßÔÌÛÎÒßÌ×ÊÛ ÑÐÛÎßÌ×ÑÒßÔ ÓÑÜÛÍ
Ü×ÎÛÝÌó×ÒÜ×ÎÛÝÌ ÓÑÜÛÍ
Oflen lhe desiied measuiand can be inleifaced diieclly lo a sensoi because lhe
measuiand is ieadily accessible oi because acceplable invasive pioceduies aie
available. When lhe desiied measuiand is nol accessible, we can use eilhei
anolhei measuiand lhal beais a known ielalion lo lhe desiied one oi some
foim of eneigy oi maleiial lhal inleiacls wilh lhe desiied measuiand lo
geneiale a new measuiand lhal is accessible. !xamples include caidiac
oulpul (volume of blood pumped pei minule by lhe heail), deleimined
fiom measuiemenls of iespiialion and blood gas concenlialion oi fiom dye
dilulion; moiphology of inleinal oigans, deleimined fiom x-iay shadows;
and pulmonaiy volumes, deleimined fiom vaiialions in lhoiacic impedance
plelhysmogiaphy.
ÍßÓÐÔ×ÒÙ ßÒÜ ÝÑÒÌ×ÒËÑËÍ ÓÑÜÛÍ
Some measuiands‰such as body lempeialuie and ion concenlialions‰
change so slowly lhal lhey may be sampled infiequenlly. Olhei quanlilies‰
‰may iequiie
conlinuous moniloiing. The fiequency conlenl of lhe measuiand, lhe ob|eclive
of lhe measuiemenl, lhe condilion of lhe palienl, and lhe polenlial liabilily of
ï ò í ß Ô Ì Û Î Ò ß Ì × Ê Û Ñ Ð Û Î ß Ì × Ñ Ò ß Ô Ó Ñ Ü Û Í é
aie collecled may go unused.
ÙÛÒÛÎßÌ×ÒÙ ßÒÜ ÓÑÜËÔßÌ×ÒÙ ÍÛÒÍÑÎÍ
Geneialing sensois pioduce lheii signal oulpul fiom eneigy laken diieclly
fiom lhe measuiand, wheieas modulaling sensois use lhe measuiand lo allei
lhe sensoi. Ioi example, a pholovollaic cell is a geneialing sensoi because il
piovides an oulpul vollage ielaled lo ils iiiadialion, wilhoul any addilional
exleinal eneigy souice. Howevei, a pholoconduclive cell is a modulaling
sensoi; lo measuie ils change in iesislance wilh iiiadialion, we musl apply
exleinal eneigy lo lhe sensoi.
ßÒßÔÑÙ ßÒÜ Ü×Ù×ÌßÔ ÓÑÜÛÍ
Signals lhal caiiy measuiemenl infoimalion aie eilhei ¿²¿´±¹, meaning
conlinuous and able lo lake on any value wilhin lhe dynamic iange, oi
¼·¹·¬¿´
values. Mosl cuiienlly available sensois opeiale in lhe analog mode, al-
lhough some inheienlly digilal measuiing devices have been developed.
¡ncieased use of digilal signal piocessing has iequiied concuiienl use of
analog-lo-digilal and digilal-lo-analog conveileis lo inleiface compuleis
wilh analog sensois and analog display devices. Reseaicheis have developed
indiiecl digilal sensois lhal use analog piimaiy sensing elemenls and digilal
vaiiable-conveision elemenls (oplical shafl encodeis). Also quasi-digilal
sensois, such as quailz-ciyslal lheimomeleis, give oulpuls wilh vaiiable
fiequency, pulse iale, oi pulse duialion lhal aie easily conveiled lo digilal
signals.
The advanlages of lhe digilal mode of opeialion include giealei accuiacy,
iepealabilily, ieliabilily, and immunily lo noise. Iuilheimoie, peiiodic cali-
bialion is usually nol iequiied. Digilal numeiical displays aie ieplacing many
analog melei movemenls because of lheii giealei accuiacy and ieadabilily.
Many clinicians, howevei, piefei analog displays when lhey aie deleimining
whelhei a physiological vaiiable is wilhin ceilain limils and when lhey aie
looking al a paiamelei lhal can change quickly, such as beal-lo-beal heail
iale. ¡n lhe lallei case, digilal displays oflen change numbeis so quickly lhal
ÎÛßÔóÌ×ÓÛ ßÒÜ ÜÛÔßÇÛÜóÌ×ÓÛ ÓÑÜÛÍ
Of couise sensois musl acquiie signals in ieal lime as lhe signals aclually
occui. The oulpul of lhe measuiemenl syslem may nol display lhe iesull
immedialely, howevei, because some lypes of signal piocessing, such as
aveiaging and liansfoimalions, need consideiable inpul befoie any iesulls
can be pioduced. Oflen such shoil delays aie acceplable unless uigenl
è ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
feedback and conliol lasks depend on lhe oulpul. ¡n lhe case of some
measuiemenls, such as cell culluies, seveial days may be iequiied befoie
an oulpul is oblained.
ïòì ÓÛÜ×ÝßÔ ÓÛßÍËÎÛÓÛÒÌ ÝÑÒÍÌÎß×ÒÌÍ
The medical insliumenlalion desciibed lhioughoul lhis book is designed lo
measuie vaiious medical and physiological paiameleis. The piincipal mea-
suiemenl and fiequency ianges foi each paiamelei aie ma|oi faclois lhal
affecl lhe design of all lhe insliumenl componenls shown in Iiguie 1.1. To gel a
biief oveiview of lypical medical paiamelei magnilude and fiequency ianges,
iefei lo Table 1.1. Shown heie aie appioximale ianges lhal aie inlended lo
include noimal and abnoimal values. Mosl of lhe paiamelei measuiemenl
ianges aie quile low compaied wilh nonmedical paiameleis. Nole, foi exam-
ple, lhal mosl vollages aie in lhe miciovoll iange and lhal piessuies aie low
(aboul 1OO mm Hg 1.93 psi 13.3 kPa). Also nole lhal all lhe signals lisled
aie in lhe audio-fiequency iange oi belowand lhal many signals conlain diiecl
cuiienl (dc) and veiy low fiequencies. These geneial piopeilies of medical
paiameleis limil lhe piaclical choices available lo designeis foi all aspecls of
insliumenl design.
Many ciucial vaiiables in living syslems aie inaccessible because lhe
piopei measuiandŠsensoi inleiface cannol be oblained wilhoul damaging
lhe syslem. \nlike many complex physical syslems, a biological syslem is
of such a naluie lhal il is nol possible lo luin il off and iemove pails of il duiing
lhe measuiemenl pioceduie. !ven if inleifeience fiom olhei physiological
syslems can be avoided, lhe physical size of many sensois piohibils lhe
foimalion of a piopei inleiface. !ilhei such inaccessible vaiiables musl be
measuied indiieclly, oi coiieclions musl be applied lo dala lhal aie affecled by
lhe measuiemenl piocess. The caidiac oulpul is an impoilanl measuiemenl
lhal is obviously quile inaccessible.
\aiiables measuied fiom lhe human body oi fiom animals aie seldom
deleiminislic. Mosl measuied quanlilies vaiy wilh lime, even when all con-
noimal palienls, even when condilions aie similai. This inheienl ª¿®·¿¾·´·¬§ has
been documenled al lhe moleculai and oigan levels, and even foi lhe whole
body. Many inleinal analomical vaiialions accompany lhe obvious exleinal
diffeiences among palienls. Laige loleiances on physiological measuiemenls
aie pailly lhe iesull of inleiaclions among many physiological syslems. Many
feedback loops exisl among physiological syslems, and many of lhe inleiie-
lalionships aie pooily undeislood. ¡l is seldom feasible lo conliol oi neulialize
lhe effecls of lhese olhei syslems on lhe measuied vaiiable. The mosl common
melhod of coping wilh lhis vaiiabilily is lo assume empiiical slalislical and
piobabilislic disliibulion funclions. Single measuiemenls aie lhen compaied
wilh lhese ²±®³- (see Seclion 1.8).
ï ò ì Ó Û Ü × Ý ß Ô Ó Û ß Í Ë Î Û Ó Û Ò Ì Ý Ñ Ò Í Ì Î ß × Ò Ì Í ç
Ì¿¾´» ïòï Ó»¼·½¿´ ¿²¼ и§-·±´±¹·½¿´ п®¿³»¬»®-
п®¿³»¬»® ±®
Ó»¿-«®·²¹ Ì»½¸²·¯«»
Ю·²½·°¿´ Ó»¿-«®»³»²¬
ο²¹» ±º п®¿³»¬»®
Í·¹²¿´ Ú®»¯«»²½§
ο²¹»ô ئ
ͬ¿²¼¿®¼ Í»²-±®
±® Ó»¬¸±¼
Ballislocaidiogiaphy
(BCG)
OŠ7 mg dcŠ4O Acceleiomelei,
sliain gage
OŠ1OO ³m dcŠ4O Displacemenl lineai
vaiiable diffeienlial
liansfoimei (L\DT)
Bladdei piessuie 1Š1OO cm H
2
O dcŠ1O Sliain-gage manomelei
(elecliomagnelic oi
ulliasonic)
Blood piessuie, aileiial
Diiecl 1OŠ4OO mm Hg dcŠ5O Sliain-gage manomelei
¡ndiiecl 25Š4OO mm Hg dcŠ6O Cuff, auscullalion
Blood piessuie, venous OŠ5O mm Hg dcŠ5O Sliain gage
Blood gases
Ð
O
2
volumeliic oi
manomeliic
Ð
CO
2
volumeliic oi
manomeliic
Ð
N
2
volumeliic oi
manomeliic
Ð
CO
volumeliic oi
manomeliic
Caidiac oulpul 4Š25 lilei/min dcŠ2O Dye dilulion, Iick
!lecliocaidiogiaphy
(!CG)
O.5Š4 m\ O.O1Š25O Skin elecliodes
!leclioencephalogiaphy
(!!G)
5Š3OO ³\ dcŠ15O Scalp elecliodes
(!lecliocoilicogiaphy
and biain deplh)
1OŠ5OOO ³\ dcŠ15O Biain-suiface oi deplh
elecliodes
!lecliogasliogiaphy
(!GG)
1OŠ1OOO ³\ dcŠ1 Skin-suiface elecliodes
O.5Š8O m\ dcŠ1 Slomach-suiface
elecliodes
!lecliomyogiaphy
(!MG)
O.1Š5 m\ dcŠ1O,OOO Needle elecliodes
!ye polenlials
!leclio-oculogiam (!OG) 5OŠ35OO ³\ dcŠ5O Conlacl elecliodes
!leclioielinogiam (!RG) OŠ9OO ³\ dcŠ5O Conlacl elecliodes
Galvanic skin iesponse
(GSR)
1Š5OO kÊ O.O1Š1 Skin elecliodes
Gasliic pH 3Š13 pH unils dcŠ1 pH elecliode; anlimony
elecliode
ïð ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
Neaily all biomedical measuiemenls depend eilhei on some foim of
eneigy being applied lo lhe living lissue oi on some eneigy being applied
as an incidenlal consequence of sensoi opeialion. X-iay and ulliasonic imaging
depend on exleinally applied eneigy inleiacling wilh living lissue. Safe levels
mechanisms of lissue damage aie nol well undeislood. A felus is pailiculaily
vulneiable duiing lhe eaily slages of developmenl. The healing of lissue is one
effecl lhal musl be limiled, because even ieveisible physiological changes can
affecl measuiemenls. Damage lo lissue al lhe moleculai level has been
demonslialed in some inslances al suipiisingly low eneigy levels.
Opeialion of insliumenls in lhe medical enviionmenl imposes impoilanl
addilional consliainls. !quipmenl musl be ieliable, easy lo opeiale, and
capable of wilhslanding physical abuse and exposuie lo coiiosive chemicals.
!leclionic equipmenl musl be designed lo minimize elecliic-shock hazaids
(Chaplei 14). The safely of palienls and medical peisonnel musl be consideied
in all phases of lhe design and lesling of insliumenls. The Medical Device
Amendmenls of 1976 and lhe Safe Medical Devices Acl of 199O amend lhe
Ì¿¾´» ïòï øݱ²¬·²«»¼÷
п®¿³»¬»® ±®
Ó»¿-«®·²¹ Ì»½¸²·¯«»
Ю·²½·°¿´ Ó»¿-«®»³»²¬
ο²¹» ±º п®¿³»¬»®
Í·¹²¿´ Ú®»¯«»²½§
ο²¹»ô ئ
ͬ¿²¼¿®¼ Í»²-±®
±® Ó»¬¸±¼
Gaslioinleslinal piessuie OŠ1OO cm H
2
O dcŠ1O Sliain-gage manomelei
Gaslioinleslinal foices 1Š5O g dcŠ1 Displacemenl syslem,
L\DT
Neive polenlials O.O1Š3 m\ dcŠ1O,OOO Suiface oi needle
elecliodes
Phonocaidiogiaphy Dynamic iange
8O dB, lhieshold
aboul 1OO ³Pa
5Š2OOO Miciophone
Plelhysmogiaphy
(volume change)
\aiies wilh oigan
measuied
dcŠ3O Displacemenl chambei
oi impedance change
Ciiculaloiy OŠ3O ml dcŠ3O Displacemenl chambei
oi impedance change
Respiialoiy funclions
Pneumolachogiaphy
OŠ6OO lilei/min dcŠ4O Pneumolachogiaph
head and diffeienlial
piessuie
Respiialoiy iale 2Š5O biealhs/min O.1Š1O Sliain gage on chesl,
impedance, nasal
lheimisloi
Tidal volume 5OŠ1OOO ml/biealh O.1Š1O Above melhods
Tempeialuie of body 32Š4OèC
9OŠ1O4 èI
dcŠO.1 Themisloi,
lheimocouple
SO\RC!: Revised fiom Ó»¼·½¿´ Û²¹·²»»®·²¹. C. D. Ray (ed.). Copyiighl ý 1974 by Yeai Book Medical
Publisheis, ¡nc., Chicago. \sed by peimission.
ï ò ì Ó Û Ü × Ý ß Ô Ó Û ß Í Ë Î Û Ó Û Ò Ì Ý Ñ Ò Í Ì Î ß × Ò Ì Í ïï
Iedeial Iood, Diug, and Cosmelics Acl lo piovide foi lhe safely and effec-
liveness of medical devices inlended foi human use (Seclion 1.13).
ïòë ÝÔßÍÍ×Ú×ÝßÌ×ÑÒÍ ÑÚ Þ×ÑÓÛÜ×ÝßÔ ×ÒÍÌÎËÓÛÒÌÍ
The sludy of biomedical insliumenls can be appioached fiom al leasl foui
viewpoinls. Techniques of biomedical measuiemenl can be giouped accoiding
lo lhe ¯«¿²¬·¬§ ¬¸¿¬ ·- -»²-»¼
any quanlily easy lo compaie.
°®·²½·°´» ±º ¬®¿²-¼«½¬·±², such as
iesislive, induclive, capacilive, ulliasonic, oi elecliochemical. Diffeienl appli-
calions of each piinciple can be used lo slienglhen undeislanding of each
concepl; also, new applicalions may be ieadily appaienl.
Measuiemenl lechniques can be sludied sepaialely foi each ±®¹¿² -§-¬»³,
such as lhe caidiovasculai, pulmonaiy, neivous, and endociine syslems. This
appioach isolales all impoilanl measuiemenls foi specialisls whoneedlo know
sensed and piinciples of liansduclion.
½´·²·½¿´
³»¼·½·²» -°»½·¿´¬·»-, such as pedialiics, obsleliics, caidiology, oi iadiology.
This appioach is valuable foi medical peisonnel who aie inleiesled in special-
ized insliumenls. Of couise, ceilain measuiemenls‰such as blood piessuie‰
aie impoilanl lo many diffeienl medical speciallies.
ïòê ×ÒÌÛÎÚÛÎ×ÒÙ ßÒÜ ÓÑÜ×ÚÇ×ÒÙ ×ÒÐËÌÍ
Ü»-·®»¼ ·²°«¬- aie lhe measuiands lhal lhe insliumenl is designed lo isolale.
ײ¬»®º»®·²¹ ·²°«¬- aie quanlilies lhal inadveilenlly affecl lhe insliumenl as a
consequence of lhe piinciples used lo acquiie and piocess lhe desiied inpuls. ¡f
spalial oi lempoial isolalion of lhe measuiand is incomplele, lhe inleifeiing
inpul can even be lhe same quanlily as lhe desiied inpul. Ó±¼·º§·²¹ ·²°«¬-
aie undesiied quanlilies lhal indiieclly affecl lhe oulpul by alleiing lhe
peifoimance of lhe insliumenl ilself. Modifying inpuls can affecl piocessing
of eilhei desiied oi inleifeiing inpuls. Some undesiiable quanlilies can acl as
bolh a modifying inpul and an inleifeiing inpul.
A lypical elecliocaidiogiaphic iecoiding syslem, shown in Iiguie 1.2, will
seive lo illusliale lhese concepls. The desiied inpul is lhe elecliocaidiogiaphic
vollage
ecg
lhal appeais belween lhe lwo elecliodes on lhe body suiface. One
inleifeiing inpul is 6O Hz noise vollage induced in lhe shaded loop by
inleifeiing vollages aie in seiies, so bolh componenls appeai al lhe inpul lo lhe
ïî ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
causes an inleifeiing vollage lo appeai acioss Æ
body
belween lhe lwo eleclio-
des and lwo inleifeiing vollages acioss Æ
1
and Æ
2
, lhe elecliode impedances.
An example of a modifying inpul is lhe oiienlalion of lhe palienl cables. ¡f
inlioduced inleifeience is zeio. ¡f lhe plane of lhe cables is peipendiculai
ïòé ÝÑÓÐÛÒÍßÌ×ÑÒ ÌÛÝØÒ×ÏËÛÍ
The effecls of mosl inleifeiing and modifying inpuls can be ieduced oi
eliminaled eilhei by alleiing lhe design of essenlial insliumenl componenls
oi by adding new componenls designed lo offsel lhe undesiied inpuls. The
foimei alleinalive is piefeiied when il is feasible, because lhe iesull is usually
Ú·¹«®» ïòî Í·³°´·B»¼ »´»½¬®±½¿®¼·±¹®¿°¸·½ ®»½±®¼·²¹ -§-¬»³ Two possible
Oiienlalion of palienl cables and changes in elecliodeŠskin impedance aie lwo
possible modifying inpuls. Æ
1
and Æ
2
iepiesenl lhe elecliodeŠskin inleiface
impedances.
ï ò é Ý Ñ Ó Ð Û Ò Í ß Ì × Ñ Ò Ì Û Ý Ø Ò × Ï Ë Û Í ïí
simplei. \nfoilunalely, designeis of insliumenls can only iaiely eliminale lhe
aclual souice of lhe undesiied inpuls. We shall discuss seveial compensalion
melhods foi eliminaling lhe effecls of inleifeiing and modifying inpuls.
×ÒØÛÎÛÒÌ ×ÒÍÛÒÍ×Ì×Ê×ÌÇ
¡f all insliumenl componenls aie inheienlly sensilive only lo desiied inpuls,
lhen inleifeiing and modifying inpuls obviously have no effecl. Ioi lhe
elecliocaidiogiaph an example is lhe lwisling of lhe elecliode wiies lo ieduce
The vollage of lhe induced noise is piopoilional lo lhe aiea of lhal loop. The
effecls of elecliode molion can be ieduced by lechniques desciibed in
Seclion 5.5.
ÒÛÙßÌ×ÊÛ ÚÛÛÜÞßÝÕ
When a modifying inpul cannol be avoided, lhen impioved insliumenl
peifoimance iequiies a slialegy lhal makes lhe oulpul less dependenl on
lhe liansfei funclion Ù
d
. The negalive feedback melhod lakes a poilion of lhe
oulpul, Ø
f
, al any inslanl of lime and feeds il back lo lhe inpul of lhe
insliumenl. This oulpul-dependenl signal is subliacled fiom lhe inpul, and
lhe diffeience becomes lhe effeclive syslem inpul. Ioi inpul ¨
d
and oulpul §,
we can wiile
¨
d
Ø
f
§ Ù
d
§ (1.1)
¨
d
Ù
d
§ 1 Ø
f
Ù
d
(1.2)
§
Ù
d
1 Ø
f
Ù
d
¨
d
(1.3)
Ù
d
Ø
f
Ù
d
1 and § 1 Ø
f
¨
d
. This well-
known ielalionship shows lhal only lhe feedback elemenl, Ø
f
, deleimines lhe
oulpul foi a given inpul. Of couise, lhis slialegy fails if Ø
f
is also affecled by
modifying inpuls. \sually lhe feedback device caiiies less powei, so il is
moie accuiale and lineai. Less inpul-signal powei is also needed foi lhis
feedback scheme, so less loading occuis. The ma|oi disadvanlage of using lhis
feedback piinciple is lhal dynamic inslabilily leading lo oscillalions can occui,
pailiculaily if Ù
d
conlains lime delays. The sludy of feedback syslems is a
well-developed discipline lhal cannol be puisued fuilhei heie (Kuo and
Golnaiaghi, 2OO3).
Í×ÙÒßÔ Ú×ÔÌÛÎ×ÒÙ
plish lhis by allenualing lhe pail of lhe signal lhal is in one oi moie fiequency
B´¬»® is ••a device oi piogiam lhal
ïì ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
sepaiales dala, signals, oi maleiial in
(¡!!!, 1997).
Iilleis may be inseiled al lhe insliumenl inpul, al some poinl wilhin lhe
insliumenl, oi al lhe oulpul of lhe insliumenl. ¡n facl, lhe limilalions of
changing images fiom a ieal-lime ulliasonic scannei.
lhe desiied inpul. Iillei elemenls may be dislincl devices lhal block oi pass all
inpuls, oi lhey may be embodied in a single device lhal seleclively blocks only
ciicuils bul use inslead mechanical, pneumalic, lheimal, oi elecliomagnelic
piinciples lo block oul undesiied enviionmenlal inpuls. Ioi example, insliu-
insliumenl componenls. !lecliomagnelic shielding is oflen used lo block
and modulalois aie used lo shifl desiied and/oi undesiied signals lo anolhei
dependenl ciileiia foi isolaling lhe desiied signal.
desiied and undesiied oulpul signals aie supeiimposed. The seleclivily needed
may be easiei lo achieve wilh highei-level oulpul signals.
ÑÐÐÑÍ×ÒÙ ×ÒÐËÌÍ
inleifeiing inpuls can be used lo cancel undesiied oulpul componenls. These
exlia inlenlional inpuls may be lhe same as lhose lo be canceled. ¡n geneial,
lhe unavoidable and lhe added opposing inpuls can be quile diffeienl, as long
as lhe lwo oulpul componenls aie equal so lhal cancellalion iesulls. The lwo
oulpuls musl cancel despile vaiialions in all lhe unavoidable inleifeiing
inpuls and vaiialions in lhe desiied inpuls. The aclual cancellalion of
undesiied oulpul componenls can be implemenled eilhei befoie oi aflei
lhe desiied and undesiied oulpuls aie combined. ¡ndeed, eilhei lhe inlen-
lional oi lhe unavoidable inleifeiing inpul signal mighl be piocessed by Ù
d
.
The melhod of opposing inpuls can also be used lo cancel lhe effecls of
modifying inpuls.
Aulomalic ieal-lime coiieclions aie implied foi lhe melhod of opposing
inpuls |usl desciibed. Aclually, oulpul coiieclions aie oflen calculaled manu-
ally oi by compulei melhods and applied aflei dala aie collecled. This iequiies
quanlilalive knowledge of lhe inleifeiing and/oi modifying inpul al lhe lime of
lhe measuiemenl and also of howlhese inpuls affecl lhe oulpul. This melhod is
ï ò é Ý Ñ Ó Ð Û Ò Í ß Ì × Ñ Ò Ì Û Ý Ø Ò × Ï Ë Û Í ïë
usually cumbeisome, loses ieal-lime infoimalion, and is oflen used only foi
ialhei slalic inleifeiing inpuls, such as lempeialuie and almospheiic piessuie.
An example of using lhe opposing-inpul melhod is lo inlenlionally induce
lhe oulpul is achieved. An obvious disadvanlage of lhis melhod is lhal lhe
Iiguie 1.2 changes. ¡n eleclionic ciicuils lhal musl opeiale ovei a wide
lempeialuie iange, ¬¸»®³·-¬±®- (lempeialuie-dependenl iesislois) aie oflen
used lo counleiacl unavoidable lempeialuie-dependenl changes in chaiaclei-
islics of aclive ciicuil elemenls, such as liansislois and inlegialed ciicuils.
ïòè Þ×ÑÍÌßÌ×ÍÌ×ÝÍ
The applicalion of slalislics lo medical dala is used lo design expeiimenls and
clinical sludies; lo summaiize, exploie, analyze, and piesenl dala; lo diaw
infeiences fiomdala by eslimalion oi hypolhesis lesling; lo evaluale diagnoslic
pioceduies; and lo assisl clinical decision making (Dawson-Saundeis and
Tiapp, 2OO4).
Medical ieseaich sludies can be ±¾-»®ª¿¬·±²¿´ -¬«¼·»-, wheiein chaiaclei-
islics of one oi moie gioups of palienls aie obseived and iecoided, oi
»¨°»®·³»²¬¿´ ·²¬»®ª»²¬·±² -¬«¼·»-, wheiein lhe effecl of a medical pioceduie
oi liealmenl is invesligaled. The simplesl obseivalional sludies aie ½¿-»ó-»®·»-
sludies lhal desciibe some chaiacleiislics of a gioup. These sludies aie wilhoul
conliol sub|ecls, in oidei only lo idenlify queslions foi fuilhei ieseaich. Ý¿-»ó
½±²¬®±´ obseivalional sludies use individuals selecled because lhey have (oi do
causes oi iisk faclois. Ý®±--ó-»½¬·±²¿´ obseivalional sludies analyze chaiaclei-
islics of palienls al one pailiculai lime lo deleimine lhe slalus of a disease oi
condilion. ݱ¸±®¬ obseivalional sludies piospeclively ask whelhei a pailiculai
chaiacleiislic is a piecuisoi oi iisk facloi foi an oulcome oi disease. !xpei-
imenlal clinical liials aie ½±²¬®±´´»¼ if lhe oulcome foi palienls adminisleied a
diug, device, oi pioceduie is compaied lo lhe oulcome foi palienls given a
placebo oi anolhei accepled liealmenl. The liials aie «²½±²¬®±´´»¼ if lheie is
no such compaiison. ݱ²½«®®»²¬ ½±²¬®±´- aie besl, because palienls aie
selecled in lhe same way and foi lhe same lime peiiod. ܱ«¾´»ó¾´·²¼ sludy
wilh ®¿²¼±³·¦»¼ seleclion of palienls lo liealmenl oplions is piefeiied,
because lhis design minimizes invesligaloi and palienl bias. Medical oulcome
sludies show cosl-effeclive impiovemenls in palienl heallh aie incieasingly
iequiied piioi lo adoplion and ieimbuisemenl foi new medical lechnologies
(Anonymous, 2OO1).
Çuanlilalive dala aie measuied on a conlinuous oi disciele ²«³»®·½¿´
-½¿´»
measuied on ²±³·²¿´ -½¿´»- lhal show lhe names of lhe calegoiies. An ±®¼·²¿´
ïê ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
-½¿´» is used when lhe calegoiies exhibil an inheienl oidei. Desciiplive
slalislics aie useful lo summaiize dala and lheii alliibules. Ü·-¬®·¾«¬·±²- of
and lhe fiequency of occuiience of lhose values.
Measuies of lhe middle, oi cenlial lendency, include lhe well-known
³»¿², which is lhe sum of obseived values divided by lhe numbei of obseiva-
lions. The mean, found as follows,
È
È
·
²
(1.4)
woiks besl as lhe measuie of cenlial lendency foi symmeliic disliibulions. The
³»¼·¿² is lhe value foi which half lhe obseivalions aie smallei and half aie
laigei; il is used foi skewed numeiical dala oi oidinal dala. The ³±¼» is lhe
obseivalion lhal occuis mosl fiequenlly; il is used foi bimodal disliibulions.
The ¹»±³»¬®·½ ³»¿² (GM) is lhe ²lh iool of lhe pioducl of lhe obseivalions:
GM È
1
È
2
È
3
È
²
²
(1.5)
¡l is used wilh dala on a logaiilhmic scale.
Measuies of spiead oi dispeision of dala desciibe lhe vaiialion in lhe
obseivalions. The ®¿²¹», which is lhe diffeience belween lhe laigesl and
smallesl obseivalions, is used lo emphasize exlieme values. The -¬¿²¼¿®¼
¼»ª·¿¬·±² is a measuie of lhe spiead of dala aboul lhe mean. ¡l is compuled as
follows:
-
È
·
È
2
² 1
(1.6)
¡l is used wilh lhe mean foi symmeliic disliibulions of numeiical dala.
Regaidless of lhe lype of symmeliic disliibulion, al leasl 75' of lhe values
always lie belween È 2- and È 2-. The ½±»ºB½·»²¬ ±º ª¿®·¿¬·±² (C\) is
calculaled as follows:
C\
-
È
1OO (1.7)
¡l slandaidizes lhe vaiialion, making il possible lo compaie lwo numeiical
disliibulions lhal aie measuied on diffeienl scales. A °»®½»²¬·´» gives lhe
peicenlage of a disliibulion lhal is less lhan oi equal lo lhe peicenlile numbei;
il may be used wilh lhe median foi oidinal dala oi skewed numeiical dala. The
·²¬»®¯«¿®¬·´» ®¿²¹» is lhe diffeience belween lhe 25lh and 75lh peicenliles, so
il desciibes lhe cenlial 5O' of a disliibulion wilh any shape. The -¬¿²¼¿®¼
»®®±® ±º ¬¸» ³»¿² (S!M) (i.e., slandaid devialion of lhe mean), -
È
- ² 1,
expiesses lhe vaiiabilily lo be expecled among lhe ³»¿²- in fuluie samples,
ï ò è Þ × Ñ Í Ì ß Ì × Í Ì × Ý Í ïé
wheieas lhe -¬¿²¼¿®¼ ¼»ª·¿¬·±² desciibes lhe vaiiabilily lo be expecled among
·²¼·ª·¼«¿´- in fuluie samples.
ÛÈßÓÐÔÛ ïòï Youi samples fiom a populalion aie 1, 1, 3, 5, 5. !slimale
lhe mean È, lhe slandaid devialion -, and lhe slandaid devialion of lhe mean
-
È
.
ßÒÍÉÛÎ MeanÈ sumof values / numbei of values 1 1 3 5
5 /5 3 slandaid devialion - 1 3
2
1 3
2
3 3
2
5 3
2
5 3
2
5 1
1 2
16 4
1 2
2 slandaid devialion of mean -
È
- ² 1 2 5 1 1.
Oflen we need lo sludy ielalionships belween lwo numeiical chaiaclei-
islics. The ½±®®»´¿¬·±² ½±»ºB½·»²¬ ® is a measuie of lhe ielalionship belween
numeiical vaiiables È and Ç foi paiied obseivalions.
®
È
·
È Ç
·
Ç
È
·
È
2
Ç
·
Ç
2
(1.8)
1 foi a negalive lineai ielalionship lo
1 foi a posilive lineai ielalionship; O indicales lhal lheie is no lineai
ielalionship belween È and Ç
lhe unils employed lo measuie lhe vaiiables, which can be diffeienl. Like lhe
ielalionship, il may be small foi a sliong cuivilineai ielalionship. Of couise, a
high coiielalion does ²±¬ imply a cause-and-effecl ielalionship belween lhe
vaiiables.
!slimalion and hypolhesis lesling aie lwo ways lo make an infeience
aboul a value in a populalion of sub|ecls fiom a sel of obseivalions diawn
fiom a sample of such sub|ecls. ¡n eslimalion, ½±²B¼»²½» ·²¬»®ª¿´- aie
calculaled foi a slalislic such as l
cale lhal a peicenlage‰say 95'‰
ey conlain lhe liue mean. Hypolhe-
sis lesling ieveals whelhei lhe sample gives enough evidence foi us lo ie|ecl
lhe ²«´´ ¸§°±¬¸»-·-, which is usually casl as a slalemenl lhal expiesses lhe
opposile of whal we lhink is liue. AÐ󪿴«» is lhe piobabilily of oblaining, if
lhe null hypolhesis is liue, a iesull lhal is al leasl as exlieme as lhe one
obseived. The Ð-value indicales how oflen lhe obseived diffeience would
occui by chance alone if, indeed, nolhing bul chance weie affecling lhe
ialhei lhan hypolhesis lesling.
Melhods foi measuiing lhe accuiacy of a diagnoslic pioceduie use lhiee
pieces of infoimalion. The -»²-·¬·ª·¬§ |TP (TP IN)j of a lesl is lhe piobabilily
ïè ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
of ils yielding liue posilive (TP) iesulls inpalienls whoaclually have lhe disease.
A lesl wilh high sensilivily has a low º¿´-»ó²»¹¿¬·ª» (IN) iale. The -°»½·B½·¬§
|TN (TN IP)jof a lesl is lhe piobabilily of ils yielding negalive iesulls in
º¿´-»ó
°±-·¬·ª» (IP) iale; il does nol give a false posilive (IP) iesull in many palienls
who do nol have lhe disease. The lhiid piece of infoimalion is lhe °®·±®
°®±¾¿¾·´·¬§, oi pievalence |(TP IN) (TN TP IN IP)j of lhe condilion
piioi lo lhe lesl (all diseased peisons divided by all peisons). Theie aie seveial
melhods foi ievising lhe piobabilily lhal a palienl has a condiliononlhe basis of
lhe iesulls of a diagnoslic lesl. Taking inlo consideialion lhe iesulls of a
diagnoslic pioceduie is only one pail of lhe complex clinical decision-making
piocess. Decision liee analysis and olhei foims of decision analysis lhal include
economic implicalions aie also used in an effoil lo make oplimal decisions
(Webslei, 2OO4).
ïòç ÙÛÒÛÎßÔ×ÆÛÜ ÍÌßÌ×Ý ÝØßÎßÝÌÛÎ×ÍÌ×ÝÍ
To enable puichaseis lo compaie commeicially available insliumenls and
evaluale new insliumenl designs, quanlilalive ciileiia foi lhe peifoimance of
insliumenls aie needed. These ciileiia musl cleaily specify how well an
insliumenl measuies lhe desiied inpul and how much lhe oulpul depends
on inleifeiing and modifying inpuls. Chaiacleiislics of insliumenl peifoim-
ance aie usually subdivided inlo lwo classes on lhe basis of lhe fiequency of lhe
inpul signals.
ͬ¿¬·½ ½¸¿®¿½¬»®·-¬·½- desciibe lhe peifoimance of insliumenls foi dc oi
veiy low fiequency inpuls. The piopeilies of lhe oulpul foi a wide iange of
conslanl inpuls demonsliale lhe qualily of lhe measuiemenl, including non-
lineai and slalislical effecls. Some sensois and insliumenls, such as piezo-
elecliic devices, iespond only lo lime-vaiying inpuls and have no slalic
chaiacleiislics.
ܧ²¿³·½ ½¸¿®¿½¬»®·-¬·½- iequiie lhe use of diffeienlial and/oi inlegial
equalions lo desciibe lhe qualily of lhe measuiemenls. Allhough dynamic
chaiacleiislics usually depend on slalic chaiacleiislics, lhe nonlineaiilies and
slalislical vaiiabilily aie usually ignoied foi dynamic inpuls, because lhe
aie appioximaled by lhe sum of slalic and dynamic chaiacleiislics. This
ieal and ideal insliumenl peifoimance.
ßÝÝËÎßÝÇ
The ¿½½«®¿½§ of a single measuied quanlily is lhe diffeience belween lhe liue
value and lhe measuied value divided by lhe liue value. This ialio is usually
expiessed as a peicenl. Because lhe liue value is seldom available, lhe
ï ò ç Ù Û Ò Û Î ß Ô × Æ Û Ü Í Ì ß Ì × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í ïç
accepled liue value oi iefeience value should be liaceable lo lhe Nalional
¡nslilule of Slandaids and Technology.
The accuiacy usually vaiies ovei lhe noimal iange of lhe quanlily
measuied, usually decieases as lhe full-scale value of lhe quanlily decieases
on a mulliiange insliumenl, andalso oflen vaiies wilh lhe fiequency of desiied,
inleifeiing, and modifying inpuls. Accuiacy is a measuie of lhe lolal eiioi
wilhoul iegaid lo lhe lype oi souice of lhe eiioi. The possibilily lhal lhe
measuiemenl is low and lhal il is high aie assumed lo be equal. The accuiacy
can be expiessed as peicenl of ieading, peicenl of full scale, numbei of digils
foi digilal ieadouls, oi 1 2 lhe smallesl division on an analog scale. Oflen lhe
accuiacy is expiessed as a sum of lhese, foi example, on a digilal device,
O.O1' of ieading O.O15' of full-scale 1 digil. ¡f accuiacy is expiessed
simply as a peicenlage, full scale is usually assumed. Some insliumenl manu-
facluieis specify accuiacy only foi a limiled peiiod of lime.
ÐÎÛÝ×Í×ÑÒ
The °®»½·-·±² of a measuiemenl expiesses lhe numbei of dislinguishable
alleinalives fiom which a given iesull is selecled. Ioi example, a melei
lhal displays a ieading of 2.434 \ is moie piecise lhan one lhal displays a
ieading of 2.43 \. High-piecision measuiemenls do nol imply high accuiacy,
howevei, because piecision makes no compaiison lo lhe liue value.
ÎÛÍÑÔËÌ×ÑÒ
The smallesl inciemenlal quanlily lhal can be measuied wilh ceilainly is lhe
®»-±´«¬·±². ¡f lhe measuied quanlily slails fiom zeio, lhe leim ¬¸®»-¸±´¼ is
synonymous wilh ®»-±´«¬·±². Resolulion expiesses lhe degiee lo which neaily
equal values of a quanlily can be disciiminaled.
ÎÛÐÎÑÜËÝ×Þ×Ô×ÌÇ
The abilily of an insliumenl lo give lhe same oulpul foi equal inpuls applied
ovei some peiiod of lime is called ®»°®±¼«½·¾·´·¬§ oi ®»°»¿¬¿¾·´·¬§. Repioduc-
ibilily does nol imply accuiacy. Ioi example, a bioken digilal clock wilh an
AMoi PMindicaloi gives veiy iepioducible values lhal aie accuiale only once
a day.
ÍÌßÌ×ÍÌ×ÝßÔ ÝÑÒÌÎÑÔ
The accuiacy of an insliumenl is nol meaningful unless all faclois, such as lhe
enviionmenl and lhe melhod of use, aie consideied. Slalislical conliol ensuies
lhal iandom vaiialions in measuied quanlilies lhal iesull fiom all faclois lhal
can be iemoved by calibialion and coiieclion faclois, bul iandom vaiialions
îð ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
inlioduce slalislical vaiialions lhal make oulpuls uniepioducible. ¡f lhe cause
of lhis vaiiabilily cannol be eliminaled, lhen slalislical analysis musl be used lo
deleimine lhe eiioi vaiialion. Making mulliple measuiemenls and aveiaging
lhe iesulls can impiove lhe eslimale of lhe liue value.
ÍÌßÌ×Ý ÍÛÒÍ×Ì×Ê×ÌÇ
A slalic calibialion is peifoimed by holding all inpuls (desiied, inleifeiing, and
modifying) conslanl excepl one. This one inpul is vaiied inciemenlally ovei lhe
noimal opeialing iange, iesulling in a iange of inciemenlal oulpuls. The slalic
sensilivily of an insliumenl oi syslem is lhe ialio of lhe inciemenlal oulpul
quanlily lolhe inciemenlal inpul quanlily. This ialiois lhe slalic componenl of Ù
d
foi desiied inpuls wilhin lhe iange of lhe inciemenlal inpuls. The inciemenlal
slope can be oblained fiom eilhei lhe secanl belween lwo ad|acenl poinls oi lhe
langenl lo one poinl on lhe calibialion cuive. The slalic sensilivily may be
conslanl foi onlypail of lhenoimal opeialing iange of lhe insliumenl, as shownin
Iiguie 1.3(a). Ioi inpulŠoulpul dala lhal indicale a sliaighl-line calibialion cuive,
lhe slope ³ and inleicepl ¾ foi lhe line wilh lhe minimal sum of lhe squaied
diffeiences belween dala poinls and lhe line aie given by lhe following equalions:
³
² ¨
d
§ ¨
d
§
² ¨
2
d
¨
d
2
(1.9)
¾
§ ¨
2
d
¨
d
§ ¨
d
² ¨
2
d
¨
d
2
(1.1O)
§ ³¨
d
¾ (1.11)
wheie ² is lhe lolal numbei of poinls and each sumis foi all ² poinls. The slalic
sensilivily foi modulaling sensois is usually given pei voll of excilalion,
because lhe oulpul vollage is piopoilional lo lhe excilalion vollage. Ioi
example, lhe slalic sensilivily foi a blood-piessuie sensoi conlaining a
sliain-gage biidge mighl be 5O ³\ \
1
mmHg
1
.
ÆÛÎÑ ÜÎ×ÚÌ
¡nleifeiing and/oi modifying inpuls can affecl lhe slalic calibialion cuive shown
in Iiguie 1.3(a) in seveial ways. Zeio diifl has occuiied when all oulpul values
inciease oi deciease by lhe same absolule amounl. The slope of lhe sensilivily
cuive is unchanged, bul lhe oulpul-axis inleicepl incieases oi decieases as
showninIiguie 1.3(b). The following faclois cancause zeiodiifl: manufacluiing
misalignmenl, vaiialions in ambienl lempeialuie, hysleiesis, vibialion, shock,
and sensilivily lo foices fiom undesiied diieclions. A change in lhe de-offsel
vollage al lhe elecliodes in lhe elecliocaidiogiaph example in Iiguie 1.2 is an
example of zeio diifl. Slow changes in lhe de-offsel vollage do nol cause a
ï ò ç Ù Û Ò Û Î ß Ô × Æ Û Ü Í Ì ß Ì × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í îï
of lhe sub|ecl do cause low-fiequency ailifacl lo appeai al lhe oulpul.
ÍÛÒÍ×Ì×Ê×ÌÇ ÜÎ×ÚÌ
When lhe slope of lhe calibialion cuive changes as a iesull of an inleifeiing and/
oi modifying inpul, a diifl in sensilivily iesulls. Sensilivily diifl causes eiioi
lhal is piopoilional lo lhe magnilude of lhe inpul. The slope of lhe calibialion
cuive can eilhei inciease oi deciease, as indicaled in Iiguie 1.3(b). Sensilivily
diifl can iesull fiom manufacluiing loleiances, vaiialions in powei supply,
nonlineaiilies, and changes in ambienl lempeialuie and piessuie. \aiialions
Ú·¹«®» ïòí (a) Slalic-sensilivily cuive lhal ielales desiied inpul ¨
d
lo oulpul §.
Slalic sensilivily may be conslanl foi only a limiled iange of inpuls. (b) Slalic
sensilivily: zeio diifl and sensilivily diifl. Dolled lines indicale lhal zeio diifl
Ó»¿-«®»³»²¬
ͧ-¬»³-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², !. O. Doebelin. Copyiighl
ý
199O by
McGiaw-Hill, ¡nc. \sed wilh peimission of McGiaw-Hill Book Co.j
îî ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
powei-supply vollage oi change in lempeialuie aie examples of sensilivily diifl.
Ô×ÒÛßÎ×ÌÇ
Asyslemoi elemenl is lineai if il has piopeilies such lhal if §
1
is lhe iesponse lo
¨
1
and §
2
is lhe iesponse lo ¨
2
, lhen §
1
§
2
is lhe iesponse lo ¨
1
¨
2
, and Õ§
1
is
lhe iesponse lo Õ¨
1
. These lwo iequiiemenls foi syslem lineaiily aie ieslaled
in Iiguie 1.4(a).
sliaighl line.
Ú·¹«®» ïòì
lineai syslem oi elemenl is shown foui limes foi diffeienl inpuls. (b) A
giaphical illuslialion of independenl nonlineaiily equals A' of lhe ieading,
oi B'of full scale, whichevei is giealei (lhal is, whichevei peimils lhe laigei
Ó»¿-«®»³»²¬ ͧ-¬»³-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹²,
!. O. Doebelin. Copyiighl ý199O by McGiaw-Hill, ¡nc. \sed wilh peimission
of McGiaw-Hill Book Co.j
ï ò ç Ù Û Ò Û Î ß Ô × Æ Û Ü Í Ì ß Ì × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í îí
Keep in mind, howevei, lhal high accuiacy does nol necessaiily imply
lineaiily. ¡n piaclice, no insliumenl has a peifecl lineai iesponse, so a measuie
of devialion fiom lineaiily is needed. ײ¼»°»²¼»²¬ ²±²´·²»¿®·¬§ expiesses lhe
ß'of
lhe ieading oi Þ' of full scale, whichevei is giealei (lhal is, whichevei
eiiois aie piopoilional lo lhe ieading. Ioi small ieadings neai zeio, howevei,
peicenlage of full scale is moie iealislic because il is nol feasible lo lesl foi
small peicenl-of-ieading devialions neai zeio. All dala poinls musl fall inside
lhe ••funnelŽŽ shown in Iiguie 1.4(b). Ioi mosl insliumenls lhal aie essenlially
lineai, if olhei souices of eiioi aie minimal, lhe accuiacy is equal lo lhe
nonlineaiily.
×ÒÐËÌ ÎßÒÙÛÍ
Seveial maximal ianges of allowed inpul quanlilies aie applicable foi vaiious
condilions. Minimal iesolvable inpuls impose a lowei bound on lhe quanlily lo
maximal inpuls lhal give lineai oulpuls.
The slalic lineai iange and lhe dynamic lineai iange may be diffeienl.
The maximal opeialing iange is lhe laigesl inpul lhal does nol damage lhe
insliumenl. Opeialion in lhe uppei pail of lhis iange is moie likely lo be
nonlineai. Iinally, sloiage condilions specify enviionmenlal and inleifeiing
inpul limils lhal should nol be exceeded when lhe insliumenl is nol being used.
These ianges aie nol always symmeliic wilh iespecl lo zeio inpul, pailiculaily
foi sloiage condilions. Typical opeialing ianges foi blood-piessuie sensois
have a posilive bias, such as 2OO mm Hg lo 6O mm Hg 26 6 lo 8 O kPa .
×ÒÐËÌ ×ÓÐÛÜßÒÝÛ
Because biomedical sensois and insliumenls usually conveil nonelecliic
quanlilies inlo vollage oi cuiienl, we inlioduce a geneialized concepl of inpul
impedance. This is necessaiy so lhal we can piopeily evaluale lhe degiee lo
which insliumenls disluib lhe quanlily being measuied. Ioi eveiy desiied
inpul È
d1
lhal we seek lo measuie, lheie is anolhei implicil inpul quanlily È
d2
such lhal lhe pioducl È
d1
È
d2
has lhe dimensions of powei. This pioducl
iepiesenls lhe inslanlaneous iale al which eneigy is liansfeiied acioss lhe
lissueŠsensoi inleiface. The geneialized inpul impedance Æ
¨
is lhe ialio of lhe
phasoi equivalenl of a sleady-slale sinusoidal »ºº±®¬ inpul vaiiable (vollage,
foice, piessuie) lo lhe phasoi equivalenl of a sleady-slale sinusoidal A±©inpul
Æ
¨
È
d1
È
d2
effoil vaiiable
flowvaiiable
(1.12)
îì ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
The powei Ð is lhe lime iale of eneigy liansfei fiom lhe measuiemenl
medium.
Ð È
d1
È
d2
È
2
d1
Æ
¨
Æ
¨
È
2
d2
(1.13)
To minimize Ð, when measuiing effoil vaiiables È
d1
, we should make lhe
geneialized inpul impedance as laige as possible. This is usually achieved by
È
d2
, small
inpul impedance is needed lo minimize Ð. The loading caused by measuiing
devices depends on lhe magnilude of lhe inpul impedance Æ
¨
compaied
wilh lhe magnilude of lhe souice impedance Æ
-
foi lhe desiied inpul.
\nfoilunalely, biological souice impedances aie usually unknown, vaiiable,
focus on maximizing lhe inpul impedance Æ
¨
foi effoil-vaiiable measuiemenl.
convenienl lo use lhe admillance Ç
¨
1 Æ
¨
lhan lhe impedance.
ïòïð ÙÛÒÛÎßÔ×ÆÛÜ ÜÇÒßÓ×Ý ÝØßÎßÝÌÛÎ×ÍÌ×ÝÍ
Only a few medical measuiemenls, such as body lempeialuie, aie conslanl oi
slowly vaiying quanlilies. Mosl medical insliumenls musl piocess signals lhal
aie funclions of lime. ¡l is lhis lime-vaiying piopeily of medical signals lhal
iequiies us lo considei dynamic insliumenl chaiacleiislics. Diffeienlial oi
inlegial equalions aie iequiied lo ielale dynamic inpuls lo dynamic oulpuls
foi conlinuous syslems. Ioilunalely, many engineeiing insliumenls can be
The inpul ¨ ¬ is ielaled lo lhe oulpul § ¬ accoiding lo lhe following equalion:
¿
²
¼
²
§
¼¬
²
¿
1
¼§
¼¬
¿
O
§ ¬ ¾
³
¼
³
¨
¼¬
³
¾
1
¼¨
¼¬
¾
O
¨ ¬ (1.14)
wheie lhe conslanls ¿
·
· O 1 ² and ¾

¶ O 1 ³ depend on lhe
physical and elecliic paiameleis of lhe syslem. By inlioducing lhe diffeienlial
opeialoi Ü
µ
¼
µ
¼¬
µ
, we can wiile lhis equalion as
¿
²
Ü
²
¿
1
Ü ¿
O
§ ¬ ¾
³
Ü
³
¾
1
Ü ¾
O
¨ ¬ (1.15)
Readeis familiai wilh Laplace liansfoims may iecognize lhal Ü can
be ieplaced by lhe Laplace paiamelei s lo oblain lhe equalion ielaling lhe
liansfoims Ç(-) and È(-). This is a ´·²»¿® diffeienlial equalion, because
ï ò ï ð Ù Û Ò Û Î ß Ô × Æ Û Ü Ü Ç Ò ß Ó × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í îë
¿
·
and ¾

aie nol funclions of lime oi lhe inpul ¨(¬). The equalion is ±®¼·²¿®§,
because lheie is only one independenl vaiiable §. !ssenlially such piopeilies
mean lhal lhe insliumenlŽs melhods of acquiiing and analyzing lhe signals do
nol change as a funclion of lime oi lhe quanlily of inpul. Ioi example, an
auloianging insliumenl may violale lhese condilions.
Mosl piaclical insliumenls aie desciibed by diffeienlial equalions of zeio,
² O 1 2 and deiivalives of lhe inpul aie usually
absenl, so ³ O.
The inpul ¨(¬
geneial iesliiclions aie placed on ¨(¬), allhough, foi pailiculai applicalions,
bounds on amplilude and fiequency conlenl aie usually assumed. Solulions foi
is lhe mosl common liansienl inpul foi insliumenlalion. Sinusoids aie lhe mosl
common peiiodic funclion lo use because, lhiough lhe Iouiiei-seiies expan-
sion, any peiiodic funclion can be appioximaled by a sum of sinusoids. Band-
limiled while noise (unifoim-powei speclial conlenl) is a common iandom
inpul because one can lesl insliumenl peifoimance foi all fiequencies in a
pailiculai bandwidlh.
ÌÎßÒÍÚÛÎ ÚËÒÝÌ×ÑÒÍ
The liansfei funclion foi a lineai insliumenl oi syslem expiesses lhe ielalion-
ship belween lhe inpul signal and lhe oulpul signal malhemalically. ¡f lhe
liansfei funclion is known, lhe oulpul can be piedicled foi any inpul. The
±°»®¿¬·±²¿´ ¬®¿²-º»® º«²½¬·±² ·- ¬¸» ®¿¬·± § Ü ¨ Ü as a funclion of lhe
diffeienlial opeialoi Ü.
§ Ü
¨ Ü
¾
³
Ü
³
¾
1
Ü ¾
O
¿
²
Ü
²
¿
1
Ü ¿
O
(1.16)
This foimof lhe liansfei funclion is pailiculaily useful foi liansienl inpuls.
Ioi lineai syslems, lhe oulpul foi liansienl inpuls, which occui only once and
do nol iepeal, is usually expiessed diieclly as a funclion of lime, §(¬), which is
lhe solulion lo lhe diffeienlial equalion.
The º®»¯«»²½§ ¬®¿²-º»® º«²½¬·±² foi a lineai syslem is oblained by subsli-
luling ¶ª foi Ü in (1.16).
Ç ¶ª
È ¶ª
¾
³
¶ª
³
¾
1
¶ª ¾
O
¿
²
¶ª
²
¿
1
¶ª ¿
O
(1.17)
wheie ¶ 1 and ª is lhe angulai fiequency in iadians pei second. The
inpul is usually given as ¨ ¬ ß
¨
sin ª¬ , and all liansienls aie assumed lo
have died oul. The oulpul §(¬) is a sinusoid wilh lhe same fiequency, bul
lhe amplilude and phase depend on ª; lhal is, § ¬ Þ ª sin ª¬ º ª .
The fiequency liansfei funclion is a complex quanlily having a magnilude
lhal is lhe ialio of lhe magnilude of lhe oulpul lo lhe magnilude of lhe
îê ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
inpul and a phase angle º lhal is lhe phase of lhe oulpul §(¬) minus lhe phase
of lhe inpul ¨(¬). The phase angle foi mosl insliumenls is negalive. We do
nol usually expiess lhe oulpul of lhe syslem as §(¬) foi each fiequency,
because we know lhal il is |usl a sinusoid wilh a pailiculai magnilude and
phase. ¡nslead, lhe amplilude ialio and lhe phase angle aie given sepaialely
as funclions of fiequency.
The dynamic chaiacleiislics of insliumenls aie illuslialed below by
sinusoidal inpuls.
ÆÛÎÑóÑÎÜÛÎ ×ÒÍÌÎËÓÛÒÌ
The simplesl nonliivial foimof lhe diffeienlial equalion iesulls when all lhe ¿Žs
and ¾Žs aie zeio excepl ¿
O
and ¾
O
.
¿
O
§ ¬ ¾
O
¨ ¬ (1.18)
This is an algebiaic equalion, so
§ Ü
¨ Ü
Ç ¶ª
È ¶ª
¾
O
¿
O
Õ slalic sensilivily (1.19)
wheie lhe single conslanl Õ ieplaces lhe lwo conslanls ¿
O
and ¾
O
. This zeio-
oidei insliumenl has ideal dynamic peifoimance, because lhe oulpul is
piopoilional lo lhe inpul foi all fiequencies and lheie is no amplilude oi
phase disloilion.
Alineai polenliomelei is a good example of a zeio-oidei insliumenl. Iiguie
1.5 shows lhal if lhe polenliomelei has puie unifoim iesislance, lhen lhe oulpul
vollage §(¬) is diieclly piopoilional lo lhe inpul displacemenl ¨(¬), wilh no lime
delay foi any fiequency of inpul. ¡n piaclice, al high fiequencies, some paiasilic
capacilance and induclance mighl cause slighl disloilion. Also, low-iesislance
ciicuils connecled lo lhe oulpul can load lhis simple zeio-oidei insliumenl.
Ú×ÎÍÌóÑÎÜÛÎ ×ÒÍÌÎËÓÛÒÌ
deiivalive of §(¬) is iequiied in lhe diffeienlial equalion.
¿
1
¼§ ¬
¼¬
¿
O
§ ¬ ¾
O
¨ ¬ (1.2O)
This equalion can be wiillen in leims of lhe diffeienlial opeialoi Ü as
¬Ü 1 § ¬ Õ¨ ¬ (1.21)
wheie Õ ¾
O
¿
O
slalic sensilivily, and ¬ ¿
1
¿
O
lime conslanl.
ï ò ï ð Ù Û Ò Û Î ß Ô × Æ Û Ü Ü Ç Ò ß Ó × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í îé
!xponenlial funclions offei solulions lo lhis equalion when appiopiiale
conslanls aie chosen. The opeialional liansfei funclion is
§ Ü
¨ Ü
Õ
1 †
(1.22)
and lhe fiequency liansfei funclion is
Ç ¶ª
È ¶ª
Õ
1 ¶ª¬
Õ
1 ª
2
¬
2
º aiclan ª¬ 1 (1.23)
The ÎÝ
¨(¬), and lhe oulpul is lhe
vollage §(¬ ei diffeienlial equalion foi lhis
Ú·¹«®» ïòë (a) A lineai polenliomelei, an example of a zeio-oidei syslem.
(b) Lineai slalic chaiacleiislic foi lhis syslem. (c) Slep iesponse is piopoilional
lo inpul. (d) Sinusoidal fiequency iesponse is conslanl wilh zeio phase shifl.
îè ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
ciicuil is ÎÝ ¼§ ¬ ¼¬ § ¬ Õ¨ ¬ . The slalic-sensilivily cuive given in
Iiguie 1.6(b) shows lhal slalic oulpuls aie equal lo slalic inpuls. This is
on because, foi slalic condilions, ¼§ ¼¬ O.
The slep iesponse in Iiguie 1.6(c) is exponenlial wilh a lime conslanl
¬ ÎÝ.
§ ¬ Õ 1 »
¬ ¬
(1.24)
The smallei lhe lime conslanl, lhe faslei lhe oulpul appioaches lhe inpul. Ioi
sinusoids, (1.23) and Iiguie 1.6(d) show lhal lhe magnilude of lhe oulpul
decieases as fiequency incieases. Ioi laigei lime conslanls, lhis deciease
occuis al lowei fiequency.
Ú·¹«®» ïòê (a) A low-pass ÎÝ
(b) Slalic sensilivily foi conslanl inpuls. (c) Slep iesponse foi laige lime
conslanls ¬
L
and small lime conslanls ¬
S
. (d) Sinusoidal fiequency iesponse
foi laige and small lime conslanls.
ï ò ï ð Ù Û Ò Û Î ß Ô × Æ Û Ü Ü Ç Ò ß Ó × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í îç
When ª 1 ¬, lhe magnilude is 1 2 O 7O7 limes smallei, and lhe
phase angle is 45 . This pailiculai fiequency ª is known as lhe ½±®²»®ô ½«¬±ºº,
oi ¾®»¿µ
fiequency sinusoids aie nol seveiely allenualed, wheieas high-fiequency
sinusoids pioduce veiy lillle oulpul vollage. The oidinale of lhe fiequency-
iesponse magnilude in Iiguie 1.6(d) is usually plolled on a log scale and
2O
log
1O
Ç ¶ª È ¶ª . A meicuiy-in-glass lheimomelei is anolhei example
ÛÈßÓÐÔÛ ïòî
2O ms. Iind lhe maximal sinusoidal inpul fiequency lhal will keep oulpul
eiioi due lo fiequency iesponse less lhan 5'. Iind lhe phase angle al lhis
fiequency.
ßÒÍÉÛÎ
Ç ¶ª
È ¶ª
Õ
1 ¶ª¬
Õ
1 ¶ª¬
Õ
1 ª
2
¬
2
O 95Õ
ª
2
¬
2
1 O 95
2
1
ª
2
1 O 95
2
O 95
2
2O 1O
3
2
ª 16 4 iad/s
º
ª

2 62 Hz
º lan
1
ª¬
1
18 2
¡f Î and Ý in Iiguie 1.6(a) aie inleichanged, lhe ciicuil becomes anolhei
¸·¹¸ó°¿-- B´¬»®. The slalic chaiacleiislic is
zeio foi all values of inpul, andlhe slep iesponse |umps immedialely lo lhe slep
vollage bul decays exponenlially lowaid zeio as lime incieases. Thus
§ ¬ Õ»
¬ ¬
. Low-fiequency sinusoids aie seveiely allenualed, wheieas
high-fiequency sinusoids aie lillle allenualed. The sinusoidal liansfei funclion
is Ç ¶ª È ¶ª ¶ª¬ 1 ¶ª¬ .
ÛÈßÓÐÔÛ ïòí Iiom a 2 k\ souice in seiies wilh a 2O kÊ iesisloi,
calculale lhe lime iequiied lo chaige a 1OO ³
1.9 k\
íð ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
ßÒÍÉÛÎ Ciicuil is shown in Iiguie 1.6(a). \se (1.24) ª
C
Ê Ê»
¬
ÎÝ
19OO \ 2OOO \ 2OOO \ »
¬
2O OOOÊ 1OO 1O
6
I
1OO\ 2OOO \ »
¬
2O OOOÊ 1OO 1O
6
I
O O5 »
¬
2O OOOÊ 1OO 1O
6
I
lnO O5
¬
2Ê I
¬ 5 99s
ÍÛÝÑÒÜóÑÎÜÛÎ ×ÒÍÌÎËÓÛÒÌ
An insliumenl is second oidei if a second-oidei diffeienlial equalion is
iequiied lo desciibe ils dynamic iesponse.
¿
2
¼
2
§ ¬
¼¬
2
¿
1
¼§ ¬
¼¬
¿
O
§ ¬ ¾
O
¨ ¬ (1.25)
Many medical insliumenls aie second oidei oi highei, and low pass. Iuilhei-
moie, many highei-oidei insliumenls can be appioximaled by second-oidei
chaiacleiislics if some simplifying assumplions can be made. The foui con-
slanls in (1.25) can be ieduced lo lhiee new ones lhal have physical
Ü
2
ª
2
²
2¦Ü
ª
²
1 § ¬ Õ¨ ¬ (1.26)
wheie
Õ
¾
O
¿
O
slalic sensilivily, oulpul unils divided by inpul unils
ª
²
¿
O
¿
2
undamped naluial fiequency, iad/s
¦
¿
1
2 ¿
O
¿
1
damping ialio, dimensionless
Again exponenlial funclions offei solulions lo lhis equalion, allhough lhe
exacl foim of lhe solulion vaiies as lhe damping ialio becomes giealei lhan,
equal lo, oi less lhan unily. The opeialional liansfei funclion is
§ Ü
¨ Ü
Õ
Ü
2
ª
2
²
2¦Ü
ª
²
1
(1.27)
ï ò ï ð Ù Û Ò Û Î ß Ô × Æ Û Ü Ü Ç Ò ß Ó × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í íï
and lhe fiequency liansfei funclion is
Ç ¶ª
È ¶ª
Õ
¶ª ª
²
2
2¦ ¶ª ª
²
1
Õ
1 ª ª
O
2 2

2
ª
2
ª
2
²
º aiclan

ª ª
²
ª
²
ª
(1.28)
A mechanical foice-measuiing insliumenl illusliales lhe piopeilies of a
second-oidei insliumenl (Doebelin, 199O). Mass, spiing, and viscous-damping
elemenls oppose lhe applied inpul foice ¨(¬), and lhe oulpul is lhe iesulling
displacemenl §(¬) of lhe movable mass allached lo lhe spiing |Iiguie 1.7(a)j. ¡f
lhe naluial fiequency of lhe spiing is much giealei lhan lhe fiequency
componenls in lhe inpul, lhe dynamic effecl of lhe spiing can be included
by adding one-lhiid of lhe spiingŽs mass lo lhe mass of lhe moving elemenls lo
oblain lhe equivalenl lolal mass Ó.
Ú·¹«®» ïòé (a) Ioice-measuiing spiing scale, an example of a second-oidei
insliumenl. (b) Slalic sensilivily. (c) Slep iesponse foi oveidamped case ¦ 2,
ciilically damped case ¦ 1, undeidamped case ¦ O 5. (d) Sinusoidal sleady-
slale fiequency iesponse, ¦ 2 ¦ 1 ¦ O Ó»¿ó
-«®»³»²¬ ͧ-¬»³-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², !. O. Doebelin. Copyiighl
ý
199O
by McGiaw-Hill, ¡nc. \sed wilh peimission of McGiaw-Hill Book Co.j
íî ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
HookeŽs lawfoi lineai spiings is assumed, so lhe spiing conslanl is Õ
s
. Diy
fiiclion is neglecled and peifecl viscous fiiclion is assumed, wilh conslanl Þ.
To eliminale giavilalional foice fiom lhe equalion, we ad|usl lhe scale
unlil § O when ¨ O. Then lhe sum of lhe foices equals lhe pioducl of mass
and acceleialion.
¨ ¬ Þ
¼§ ¬
¼¬
Õ
s
§ ¬ Ó
¼
2
§ ¬
¼¬
2
(1.29)
This equalion has lhe same foim as (1.26) when lhe slalic sensilivily, un-
Õ
s
, Þ,
and Ó, as follows:
Õ
1
Õ
s
(1.3O)
ª
²
Õ
s
Ó (1.31)
¦
Þ
2 Õ
³
Ó
(1.32)
The slalic iesponse is § ¬ Õ¨ ¬ , as shown in Iiguie 1.7(b). The slep
iesponse can have lhiee foims, depending on lhe damping ialio. Ioi a
unil-slep inpul, lhese lhiee foims aie
Oveidamped, ¦ 1:
§ ¬
¦ ¦
2
1
2 ¦
2
1
Õ»
¦ ¦
2
1 ª²¬
¦ ¦
2
1
2 ¦
2
1
Õ»
¦ ¦
2
1 ª²¬
Õ
(1.33)
Ciilically damped, ¦ 1:
§ ¬ 1 ª
²
¬ Õ»
ª
²
¬
Õ (1.34)
\ndeidamped, ¦ 1:
§ ¬
»
¦ª²¬
1 ¦
2
Õsin 1 ¦
2
ª
²
¬ º Õ
º aicsin 1 ¦
2
1 35
!xamples of lhese lhiee slep iesponses aie iepiesenled in Iiguie 1.7(c). Only
ï ò ï ð Ù Û Ò Û Î ß Ô × Æ Û Ü Ü Ç Ò ß Ó × Ý Ý Ø ß Î ß Ý Ì Û Î × Í Ì × Ý Í íí
value. !qualion (1.35) shows lhal lhe fiequency of lhe oscillalions in lhe
undeidamped iesponse in Iiguie 1.7(c) is lhe damped naluial fiequency
ª
d
ª
n
1 ¦
2
. Apiaclical compiomise belween iapid iise lime and minimal
oveishool is a damping ialio of aboul O.7.
ÛÈßÓÐÔÛ ïòì
ing ialio ¦ fiom lhe slep iesponse.
ßÒÍÉÛÎ To oblain lhe maximums foi lhe undeidamped iesponse, we lake
lhe deiivalive of (1.35) and sel il lo zeio. Ioi ¦ O 3 we appioximale posilive
maximums when lhe sine aigumenl equals 3° 2 7° 2, and so foilh. This
occuis al
¬
²
3° 2 º
ª
²
1 ¦
2
and ¬
² 1
7° 2 º
ª
²
1 ¦
2
(1.36)
§
²
lo lhe second posilive oveishool §
² 1
|Iiguie 1.7(c)j is
§
²
§
² 1
Õ
1 ¦
2
exp ¦ª
²
3° 2 º
ª
²
1 ¦
2
Õ
1 ¦
2
exp ¦ª
²
7° 2 º
ª
²
1 ¦
2
exp
2°¦
1 ¦
2
ln
§
²
§
² 1
Ô
2°¦
1 ¦
2
(1.37)
wheie Ô ´±¹¿®·¬¸³·½ ¼»½®»³»²¬. Solving foi ¦ yields
¦
Ô

2
Ô
2
(1.38)
Ioi sinusoidal sleady-slale iesponses, lhe fiequency liansfei funclion
(1.28) and Iiguie 1.7(d) show lhal low-pass fiequency iesponses iesull. The
iale of decline in lhe amplilude fiequency iesponse is lwice lhe iale of lhal
s. Nole lhal iesonance phenomena can
occui if lhe damping ialio is loo small. Also nole lhal lhe oulpul phase
lag can be as much as 18Oè, wheieas foi single-oidei insliumenls, lhe maximal
phase lag is 9O .
íì ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
Ì×ÓÛ ÜÛÔßÇ
¡nsliumenl elemenls lhal give an oulpul lhal is exaclly lhe same as lhe inpul,
excepl lhal il is delayed in lime by ¬
d
¬·³»ó¼»´¿§ »´»³»²¬-. The
malhemalical expiession foi lhese elemenls is
§ ¬ Õ
¨
¬ ¬
d
¬ ¬
d
(1.39)
These elemenls may also be called analog delay lines, lianspoil lags, oi dead
angles lhal imply lime delays, lhe phase angle vaiies wilh fiequency, so lhe
delay is nol conslanl foi all fiequencies. Ioi lime delays, lhe slalic chaiaclei-
islic is lhe conslanl Õ
sinusoidal fiequency iesponse foi magnilude and phase is
Ç ¶ª
È ¶ª
Õ»
¶ª¬
d
(1.4O)
Time delays aie piesenl in liansmission lines (elecliic, mechanical, hydiaulic
blood vessels, and pneumalic iespiialoiy lubing), magnelic lape iecoideis, and
some digilal signal-piocessing schemes. \sually lhese lime delays aie lo be
avoided, especially in insliumenls oi syslems lhal involve feedback, because
undesiied oscillalions may iesull.
¡f lhe insliumenl is used sliiclly foi measuiemenl and is nol pail of a
feedback-conliol syslem, lhen some lime delay is usually acceplable. The
liansfei funclion foi undisloiled signal iepioduclion wilh lime delay becomes
Ç ¶ª È ¶ª Õ ª¬
d
. Oui pievious sludy of lime-delay elemenls shows
lhal lhe oulpul magnilude is Õ limes lhe inpul magnilude foi all fiequencies
and lhal lhe phase lag incieases lineaily wilh fiequency.
The liansfei-funclion iequiiemenls concein lhe ±ª»®¿´´ insliumenl lians-
fei funclion. The oveiall liansfei funclion of lineai elemenls connecled in
seiies is lhe pioducl of lhe liansfei funclions foi lhe individual elemenls. Many
combinalions of nonlineai elemenls can pioduce lhe oveiall lineai liansfei
funclion iequiied. \aiious foims of modulalion and demodulalion aie used,
and unavoidable sensoi nonlineaiilies can somelimes be compensaled foi by
olhei insliumenl elemenls.
ïòïï ÜÛÍ×ÙÒ ÝÎ×ÌÛÎ×ß
As shown, many faclois affecl lhe design of biomedical insliumenls. The
faclois lhal impose consliainls on lhe design aie of couise diffeienl foi
each lype of insliumenl. Howevei, some of lhe geneial iequiiemenls
can be calegoiized as signal, enviionmenlal, medical, and economic faclois.
ï ò ï ï Ü Û Í × Ù Ò Ý Î × Ì Û Î × ß íë
Iiguie 1.8 shows how lhese faclois aie incoipoialed inlo lhe inilial design and
developmenl of an insliumenl.
Nole lhal lhe lype of sensoi selecled usually deleimines lhe signal-
Ú·¹«®» ïòè Ü»-·¹² °®±½»-- º±® ³»¼·½¿´ ·²-¬®«³»²¬- Choice and design of
insliumenls aie affecled by signal faclois and also by enviionmenlal, medical,
and economic faclois. (Revised fiom Ì®¿²-¼«½»®- º±® Þ·±³»¼·½¿´ Ó»¿-«®»ó
³»²¬-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², R. S. C. Cobbold. Copyiighl ý 1974, 1ohn
Wiley and Sons, ¡nc. \sed by peimission of 1ohn Wiley and Sons, ¡nc.)
íê ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
peifoimance and inleiaclion of lhe elemenls in a complex insliumenl oflen
compiomises lhioughoul lhe developmenl of lhe insliumenl. ¡n Chaplei 2, we
shall examine basic melhods of sensing biomedical quanlilies lo ensuie lhal
many sensoi design alleinalives aie consideied (King and Iiies, 2OO9).
ïòïî ÝÑÓÓÛÎÝ×ßÔ ÓÛÜ×ÝßÔ ×ÒÍÌÎËÓÛÒÌßÌ×ÑÒ
ÜÛÊÛÔÑÐÓÛÒÌ ÐÎÑÝÛÍÍ
A commeicial medical insliumenl pio|ecl has many phases, and lhe size of lhe
leam needed giows as lhe pio|ecl piogiesses. ¡deas oflen come fiom people
woiking wheie heallh caie is deliveied, because clinical needs aie mosl evidenl
lheie. Physicians, nuises, clinical engineeis, and sales peisonnel aie lheiefoie
good souices of ideas. ¡ndusliy engineeis and maikeling peisonnel should
spend lime in hospilals obseiving how lheii pioducls aie aclually being used
(and misused). \nsoliciled invenlions aie oflen piesenled lo indusliy. Mosl
companies have one oi moie people who aie iesponsible foi evalualing new
ideas, so il is veiy impoilanl foi lhose who wanl lo piopose a new idea lo be in
conlacl wilh a peison who can undeisland lhe idea and who has lhe aulhoiily
lo pioceed wilh a delailed evalualion. A simple, signed nondisclosuie agiee-
menl is adequale (bul essenlial) lo piolecl palenl iighls when delailed ideas
aie discussed.
oflen nol appiecialed unlil al leasl a pieliminaiy º»¿-·¾·´·¬§ ¿²¿´§-·- is done.
The feasibilily analysis and wiillen °®±¼«½¬ ¼»-½®·°¬·±² should considei lhe
lhe companyŽs cuiienl oi planned pioducl lines and sales melhods. Deleimin-
ing medical feasibilily enlails examining lhe clinical need foi lhe pioducl,
including palienl indicalions, numbei of palienls, clinical specially, and exaclly
how, why, and by whom lhe device will be ulilized. Maikeling ieseaich and
analysis can be useful foi evolulionaiy pioducls bul aie nol ieliable foi
ievolulionaiy pioducls, especially when a change in medical piaclice is
iequiied. Technical feasibilily analysis should include a desciiplion of lhe
nenls, bieaklhioughs oi invenlions iequiied, syslems analysis, and pieliminaiy
cosl eslimales. A funclional piololype lhal includes lhe sensoi, piimaiy signal
piocessing elemenls, and olhei new oi unique componenls should be buill and
lesled on animals and humans as eaily as possible. The manufacluiing
feasibilily analysis should be done eaily, when ma|oi alleinalive lechnologies
peisonnel iequiiemenls, compelilion, palenls, slandaids, manufacluiing ie-
quiiemenls, sales and seivice iequiiemenls, and lhe lime schedule foi lhe
pio|ecl. !xpeiience has shown lhal abbievialing lhe feasibilily phase oi adding
fealuies aflei lhis phase usually causes disasleis lalei. A delailed feasibilily
ï ò ï î Ý Ñ Ó Ó Û Î Ý × ß Ô Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò íé
ieview should be iequiied al lhe end of lhis phase. ¡f lhe iesulls aie nol cleaily
favoiable, lhe pio|ecl should be abandoned oi lhe feasibilily phase should be
conlinued.
Aflei a favoiable feasibilily ieview is complele, a delailed °®±¼«½¬ -°»½·ó
B½¿¬·±² musl be wiillen lo desciibe all lhe pioducl fealuies. ¡ncluded should be
numeiical values foi peifoimance, many inleinal lesling iequiiemenls, usei
inleiface iequiiemenls, enviionmenlal lesling iequiiemenls, and even lhe size,
eveiylhing aboul ••whalŽŽ is iequiied bul nolhing aboul ••howŽŽ il is lo be
design engineeis, qualily assuiance engineeis, and manufacluiing engineeis
denlial documenl in mosl companies; only lhe main exleinal peifoimance
facluiable piololype. Ioi mosl insliumenls, funclions musl be paililioned inlo
haidwaie and soflwaie befoie delailed design can begin. Ciicuil diagiams,
delailed soflwaie iequiiemenls, and mechanical designs aie made by means of
compulei-aided-design (CAD) lools lhal allow such delailed simulalions of
funclional opeialion lhal lheie is lillle need foi ••bieadboaidŽŽ piololypes.
Design ieviews focus on syslems issues and pioblems lhal lhe company may
lesl, design assuiance, and manufacluiing engineeis. These piololypes aie also
lesled on animals oi human sub|ecls lo veiify expecled opeialion and pei-
foimance al a few clinical lesling cenleis. Dala fiom lhese ½´·²·½¿´ º»¿-·¾·´·¬§
¬®·¿´- (including iepealed obseivalions of useis) should be sludied closely,
¼»-·¹² ®»ª·»© should include lesl iesulls foi all
menl of manufacluiabilily, and moie delailed cosl eslimales.
Pioduclion engineeis musl be involved lhioughoul lhe design and devel-
opmenl piocess lo avoid a iedesign foi manufacluiabilily. Special pioduclion
be ieleased by lhe design and developmenl engineeis. Any changes made aflei
»²¹·²»»®·²¹ ½¸¿²¹» ±®¼»®
(!CO). Small pioduclion iuns aie usually needed lo discovei pioblems and
high volume, as consumei pioducls aie, so full aulomalion of pioduclion is nol
cosl-effeclive. !ven aflei full pioduclion begins, some !COs may be needed lo
be documenled, along wilh lhe coiieclive aclion laken.
Thioughoul lhe pioducl life cycle, which includes lhe peiiod aflei lhe
pioducl is no longei offeied foi sale, lechnical suppoil foi usei queslions and
íè ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
pioblems musl be piovided. Successful companies musl be commilled lo
iepaiiing oi ieplacing lheii pioducls lhioughoul lhe enliie expecled lifelime
of lhe pioducl.
ïòïí ÎÛÙËÔßÌ×ÑÒ ÑÚ ÓÛÜ×ÝßÔ ÜÛÊ×ÝÛÍ
¡n 1976 lhe \niled Slales Congiess passed whal aie known as lhe Ó»¼·½¿´
Ü»ª·½» ß³»²¼³»²¬- (Public Law 94-295) lo lhe Iedeial Iood, Diug, and
Cosmelics Acl lhal dales back lo lhe 193Os. ¡n lhe Safe Medical Devices Acl of
199O, fuilhei amendmenls weie made (Pacela, 1991). The piimaiy puipose was
³»¼·½¿´ ¼»ª·½» is ••any ilem
piomoled foi a medical puipose lhal does nol iely on chemical aclion lo
achieve ils inlended effeclŽŽ (Kesslei »¬ ¿´., 1987). Medical devices weie
¡¡¡ was based on lhe piinciple lhal devices lhal pose giealei polenlial hazaids
should be sub|ecl lo moie iegulaloiy iequiiemenls. Second, seven calegoiies
weie eslablished: pieamendmenl, poslamendmenl, subslanlially equivalenl,
implanl, cuslom, invesligalional, and liansilional (!ndeile »¬ ¿´., 2OO5).
The seven calegoiies inlo which medical devices aie divided aie desciibed
used in medical devices has become an aiea of incieasing concein; seveial
iequiiemenls foi mainlaining liaceabilily of devices lo lhe ullimale cuslomei,
poslmaikeling suiveillance foi life-suslaining and life-suppoiling implanls,
and hospilal iepoiling iequiiemenls foi adveise incidenls weie added lo lhe
law in 199O.
Ý´¿-- × ¹»²»®¿´ ½±²¬®±´-ò Manufacluieis aie iequiied lo peifoim
of adveise expeiiences, and good manufacluiing piaclices. These conliols
apply lo all lhiee classes.
Ý´¿-- ×× °»®º±®³¿²½» -¬¿²¼¿®¼-ò These slandaids weie lo be
called foi in lhe amendmenls and lhe enoimily of lhe lask have iesulled in
needed. The iesull has been oveiieliance on lhe poslamendmenl ••sub-
slanlial equivalenceŽŽ known as lhe 51O(k) piocess.
Ý´¿-- ××× °®»³¿®µ»¬·²¹ ¿°°®±ª¿´ò Such appioval is iequiied foi
devices used in suppoiling oi suslaining human life and pievenling
impaiimenl of human heallh. The IDA has exlensively iegulaled lhese
devices by iequiiing manufacluieis lo piove lheii safely and effecliveness
piioi lo maikel ielease.
ï ò ï í Î Û Ù Ë Ô ß Ì × Ñ Ò Ñ Ú Ó Û Ü × Ý ß Ô Ü Û Ê × Ý Û Í íç
Ì¿¾´» ïòî ÚÜß Ó»¼·½¿´ Ü»ª·½» Ý¿¬»¹±®·»-
Ý¿¬»¹±®§ Ü»-½®·°¬·±² Ý´¿--·B½¿¬·±² Ϋ´»- Û¨¿³°´»-
Pieamendmenl
devices (oi
old devices)
Devices on lhe
maikel befoie
May 28, 1976,
when lhe
Medical Device
Amendmenls
weie enacled.
Devices aie assigned lo 1
of 3 classes. A
piesumplion exisls lhal
pieamendmenl devices
should be placed in
Class ¡ unless lheii
safely and effecliveness
cannol be ensuied
wilhoul lhe giealei
iegulalion affoided by
Classes ¡¡ and ¡¡¡. A
manufacluiei may
pelilion lhe IDA foi
Analog elecliocaidiog-
iaphy machine; elec-
liohydiaulic
lilholiiploi;
conliaceplive
inliauleiine device
and accessoiies; infanl
iadianl waimei;
conliaceplive lubal
occlusion device;
aulomaled hepaiin
analyzei; aulomaled
diffeienlial cell
counlei; aulomaled
blood-cell sepaialoi;
liansabdominal
aminoscope.
Poslamendmenl
devices (oi
new devices)
Devices pul on lhe
maikel aflei
May 28, 1976.
\nless shown lo be
subslanlially equivalenl
lo a device lhal was on
lhe maikel befoie lhe
amendmenls look
effecl, lhese devices aie
aulomalically placed in
Class ¡¡¡. A
manufacluiei may
pelilion lhe IDA foi
Magnelic iesonance im-
agei; exliacoipoieal
shock-wave lilholiip-
loi; absoibable
sponge; YAG lasei;
A¡DS-anlibody lesl
kil; hydiophilic conlacl
lenses; peiculaneous
calhelei foi
liansluminal coionaiy
angioplasly;
implanlable
giowlh slimulaloi;
alpha-felopiolein R¡A
kil; hepalilis B-
anlibody deleclion kil.
Subslanlially
equivalenl
devices
Poslamendmenl
devices lhal aie
subslanlially
equivalenl lo
pieamendmenl
devices.
Devices aie assigned lo lhe
same class as lheii
pieamendmenl
counleipails and sub|ecl
lo lhe same
iequiiemenls. ¡f and
when lhe IDA iequiies
lesling and appioval of
pieamendmenl devices,
lheii subslanlially
equivalenl counleipails
will also be sub|ecl lo
lesling and appioval.
Digilal
elecliocaidiogiaphy
machines; YAG laseis
foi ceilain uses;
lampons; !L¡SA
diagnoslic kils; devices
used lo lesl foi diug
abuse.
ìð ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
Ì¿¾´» ïòî øݱ²¬·²«»¼÷
Ý¿¬»¹±®§ Ü»-½®·°¬·±² Ý´¿--·B½¿¬·±² Ϋ´»- Û¨¿³°´»-
¡mplanled
devices
Devices lhal aie
inseiled inlo a
suigically
foimed oi
naluial body
cavily and
inlended lo
iemain lheie foi
3O days.
Devices aie assumed lo
iequiie placemenl in
Class ¡¡¡ unless a less-
iegulaled class will
ensuie safely and
effecliveness.
Phienic-neive slimulaloi;
pacemakei pulse
geneialoi; inliacaidiac
palch; vena cava
clamp.
Cuslom devices Devices nol
geneially
available lo
olhei licensed
piaclilioneis and
nol available in
Pioducl musl be
designed foi a
pailiculai
palienl and may
nol be offeied
foi geneial
commeicial
disliibulion.
Devices aie exempl fiom
piemaikeling lesling
and peifoimance
slandaids bul aie
sub|ecl lo geneial
conliols.
Denluies; oilhopedic
shoes.
¡nvesligalional
devices
\nappioved
devices
undeigoing
clinical
invesligalion
undei lhe
aulhoiily of an
¡nvesligalional
Device
!xemplion.
Devices aie exempl if an
¡nvesligalional Device
!xemplion has been
gianled.
hypeilheimia
equipmenl; DNA
piobes; lasei
angioplasly devices;
posilion emission
lomogiaphy machines.
Tiansilional
devices
Devices lhal weie
iegulaled as
diugs befoie
enaclmenl of lhe
slalule bul aie
medical devices.
Devices aie aulomalically
assigned lo Class ¡¡¡ bul
Class ¡ oi ¡¡.
Anlibiolic susceplibilily
disks; bone
heleiogiafls;
gonoiihea diagnoslic
pioducls; in|eclable
silicone; inliaoculai
lenses; suigical
suluies; sofl conlacl
lenses.
SO\RC!: Repiinled wilh peimission fiom ̸» Ò»© Û²¹´¿²¼ Ö±«®²¿´ ±º Ó»¼·½·²» 317(6), 357Š366, 1987.
ï ò ï í Î Û Ù Ë Ô ß Ì × Ñ Ò Ñ Ú Ó Û Ü × Ý ß Ô Ü Û Ê × Ý Û Í ìï
ÐÎÑÞÔÛÓÍ
ïòï Ú·²¼ ¬¸» ·²¼»°»²¼»²¬ ²±²´·²»¿®·¬§ô ¿- ¼»•²»¼ ·² Ú·¹«®» ïòìø¾÷ô º±® ¬¸»
º±´´±©·²¹ -»¬ ±º ·²°«¬- ¿²¼ ±«¬°«¬- º®±³ ¿ ²»¿®´§ ´·²»¿® -§-¬»³ò ײ-¬®«³»²¬ ©¿-
¼»-·¹²»¼ º±® ¿² ±«¬°«¬ »¯«¿´ ¬± ¬©·½» ¬¸» ·²°«¬ò Ú«´´ -½¿´» ·- îðò
¡npuls O 5O 1 5O 2 OO 5 OO 1O OO
Oulpuls O 9O 3 O5 4 OO 9 9O 2O 5O
ïòî Ú·²¼ ¬¸» ½±®®»´¿¬·±² ½±»º•½·»²¬ ®
given in Pioblem 1.1.
ïòí Ü»®·ª» ¬¸» ±°»®¿¬·±²¿´ ¬®¿²-º»® º«²½¬·±² ¿²¼ ¬¸» -·²«-±·¼¿´ ¬®¿²-º»®
º«²½¬·±² º±® ¿² ÎÝ
fiequency iesponse (magnilude and phase).
ïòì ß •®-¬ó±®¼»® ´±©ó°¿-- ·²-¬®«³»²¬ ³«-¬ ³»¿-«®» ¸«³³·²¹¾·®¼ ©·²¹
¼·-°´¿½»³»²¬- ø¿--«³» -·²«-±·¼¿´÷ ©·¬¸ º®»¯«»²½§ ½±²¬»²¬ «° ¬± ïðð ئ
©·¬¸ ¿² ¿³°´·¬«¼» ·²¿½½«®¿½§ ±º ´»-- ¬¸¿² ëûò ɸ¿¬ ·- ¬¸» ³¿¨·³¿´ ¿´´±©¿¾´»
¬·³» ½±²-¬¿²¬ º±® ¬¸» ·²-¬®«³»²¬á ɸ¿¬ ·- ¬¸» °¸¿-» ¿²¹´» ¿¬ ëð ئ ¿²¼ ¿¬
ïðð ئá
ïòë ß ³»®½«®§ ¬¸»®³±³»¬»® ¸¿- ¿ ½§´·²¼®·½¿´ ½¿°·´´¿®§ ¬«¾» ©·¬¸ ¿² ·²¬»®²¿´
¼·¿³»¬»® ±º ðòî ³³ò ׺ ¬¸» ª±´«³» ±º ¬¸» ¬¸»®³±³»¬»® ¿²¼ ¬¸¿¬ ±º ¬¸» ¾«´¾ ¿®»
²±¬ ¿ºº»½¬»¼ ¾§ ¬»³°»®¿¬«®»ô ©¸¿¬ ª±´«³» ³«-¬ ¬¸» ¾«´¾ ¸¿ª» ·º ¿ -»²-·¬·ª·¬§ ±º
2 ³³ Ý ·- ¬± ¾» ±¾¬¿·²»¼á ß--«³» ±°»®¿¬·±² ²»¿® 24 Ýò ß--«³» ¬¸¿¬ ¬¸» -¬»³
ª±´«³» ·- ²»¹´·¹·¾´» ½±³°¿®»¼ ©·¬¸ ¬¸» ¾«´¾ ·²¬»®²¿´ ª±´«³»ò Ü·ºº»®»²¬·¿´
»¨°¿²-·±² ½±»º•½·»²¬ ±º ع 1 82 1O
4
³´ ³´ Ý ò
ïòê Ú±® ¬¸» -°®·²¹ -½¿´» -¸±©² ·² Ú·¹«®» ïòéø¿÷ô •²¼ ¬¸» ¬®¿²-º»® º«²½¬·±² ©¸»²
¬¸» ³¿-- ·- ²»¹´·¹·¾´»ò
ïòé Ú·²¼ ¬¸» ¬·³» ½±²-¬¿²¬ º®±³ ¬¸» º±´´±©·²¹ ¼·ºº»®»²¬·¿´ »¯«¿¬·±²ô ¹·ª»² ¬¸¿¬
¨ is lhe inpul, § is lhe oulpul, and ¿ lhiough ¸ aie conslanls.
¿
¼§
¼¬
¾¨ ½ ¸§ »
¼§
¼¬
º¨ ¹
ïòè ß ´±©ó°¿-- •®-¬ó±®¼»® ·²-¬®«³»²¬ ¸¿- ¿ ¬·³» ½±²-¬¿²¬ ±º îð ³-ò Ú·²¼ ¬¸»
º®»¯«»²½§ô ·² ¸»®¬¦ô ±º ¬¸» ·²°«¬ ¿¬ ©¸·½¸ ¬¸» ±«¬°«¬ ©·´´ ¾» çíû±º ¬¸» ¼½ ±«¬°«¬ò
Ú·²¼ ¬¸» °¸¿-» ¿²¹´» ¿¬ ¬¸·- º®»¯«»²½§ò
ïòç ß -»½±²¼ó±®¼»® ·²-¬®«³»²¬ ¸¿- ¿ ¼¿³°·²¹ ®¿¬·± ±º ðòì ¿²¼ ¿² «²¼¿³°»¼
²¿¬«®¿´ º®»¯«»²½§ ±º èë ئò ͵»¬½¸ ¬¸» -¬»° ®»-°±²-»ô ¿²¼ ¹·ª» ²«³»®·½¿´ ª¿´«»-
º±® ¬¸» ¿³°´·¬«¼» ¿²¼ ¬·³» ±º ¬¸» •®-¬ ¬©± °±-·¬·ª» ³¿¨·³¿ò ß--«³» ¬¸¿¬ ¬¸»
·²°«¬ ¹±»- º®±³ 𠬱 ï ¿²¼ ¬¸¿¬ ¬¸» -¬¿¬·½ -»²-·¬·ª·¬§ ·- ïðò
ïòïð ݱ²-·¼»® ¿² «²¼»®¼¿³°»¼ -»½±²¼ó±®¼»® -§-¬»³ ©·¬¸ -¬»° ®»-°±²-» ¿-
-¸±©² ·² Ú·¹«®» ïòéø½÷ò ß ¼·ºº»®»²¬ ©¿§ ¬± ¼»•²» ´±¹¿®·¬¸³·½ ¼»½®»³»²¬ ·-
Ù ln
§
²
§
² 1
ìî ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
Heie ² iefeis nol lo lhe numbei of posilive peaks shown in Iiguie 1.7(c) bul lo
bolh posilive and negalive peaks. Thal is, ² incieases by 1 foi each half cycle.
Deiive an equalion foi lhe damping ialio ¦
of logaiilhmic deciemenl.
ÎÛÚÛÎÛÒÝÛÍ
Anonymous, Ü»-·¹²»®- Ø¿²¼¾±±µæ Ó»¼·½¿´ Û´»½¬®±²·½-ò ßλ-±«®½» ¿²¼ Þ«§»®- Ù«·¼» º±® Ó»¼·½¿´
Û´»½¬®±²·½- Û²¹·²»»®·²¹ ¿²¼ Ü»-·¹², 3id ed. Sanla Monica, CA: Canon Communicalions,
¡nc.1994.
Anonymous, Ø»¿´¬¸ Ü»ª·½»- ͱ«®½»¾±±µ. Plymoulh Meeling, PA: !CR¡, 2OO7.
Anonymous, Ø«³¿² Ú¿½¬±®- Û²¹·²»»®·²¹ Ù«·¼»´·²»- ¿²¼ Ю»º»®®»¼ Ю¿½¬·½»- º±® ¬¸» Ü»-·¹² ±º
Ó»¼·½¿´ Ü»ª·½»-, 2nd ed. Ailinglon, \A: ANS¡/AAM¡ H!48, 1993.
Anonymous, Ó»¼·½¿´ Ñ«¬½±³»- ¿²¼ Ù«·¼»´·²»- ͱ«®½»¾±±µ. New Yoik, NY: Iaulknei and Giay,
¡nc., 2OO1.
Anonymous, Ю±¼«½¬ Ü»ª»´±°³»²¬ Ü·®»½¬±®§. Monlvale, N1: Medical !conomics Co., 1996.
Bionzino, 1. D. (ed.), ̸» Þ·±³»¼·½¿´ Û²¹·²»»®·²¹ Ø¿²¼¾±±µ, 3id ed. Boca Ralon, IL: CRCPiess,
2OO6.
Biush, L. C., ̸» Ù«·¼» ¬± Þ·±³»¼·½¿´ ͬ¿²¼¿®¼-, 21sl ed. Biea, CA: Çuesl Publishing Co., 1999.
Cobbold, R. S. C., Ì®¿²-¼«½»®- º±® Þ·±³»¼·½¿´ Ó»¿-«®»³»²¬-æ Ю·²½·°´»- ¿²¼ ß°°´·½¿¬·±²-. New
Yoik: Wiley, 1974.
Cohen, B. 1., Ó»¼·½¿´ Ì»®³·²±´±¹§æ ß² ×´´«-¬®¿¬»¼ Ù«·¼», 4lh ed. Philadelphia: Lippincoll, 2OO4.
Ciomwell, L., I. 1. Weibell, and !. A. Pfeiffei, Þ·±³»¼·½¿´ ײ-¬®«³»²¬¿¬·±² ¿²¼ Ó»¿-«®»³»²¬-, 2nd
ed. !nglewood Cliffs, N1: Pienlice-Hall, 198O.
Davis, N. M., Ó»¼·½¿´ ß¾¾®»ª·¿¬·±²-æ ïëôððð ݱ²ª»²·»²½»- ¿¬ ¬¸» Û¨°»²-» ±º ݱ³³«²·½¿¬·±² ¿²¼
Í¿º»¬§, 1Olh ed. Hunlinglon \alley, PA: Neil M. Davis Associales, 2OO1.
Dawson-Saundeis, B., and R. G. Tiapp, Þ¿-·½ ¿²¼ Ý´·²·½¿´ Þ·±-¬¿¬·-¬·½-. 4lh ed. Noiwalk, CT:
Applelon & Lange, 2OO4.
Doebelin, !. O., Ó»¿-«®»³»²¬ ͧ-¬»³-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², 4lh ed. New Yoik: McGiaw-Hill,
199O.
Doiland, N. W. (ed.), ܱ®´¿²¼K- ×´´«-¬®¿¬»¼ Ó»¼·½¿´ Ü·½¬·±²¿®§, 3Olh ed. Philadelphia: Saundeis,
2OO3.
!kelman, K. B., Ò»© Ó»¼·½¿´ Ü»ª·½»-æ ײª»²¬·±²ô Ü»ª»´±°³»²¬ô ¿²¼ Ë-». Washinglon, DC:
Nalional Academy Piess, 1988.
!ndeile, 1. D., S. M. Blanchaid, and 1. D. Bionzino, ײ¬®±¼«½¬·±² ¬± Þ·±³»¼·½¿´ Û²¹·²»»®·²¹, 2nd
ed., San Diego: Academic, 2OO5.
Iiikin, B. G., and 1. A. Whilwoilh, Ü·½¬·±²¿®§ ±º Ó»¼·½¿´ Û°±²§³-, 2nd ed. Paik Ridge, N1:
Pailhenon, 1996.
Geddes, L. A., and L. !. Bakei, Ю·²½·°´»- ±º ß°°´·»¼ Þ·±³»¼·½¿´ ײ-¬®«³»²¬¿¬·±², 3id ed. New
Yoik: Wiley, 1989.
Habei, K., ݱ³³±² ß¾¾®»ª·¿¬·±²- ·² Ý´·²·½¿´ Ó»¼·½·²». New Yoik: Raven Piess, 1988.
Hamillon, B., and B. Guides, Ó»¼·½¿´ ß½®±²§³-ô ͧ³¾±´- ¿²¼ ß¾¾®»ª·¿¬·±²-, 2nd ed. New Yoik:
Neal-Schuman, 1988.
Heislei, R., Ü·½¬·±²¿®§ ±º ß¾¾®»ª·¿¬·±²- ·² Ó»¼·½¿´ ͽ·»²½»-. New Yoik: Spiingei, 1989.
¡nslilule of !lecliical and !leclionics !ngineeis (¡!!!), ×ÛÛÛ Í¬¿²¼¿®¼ Ü·½¬·±²¿®§ ±º Û´»½¬®·½¿´
¿²¼ Û´»½¬®±²·½ Ì»®³-, 6lh ed. Piscalaway, N1: ¡nslilule of !lecliical and !leclionics
!ngineeis, 1997.
1acobson, B., and 1. G. Webslei, Ó»¼·½·²» ¿²¼ Ý´·²·½¿´ Û²¹·²»»®·²¹. !nglewood Cliffs, N1:
Pienlice-Hall, 1977.
Kesslei, D. A., ••The fedeial iegulalion of medical devices.ŽŽ Òò Û²¹´ò Öò Ó»¼ò, 1987, 317(6), 357Š
366.
Î Û Ú Û Î Û Ò Ý Û Í ìí
King, P. H., and R. C. Iiies, Ü»-·¹² ±º Þ·±³»¼·½¿´ Ü»ª·½»- ¿²¼ ͧ-¬»³-, 2
nd
ed. Boca Ralon, IL:
CRC Piess, 2OO9.
Kuo, B., and I. Golnaiaghi, ß«¬±³¿¬·½ ݱ²¬®±´ ͧ-¬»³-, 8lh ed. New Yoik: Wiley, 2OO3.
Öò
Ó»¼ò Û²¹ò Ì»½¸²±´ò, 199O, 14(3), 111Š113.
Pacela, A. I. (ed.), ••Safe medical devices law: Sweeping changes foi hospilals and lhe slandaids
indusliy,ŽŽ Þ·±³»¼ò Í¿º»¬§ ¿²¼ ͬ¿²¼. Special Supplemenl No. 12, Iebiuaiy 1991.
Rabbill, 1. T., and P. A. Beigh, ̸» ×ÍÑ çððð Þ±±µ, 2nd ed. While Plains, NY: Çualily Resouices,
1994.
Ray, C. D. (ed.), Ó»¼·½¿´ Û²¹·²»»®·²¹. Chicago: Yeai Book, 1974.
Scoll, D., and 1. G. Webslei, ••Developmenl phases foi medical devices.ŽŽ Ó»¼ò ײ-¬®«³ò, 1986,
2O(1), 48Š52.
Slanaszek, M. 1., ̸» ײª»®¬»¼ Ó»¼·½¿´ Ü·½¬·±²¿®§, 2nd ed. Lancaslei, PA: Technomic Publishing
Co., 1991.
Tompkins, W. 1., and 1. G. Webslei (eds.), Ü»-·¹² ±º Ó·½®±½±³°«¬»®óÞ¿-»¼ Ó»¼·½¿´ ײ-¬®«³»²ó
¬¿¬·±². !nglewood Cliffs, N1: Pienlice-Hall, 1981.
Webslei, 1. G. (ed.), Þ·±·²-¬®«³»²¬¿¬·±². Hoboken N1: Wiley, 2OO4.
Webslei, 1. G. (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed. \ols. 1-6. New
Yoik: Wiley, 2OO6.
Webslei, 1. G., and A. M. Cook (eds.), Ý´·²·½¿´ Û²¹·²»»®·²¹æ Ю·²½·°´»- ¿²¼ Ю¿½¬·½»-. !nglewood
Cliffs, N1: Pienlice-Hall, 1979.
ìì ï Þ ß Í × Ý Ý Ñ Ò Ý Û Ð Ì Í Ñ Ú Ó Û Ü × Ý ß Ô × Ò Í Ì Î Ë Ó Û Ò Ì ß Ì × Ñ Ò
î
ÞßÍ×Ý ÍÛÒÍÑÎÍ ßÒÜ
ÐÎ×ÒÝ×ÐÔÛÍ
α¾»®¬ ßò л«®¿ ¿²¼ Ö±¸² Ùò É»¾-¬»®
This chaplei deals wilh basic mechanisms and piinciples of lhe sensois used in
a numbei of medical insliumenls. A¬®¿²-¼«½»® is a device lhal conveils eneigy
fiomone foimloanolhei. A-»²-±® conveils a physical paiamelei loan elecliic
oulpul. An ¿½¬«¿¬±® conveils an elecliic signal lo a physical oulpul. An elecliic
oulpul fiom lhe sensoi is noimally desiiable because of lhe advanlages il gives
in fuilhei signal piocessing (Pallas-Aieny and Webslei, 2OO1). As we shall see
in lhis chaplei, lheie aie many melhods used lo conveil physiological evenls lo
elecliic signals. Dimensional changes may be measuied by vaiialions in
iesislance, induclance, capacilance, and piezoelecliic effecl. Theimislois
and lheimocouples aie employed lo measuie body lempeialuies. !leclio-
magnelic-iadialion sensois include lheimal and pholon deleclois. ¡n oui
discussion of lhe design of medical insliumenls in lhe following chapleis,
we shall use lhe piinciples desciibed in lhis chaplei (Togawa »¬ ¿´., 1997).
îòï Ü×ÍÐÔßÝÛÓÛÒÌ ÓÛßÍËÎÛÓÛÒÌÍ
The physician and biomedical ieseaichei aie inleiesled in measuiing lhe size,
shape, and posilion of lhe oigans and lissues of lhe body. \aiialions in lhese
paiameleis aie impoilanl in disciiminaling noimal fiom abnoimal funclion.
Displacemenl sensois can be used in bolh diiecl and indiiecl syslems of
measuiemenl. Diiecl measuiemenls of displacemenl aie used lo deleimine
lhe change indiamelei of blood vessels and lhe changes in volume and shape of
caidiac chambeis.
¡ndiiecl measuiemenls of displacemenl aie usedlo quanlify movemenls of
liquids lhiough heail valves. An example is lhe movemenl of a miciophone
diaphiagm lhal delecls lhe movemenl of lhe heail indiieclly and lhe iesulling
heail muimuis.
Heie we will desciibe lhe following lypes of displacemenl-sensilive
measuiemenl melhods: iesislive, induclive, capacilive, and piezoelecliic
(Nyce, 2OO4).
ìë
îòî ÎÛÍ×ÍÌ×ÊÛ ÍÛÒÍÑÎÍ
ÐÑÌÛÒÌ×ÑÓÛÌÛÎÍ
Iiguie 2.1 shows lhiee lypes of polenliomeliic devices foi measuiing displace-
menl. The polenliomelei shown in Iiguie 2.1(a) measuies lianslalional dis-
placemenls fiom 2 lo 5OO mm. Rolalional displacemenls ianging fiom 1Oè lo
moie lhan 5Oè aie delecled as shown in Iiguie 2.1(b) and (c). The iesislance
elemenls (composed of wiie-wound, caibon-nlm, melal-nlm, conducling-
plaslic, oi ceiamic maleiial) may be exciled by eilhei dc oi ac vollages. These
polenliomeleis pioduce a lineai oulpul (wilhinO.O1'of full scale) as a funclion
of displacemenl, piovided lhal lhe polenliomelei is nol elecliically loaded.
The iesolulion of lhese polenliomeleis is a funclion of lhe consliuclion. ¡l
is possible lo achieve a conlinuous slepless conveision of iesislance foi low-
iesislance values up lo 1O Ê by ulilizing a sliaighl piece of wiie. Ioi giealei
vaiialions in iesislance, fiom seveial ohms lo seveial megohms, lhe iesislance
wiie is wound on a mandiel oi caid. The vaiialion in iesislance is lheieby nol
conlinuous, bul ialhei slepwise, because lhe wipei moves fiom one luin of
wiie lo lhe nexl. The fundamenlal limilalion of lhe iesolulion is a funclion of
lhe wiie spacing, which may be as small as 2O ³m. The fiiclional and ineilial
componenls of lhese polenliomeleis should be low in oidei lo minimize
dynamic disloilion of lhe syslem.
ÍÌÎß×Ò ÙßÙÛÍ
When a nne wiie (25 ³m) is sliained wilhin ils elaslic limil, lhe wiie`s iesislance
changes because of changes in lhe diamelei, lenglh, and iesislivily. The
iesulling sliain gages may be used lo measuie exliemely small displacemenls,
on lhe oidei of nanomeleis. The following deiivalion shows how each of lhese
paiameleis inûuences lhe iesislance change. The basic equalion foi lhe
Ú·¹«®» îòï ̸®»» ¬§°»- ±º °±¬»²¬·±³»¬®·½ ¼»ª·½»- º±® ³»¿-«®·²¹ ¼·-°´¿½»ó
³»²¬- (a) Tianslalional. (b) Single-luin, (c) Mulliluin. (Iiom Ó»¿-«®»³»²¬
ͧ-¬»³-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², by !. O. Doebelin. Copyiighl
ý
199O by
McGiaw-Hill, ¡nc. \sed wilh peimission of McGiaw-Hill Book Co.)
ìê î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
iesislance Î of a wiie wilh iesislivily ® (ohm melei), lenglh Ô (meleis), and
cioss-seclional aiea ß (melei squaied) is given by
Î
®Ô
ß
(2.1)
The diffeienlial change in Î is found by laking lhe diffeienlial
¼Î
®¼Ô
ß
®ß
2
Ô¼ß Ô
¼®
ß
(2.2)
We shall modify lhis expiession so lhal il iepiesenls nnile changes in lhe
paiameleis and is also a funclion of slandaid mechanical coefncienls. Thus
dividing membeis of (2.2) by coiiesponding membeis of (2.1) and inlioducing
inciemenlal values, we gel
ÜÎ
Î
ÜÔ
Ô
Üß
ß
Ü®
®
(2.3)
Poisson`s ialio ³. ielales lhe change in diamelei ÜÜ lo lhe change in lenglh:
ÜÜ Ü ³ÜÔ Ô. Subsliluling lhis inlo lhe cenlei leim of (2.3) yields
ÜÎ
Î
1 2³
ÜÔ
Ô
Dimensional
effecl
Ü®
®
Piezoiesislive
effecl
(2.4)
Nole lhal lhe change in iesislance is a funclion of changes in dimension‰
lenglh ÜÔ Ô and aiea 2³ÜÔ Ô ‰plus lhe change in iesislivily due lo
sliain-induced changes in lhe lallice sliucluie of lhe maleiial, Ü® ®. The gage
facloi Ù, found by dividing (2.4) by ÜÔ Ô, is useful in compaiing vaiious
sliain-gage maleiials.
Ù
ÜÎ Î
ÜÔ Ô
1 2³
Ü® ®
ÜÔ Ô
(2.5)
Table2.1gives lhe gagefaclois andlempeialuiecoefncienl of iesislivily of vaiious
sliain-gage maleiials. Nole lhal lhe gage facloi foi semiconducloi maleiials is
appioximalely 5O lo 7O limes lhal of lhe melals.
Also nole lhal lhe gage facloi foi melals is piimaiily a funclion of
dimensional effecls. Ioi mosl melals, ³ O 3 and lhus Ù is al leasl 1.6,
wheieas foi semiconduclois, lhe piezoiesislive effecl is dominanl. The desii-
able fealuie of highei gage faclois foi semiconducloi devices is offsel by lheii
giealei iesislivilylempeialuie coefncienl.
Designs foi insliumenls lhal use semiconducloi maleiials musl incoipo-
iale lempeialuie compensalion.
Sliain gages can be classined as eilhei unbonded oi bonded. An unbonded
sliain-gage unil is shown in Iiguie 2.2(a). The foui sels of sliain-sensilive wiies
î ò î Î Û Í × Í Ì × Ê Û Í Û Ò Í Ñ Î Í ìé
aie connecled lo foim a Whealslone biidge, as shown in Iiguie 2.2(b). These
wiies aie mounled undei sliess belween lhe fiame and lhe movable aimaluie
such lhal pieload is giealei lhan any expecled exleinal compiessive load. This
is necessaiy lo avoid pulling lhe wiies in compiession. This lype of sensoi may
be used foi conveiling blood piessuie lo diaphiagm movemenl, lo iesislance
change, lhen lo an elecliic signal.
A bonded sliain-gage elemenl, consisling of a melallic wiie, elched foil,
vacuum-deposiled nlm, oi semiconducloi bai, is cemenled lo lhe sliained
suiface. Iiguie 2.3 shows lypical bonded sliain gages. The devialion fiom
lineaiily is appioximalely 1'. One melhod of lempeialuie compensalion foi
lhe naluial lempeialuie sensilivily of bonded sliain gages involves using a
second sliain gage as a dummy elemenl lhal is also exposed lo lhe lempeialuie
vaiialion, bul nol lo sliain. When possible, lhe foui-aim biidge shown in
Iiguie 2.2 should be used, because il nol only piovides lempeialuie compen-
salion bul also yields foui limes giealei oulpul if all foui aims conlain aclive
gages. Ioui bonded melal sliain gages can be used on canlilevei beams lo
measuie bile foice in denlal ieseaich (Dechow, 2OO6).
Sliain-gage lechnology advanced in lhe 196Os wilh lhe inlioduclion of lhe
semiconducloi sliain-gage elemenl, which has lhe advanlage of having a high
gage facloi, as shown in Table 2.1. Howevei, il is moie lempeialuie sensilive
and inheienlly moie nonlineai lhan melal sliain gages because lhe piezo-
iesislive effecl vaiies wilh sliain. Semiconducloi elemenls can be used as
Ì¿¾´» îòï Ю±°»®¬·»- ±º ͬ®¿·²óÙ¿¹» Ó¿¬»®·¿´-
Ó¿¬»®·¿´ ݱ³°±-·¬·±² øû÷ Ù¿¹» Ú¿½¬±®
Ì»³°»®¿¬«®»
ݱ»ºB½·»²¬ ±º
λ-·-¬·ª·¬§
ø%Ý
ï
ïð
ë
÷
Conslanlan
(advance)
Ni
45
, Cu
55
2.1 2
¡soelaslic Ni
36
, Ci
8
(Mn, Si, Mo)
4
Ie
52
3.52 lo 3.6 17
Kaima Ni
74
, Ci
2O
, Ie
3
Cu
3
2.1 2
Manganin Cu
84
, Mn
l2
, Ni
4
O.3 lo O.47 2
Alloy 479 Pl
92
,W
8
3.6 lo 4.4 24
Nickel Puie 12 lo 2O 67O
Nichiome \ Ni
8O
, Ci
2O
2.1 lo 2.63 1O
Silicon ( ° lype) 1OO lo 17O 7O lo 7OO
Silicon (² lype) 1OO lo 14O 7O lo 7OO
Geimanium (° lype) 1O2
Geimanium (² lype) 15O
SO\RC!: Iiom R. S. C. Cobbold, Ì®¿²-¼«½»®- º±® Þ·±³»¼·½¿´ Ó»¿-«®»³»²¬-, 1974, 1ohn Wiley &
Sons, ¡nc.. \sed wilh peimission of 1ohn Wiley & Sons, ¡nc., New Yoik.
ìè î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
Ú·¹«®» îòí ̧°·½¿´ ¾±²¼»¼ -¬®¿·²ó¹¿¹» «²·¬- (a) iesislance-wiie lype, (b) foil
lype, (c) helical-wiie lype. Aiiows above unils show diieclion of maximal
sensilivily lo sliain. |Pails (a) and (b) aie modined fiom ײ-¬®«³»²¬¿¬·±² ·²
ͽ·»²¬·B½ λ-»¿®½¸, K. S. Lion. Copyiighl ý 1959 by McGiaw-Hill, ¡nc. \sed
wilh peimission of McGiaw-Hill Book Co.j
Ú·¹«®» îòî (a) \nbonded sliain-gage piessuie sensoi. The diaphiagm is
diieclly coupled by an aimaluie lo an unbonded sliain-gage syslem. Wilh
incieasing piessuie, lhe sliain on gage paii B and C is incieased, while lhal on
gage paii A and D is decieased. (b) Whealslone biidge wilh foui aclive
elemenls: Î
1
B Î
2
A Î
3
D, and Î
4
C when lhe unbonded sliain
gage is connecled foi lianslalional molion. Resisloi Î
y
and polenliomelei Î
x
aie used lo inilially balance lhe biidge, \
i
is lhe applied vollage, and Ü
o
is lhe
oulpul vollage on a vollmelei oi similai device wilh aninleinal iesislance of Î
i
.
î ò î Î Û Í × Í Ì × Ê Û Í Û Ò Í Ñ Î Í ìç
bonded, unbonded, oi inlegialed sliain-gage unils. These inlegialed devices
can be consliucled wilh eilhei siliconoi geimanium° oi ² lype as lhe subsliale
lhal foims lhe sliucluial membei. The opposile-lype maleiial is diffused inlo
lhe subsliale. Opposile signs foi lhe gage facloi iesull foi ²- and °-lype
subsliale gages. A laige gage facloi can be allained wilh lighlly doped
maleiial. Iiguie 2.4 shows lypical semiconducloi sliain-gage unils.
°
°
°
²
²
°
° Ú
°
²
²
²-type Si
plane
Silicon
Ð
2
Í
2
Ï
2
(Š)
Î
2
Î
2
Î
3
(+) (+)
(+)
(Š) (Š)
(+) Ì
2
Diffused
° region
Ð
1
Ï
1
(Š)
Í
1
Î
1
Ì
2
Í
2
Ï
1
Î
1
Î
1
Î
1
Ì
1
Î
2
Ï
2
Í
1
Ì
1
ß
ߊ ß
ß
Top view
Top view
Clamp
Cross-sectional view
Side view
°-type
diffused
layer
°-type diffused layer
(a)
(b)
(c)
Ú·¹«®» îòì ̧°·½¿´ -»³·½±²¼«½¬±® -¬®¿·²ó¹¿¹» «²·¬- (a) unbonded, unifoimly
doped, (b) diffused °-lype gage, (c) inlegialed piessuie sensoi, (d) inlegialed
canlilevei-beam foice sensoi. (Iiom Ì®¿²-¼«½»®- º±® Ó»¼·½¿´ Ó»¿-«®»³»²¬-æ
ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², R. S. C. Cobbold. Copyiighl
ý
1974, 1ohn Wiley &
Sons, ¡nc. Repiinled by peimission of 1ohn Wiley & Sons, ¡nc.)
ëð î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
The inlegialed-lype sensoi has an advanlage in lhal a piessuie sensoi can
be fabiicaled by using a silicon subsliale foi lhe sliucluial membei of lhe
diaphiagm. The gages aie diffused diieclly onlolhe diaphiagm. When piessuie
is applied lo lhe diaphiagm, a iadial sliess componenl occuis al lhe edge. The
sign of lhis componenl is opposile lo lhal of lhe langenlial sliess componenl
neai lhe cenlei. The placemenl of lhe eighl diffused sliain-gage unils shown in
Iiguie 2.4(c) gives high sensilivily and good lempeialuie compensalion
(Cobbold, 1974). Iiguie 2.5 shows a disposable blood-piessuie sensoi lhal
uses an inlegialed silicon chip. Silicon sliain-gage piessuie sensois can be
placed on lhe lip of a calhelei and inseiled diieclly inlo lhe blood, iesulling in
moie accuiale measuiemenls and faslei iesponse limes (Koiiles, 1987).
!laslic-iesislance sliain gages aie exlensively used in biomedical applica-
lions, especially in caidiovasculai and iespiialoiy dimensional and plelhysmo-
giaphic (volume-measuiing) deleiminalions. These syslems noimally consisl of a
naiiow silicone-iubbei lube |O.5 mm innei diamelei (¡D), 2 mm oulei diamelei
(OD)j fiom 3 lo 25 cm long and nlled wilh meicuiy oi wilh an elecliolyle oi
conduclive pasle. The ends of lhe lube aie sealed wilh elecliodes (amalgamaled
coppei, silvei, oi plalinum). As lhe lube slielches, lhe diamelei of lhe lube
decieases and lhe lenglh incieases, causing lhe iesislance lo inciease. The
iesislance pei unil lenglh of lypical gages is appioximalely O.O2 lo 2 Ê/cm. These
unils measuie much highei displacemenls lhan olhei gages.
The elaslic sliain gage is lineai wilhin 1' foi 1O' of maximal exlension.
As lhe exlension is incieased lo 3O'of maximum, lhe nonlineaiily ieaches 4'
of full scale. The inilial nonlineaiily (dead band) is asciibed lo slackness of lhe
Ú·¹«®» îòë ×-±´¿¬·±² ·² ¿ ¼·-°±-¿¾´» ¾´±±¼ó°®»--«®» -»²-±® Disposable blood-
piessuie sensois aie made of cleai plaslic so aii bubbles aie easily seen. Saline
ûows fiom an inliavenous (¡\) bag lhiough lhe cleai ¡\ lubing and lhe sensoi
lo lhe palienl. This ûushes blood oul of lhe lip of lhe indwelling calhelei lo
pievenl clolling. A levei can open oi close lhe ûush valve. The silicon chip has
a silicon diaphiagm wilh a foui-iesisloi Whealslone biidge diffused inlo il. ¡ls
elecliical conneclions aie piolecled fiom lhe saline by a complianl silicone
elaslomei gel, which also piovides elecliical isolalion. This pievenls elecliic
shock fiom lhe sensoi lo lhe palienl and pievenls desliuclive cuiienls duiing
denbiillalion fiom lhe palienl lo lhe silicon chip.
î ò î Î Û Í × Í Ì × Ê Û Í Û Ò Í Ñ Î Í ëï
unil. Long-leim cieep is a piopeily of lhe iubbei lubing. This is nol a pioblem
foi dynamic measuiemenls.
Opeialional pioblems include mainlaining a good conlacl belween lhe mei-
cuiy and lhe elecliodes, ensuiing conlinuily of lhe meicuiy column, and conlioll-
ing lhe diifl in iesislance due lo a ielalively laige gage lempeialuie coefncienl.
¡n addilion, accuiale calibialion is difncull because of lhe mass-elaslicily and
sliesssliain ielalions of lhe lissuesliain-gage complex. The low value of iesisl-
ance means moie powei is iequiied lo opeiale lhese sliain-gage unils.
Lawlon and Collins (1959) deleimined lhe slalic and dynamic iesponse of
elaslic sliain gages. They found lhal lhe amplilude and phase weie conslanl up
lo 1O Hz. Signincanl disloilion occuiied foi fiequencies giealei lhan 3O Hz.
Cobbold (1974) indicaled lhal a pioblem nol fully appiecialed is lhal lhe gage
does nol dislend fully duiing pulsalions when diamelei of lhe vessel is being
measuied. The mass of lhe gage and ils nnile mechanical iesislance can cause il
lo dig inlo lhe vessel wall as lhe vessel expands, so il can give a ieading seveial
limes lowei lhan lhal measuied using ulliasonic oi cineangiogiaphic melhods.
Hokanson »¬ ¿´. (1975) desciibed an elecliically calibialed meicuiy-in-
iubbei sliain gage. Lead-wiie eiiois aie common wilh lhese devices because of
lhe low iesislance of lhe sliain gage. ¡n Hokanson`s design, lhe pioblem was
eliminaled by effeclively placing lhe sliain gage al lhe coineis of lhe mea-
suiemenl biidge. A conslanl-cuiienl souice causes an oulpul lhal is lineai foi
laige changes in gage iesislance. Iiguie 2.6 shows lhe device and ils oulpul
when applied lo lhe human calf.
Ú·¹«®» îòê Ó»®½«®§ó·²ó®«¾¾»® -¬®¿·²ó¹¿¹» °´»¬¸§-³±¹®¿°¸§ (a) Ioui-lead
gage applied lo human calf, (b) Biidge oulpul foi venous-occlusion plelhys-
mogiaphy. (c) Biidge oulpul foi aileiial-pulse plelhysmogiaphy. |Pail (a) is
based on D. !. Hokanson, D. S. Sumnei, and D. !. Sliandness, 1i., An
elecliically calibialed plelhysmogiaph foi diiecl measuiemenl of limb blood
ûow.`` 1975, BM!-22, 2529; used wilh peimission of ×ÛÛÛ Ì®¿²-ò Þ·±³»¼ò
Û²¹ò, 1975, New Yoik.j
ëî î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
îòí ÞÎ×ÜÙÛ Ý×ÎÝË×ÌÍ
The Whealslone biidge ciicuil is ideal foi measuiing small changes in iesisl-
ance. Iiguie 2.2(b) shows a Whealslone biidge wilh an applied dc vollage of
i
and a ieadoul melei Ü
o
wilh inleinal iesislance Î
i
. ¡l can be shown by lhe
vollage-dividei appioach lhal Ü
o
is zeio‰lhal is, lhe biidge is balanced‰
when Î
1
Î
2
Î
4
Î
3
.
Resislance-lype sensois may be connecled in one oi moie aims of a biidge
ciicuil. The vaiialion in iesislance can be delecled by measuiing Ü
o
wilh a
diffeienlial amplinei feeding an analog-lo-digilal conveilei (ADC), which
feeds a compulei.
Assume lhal all values of iesislance of lhe biidge aie inilially equal lo Î
O
and lhal Î
O
Î
1
. An inciease in iesislance, ÜÎ, of all iesislances slill iesulls in
a balanced biidge. Howevei, if Î
1
and Î
3
inciease by ÜÎ, and Î
2
and Î
4
deciease by ÜÎ, lhen
Ü
o
ÜÎ
Î
O
i
(2.6)
Because of lhe symmeliy a similai expiession iesulls if Î
2
and Î
4
inciease by
ÜÎ and Î
1
and Î
3
deciease by ÜÎ. Nole lhal (2.6), foi lhe foui-aclive-aim
biidge, shows lhal Ü
o
is lineaily ielaled lo ÜÎ. A nonlineaiily in ÜÎ Î
O
is
piesenl even when Î
O
Î
1
O.
¡l is common piaclice lo incoipoiale a balancing scheme in lhe biidge
ciicuil |see Iiguie 2.2(b)j. Resisloi Î
y
and polenliomelei Î
x
aie used lo
change lhe inilial iesislance of one oi moie aims. This aiiangemenl biings lhe
biidge inlo balance so lhal zeio vollage oulpul iesulls fiom zeio`` (oi ¾¿-»ó
´»ª»´) inpul of lhe measuied paiamelei.
To minimize loading effecls, Î
x
is appioximalely 1O limes lhe iesislance of
lhe biidge leg, and Î
y
limils lhe maximal ad|uslmenl. Sliain-gage applicalions
noimally use a value of Î
y
25 limes lhe iesislance of lhe biidge leg.
Alleinaling-cuiienl (ac) balancing ciicuils aie moie complicaled because a
ieaclive as well as a iesislive imbalance musl be compensaled.
îòì ×ÒÜËÝÌ×ÊÛ ÍÛÒÍÑÎÍ
An induclance Ôcan be used lo measuie displacemenl by vaiying any lhiee of
lhe coil paiameleis:
Ô ²
2
Ù³ (2.7)
wheie
² numbei of luins of coil
Ù geomeliic foim facloi
³ effeclive peimeabilily of lhe medium
!ach of lhese paiameleis can be changed by mechanical means.
î ò ì × Ò Ü Ë Ý Ì × Ê Û Í Û Ò Í Ñ Î Í ëí
Iiguie 2.7 shows (a) self-induclance, (b) mulual-induclance, and (c) diffei-
enlial liansfoimei lypes of induclivedisplacemenl sensois. ¡l is usuallypossiblelo
conveil a mulual-induclance syslem inlo a self-induclance syslem by seiies of
paiallel conneclions of lhe coils. Nole in Iiguie 2.7 lhal lhe mulual-induclance
device(b)becomesaself-induclancedevice(a)whenleiminals¾½aieconnecled.
An induclive sensoi has an advanlage in nol being affecled by lhe
dielecliic piopeilies of ils enviionmenl. Howevei, il may be affecled by
exleinal magnelic nelds due lo lhe pioximily of magnelic maleiials.
The vaiiable-induclance melhod employing a single displaceable coie is
shown in Iiguie 2.7(a). This device woiks on lhe piinciple lhal alleialions in
lhe self-induclance of a coil may be pioduced by changing lhe geomeliic foim
facloi oi lhe movemenl of a magnelic coie wilhin lhe coil. The change in
induclance foi lhis device is nol lineaily ielaled lo displacemenl. The facl lhal
lhese devices have low powei iequiiemenls and pioduce laige vaiialions in
induclance makes lhem alliaclive foi iadiolelemeliy applicalions.
The mulual-induclance sensoi employs lwo sepaiale coils and uses lhe vaiia-
lion in lheii mulual magnelic coupling lo measuie displacemenl |Iiguie 2.7(b)j.
Cobbold (1974) desciibes lhe applicalion of lhese devices in measuiing caidiac
dimensions, moniloiing infanl iespiialion, and asceilaining aileiial diameleis.
\an Cilleis (1966) piovides a good desciiplion of applicalions of mulual
induclance liansfoimeis in measuiing changes in dimension of inleinal oigans
(kidney, ma|oi blood vessels, and lefl venliicle). The induced vollage in lhe
secondaiy coil is a funclion of lhe geomeliy of lhe coils (sepaialion and axial
alignmenl), lhe numbei of piimaiy and secondaiy luins, and lhe fiequency and
amplilude of lhe excilalion vollage. The induced vollage in lhe secondaiy coil
is a nonlineai funclion of lhe sepaialion of lhe coils. ¡n oidei lo maximize lhe
oulpul signal, a fiequency is selecled lhal causes lhe secondaiy coil (luned
ciicuil) lo be in iesonance. The oulpul vollage is delecled wilh slandaid
demodulaloi and amplinei ciicuils.
The lineai vaiiable diffeienlial liansfoimei (L\DT) is widely used in
physiological ieseaich andclinical medicine lo measuie piessuie, displacemenl,
and foice (Kesavan and Reddy, 2OO6). As shown in Iiguie 2.7(c), lhe L\DT is
composedof apiimaiycoil (leiminals ab) andlwosecondaiycoils (ceandde)
connecled in seiies. The coupling belween lhese lwo coils is changed by lhe
Ú·¹«®» îòé ײ¼«½¬·ª» ¼·-°´¿½»³»²¬ -»²-±®- (a) self-induclance, (b) mulual
induclance, (c) diffeienlial liansfoimei.
ëì î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
molion of a high-peimeabilily alloy slug belween lhem. The lwo secondaiy
coils aie connecled in opposilion in oidei lo achieve a widei iegion of lineaiily.
The piimaiy coil is sinusoidally exciled, wilh a fiequency belween 6O Hz
and 2O kHz. The alleinaling magnelic neld induces neaily equal vollages
ce
and
de
in lhe secondaiy coils. The oulpul vollage
cd ce de
. When lhe
slug is symmeliically placed, lhe lwo secondaiy vollages aie equal and lhe
oulpul signal is zeio.
Lineai vaiiable diffeienlial liansfoimei chaiacleiislics include lineaiily
ovei a laige iange, a change of phase by 18Oè when lhe coie passes lhiough lhe
cenlei posilion, and saluialion on lhe ends. Specincalions of commeicially
available L\DTs include sensilivilies on lhe oidei of O.5 lo 2 m\ foi a
displacemenl of O.O1 mm/\ of piimaiy vollage, full-scale displacemenl of
O.1 lo 25O mm, and lineaiily of O.25'. Sensilivily foi L\DTs is much highei
lhan lhal foi sliain gages.
A disadvanlage of lhe L\DT is lhal il iequiies moie complex signal-
piocessing insliumenlalion. Iiguie 2.8 shows lhal essenlially lhe same
Ú·¹«®» îòè (a) As ¨ moves lhiough lhe null posilion, lhe phase changes 18Oè,
while lhe magnilude of
o
is piopoilional lo lhe magnilude of ¨. (b) An
oidinaiy ieclinei demodulaloi cannol dislinguish belween (a) and (b), so a
phase-sensilive demodulaloi is iequiied.
î ò ì × Ò Ü Ë Ý Ì × Ê Û Í Û Ò Í Ñ Î Í ëë
magnilude of oulpul vollage iesulls fiom lwo veiy diffeienl inpul displace-
menls. The diieclion of displacemenl may be deleimined by using lhe facl lhal
lheie is a 18Oè phase shifl when lhe coie passes lhiough lhe null posilion. A
phase-sensilive demodulaloi is used lo deleimine lhe diieclion of displace-
menl. Iiguie 3.17 shows a iing-demodulaloi syslemlhal could be used wilh lhe
L\DT.
îòë ÝßÐßÝ×Ì×ÊÛ ÍÛÒÍÑÎÍ
The capacilance belween lwo paiallel plales of aiea ßsepaialed by dislance
¨ is
Ý »
O
»
i
ß
¨
(2.8)
wheie »
O
is lhe dielecliic conslanl of fiee space (Appendix A.1) and »
i
is lhe
ielalive dielecliic conslanl of lhe insulaloi (1.O foi aii) (Bowman and Meindl,
1988). ¡n piinciple il is possible lo moniloi displacemenl by changing any of
lhe lhiee paiameleis »
i
, ß, oi ¨. Howevei, lhe melhod lhal is easiesl lo
implemenl and lhal is mosl commonly used is lo change lhe sepaialion
belween lhe plales.
The sensilivily Õof a capacilive sensoi lo changes in plale sepaialion ܨ is
found by diffeienlialing (2.8).
Õ
ÜÝ
ܨ
»
O
»
i
ß
¨
2
(2.9)
Nole lhal lhe sensilivily incieases as lhe plale sepaialion decieases.
By subsliluling (2.8) inlo (2.9), we can develop an expiession showing lhal
lhe peicenl change in Ýaboul any neulial poinl is equal lo lhe pei-unil change
in ¨ foi small displacemenls. Thus
¼Ý
¼¨
Ý
¨
(2.1O)
oi
¼Ý
Ý
¼¨
¨
(2.11)
The capacilance miciophone shown in Iiguie 2.9 is an excellenl example of a
ielalively simple melhod foi delecling vaiialion in capacilance (Doebelin,
199O; Cobbold, 1974). This is a dc-exciled ciicuil, so no cuiienl ûows when lhe
capaciloi is slalionaiy (wilh sepaialion ¨
O
), and lhus
1
Û. A change in
ëê î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
posilion ܨ ¨
1
¨
O
pioduces a vollage
o 1
Û. The oulpul vollage Ê
o
is
ielaled lo ¨
1
by
Ê
o
¶ª
È
1
¶ª
Û ¨
O
¶ª¬
¶ª¬ 1
(2.12)
wheie ¬ ÎÝ Î»
O
»
i
ß ¨
O
.
Typically, Î is 1 MÊ oi highei, and lhus lhe ieadoul device musl have a
high (1O MÊ oi highei) inpul impedance.
Ioi ª¬ 1 Ê
O
¶ª È
1
¶ª Û ¨
O
, which is a conslanl. Howevei, lhe
iesponse diops off foi low fiequencies, and il is zeio when ª O. Thus (2.12)
desciibes a high-pass nllei. This fiequency iesponse is quile adequale foi a
miciophone lhal does nol measuie sound piessuies al fiequencies below
2O Hz. Howevei, il is inadequale foi measuiing mosl physiological vaiiables
because of lheii low-fiequency componenls.
Complianl plaslics of diffeienl dielecliic conslanls may be placed belween foil
layeis lo foima capacilive mal lo be placed ona bed. Palienl movemenl geneiales
chaige, which is amplined and nlleied lo display iespiialoiy movemenls fiom lhe
lungs and ballislogiaphic movemenls fiom lhe heail (Alihanka »¬ ¿´ô 1982).
A capacilance sensoi can be fabiicaled fiom layeis of mica insulalois
sandwiched belween coiiugaled melal layeis. Applied piessuie ûallens lhe
coiiugalions and moves lhe melallic plales closei lo each olhei, lhus incieasing
lhe capacilance. The sensoi is nol damagedby laige oveiloads, because ûallening
of lhe coiiugalions does nol cause lhe melal lo yield. The sensoi measuies lhe
piessuie belween lhe fool and lhe shoe (Palel »¬ ¿´ò, 1989). Tsoukalas »¬ ¿´ò (2OO6)
desciibe miciomachined silicon capacilive sensois and lheii eleclionic inleifaces.
ÛÈßÓÐÔÛ îòï Ioi a 1 cm
2
capacilance sensoi, Î is 1OO MÊ. Calculale ¨,
lhe plale spacing iequiied lo pass sound fiequencies above 2O Hz.
ßÒÍÉÛÎ Iiom lhe coinei fiequency, Ý 1 2°ºÎ 1 2°2O 1O
8
8OpI Iiom (2.8) we can calculale ¨ given lhe value of Ý.
¨
»
O
»
i
ß
Ý
8 854 1O
12
1 1O
4
8O 1O
12
1 11 1O
5
m 11 1 ³m
Ú·¹«®» îòç Capacilance sensoi foi measuiing dynamic displacemenl
changes.
î ò ë Ý ß Ð ß Ý × Ì × Ê Û Í Û Ò Í Ñ Î Í ëé
îòê Ð×ÛÆÑÛÔÛÝÌÎ×Ý ÍÛÒÍÑÎÍ
绦±»´»½¬®·½ -»²-±®- aie used lo measuie physiological displacemenls and
iecoid heail sounds. Piezoelecliic maleiials geneiale an elecliic polenlial
when mechanically sliained, and conveisely an elecliic polenlial can cause
physical defoimalion of lhe maleiial. The piinciple of opeialion is lhal when
an asymmeliical ciyslal lallice is disloiled, a chaige ieoiienlalion lakes place,
causing a ielalive displacemenl of negalive and posilive chaiges. The displaced
inleinal chaiges induce suiface chaiges of opposile polaiily on opposile sides
of lhe ciyslal. Suiface chaige can be deleimined by measuiing lhe diffeience in
vollage belween elecliodes allached lo lhe suifaces.
¡nilially, we assume innnile leakage iesislance. Then, lhe lolal induced
chaige ¯ is diieclly piopoilional lo lhe applied foice º.
¯ µº (2.13)
wheie µ is lhe piezoelecliic conslanl, C N. The change in vollage can be found
by assuming lhal lhe syslem acls like a paiallel-plale capaciloi wheie lhe
vollage acioss lhe capaciloi is chaige ¯ divided by capacilance Ý. Then, by
subslilulion of (2.8), we gel
µº
Ý
µº¨
»
O
»
i
ß
(2.14)
Tables of piezoelecliic conslanls aie given in lhe lileialuie (Lion, 1959; and
Cobbold, 1974).
Typical values foi µ aie 2.3 pC N foi quailz and 14O pC N foi baiium
lilanale. Ioi a piezoelecliic sensoi of 1 cm
2
aiea and 1 mm lhickness wilh an
applied foice due lo a 1O g weighl, lhe oulpul vollage is O.23 m\ and 14 m\
foi lhe quailz and baiium lilanale ciyslals, iespeclively.
Theie aie vaiious modes of opeialion of piezoelecliic sensois, depending
on lhe maleiial and lhe ciyslallogiaphic oiienlalion of lhe plale (Lion, 1959).
These modes include lhe lhickness oi longiludinal compiession, liansveisal
compiession, lhickness-sheai aclion, and face-sheai aclion.
Also available aie piezoelecliic polymeiic nlms, such as polyvinylidene
ûuoiide (P\DI) (Hennig, 1988; Webslei, 1988). These nlms aie veiy lhin,
lighlweighl and plianl, and lhey can be cul easily and adapled lo uneven
suifaces. The low mechanical qualily facloi does nol peimil iesonance appli-
calions, bul il peimils acouslical bioadband applicalions foi miciophones and
loudspeakeis.
Piezoelecliic maleiials have a high bul nnile iesislance. As a consequence,
if a slalic deûeclion ¨ is applied, lhe chaige leaks lhiough lhe leakage iesisloi
(on lhe oidei of 1OO GÊ). ¡l is obviously quile impoilanl lhal lhe inpul
impedance of lhe exleinal vollage-measuiing device be an oidei of magnilude
highei lhan lhal of lhe piezoelecliic sensoi. ¡l would be helpful lo look al lhe
ëè î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
equivalenl ciicuil foi lhe piezoelecliic sensoi |Iiguie 2.1O(a)j in oidei lo
quanlify ils dynamic-iesponse chaiacleiislics.
This ciicuil has a chaige geneialoi ¯ denned by
¯ Õ¨ (2.15)
wheie wheie
Õ piopoilionalily conslanl, C/m
¨ deûeclion
The ciicuil may be simplined by conveiling lhe chaige geneialoi lo a
cuiienl geneialoi, ·
s
.
·
s
¼¯
¼¬
Õ
¼¨
¼¬
(2.16)
Ú·¹«®» îòïð (a) !quivalenl ciicuil of piezoelecliic sensoi, wheie Î
s
= sensoi
leakage iesislance, Ý
s
= sensoi capacilance, Ý
c
= cable capacilance, Ý
a
=
amplinei inpul capacilance, Î
a
= amplinei inpul iesislance, and ¯ = chaige
geneialoi. (b) Modined equivalenl ciicuil wilh cuiienl geneialoi ieplacing
chaige geneialoi. (Iiom Ó»¿-«®»³»²¬ ͧ-¬»³-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², by !.
O. Doebelin. Copyiighl ý199O by McGiaw-Hill, ¡nc. \sed wilh peimission of
McGiaw-Hill Book Co.)
î ò ê Ð × Û Æ Ñ Û Ô Û Ý Ì Î × Ý Í Û Ò Í Ñ Î Í ëç
The modined ciicuil is shown in Iiguie 2.1O(b), wheie lhe iesislances and
capacilances have been combined. Assuming lhal lhe amplinei does nol diaw
any cuiienl, we lhen have
·
s
·
Ý
·
Î
(2.17)
o Ý
1
Ý
·
Ý
¼¬ (2.18)
·
s
·
Î
Ý
¼
o
¼¬
Õ
¼¨
¼¬
o
Î
(2.19)
oi
Ê
o
¶ª
È ¶ª
Õ
s
¶ª¬
¶ª¬ 1
(2.2O)
wheie
Õ
s
Õ Ý (sensilivily, \/m)
¬ ÎÝ (lime conslanl)
ÛÈßÓÐÔÛ îòî A piezoelecliic sensoi has Ý 5OO pI. The sensoi leakage
iesislance is 1O GÊ. The amplinei inpul impedance is 5 MÊ. Whal is lhe low-
coinei fiequency?
ßÒÍÉÛÎ We may use lhe modined equivalenl ciicuil of lhe piezoelecliic
sensoi given in Iiguie 2.1O(b) foi lhis calculalion.
º
c
1 2°ÎÝ 1 2° 5 1O
6
5OO 1O
12
64 Hz
Nole lhal by incieasing lhe inpul impedance of lhe amplinei by a facloi of 1OO,
we can lowei lhe low-coinei fiequency lo O.64 Hz.
ÛÈßÓÐÔÛ îòí Ioi a piezoelecliic sensoi plus cable lhal has 1 nI capaci-
lance, design a ª±´¬¿¹» ¿³°´·B»® (nol a chaige amplinei) by using only ±²»
noninveiling amplinei lhal has a gain of 1O. ¡l should handle a chaige of 1 ³C
geneialed by lhe caiolid pulse wilhoul saluialion. ¡l should nol diifl inlo
saluialion because of bias cuiienls. ¡l should have a fiequency iesponse fiom
O.O5 lo 1OO Hz. Add lhe minimal numbei of exlia componenls lo achieve lhe
design specincalions.
ßÒÍÉÛÎ Calculale lhe vollage fiom Ê Ï Ý 1³C 1 nI 1 k\. Be-
cause lhis is loo high, add a shunl capaciloi Ý
s
1 ³I lo achieve 1.O \.
Allow foi a gain of 1O. To achieve low-coinei fiequency, add shunl
êð î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
Î
s
1 2°º
c
Ý 1 2° O O5 1³I 3 2 MÊ. To achieve gain of 1O in a
noninveiling amplinei, selecl Î
f
1O kÊ and Î
i
11 1 kÊ. To achieve
high-coinei fiequency, Ý
f
1 2°º
c
Î
f
1 2° 1OO 1OkÊ 16OnI.
Iiguie 2.11 shows lhe vollage-oulpul iesponse of a piezoelecliic sensoi lo
a slep displacemenl ¨. The oulpul decays exponenlially because of lhe nnile
inleinal iesislance of lhe piezoelecliic maleiial. Al lime equal lo Ì lhe foice is
ieleased, and a displacemenl iesloialion iesulls lhal is equal lo and opposile of
lhe oiiginal displacemenl. This causes a sudden deciease in vollage of magni-
lude Õ¨ Ý, wilh a iesulling undeishool equal lo lhe decay piioi lo lhe ielease
of lhe displacemenl. The decay and undeishool can be minimized by incieas-
ing lhe lime conslanl, ¬ ÎÝ. The simplesl appioach lo incieasing ¬ is lo add a
paiallel capaciloi. Howevei, doing so ieduces lhe sensilivily in lhe midband
fiequencies accoiding lo (2.2O).
Anolhei appioach lo impioving lhe low-fiequency iesponse is lo use lhe
chaige amplinei desciibed in Seclion 3.8.
Because of ils mechanical iesonance, lhe high-fiequency equivalenl
ciicuil foi a piezoelecliic sensoi is complex. This effecl can be iepiesenled
by adding a seiies ÎÔÝ ciicuil in paiallel wilh lhe sensoi capacilance and
leakage iesislance. Iiguie 2.12 shows lhe high-fiequency equivalenl ciicuil
and ils fiequency iesponse. Nole lhal in some applicalions‰foi example, in
lhe case of ciyslal nlleis‰lhe mechanical iesonance is useful foi accuiale
fiequency conliol.
Piezoelecliic sensois aie used quile exlensively in caidiology foi exleinal
(body-suiface) and inleinal (inliacaidiac) phonocaidiogiaphy. They aie also
used in lhe deleclion of Koiolkoff sounds in blood-piessuie measuiemenls
(Chaplei 7). Addilional applicalions of piezoelecliic sensois involve lheii use in
measuiemenls of physiological acceleialions. A piezoelecliic sensoi and ciicuil
canmeasuie lheacceleialiondue lohumanmovemenls andpiovide aneslimale
of eneigy expendiluie (Seivais »¬ ¿´òô 1984). Seclion 8.4 desciibes ulliasonic
blood-ûow meleis in which lhe piezoelecliic elemenl opeialing al mechanical
iesonance emils and senses high-fiequency sounds. Li and Su (2OO6) desciibe
piezoelecliic sensois as sensilive mass sensois lo delecl and measuie a bioad
vaiiely of biomedical analyles in bolh gas and liquid phases based on lhe
adsoiplion and/oi desoiplion of laigel analyle(s) on lhe sensoi suiface.
Ú·¹«®» îòïï Í»²-±® ®»-°±²-» ¬± ¿ -¬»° ¼·-°´¿½»³»²¬ (Iiom Doebelin, !. O.
199O. Ó»¿-«®»³»²¬ ͧ-¬»³-æ ß°°´·½¿¬·±² ¿²¼ Ü»-·¹², New Yoik: McGiaw-
Hill.)
î ò ê Ð × Û Æ Ñ Û Ô Û Ý Ì Î × Ý Í Û Ò Í Ñ Î Í êï
îòé ÌÛÓÐÛÎßÌËÎÛ ÓÛßÍËÎÛÓÛÒÌÍ
Apalienl`s body lempeialuie gives lhe physician impoilanl infoimalion aboul
lhe physiological slale of lhe individual. !xleinal body lempeialuie is one of
many paiameleis used lo evaluale palienls in shock, because lhe ieduced
blood piessuie of a peison in ciiculaloiy shock iesulls in low blood ûow lo lhe
peiipheiy. Adiop in lhe big-loe lempeialuie is a good eaily clinical waining of
shock. ¡nfeclions, on lhe olhei hand, aie usually ieûecled by an inciease in
body lempeialuie, wilh a hol, ûushed skin and loss of ûuids. ¡ncieased
venlilalion, peispiialion, and blood ûow lo lhe skin iesull when high feveis
deslioy lempeialuie-sensilive enzymes and pioleins. Aneslhesia decieases
body lempeialuie by depiessing lhe lheimal iegulaloiy cenlei. ¡n facl,
physicians ioulinely induce hypolheimia in suigical cases in which lhey
wish lo deciease a palienl`s melabolic piocesses and blood ciiculalion.
¡n pedialiics, special healed incubalois aie used foi slabilizing lhe body
lempeialuie of infanls. Accuiale moniloiing of lempeialuie and iegulaloiy
Ú·¹«®» îòïî (a) High-fiequency ciicuil model foi piezoelecliic sensoi. Î
s
is
lhe sensoi leakage iesislance and Ý
s
is lhe capacilance. Ô
m
, Ý
m
, and Î
m
iepiesenl lhe mechanical syslem, (b) Piezoelecliic sensoi fiequency iesponse.
(IiomÌ®¿²-¼«½»®- º±® Þ·±³»¼·½¿´ Ó»¿-«®»³»²¬-æ Ю·²½·°´»- ¿²¼ ß°°´·½¿¬·±²-,
by R. S. C. Cobbold. Copyiighl (c) 1974, 1ohn Wiley and Sons, ¡nc. Repiinled
by peimission of 1ohn Wiley and Sons, ¡nc.)
êî î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
conliol syslems aie used lo mainlain a desiiable ambienl lempeialuie foi lhe
infanl.
¡n lhe sludy of ailhiilis, physicians have shown lhal lempeialuies of |oinls
aie closely coiielaled wilh lhe amounl of local inûammalion. The incieased
blood ûow due lo ailhiilis and chionic inûammalion can be delecled by
lheimal measuiemenls.
The specinc sile of body-lempeialuie iecoiding musl be selecled caiefully
so lhal il liuly ieûecls lhe palienl`s lempeialuie. Also, enviionmenlal changes
and ailifacls can cause misleading ieadings. Ioi example, lhe skin and oial-
mucosa lempeialuie of a palienl seldom ieûecls liue body-coie lempeialuie.
The following lypes of lheimally sensilive melhods of measuiemenl will be
desciibed heie: lheimocouples, lheimislois, and iadialion and nbei-oplic
deleclois (Samaias, 2OO6). The vollage acioss a °² |unclion changes aboul
2 m\/ C so lempeialuie sensois lhal use lhis piinciple aie available (Togawa,
2OO6).
îòè ÌØÛÎÓÑÝÑËÐÔÛÍ
̸»®³±»´»½¬®·½ ¬¸»®³±³»¬®§ is based on lhe discoveiy of Seebeck in 1821. He
obseived lhal an »´»½¬®±³±¬·ª» º±®½» (emf) exisls acioss a |unclion of lwo
dissimilai melals. This phenomenon is due lo lhe sum of lwo independenl
effecls. The nisl effecl, discoveied by Pelliei, is an emf due solely lo lhe conlacl
of lwo unlike melals and lhe |unclion lempeialuie. The nel Pelliei emf is
ioughly piopoilional lo lhe diffeience belween lhe lempeialuies of lhe lwo
|unclions. The second effecl, ciediled lo Thomson (Loid Kelvin), is an emf due
lo lhe lempeialuie giadienls along each single conducloi. The nel Thomson
emf is piopoilional lo lhe diffeience belween lhe squaies of lhe absolule
|unclion lempeialuies (Ì
1
and Ì
2
). The magniludes of lhe Pelliei and Thom-
son emfs can be deiived fiom lheimodynamic piinciples (Anonymous, 1974),
and eilhei may piedominale, depending on lhe melals chosen.
Knowledge of lhese lwo effecls is nol geneially useful in piaclical appli-
calions, so empiiical calibialion dala aie usually cuive nlled wilh a powei
seiies expansion lhal yields lhe Seebeck vollage,
Û ¿Ì
1
2
¾Ì
2
(2.21)
wheie Ì is in degiees Celsius and lhe iefeience |unclion is mainlained al O èC.
Iiguie 2.13(a) is a lheimocouple ciicuil wilh lwo dissimilai melals, ß and
Þ, al lwo diffeienl lempeialuies, Ì
1
, and Ì
2
. The nel emf al leiminals ½¼ is a
funclion of lhe diffeience belween lhe lempeialuies al lhe lwo |unclions and
lhe piopeilies of lhe lwo melals. ¡n lhe piaclical silualion, one |unclion is held
al a conslanl known lempeialuie (by an ice balh oi conliolled oven) foi a
iefeience in oidei lo deleimine lhe desiied oi unknown lempeialuie.
î ò è Ì Ø Û Î Ó Ñ Ý Ñ Ë Ð Ô Û Í êí
An undeislanding of lhe lhiee empiiical lheimocouple laws leads lo using
lhem piopeily. The nisl law, ¸±³±¹»²»±«- ½·®½«·¬-, slales lhal in a ciicuil
composed of a single homogeneous melal, one cannol mainlain an elecliic
cuiienl by lhe applicalion of heal alone. ¡n Iiguie 2.13(b), lhe nel emf al ½¼ is
lhe same as in Iiguie 2.13(a), iegaidless of lhe facl lhal a lempeialuie
disliibulion (Ì
3
) exisls along one of lhe wiies (ß).
The second law, ·²¬»®³»¼·¿¬» ³»¬¿´-, slales lhal lhe nel emf in a ciicuil
consisling of an inleiconneclion of a numbei of unlike melals, mainlained al
lhe same lempeialuie, is zeio. The piaclical implicalion of lhis piinciple is lhal
lead wiies may be allached lo lhe lheimocouple wilhoul affecling lhe accuiacy
of lhe measuied emf, piovided lhal lhe newly foimed |unclions aie al lhe same
lempeialuie |Iiguie 2.13(c)j.
The lhiid law, successive oi ·²¬»®³»¼·¿¬» ¬»³°»®¿¬«®»-, is illuslialed in
Iiguie 2.13(d), wheie emf Û
1
is geneialed when lwo dissimilai melals have
|unclions al lempeialuies Ì
1
andÌ
2
and emf Û
2
iesulls foi lempeialuies Ì
2
and
Ì
3
. ¡l follows lhal an emf Û
1
Û
2
iesulls al ½¼ when lhe |unclions aie al
lempeialuies Ì
1
and Ì
3
. This piinciple makes il possible foi calibialion cuives
deiived foi a given iefeience-|unclion lempeialuie lo be used lo deleimine lhe
calibialion cuives foi anolhei iefeience lempeialuie.
The ¬¸»®³±»´»½¬®·½ -»²-·¬·ª·¬§ ¿ (also called lhe ¬¸»®³±»´»½¬®·½ °±©»® oi lhe
Í»»¾»½µ ½±»ºB½·»²¬) is found by diffeienlialing (2.21) wilh iespecl lo Ì. Then
¿
¼Û
¼Ì
¿ ¾Ì (2.22)
Ú·¹«®» îòïí ̸»®³±½±«°´» ½·®½«·¬- (a) Pelliei emf, (b) law of homogeneous
ciicuils, (c) law of inleimediale melals, (d) law of inleimediale lempeialuies.
êì î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
Nole lhal ¿ is nol a conslanl bul vaiies (usually incieases) wilh lempeialuie.
The sensilivilies of common lheimocouples iange fiom 6.5 lo 8O ³\/ C al
2O C, wilh accuiacies fiom ¼' lo 1'.
Ioi accuiale ieadings, lhe iefeience |unclion should be kepl in a liiple-
poinl-of-walei device lhe lempeialuie of which is O O1 O OOO5 C (Doebelin,
199O). Noimally lhe accuiacy of a piopeily consliucled ice balh, O O5 C wilh a
iepioducibilily of O OO1 C is all lhal is necessaiy. Tempeialuie-conliolled
ovens can mainlain a iefeience lempeialuie lo wilhin O 4 C. Iiguie 2.14
shows lhal modein lheimocouple signal condilioneis conlain an eleclionic
cold |unclion (Tompkins and Webslei, 1988; Sheingold, 198O).
¡ncieased sensilivily may be achieved by connecling a numbei of lhei-
mocouples in seiies, all of lhem measuiing lhe same lempeialuie and using lhe
same iefeience |unclion. An aiiangemenl of mulliple-|unclion lheimocouples
is iefeiied lo as a ¬¸»®³±°·´». Paiallel combinalions may be used lo measuie
aveiage lempeialuie.
¡l is easy lo oblain a diiecl ieadoul of lhe lheimocouple vollage using a
digilal vollmelei. Chail iecoidings may be secuied by using a self-balancing
polenliomelei syslem. The lineaiily of lhis lallei device is dependenl only
on lhe lheimocouple and polenliomelei; il is independenl of lhe olhei
ciicuiliy.
Theimocouples have lhe following advanlages: fasl iesponse lime (lime
conslanl as small as 1 ms), small size (down lo 12 ³m diamelei), ease of
fabiicalion, and long-leim slabilily. Theii disadvanlages aie small oulpul
vollage, low sensilivily, and lhe need foi a iefeience lempeialuie.
Numeious examples of lhe use of lheimocouples in biomedical ie-
seaich aie given in lhe lileialuie (Wien, 2OO6). Theimocouples can be
made small in size, so lhey can be inseiled inlo calheleis and hypodeimic
needles.
Ú·¹«®» îòïì The LT1O25 eleclionic cold |unclion and lhe hol |unclion of lhe
lheimocouple yield a vollage lhal is amplined by an inveiling amplinei.
î ò è Ì Ø Û Î Ó Ñ Ý Ñ Ë Ð Ô Û Í êë
îòç ÌØÛÎÓ×ÍÌÑÎÍ
Theimislois aie semiconduclois made of ceiamic maleiials lhal aie lheimal
iesislois wilh a high negalive lempeialuie coefncienl. These maleiials ieacl lo
lempeialuie changes in a way lhal is opposile lo lhe way melals ieacl lo such
changes. The iesislance of lheimislois decieases as lempeialuie incieases and
incieases as lempeialuie decieases (Melo, 2OO6).
Sapoff (1971) ieviewed lhe vaiious lypes of lheimislois lhal have been
found lo be mosl suilable foi biomedical use. The iesislivily of lheimisloi
semiconduclois used foi biomedical applicalions is belween O.1 and 1OO Ê m.
These devices aie small in size (lhey can be made less lhan O.5 mm in
diamelei), have a ielalively laige sensilivily lo lempeialuie changes ( 3 lo
5 C), and have excellenl long-leim slabilily chaiacleiislics ( O 2 of
nominal iesislance value pei yeai).
Iiguie 2.15(a) shows a lypical family of iesislance-veisus-lempeialuie
chaiacleiislics of lheimislois. These piopeilies aie measuied foi lhe
Ú·¹«®» îòïë (a) Typical lheimisloi zeio-powei iesislance ialiolempeialuie
chaiacleiislics foi vaiious maleiials. (b) Theimisloi vollage-veisus-cuiienl
chaiacleiislic foi a lheimisloi inaii and walei. The diagonal lines wilh a posilive
slope give lineai iesislance values and show lhe degiee of lheimisloi lineaiily al
low cuiienls. The inleiseclion of lhe lheimisloi cuives and lhe diagonal lines
wilh negalive slope give lhe device powei dissipalion. Poinl ß is lhe maximal
cuiienl value foi no appieciable self-heal. Poinl Þis lhe peak vollage. Poinl Ýis
lhe maximal safe conlinuous cuiienl in aii. |Pail (b) is fiom̸»®³·-¬±® Ó¿²«¿´,
!MC-6, ý 1974, Ienwal !leclionics, Iiamingham, MA. \sed by peimission.j
êê î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
lheimisloi opeialed al a veiy small amounl of powei such lhal lheie is
negligible self-healing. This iesislance is commonly iefeiied lo as ¦»®±ó°±©»®
®»-·-¬¿²½». The empiiical ielalionship belween lhe lheimisloi iesislance Î
l
and
absolule lempeialuie Ì in kelvin (K) (lhe S¡ unil µ»´ª·² does nol use a degiee
sign) is
Î
l
Î
O
»
¾ Ì
O
Ì ÌÌ
O
(2.23)
wheie
¾ maleiial conslanl foi lheimisloi, K
Ì
O
slandaid iefeience lempeialuie, K
The value of ¾ incieases slighlly wilh lempeialuie. Howevei, lhis does nol
piesenl a pioblem ovei lhe limiled lempeialuie spans foi biomedical woik
(1O Clo 2O C). ¾, also known as lhe chaiacleiislic lempeialuie, is in lhe iange
of 25OO lo 5OOO K. ¡l is usually aboul 4OOO K.
The lempeialuie coefncienl ¿ can be found by diffeienlialing (2.23) wilh
iespecl lo Ì and dividing by Î
l
. Thus
¿
1
Î
l
¼Î
1
¼Ì
¾
Ì
2
K (2.24)
Nole fiom (2.24) lhal ¿ is a nonlineai funclion of lempeialuie. This non-
lineaiily is also ieûecled in Iiguie 2.15(a).
The vollage-veisus-cuiienl chaiacleiislics of lheimislois, as shown in
Iiguie 2.15(b), aie lineai up lo lhe poinl al which self-healing becomes a
pioblem. When lheie is laige self-healing, lhe lheimisloi vollage diop de-
cieases as lhe cuiienl incieases. This poilion of lhe cuive displays a negalive-
iesislance chaiacleiislic.
¡n lhe lineai poilion, Ohm`s law applies and lhe cuiienl is diieclly
piopoilional lo lhe applied vollage. The lempeialuie of lhe lheimisloi is
lhal of ils suiioundings. Howevei, al highei cuiienls a poinl is ieached,
because of incieased cuiienl ûow, al which lhe heal geneialed in lhe lheimis-
loi iaises lhe lempeialuie of lhe lheimisloi above ambienl. Al lhe peak of lhe
· chaiacleiislic, lhe inciemenlal iesislance is zeio, and foi highei cuiienls a
negalive-iesislance ielalionship occuis. Opeialions in lhis iegion iendei lhe
device vulneiable lo lheimal desliuclion.
Iiguie 2.15(b) shows lhe diffeience in lhe self-heal iegions foi a lheimisloi
in walei and aii due lo lhe diffeiences in lheimal iesislance of aii and walei.
The piinciple of vaiialion in lheimal iesislance can be used lo measuie blood
velocily, as desciibed in Seclion 8.5.
ÛÈßÓÐÔÛ îòì Skelch lypical lheimisloi · chaiacleiislics wilh and wilh-
oul a heal sink. !xplain why lheie is a diffeience.
î ò ç Ì Ø Û Î Ó × Í Ì Ñ Î Í êé
ßÒÍÉÛÎ Iiguie 2.15(b) shows lypical lheimisloi · chaiacleiislics in walei
and aii. Ioi low cuiienls Ohm`s law applies, and lhe cuiienl is diieclly
piopoilional lo lhe applied vollage in bolh cases. The lheimisloi lempeialuie
is close loambienl. The syslemwilhwalei canieach highei cuiienl levels andslill
iemain in a lineai poilion of lhe · cuive since lhe walei keeps lhe lheimisloi
close lo ambienl lempeialuie. !venlually lhe lheimisloi-walei combinalion will
self-heal and a negalive-iesislance ielalionship will iesull. ¡n lhe same mannei,
lhe heal sinkkeeps lhe lheimisloi lempeialuie close loambienl al highei cuiienl
levels and yields chaiacleiislics similai lo Iiguie 2.15(b).
ÛÈßÓÐÔÛ îòë Ioi a lheimisloi assume self-healing O 1 C, vollage 5 \,
dissipalion coefncienl DC 2 O mW C. Calculale minimum lheimisloi
iesislance.
ßÒÍÉÛÎ
ÜÌ
Ð
D C
Ê
2
Î
D C
Î
Ê
2
ÜÌ D C
5
2
O 1 C O OO2W C
125 OOO Ê
Choose nexl laigei available size 5OO OOOÊ
The cuiienllime chaiacleiislics of a lheimisloi aie impoilanl in any
dynamic analysis of lhe syslem. When a slep change in vollage is applied lo a
seiies ciicuil consisling of a iesisloi and a lheimisloi, a cuiienl ûows. The lime
delay foi lhe cuiienl lo ieach ils maximal value is a funclion of lhe vollage
applied, lhe mass of lhe lheimisloi, and lhe value of lhe seiies-ciicuil iesisl-
ance. Time delays fiom milliseconds lo seveial minules aie possible wilh
lheimisloi ciicuils. Similai lime delays occui when lhe lempeialuie suiiound-
ing lhe lheimisloi is changed in a slep fashion.
\aiious ciicuil schemes foi lineaiizing lhe iesislance-veisus-lempeialuie
chaiacleiislics of lheimislois have been pioposed (Cobbold, 1974; Doebelin,
199O). Modein insliumenls use miciocompuleis lo coiiecl foi nonlineaiilies,
ialhei lhan lhe foimei ciicuil schemes.
The ciicuiliy used foi lheimisloi ieadoul is essenlially lhe same as foi
conduclive sensois, and many of lhe same lechniques apply. Biidge ciicuils
give high sensilivily and good accuiacy. The biidge ciicuil shown in Iiguie
2.2(b) could be used wilh Î
3
Î
l
and Î
4
lhe lheimisloi iesislance al lhe
midscale value.
\eiy small diffeiences in lempeialuie can be found using a diffeienlial-
lempeialuie biidge. ¡l is oflen necessaiy lo measuie such minule diffeiences in
biological woik. An example is lhe need lo deleimine lhe lempeialuie
diffeience belween lwo oigans oi belween mulliple siles in lhe same oigan.
êè î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
A dc diffeienlial biidge can achieve a lineaiily of bellei lhan 1' of full-
scale oulpul when bead lheimislois malched lo wilhin 1 of each olhei al
25 èC aie used. The dc slabilily of lhis biidge is nol noimally a pioblem,
because lhe oulpul vollage of lhe biidge‰even foi lempeialuie diffeiences of
O.O1'‰is laigei lhan lhe dc diifl of good inlegialed-ciicuil opeialional
amplineis (Cobbold, 1974).
Opeialional-amplinei ciicuils may be used lo measuie lhe cuiienl in a
lheimisloi as a funclion of lempeialuie. ¡n essence, lhis ciicuil applies a
conslanl vollage lo lhe lheimisloi and monilois ils cuiienl wilh a cuiienl-lo-
vollage conveilei.
\aiious shapes of lheimislois aie available: beads, chips, iods, and
washeis (Sapoff, 1971). The glass-encapsulaled bead lheimisloi is lhe one
mosl commonly used in biomedical applicalions. The glass coaling piolecls
lhe sensing elemenl fiom lhe hoslile enviionmenl of lhe body wilhoul
signincanlly affecling lhe lheimal iesponse lime of lhe syslem. The small
size of lhese lheimislois makes possible lheii placemenl al lhe lip of calheleis
oi hypodeimic needles. The lheimodilulion-calhelei syslem discussed in
Seclion 8.2 employs a foui-lumen calhelei wilh a lheimisloi localed neai
lhe calhelei lip.
An addilional applicalion of lheimislois is in lhe clinical measuiemenl of
oial lempeialuie. Theimisloi piobes wilh disposable shealhs aie piesenlly
used, bul lhese exhibil a nisl-oidei slep iesponse as shown in Iiguie 1.6(c). To
yield lhe oial lempeialuie piioi lo slabilizalion, a nxed coiieclion of aboul
1 C is added lo lhe piobe lempeialuie when lhe iale of change of piobe
lempeialuie decieases below O 1 C/s.
A pioblem wilh lheimisloi neonalal skin suiface lempeialuie-moniloiing
insliumenls is lhal lhe piobes fall off. Theimal conlacl wilh lhe skin can be
moniloied by applying a 14 s pulse eveiy 4.5 min and moniloiing lhe iesullanl
lempeialuie iise (Re and Neuman, 1991).
îòïð ÎßÜ×ßÌ×ÑÒ ÌØÛÎÓÑÓÛÌÎÇ
The basis of ®¿¼·¿¬·±² ¬¸»®³±³»¬®§ is lhal lheie is a known ielalionship
belween lhe suiface lempeialuie of an ob|ecl and ils iadianl powei. This
piinciple makes il possible lo measuie lhe lempeialuie of a body wilhoul
physical conlacl wilh il. Medical lheimogiaphy is a lechnique wheieby lhe
lempeialuie disliibulion of lhe body is mapped wilh a sensilivily of a few
lenlhs of a kelvin. ¡l is based on lhe iecognilion lhal skin lempeialuie can vaiy
fiom place lo place depending on lhe cellulai oi ciiculaloiy piocesses occui-
iing al each localion in lhe body. Theimogiaphy has been used foi lhe eaily
deleclion of bieasl cancei, bul lhe melhod is conlioveisial. ¡l has also been
used foi deleimining lhe localion and exlenl of ailhiilic disluibances, foi
gauging lhe deplh of lissue desliuclion fiom fioslbile and buins, and foi
delecling vaiious peiipheial ciiculaloiy disoideis (venous lhiombosis, caiolid
î ò ï ð Î ß Ü × ß Ì × Ñ Ò Ì Ø Û Î Ó Ñ Ó Û Ì Î Ç êç
aileiy occlusions, and so foilh) (Çi, 2OO6). Heie we shall deal wilh lhe basic
piinciples of lheimal iadialion and delecloi syslems.
!veiy body lhal is above absolule zeio iadiales elecliomagnelic powei,
lhe amounl being dependenl on lhe body`s lempeialuie and physical piopeil-
ies. Ioi ob|ecls al ioom lempeialuie, lhe speclium is piedominanlly in lhe fai-
and exlieme-fai-infiaied iegions.
A blackbody is an ideal lheimal iadialoi; as such, il absoibs all incidenl
iadialion and emils lhe maximal possible lheimal iadialion. The iadialion
emilled fiom a body is given by Planck`s law mulliplied by emissivily ». This
expiession ielales lhe iadianl ûux pei unil aiea pei unil wavelenglh É
´
al a
wavelenglh ´ ³m and is slaled as
É
´
»Ý
1
´
5
»
Ý
2
´Ì
1
W/cm
2
³m (2.25)
wheie
Ý
1
3 74 1OO W ³m
4
cm
2
Ý
2
1 44 1O
4
³m K
Ì blackbody lempeialuie, K
» emissivily, lhe exlenl by which a suiface deviales fiom a blackbody
(» 1)
Iiguie 2.16(a) shows a plol of (2.25), lhe speclial iadianl emillance veisus
wavelenglh foi a blackbody al 3OO K.
Wien`s displacemenl law gives lhe wavelenglh ´
m
foi which É
´
is a
maximum. ¡l can simply be found by diffeienlialing (2.25) and selling lhis
lo zeio.
´
m
2898
Ì
³m (2.26)
Iiguie 2.16(a) indicales ´
m
9 66 ³m Ì 3OOK . Nole fiom (2.25) lhal lhe
maximal level of speclial emillance incieases wilh Ì, and fiom(2.26) lhal ´
m
is
inveisely ielaled lo Ì.
The lolal iadianl powei É
l
, can be found by inlegialing lhe aiea undei lhe
cuive. This expiession is known as lhe ͬ»º¿²PÞ±´¬¦³¿²² ´¿©.
É
l
»-Ì
4
W/cm
2
(2.27)
wheie - is lhe SlefanBollzmann conslanl (see Appendix).
¡l is of inleiesl lo examine howlhe peicenlage of lolal iadianl powei vaiies
wilh wavelenglh foi ioom-lempeialuie ob|ecls. This paiamelei, plolled in
Iiguie 2.14(a), is found by dividing
´
O
É
´
¼´ by lhe lolal iadianl powei É,
(2.27). Nole lhal appioximalely 8O' of lhe lolal iadianl powei is found in lhe
wavelenglh band fiom 4 lo 25 ³m.
éð î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
Ú·¹«®» îòïê (a) Speclial iadianl emillance veisus wavelenglh foi a blackbody
al 3OO Kon lhe lefl veilical axis; peicenlage of lolal eneigy on lhe iighl veilical
axis. (b) Speclial liansmission foi a numbei of oplical maleiials. (c) Speclial
sensilivily of pholon and lheimal deleclois. |Pail (a) is fiom Ì®¿²-¼«½»®- º±®
Þ·±³»¼·½¿´ Ó»¿-«®»³»²¬-æ Ю·²½·°´»- ¿²¼ ß°°´·½¿¬·±²-, R. S. C. Cobbold.
Copyiighl ý 1974, 1ohn Wiley & Sons, ¡nc. Repiinled by peimission of 1ohn
Wiley & Sons, ¡nc. Pails (b) and (c) aie fiom Ó»¿-«®»³»²¬ ͧ-¬»³-æ ß°°´·½¿ó
¬·±² ¿²¼ Ü»-·¹², !. O. Doebelin. Copyiighl ý199O by McGiaw-Hill, ¡nc. \sed
wilh peimission of McGiaw-Hill Book Co.j
î ò ï ð Î ß Ü × ß Ì × Ñ Ò Ì Ø Û Î Ó Ñ Ó Û Ì Î Ç éï
Deleimining lhe effecl of changes in suiface emissivily wilh wavelenglh is
impoilanl in oidei lo accuialely deleimine lhe lempeialuie of a given souice.
¡l can be shown lhal foi Ì 3OOK and ´ 3 ³m, a 5' change in » is
equivalenl lo a lempeialuie change of appioximalely 1 C. \aiialions in »
wilh ß should be found in lhe case of absolule-lempeialuie deleiminalions,
bul lhey aie less signincanl when ielalive lempeialuie is desiied, piovided lhal
» iemains conslanl ovei lhe suiface aiea being measuied. The dala ielaling lhe
vaiialion of » wilh ß foi human skin aie nol consislenl and show vaiialions as
laige as 5' fiom unily ovei lhe ´ span fiom 2 lo 6 mm (Cobbold, 1974).
The lenses used in infiaied insliumenls musl be caiefully selecled foi lheii
infiaied speclial piopeilies. Special maleiials musl be chosen because slan-
daid glass used foi lhe visible speclium does nol pass wavelenglhs longei lhan
2 ³m. On lhe olhei hand, some maleiials (such as aisenic liisulnde) ieadily
pass infiaied and nol visible lighl. Iiguie 2.16(b) shows lhe speclial liansmis-
sion foi a numbei of oplical maleiials.
¡nfiaied deleclois and insliumenl syslems musl be designed wilh a high
sensilivily because of lhe weak signals. These devices musl have a shoil
iesponse lime and appiopiiale wavelenglhbandwidlh iequiiemenls lhal
malch lhe iadialion souice. Theimal and pholon deleclois aie used as infiaied
deleclois. The deleclois aie of lwo lypes, bolh of which aie desciibed in
Seclion 2.16. The lheimal delecloi has low sensilivily and iesponds lo all
wavelenglhs, as shown in Iiguie 2.16(c), wheieas quanlum deleclois iespond
only lo a limiled wavelenglh band.
Suilable insliumenlalion musl be used lo amplify, piocess, and display
lhese weak signals fiom iadialion deleclois. Mosl iadiomeleis make use of a
beam-choppei syslemloinleiiupl lhe iadialion al a nxediale (seveial hundied
heilz). This aiiangemenl allows lhe use of high-gain ac amplineis wilhoul lhe
inheienl pioblems of slabilily associaled wilh dc amplineis. ¡n addilion,
compaiison of iefeience souices and lechniques of lempeialuie compensalion
aie moie applicable lo ac-insliumenlalion syslems.
Iiguie 2.17 shows a lypical chopped-beam iadialion-lheimomelei syslem
(Cobbold, 1974). A miiioi focuses lhe iadialion on lhe delecloi. Howevei, a
blackenedchoppei inleiiupls lhe iadialion beamal a conslanl iale. The oulpul
of lhe delecloi ciicuil is a seiies of pulses wilh amplilude dependenl on lhe
slienglh of lhe iadialion souice. This ac signal is amplined, while lhe mean
value, which is sub|ecl lo diifl, is blocked. A iefeience-phase signal, used lo
synchionize lhe phase-sensilive demodulaloi (Seclion 3.15), is geneialed in a
special ciicuil consisling of a lighl souice and delecloi. The signal is lhen
nlleied lo piovide a dc signal piopoilional lo lhe laigel lempeialuie. This
signal can lhen be displayed oi iecoided. ¡nfiaied micioscopes have also been
designed using lhese lechniques.
Iiguie 2.18 shows one applicalion of iadialion lheimomeliy is an insliu-
menl lhal deleimines lhe inleinal oi coie body lempeialuie of lhe human by
measuiing lhe magnilude of infiaied iadialion emilled fiom lhe lympanic
membiane and suiiounding eai canal. The lympanic membiane and hypo-
lhalamus aie peifused by lhe same vasculaluie. The hypolhalamus is lhe
éî î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
body`s main lheimoslal, which iegulales lhe coie body lempeialuie. This
appioach has advanlages ovei using meicuiy lheimomeleis, lheimocouples,
oi lheimislois. The slandaid lempeialuie-measuiing lechniques measuie lhe
lempeialuie of lhe sensoi, nol lhal of lhe sub|ecl. The sensoi musl be in
conlacl wilh lhe palienl long enough foi ils lempeialuie lo become lhe same
as, oi close lo, lhal of lhe sub|ecl whose lempeialuie is being measuied.
Howevei, lhe infiaied lheimomeliy device delecls emilled eneigy lhal is
piopoilional lo lhe aclual lempeialuie of lhe sub|ecl. Theie is negligible
lheimal lime conslanl foi lhe pyioelecliic sensoi (Iiaden, 1997). The infiaied
lympanic lempeialuie-moniloiing syslem has a iesponse lime in lhe oidei of
O.1 s and an accuiacy of appioximalely O 1 C. A disposable sanilaiy piobe
covei is used lo pievenl cioss-conlaminalion fiom palienl lo palienl. !ai
lheimomeliy offeis seveial clinical benenls ovei laking sublingual (oial) oi
ieclal measuiemenls. Response is iapid, and ieadings can be oblained
Ú·¹«®» îòïé Slalionaiy chopped-beam iadialion lheimomelei (Iiom Ì®¿²-ó
¼«½»®- º±® Þ·±³»¼·½¿´ Ó»¿-«®»³»²¬-æ Ю·²½·°´»- ¿²¼ ß°°´·½¿¬·±²-ô by R. S. C.
Cobbold. Copyiighl (c) 1974, 1ohn Wiley and Sons, ¡nc. Repiinled by peimis-
sion of 1ohn Wiley and Sons, ¡nc.)
Ear
IR
Shutter
Ambient sensor
Sensor
Amp.
MUX
A/D
Shutter
switch
Window
Waveguide
Micro
processor
Digital
display
Ì
a
Ì
b
Ú·¹«®» îòïè The infiaied lheimomelei opens a shullei lo expose lhe sensoi
lo iadialion fiom lhe lympanic membiane. |Iiom 1. G. Webslei (ed.), Þ·±ó
·²-¬®«³»²¬¿¬·±², New Yoik: 1ohn Wiley & Sons, 2OO4.j
î ò ï ð Î ß Ü × ß Ì × Ñ Ò Ì Ø Û Î Ó Ñ Ó Û Ì Î Ç éí
independenl of usei lechnique and degiee of palienl aclivily oi coopeialion
(Iiaden, 1991).
¡nfiaied lympanic lempeialuie-moniloiing syslems iequiie a calibialion
laigel in oidei lo mainlain lheii high accuiacy.
îòïï Ú×ÞÛÎóÑÐÌ×Ý ÌÛÓÐÛÎßÌËÎÛ ÍÛÒÍÑÎÍ
Iiguie 2.19 shows lhe delails of a GaAs semiconducloi lempeialuie piobe
(Samaias, 2OO6). Asmall piism-shaped sample of single-ciyslal undoped GaAs
is epoxied al lhe ends of lwo side-by-side oplical nbeis. The sensois and nbeis
can be quile small, compalible wilh biological implanlalion aflei being
shealhed. One nbei liansmils lighl fiom a lighl-emilling diode souice lo
lhe sensoi, wheie il is passed lhiough lhe GaAs and collecled by lhe olhei
nbei foi deleclion in lhe ieadoul insliumenl. Some of lhe oplical powei
liaveling lhiough lhe semiconducloi is absoibed, by lhe piocess of iaising
valence-band eleclions, acioss lhe foibidden eneigy gap inlo lhe conduclion
band. Because lhe foibidden eneigy gap is a sensilive funclion of lhe maleiial`s
lempeialuie, lhe amounl of powei absoibed incieases wilh lempeialuie.
This nonmelallic piobe is pailiculaily suiled foi lempeialuie measuie-
menl in lhe sliong elecliomagnelic healing nelds used in healing lissue foi
cancei lheiapy oi in palienl iewaiming.
îòïî ÑÐÌ×ÝßÔ ÓÛßÍËÎÛÓÛÒÌÍ
Oplical syslems aie widely used in medical diagnosis. The mosl common use
occuis in lhe clinical-chemisliy lab, in which lechnicians analyze samples of
blood and olhei lissues iemoved fiom lhe body. Oplical insliumenls aie also
used duiing caidiac calheleiizalion lo measuie lhe oxygen saluialion of
hemoglobin and lo measuie caidiac oulpul.
Ú·¹«®» îòïç Delails of lhe nbei-sensoi aiiangemenl foi lhe GaAs semi-
conducloi lempeialuie piobe.
éì î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
Iiguie 2.2O(a) shows lhal lhe usual oplical insliumenl has a souice, nllei,
and delecloi. Iiguie 2.2O(b) shows a common aiiangemenl of componenls.
Iiguie 2.2O(c) shows lhal in some cases, lhe funclion of souice, nllei, sample,
and delecloi may be accomplished by solid-slale componenls.
The iemaindei of lhis chaplei is divided inlo seclions lhal deal wilh
souices, geomeliical oplics, nlleis, deleclois, and combinalions lheieof.
îòïí ÎßÜ×ßÌ×ÑÒ ÍÑËÎÝÛÍ
ÌËÒÙÍÌÛÒ ÔßÓÐÍ
¡ncandescenl lungslen-wiie nlamenl lamps aie lhe mosl commonly used
souices of iadialion. Theii iadianl oulpul vaiies wilh lempeialuie and wave-
lenglh, as given by (2.25). Ioi ´ 1 ³m, lungslen has an emissivily of aboul
O.4 and lhus emils aboul 4O' of whal il would if lhe emissivily weie 1.O.
The ielalive-oulpul speclium shown in Iiguie 2.21(a) is only slighlly alleied.
Ioi highei lempeialuies, ´
m
, lhe maximal wavelenglh of lhe iadianl-oulpul
Ú·¹«®» îòîð (a) Geneial block diagiam of an oplical insliumenl. (b) Highesl
efnciency is oblained by using an inlense lamp and lenses lo galhei and focus
lhe lighl on lhe sample in lhe cuvelle, and a sensilive delecloi. (c) Solid-slale
lamps and deleclois may simplify lhe syslem.
î ò ï í Î ß Ü × ß Ì × Ñ Ò Í Ñ Ë Î Ý Û Í éë
Ú·¹«®» îòîï Í°»½¬®¿´ ½¸¿®¿½¬»®·-¬·½- ±º -±«®½»-ô B´¬»®-ô ¼»¬»½¬±®-ô ¿²¼ ½±³¾·²¿ó
¬·±²- ¬¸»®»±º (a) Lighl souices: lungslen (W) al 3OOO K has a bioad speclial
oulpul. Al 2OOO K, oulpul is lowei al all wavelenglhs and peak oulpul shifls lo
longei wavelenglhs. Lighl-emilling diodes yield a naiiow speclial oulpul wilh
GaAs in lhe infiaied, GaP in lhe ied, and GaAsP in lhe gieen. Monochiomalic
oulpuls fiomcommon laseis aie shown by dashed lines: Ai, 515 nm; HeNe, 633
nm; iuby, 693 nm; Nd, 1O64 nm; CO
2
(nol shown), 1O,6OO nm. (b) Iilleis: A
Coining 5-56 glass nllei passes a blue wavelenglh band. A Kodak 87 gelalin
nllei passes infiaied and blocks visible wavelenglhs. Geimanium lenses pass
long wavelenglhs lhal cannol be passed by glass. Hemoglobin Hb and oxy-
hemoglobin HbO pass equally al 8O5 nm and have maximal diffeience al
66O nm. (c) Deleclois: The S4 iesponse is a lypical phololube iesponse. The
eye has a ielalively naiiow iesponse, wilh colois indicaled by \BGYOR. CdS
plus a nllei has a iesponse lhal closely malches lhal of lhe eye. Si °² |unclions
aie widely used. PbS is a sensilive infiaied delecloi. ¡nSb is useful in fai
infiaied. Ò±¬»: These aie only ielalive iesponses. Peak iesponses of diffeienl
deleclois diffei by 1O
7
. (d) Combinalion: ¡ndicaled cuives fiom(a), (b), and (c)
aie mulliplied al each wavelenglh lo yield (d), which shows how well souice,
nllei, and delecloi aie malched. (e) Pholon eneigy: ¡f il is less lhan 1 e\, il is
loo weak lo cause cuiienl ûow in Si °² |unclions.
éê î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
cuives, shifls lo a shoilei wavelenglh, as given by (2.26) and as shown in Iiguie
2.21(a).
Low lempeialuies, lhen, yield a ieddish coloi (infiaied lamps), wheieas
high lempeialuies yield a bluish coloi (pholoûood lamps). The lolal iadialion
is given by (2.27). Hence lhe iadianl oulpul incieases iapidly wilh lempeialuie,
as do lhe efnciency, lhe evapoialion of lungslen, and lhe blackening of lhe
glass bulb. The life of lhe nlamenl is lhus diaslically shoilened by highei
lempeialuies.
Iilamenls aie usually coiled lo inciease lheii emissivily and efnciency. Ioi
use in insliumenls, shoil lineai coils may be aiianged wilhin a compacl, neaily
squaie aiea lying in a single plane. To pioduce a souice of unifoim iadianl
oulpul ovei a subslanlial aiea, iibbon nlamenls may be used.
Tungslenhalogen lamps have iodine oi biomine added lo lhe gases
noimally used lo nll lhe bulb. The small quailz bulbs opeiale al lempeialuies
above 25O C and usually iequiie cooling by a blowei. The halogen combines
wilh lungslen al lhe wall. The iesulling gas migiales back lo lhe nlamenl,
wheie il decomposes and deposils lungslen on lhe nlamenl. As a iesull, lhese
lamps mainlain moie lhan 9O' of lheii inilial iadianl oulpul lhioughoul lheii
life. The iadianl oulpul of a convenlional lamp, on lhe olhei hand, declines as
much as 5O' ovei ils lifelime.
ßÎÝ Ü×ÍÝØßÎÙÛÍ
The ûuoiescenl lamp is nlled wilh a low-piessuie AiHg mixluie. !leclions
aie acceleialed and collide wilh lhe gas aloms, which aie iaised lo an exciled
level. As a given alom`s eleclion undeigoes a liansilion fioma highei level lo a
lowei level, lhe alom emils a quanlum of eneigy. The eneigy pei quanlum
Û ¸ ¸½ ´, wheie ¸ Planck`s conslanl, fiequency, ½ velocily of
lighl, and ´ wavelenglh.
Because lhe sliongesl liansilion of lhe meicuiy alom coiiesponds lo
aboul 5 e\, Iiguie 2.21(e) shows lhe iesulling wavelenglh lo be aboul
25O nm. A phosphoi on lhe inside of lhe glass bulb absoibs lhis ulliaviolel
iadialion and emils lighl of longei, visible wavelenglhs. The ûuoiescenl
lamp has low iadianl oulpul pei unil aiea, so il is nol used in oplical
insliumenls. Howevei, il can be iapidly luined on and off in aboul 2O ³s,
so il is used in lhe ¬¿½¸·-¬±-½±°» (which piesenls biief slimuli lo lhe eye) used
in measuiemenls of visual peiceplion. Olhei low-piessuie dischaige lamps
include lhe glow lamp (such as lhe neon lamp), lhe sodium-vapoi lamp, and
lhe lasei.
High-piessuie dischaige lamps aie moie impoilanl foi oplical insliumenls
because lhe aic is compacl and lhe iadianl oulpul pei unil aiea is high. The
caibon aic has been in use foi lhe longesl lime, bul il has laigely been ieplaced
by lhe meicuiy lamp (bluish-gieen coloi), lhe sodium lamp (yellowcoloi), and
lhe xenon lamp (while coloi). These lamps usually have a cleai quailz bulb
wilh elecliodes al bolh ends of lhe spheiical bulb. The ziiconium aic lamp
piovides an inlense poinl souice.
î ò ï í Î ß Ü × ß Ì × Ñ Ò Í Ñ Ë Î Ý Û Í éé
Ô×ÙØÌóÛÓ×ÌÌ×ÒÙ Ü×ÑÜÛÍ øÔÛÜÍ÷
Lighl-emilling diodes aie °² |unclion devices lhal aie oplimized foi iadianl
oulpul. The oidinaiy silicon°² |unclionchaiacleiislic showninIiguie 2.22 emils
iadianl powei when a cuiienl (lypically 2O mA) passes in lhe foiwaid diieclion.
Sponlaneous iecombinalion of in|ecled hole and eleclion paiis iesulls in lhe
emission of iadialion. Because lhe silicon band gap is 1.1 e\, lhe wavelenglh is al
aboul 11OO nm. The silicon device is nol efncienl. Howevei, GaAs has a slighlly
highei band gap, as shown in Iiguie 2.22, and lheiefoie iadiales al 9OO nm, as
shown in Iiguie 2.21(a). Allhough lhe oulpul is nol visible, lhe efnciency is high
and lhe GaAs device is widely used. ¡l can be swilched in less lhan 1O ns.
Iiguie 2.21(c) and Iiguie 2.21(e) show lhal, in oidei lo pioduce visible
lighl, lhe band gap of a °² |unclion musl exceed 1.9 e\. The GaP L!D in
Iiguie 2.22 has a band gap of 2.26 e\, iequiies a laigei foiwaid-bias vollage
lhan silicon diodes, and is eleclioluminescenl al 7OO nm, as shown in Iiguie
2.21(a). ¡l is an efncienl visible L!D and pioduces a biighl ied lighl. The
GaAsP L!Ds make use of a special phosphoi lhal absoibs lwo pholons al one
wavelenglh and emils a single pholon al a shoilei wavelenglh. The GaAs is Si
doped lo emil iadialion al 94O nm. Powei al lhis wavelenglh is absoibed by lhe
phosphoi coaling lhal emils gieen lighl al 54O nm, as shown in Iiguie 2.21(a).
The decay lime of lhe phosphoi is aboul 1 ms.
Lighl-emilling diodes aie compacl, iugged, economical, and neaily mono-
chiomalic. They aie widely used in a vaiiely of medical, lianspoilalion, and
indusliial ciicuils. A vaiiely of ciicuils aie available foi L!Ds and pholo-
deleclois using eilhei sleady oi modulaled iadialion.
ÔßÍÛÎÍ
Ô¿-»® (lighl amplincalion by slimulaled emissionof iadialion) aclion can occui
in GaAs. The end faces lhal aie peipendiculai lo lhe °² |unclion aie polished
Ú·¹«®» îòîî Ioiwaid chaiacleiislics foi °² |unclions. Oidinaiy silicondiodes
have a band gap of 1.1 e\ and aie inefncienl iadialois in lhe neai-infiaied
iange. GaAs has a band gap of 1.44 e\ and iadiales al 9OO nm. GaP has a band
gap of 2.26 e\ and iadiales al 7OO nm.
éè î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
lo seive as pailial miiiois, lhus foiming a iesonanl oplical cavily. The foiwaid
cuiienl pumps a laige populalion of lhe molecules lo an exciled eneigy level.
Radialion incidenl on lhe molecules causes lhe pioduclion of addilional
iadialion lhal is idenlical in chaiaclei. This phenomenon, known as -¬·³«´¿¬»¼
»³·--·±², is pioduced by lhe feedback fiom lhe miiiois. Lasei oulpul is highly
monochiomalic, collimaled (paiallel), and phase coheienl. Howevei, °²
|unclion laseis aie nol widely used because lhey opeiale in lhe infiaied
and iequiie cuiienl densilies of 1O
3
A/cm
2
oi moie, lhus necessilaling pulsed
(1O1OO ns) opeialion ialhei lhan conlinuous wave (CW).
The mosl common lasei is lhe HeNe lasei lhal opeiales al 633 nm in lhe
ied iegion, as shown in Iiguie 2.21(a). The lasei is opeialed by a low-piessuie
aic similai lo a neon sign and piovides up lo 1OO mW. Pailially ieûeclive
miiiois al each end piovide lhe iesonanl oplical cavily and lasei aclion.
Aigon laseis piovide lhe highesl conlinuous-powei levels (115 W) in lhe
visible pail of lhe speclium al 515 nm |Iiguie 2.21(a)j. This high-powei oulpul
peimils pholocoagulalion of blood vessels in lhe eyes of palienls suffeiing
fiom diabelic ielinopalhy.
CO
2
laseis piovide 5O5OO Wof CWoulpul powei and aie used foi culling
plaslics, iubbei, and melals up lo 1 cm lhick.
Two solid-slale laseis‰bolh usually opeialed in lhe pulsed mode‰aie
widely used. The laseis aie pumped by niing a ûash lube lhal is wound aiound
lhem. The iuby lasei has a modeiale (1 m1) oulpul in lhe ied iegion of lhe
speclium al 693 nm, as shown in Iiguie 2.21(a). The neodymium in ylliium
aluminumgainel (Nd: YAG) lasei has a high (2 W/mm
2
) oulpul in lhe infiaied
iegion al 1O64 nm, as shown in Iiguie 2.21(a).
The mosl impoilanl medical use of lhe lasei has been lo mend leais in lhe
ielina. A lypical pholocoagulaloi uses a pulsed iuby lasei wilh a conliollable
oulpul. ¡l is focused on a leai in lhe ielina. The heal dissipaled by lhe pulse foims
a buin, which, on healing, develops scai lissue lhal mends lhe oiiginal leai.
Seclion 13.1O piovides fuilhei infoimalion on lheiapeulic applicalions of laseis.
Safely lo lhe eye should be consideied wilh iespecl lo some lighl souices. ¡l is
safe lo look al a 1OO W fiosled lighl bulb foi long peiiods of lime. Howevei,
looking al cleai incandescenl lamps, lhe sun, high-piessuie aic souices, oi laseis
cancause buins on lhe ielina. Pioleclive eyeweai woinby lhe physician lopiolecl
againsl laseis usually consisls of a sel of nlleis lhal allenuale al lhe specinc
wavelenglhs emilledby lhe lasei bul liansmil as muchvisible iadialionas possible.
îòïì ÙÛÑÓÛÌÎ×ÝßÔ ßÒÜ Ú×ÞÛÎ ÑÐÌ×ÝÍ
ÙÛÑÓÛÌÎ×ÝßÔ ÑÐÌ×ÝÍ
Theie aie a numbei of geomeliic faclois lhal modify lhe powei liansmilled
belween lhe souice and lhe delecloi. ¡n Iiguie 2.2O(b), lhe mosl obvious
oplical elemenls aie lhe lenses. The lamp emils iadialion in all diieclions. The
î ò ï ì Ù Û Ñ Ó Û Ì Î × Ý ß Ô ß Ò Ü Ú × Þ Û Î Ñ Ð Ì × Ý Í éç
nisl lens should have as small an º ²«³¾»® (ialio of focal lenglh lo diamelei) as
piaclical. Thus il collecls lhe laigesl piaclical solid angle of iadialion fiom lhe
lamp. The nisl lens is usually placed one focal lenglh away fiom lhe lamp, so
lhal lhe iesulling iadialion is ½±´´·³¿¬»¼ (lhal is, lhe iays aie paiallel). Thus, foi
a poinl souice, lhe second lens can be placed al any dislance wilhoul losing any
iadialion. Also, some inleifeience nlleis opeiale besl in collimaled iays.
The second lens focuses lhe iadialion on a small aiea of sample in lhe
cuvelle. Because lhe iadialionnowdiveiges, lhiid and fouilh lenses aie used lo
collecl all lhe iadialion and focus il on a delecloi. Some specliopholomeleis
|Iiguie 2.2O(c)j liansmil collimaled iadialion lhiough lhe sample seclion. The
lenses can be coaled wilh a coaling lhal is a quailei-wavelenglh lhick lo
pievenl ieûeclive losses al aiiglass suifaces. Iull miiiois may be used lo fold
lhe oplical palh lo pioduce a compacl insliumenl. Half-silveied miiiois enable
useis lo splil lhe beaminlo lwo beams foi analysis oi lo combine lwo beams foi
analysis by a single delecloi. Cuived miiiois may funclion as lenses foi
wavelenglhs lhal aie absoibed by noimal glass lenses.
Scalleied iadialion musl be pievenled fiom ieaching lhe delecloi. ¡nlei-
nal suppoil sliucluies and mechanical componenls of oplical insliumenls aie
inleinally painled ûal black lo pievenl scalleied iadialion. Slops (apeiluies
lhal pass only lhe desiied beam size) may be placed al seveial localions along
lhe insliumenl`s oplical axis lo liap scalleied iadialion.
Ú×ÞÛÎ ÑÐÌ×ÝÍ
Iibei oplics aie an efncienl way of liansmilling iadialion fiom one poinl lo
anolhei (Modell and Peielman, 2OO6). Tianspaienl glass oi plaslic nbei wilh a
iefiaclive index ²
1
is coaled oi suiiounded by a second maleiial of a lowei
iefiaclive index ²
2
. By Snell`s law,
²
2
sin«
2
²
1
sin«
1
(2.28)
wheie « is lhe angle of incidence shown in Iiguie 2.23. Because
²
1
²
2
sin«
2
sin«
1
, so sin«
2
1 O foi a value of «
1
lhal is less lhan 9O .
Ioi values of «
1
giealei lhan lhis, sin «
2
is giealei lhan unily, which is
impossible, and lhe iay is inleinally ieûecled. The ciilical angle foi ieûeclion
«
ic
is found by selling sin «
2
1 O, which gives
sin«
ic
²
2
²
1
(2.29)
Aiay is inleinally ieûecled foi all angles of incidence giealei lhan «
ic
. Because
iays enleiing lhe end of a nbei aie usually iefiacled fiom aii ² 1 O inlo
glass (² 1 62 foi one lype), a laigei cone of iadialion «
3
is accepled by a
nbei lhan lhal indicaled by calculalions using 9O «
ic
. Rays enleiing lhe end
of lhe nbei al laigei angles «
4
aie nol liansmilled down lhe nbei; lhey escape
lhiough lhe walls.
èð î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
Iibei-oplic (IO) sensois aie ieplacing some convenlional sensois foi
measuiing a vaiiely of elecliical, eleclionic, mechanical, pneumalic, and
hydiaulic vaiiables (Siiohi and Kolhiyal, 1991; \dd, 1991). They aie chemi-
cally ineil and have fieedom fiom elecliomagnelic inleifeience.
A5O cmglass nbei exhibils a liansmission exceeding 6O' foi wavelenglhs
belween 4OO and 12OO nm. A 5O cm plaslic nbei has a liansmission exceeding
7O'foi wavelenglhs belween 5OO and 85O nm. Allhough a single nbei is useful
foi sampling incidenl iadialion of a small aiea, mosl applicalions use ûexible
bundles of aboul 4OO nbeis. ¡n ²±²½±¸»®»²¬ ¾«²¼´»- (called ´·¹¸¬ ¹«·¼»-), lhe
diamelei of a nbei is lypically 13 lo 1OO nm. Theie is no coiielalion belween a
nbei`s spalial posilion al lhe inpul and al lhe oulpul. These nbeis aie useful
only foi liansmilling iadialion. ¡n one applicalion, lighl is liansmilled lhiough
lhe ûexible bundle foi viewing inleinal oigans (Noilhiop, 2OO2). ¡n a second
applicalion, an insliumenl lhal measuies blood oxygen saluialion wilhin lhe
vessels alleinalely liansmils iadialion al lwo wavelenglhs down one bundle
(Chaplei 1O). The iadialion is backscalleied by lhe ied-blood cells and
ieluined lo lhe insliumenl foi analysis lhiough a second bundle.
¡n ½±¸»®»²¬óB¾»® ¾«²¼´»-, lhe nbeis occupy lhe same ielalive posilion al
bolh end faces. An image al one end is failhfully liansmilled lo lhe olhei end.
The mosl impoilanl medical applicalion of lhese nbeis is in lhe »²¼±-½±°»
(a lube foi examining body cavilies lhiough naluial openings) (Hoopei, 2OO6).
A lypical endoscope is 1 m long and 1 cm in diamelei and may be used foi
viewing lhe lining of lhe slomach, inleslines, and so foilh. A noncoheienl
bundle liansmils lighl foi illuminalion. A small lens focuses lhe image of lhe
lining onlo lhe end of a coheienl bundle, which liansmils lhe image in such a
way lhal il may be viewed oi phologiaphed. !xleinal leveis make il possible lo
sleei lhe inleinal end of lhe oplical-nbei device ovei a 36O iange so lhal lhe
examining physician can look al cavily walls and aiound coineis.
Ú·¹«®» îòîí Ú·¾»® ±°¬·½- The solid line shows iefiaclion of iays lhal escape
lhiough lhe wall of lhe nbei. The dashed line shows lolal inleinal ieûeclion
wilhin a nbei.
î ò ï ì Ù Û Ñ Ó Û Ì Î × Ý ß Ô ß Ò Ü Ú × Þ Û Î Ñ Ð Ì × Ý Í èï
Ô×ÏË×Ü ÝÎÇÍÌßÔÍ
Liquid ciyslals change lheii slale in such a way lhal lhey modify passive
scalleiing oi absoiplion of lighl. As lhe ciyslals mell, lhe lhiee-dimensional
oidei becomes a lwo-dimensional oi one-dimensional oidei. Layeis oi sliands
foim lhal can be seen as a claiincalion of lhe pieviously luibid mell.
¡n one medical applicalion, lhe palienl`s body is painled wilh a black walei-
soluble vainish lo showup lhe coloi of lhe liquid ciyslals bellei. Liquid ciyslals
aie painled ovei lhe vainish, and any inûammalion causes a iise in lempeialuie
lhal is indicaled by a coloi pallein. Liquid ciyslals aie also used, in disposable
lheimomeleis, in lhe measuiemenl of oial lempeialuies. They aie widely used
in wiislwalches, because a low-vollage (115 \), low-powei 1 ³W/cm
2
elecliic neld causes obseivable changes in digilal-display elemenls.
îòïë ÑÐÌ×ÝßÔ Ú×ÔÌÛÎÍ
Ú×ÔÌÛÎÍ
Iilleis aie fiequenlly inseiled in lhe oplical syslem lo conliol lhe disliibulion
of iadianl powei oi wavelenglh. To ieduce iadianl powei only, neulial-densily
nlleis aie used. When glass is pailially silveied, mosl of lhe powei is ieûecled,
and lhe desiied fiaclion of lhe powei is liansmilled. When caibon pailicles aie
suspended in plaslic, mosl of lhe powei is absoibed and lhe desiied fiaclion of
lhe powei is liansmilled. Two Polaioid nlleis may also be used loallenuale lhe
lighl. !ach nllei liansmils only lhal poilion of lhe lighl lhal is in a pailiculai
slale of polaiizalion. As one is iolaled wilh iespecl lo lhe olhei, lhe oplical
liansmission of lhe combinalion vaiies.
Coloi nlleis liansmil ceilain wavelenglhs and ie|ecl olheis. Gelalin nlleis
aie lhe mosl common lype of absoiplion nlleis. An oiganic dye is dissolved in
an aqueous gelalin solulion, and a lhin nlm is diied on a glass subsliale. An
example shown in Iiguie 2.21(b) is lhe infiaied Kodak 87 Wiallen nllei. Glass
nlleis, made by combining addilives wilh lhe glass ilself in ils mollen slale, aie
exlensively used. They piovide ialhei bioad passbands, as illuslialed by lhe
blue Coining 5-56 nllei shown in Iiguie 2.21(b).
ײ¬»®º»®»²½» B´¬»®- aie foimed by deposiling a ieûeclive slack of layeis on
bolh sides of a lhickei spacei layei. This sandwich consliuclion piovides mulliple
ieûeclion and inleifeience effecls lhal yield shaip-edge high, low, and bandpass
nlleis wilh bandwidlhs fiomO.5 lo 2OO nm. ¡nleifeience nlleis aie geneially used
wilh collimaled iadialion and cosl moie lhan lhose |usl menlioned. ¡nleifeience
coalings aie used on dichioic miiiois (cold miiiois), which ieûecl visible
iadialion fiom pio|eclion lamps. The nonuseful infiaied iadialion is liansmilled
lhiough lhe coaling and miiioi lo lhe oulside of lhe oplical syslem. This ieduces
heal wilhin lhe oplical syslem wilhoul saciincing lhe useful lighl.
Ü·ºº®¿½¬·±² ¹®¿¬·²¹- aie widely employed lo pioduce a wavelenglh spec-
lium in lhe specliomelei. Plane gialings aie foimed by culling lhousands of
èî î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
closely spaced paiallel giooves in a maleiial. The gialing is coaled wilh
aluminum, which ieûecls and dispeises while lighl inlo a diffiaclion speclium.
A naiiow slil selecls a naiiow band of wavelenglhs foi use.
Allhough cleai glass is nol oidinaiily lhoughl of as a nllei, Iiguie 2.21(b)
shows lhal ciown glass does nol liansmil below 3OO nm. Ioi insliumenls lhal
opeiale in lhe ulliaviolel, fused quailz (silica glass) is used. Mosl glasses do
nol liansmil well above 26OO nm, so insliumenl makeis use eilhei cuived
miiiois foi infiaied insliumenls oi lenses made of Ge, Si, AsS
3
, CaI
2
, oi
Al
2
O
3
.
Conway »¬ ¿´. (1984) desciibe an oplical melhod foi measuiing lhe
peicenlage of fal in lhe body. They found lhal fal has an absoiplion band
al 93O nm and lhal walei has an absoiplion band al 97O nm. Iiom a single-
beam iapid-scanning specliopholomelei, lhey conducled lighl lo and ieûecled
lighl fiom nve siles on lhe body lhiough a nbei-oplic piobe. The melhod
successfully piedicled peicenl body fal in 17 sub|ecls ® O 91 when com-
paied wilh lhe D
2
O dilulion lechnique.
îòïê ÎßÜ×ßÌ×ÑÒ ÍÛÒÍÑÎÍ
Radialion sensois may be classined inlo lwo geneial calegoiies: lheimal
sensois and quanlum sensois (Mendelson, 2OO6).
ÌØÛÎÓßÔ ÍÛÒÍÑÎÍ
The ¬¸»®³¿´ -»²-±® absoibs iadialion and liansfoims il inlo heal, lhus causing a
iise in lempeialuie in lhe sensois. Typical lheimal sensois aie lhe lheimisloi and
lhe lheimocouple. The sensilivily of such a sensoi does nol change wilh (is ûal
wilh) wavelenglh, and lhe sensoi has slow iesponse |Iiguie 2.21(c)j. Changes in
oulpul due lo changes in ambienl lempeialuie cannol be dislinguished fiom
changes in oulpul due lo lhe souice, so a windmill-shaped mechanical choppei is
fiequenlly used lo inleiiupl lhe iadialion fiom lhe souice peiiodically.
The °§®±»´»½¬®·½ -»²-±® (Iiaden, 1997) absoibs iadialion and conveils il
inlo heal. The iesulling iise in lempeialuie changes lhe polaiizalion of lhe
ciyslals, which pioduces a cuiienl piopoilional lo lhe iale of change of
lempeialuie. As il is foi lhe piezoelecliic sensoi, dc iesponse is zeio, so a
choppei is iequiied foi dc measuiemenls.
ÏËßÒÌËÓ ÍÛÒÍÑÎÍ
Ï«¿²¬«³ -»²-±®- absoib eneigy fiom individual pholons and use il lo ielease
eleclions fiom lhe sensoi maleiial. Typical quanlum sensois aie lhe eye, lhe
phololube, lhe pholodiode, and phologiaphic emulsion. Such sensois aie
sensilive ovei only a iesliicled band of wavelenglhs; mosl iespond iapidly.
Changes in ambienl lempeialuie cause only a second-oidei change in sensi-
livily of lhese sensois.
î ò ï ê Î ß Ü × ß Ì × Ñ Ò Í Û Ò Í Ñ Î Í èí
ÐØÑÌÑÛÓ×ÍÍ×ÊÛ ÍÛÒÍÑÎÍ
豬±»³·--·ª» -»²-±®-‰an example is lhe °¸±¬±¬«¾»‰have pholocalhodes
coaled wilh alkali melals. ¡f lhe eneigy of lhe pholons of lhe incoming
iadialion is sufncienl lo oveicome lhe woik funclion of lhe pholocalhode,
lhe foices lhal bind eleclions lo lhe pholocalhode aie oveicome, and il emils
eleclions. !leclions aie alliacled lo a moie posilive anode and foim a cuiienl
lhal is measuied by an exleinal ciicuil. Pholon eneigies below 1 e\ aie nol
laige enough lo oveicome lhe woik funclion, so wavelenglhs longei lhan
12OO nm cannol be delecled. Iiguie 2.21(c) shows lhe speclial iesponse of lhe
mosl common pholocalhode, lhe S4, which has lowei sensilivily in lhe ullia-
violel iegion because of absoiplion of iadialion in lhe glass envelope.
The °¸±¬±³«´¬·°´·»® shown in Iiguie 2.24 is a phololube combined wilh an
eleclion mullipliei (Lion, 1975). !ach acceleialedeleclion hils lhe nisl dynode
wilh enough eneigy lo libeiale seveial eleclions by secondaiy emission. These
eleclions aie acceleialed lo lhe second dynode, wheie lhe piocess is iepealed,
and so on. Time iesponse is less lhan 1O ns. Pholomulliplieis aie lhe mosl
sensilive pholodeleclois. When lhey aie cooled (lo pievenl eleclions fiom
being lheimally geneialed), lhey can counl individual pholons. The eye is
almosl as sensilive; undei lhe mosl favoiable condilions, il can delecl six
pholons aiiiving in a small aiea wilhin 1OO ms. Pholodiodes have ieplaced
pholomulliplieis in many applicalions.
ÐØÑÌÑÝÑÒÜËÝÌ×ÊÛ ÝÛÔÔÍ
豬±®»-·-¬±®- aie lhe simplesl solid-slale pholoelecliic sensois. A pholo-
sensilive ciyslalline maleiial such as CdS oi PbS |Iiguie 2.21(c)j is deposiled
Ú·¹«®» îòîì 豬±³«´¬·°´·»® An incoming pholon sliikes lhe pholocalhode
and libeiales an eleclion. This eleclion is acceleialed lowaid lhe nisl dynode,
which is 1OO \ moie posilive lhan lhe calhode. The impacl libeiales seveial
eleclions by secondaiy emission. They aie acceleialed lowaid lhe second
dynode, which is 1OO \ moie posilive lhan lhe nisl dynode. This eleclion
mulliplicalion conlinues unlil il ieaches lhe anode, wheie cuiienls of aboul
1 ³A ûow lhiough Î
L
.
èì î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
on a ceiamic subsliale, and ohmic elecliodes aie allached. ¡f a pholon of lhe
incoming iadialion has sufncienl eneigy lo |ump lhe band gap, holeeleclion
paiis aie pioduced because lhe eleclion is iaised fiom lhe valence band lo lhe
conduclion band. The piesence of lhe eleclions in lhe conduclion band and of
lhe holes in lhe valence band incieases lhe conduclivily of lhe ciyslalline
maleiial so lhal lhe iesislance decieases wilh inpul iadialion. Pholocuiienl is
lineai al low levels of iadialion bul nonlineai al levels lhal aie noimally used.
¡l is independenl of lhe polaiily of applied vollage. Aflei a slep inciease oi
deciease of iadialion, lhe pholocuiienl iesponse iises and decays wilh a lime
conslanl of fiom1O lo O.O1 s, depending on whelhei lhe iadialion is lowoi high.
ÐØÑÌÑÖËÒÝÌ×ÑÒ ÍÛÒÍÑÎÍ
Pholo|unclion sensois aie foimed fiom °² |unclions and aie usually made of
silicon. ¡f a pholonhas sufncienl eneigy lo|umplhe bandgap, holeeleclionpaiis
aie pioduced lhal modify lhe |unclion chaiacleiislics, as shown in Iiguie 2.25. ¡f
lhe |unclion is ieveise-biased, lhe ieveise pholocuiienl ûowing fiomlhe calhode
lo lhe anode incieases lineaily wilh an inciease in iadialion. The iesulling
pholodiode iesponds in aboul 1 ³s. ¡n phololiansislois, lhe base lead is nol
connecled, and lhe iesulling iadialion-geneialedbase cuiienl is mullipliedby lhe
cuiienl gain (bela) of lhe liansisloi lo yield a laige cuiienl fiom collecloi lo
emillei. The iadialioncuiienl chaiacleiislics have a nonlineaiily of aboul 2'
because bela vaiies wilh collecloi cuiienl. The iesponse lime is aboul 1O ³s.
Ú·¹«®» îòîë ʱ´¬¿¹»P½«®®»²¬ ½¸¿®¿½¬»®·-¬·½- ±º ·®®¿¼·¿¬»¼ -·´·½±² ¶«²½¬·±²
Ioi O iiiadiance, bolh foiwaid and ieveise chaiacleiislics aie noimal. Ioi
1 mW/cm
2
, open-ciicuil vollage is 5OO m\, and shoil-ciicuil cuiienl is O 8 ³A.
Ioi 1OmW/cm
2
, open-ciicuil vollage is 6OO m\, and shoil-ciicuil cuiienl is
8 ³A.
î ò ï ê Î ß Ü × ß Ì × Ñ Ò Í Û Ò Í Ñ Î Í èë
Silicon °² |unclions aie also manufacluied as pholo Dailinglon liansislois,
pholo I!Ts, pholo uni|unclion liansislois, and pholo silicon-conliolled ieclineis
(SCRs). Pholon coupleis aie L!Dpholodiode combinalions lhal aie used foi
isolaling elecliic ciicuils. Ioi example, lhey aie used foi bieaking giound loops
and foi pievenling dangeious levels of cuiienl fiom leaking oul of equipmenl
and enleiing lhe heail of a palienl (Seclion 14.9). Modein pholo|unclion sensois
have become so sensilive and wilh iapid iesponse limes so lhal in many
applicalions lhey have ieplaced pholomulliplieis.
ÐØÑÌÑÊÑÔÌß×Ý ÍÛÒÍÑÎÍ
The same silicon °² |unclion can be used in lhe pholovollaic mode. Iiguie
2.25 shows lhal lheie is an open-ciicuil vollage when lhe |unclion ieceives
iadialion. The vollage iises logaiilhmically fiom 1OO lo 5OO m\ as lhe inpul
iadialion incieases by a facloi of 1O4. This is lhe piinciple of lhe solai cell lhal
is used foi diiecl conveision of lhe sun`s iadialion inlo elecliic powei.
ÍÐÛÝÌÎßÔ ÎÛÍÐÑÒÍÛ
All of lhe afoiemenlioned silicon sensois have lhe speclial iesponse shown in
Iiguie 2.21(c). Theie is no iesponse above 11OO nm because lhe eneigy of lhe
pholons is loo low lo peimil lhem lo |ump lhe band gap. Ioi wavelenglhs
shoilei lhan 9OO nm, lhe iesponse diops off because lheie aie fewei, moie-
eneigelic pholons pei wall. !ach pholon geneiales only one holeeleclion
paii.
Because none of lhe commonsensois is capable of measuiing lhe iadialion
emilled by lhe skin (3OO K), which has a peak oulpul al 9OOO nm, special
sensois have been developed, such as lhe ¡nSb sensoi shown in Iiguie 2.21(c).
îòïé ÑÐÌ×ÝßÔ ÝÑÓÞ×ÒßÌ×ÑÒÍ
¡n oidei lo specify lhe combinalions of souices, nlleis, and sensois, insliumenl
designeis iequiie iadiomeliic unils lhal musl be weighled accoiding lo lhe
iesponse cuive of each elemenl. The lolal effeclive iiiadiance, Û
e
, is found by
bieaking up lhe speclial cuives inlo many naiiow bands and lhen mulliplying
each logelhei and adding lhe iesulling inciemenls (Slimson, 1974). Thus
Û
e
Í
´
Ú
´
Ü
´
Ü´ (2.3O)
wheie
Í
´
ielalive souice oulpul
Ú
´
ielalive nllei liansmission
Ü
´
ielalive sensoi iesponsivily
èê î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
Iiguie 2.21(d) shows seveial iesulls of lhis lype of calculalion. One of lhe
examples shown is an efncienl syslem capable of making measuiemenls in
lhe daik wilhoul slimulaling lhe eye. Such a device can be used foi liacking
eye movemenls. ¡l can be foimed fiom a lungslen souice, a Kodak 87
Wiallen nllei, and a silicon sensoi. ¡f GaAs piovides enough oulpul, il can
ieplace bolh lhe lungslen souice and lhe Kodak 87 Wiallen nllei (Boiah,
2OO6).
ÐÎÑÞÔÛÓÍ
îòï Ú±® Ú·¹«®» Ðîòïô °´±¬ ¬¸» ®¿¬·± ±º ¬¸» ±«¬°«¬ ª±´¬¿¹» ¬± ¬¸» ·²°«¬ ª±´¬¿¹»
± ·
¿- ¿ º«²½¬·±² ±º ¬¸» ¼·-°´¿½»³»²¬ ¨
i
of a polenliomelei wilh a lolal
displacemenl ¨
l
foi ianges of Î
m
, lhe inpul iesislance of lhe melei. Show lhal
lhe maximal eiioi occuis in lhe neighboihood of ¨
i
¨
l
O 67. Whal is lhe
value of lhis maximal eiioi?
îòî ̸» °®¿½¬·½¿´ ´·³·¬¿¬·±² º±® ©·®» -°¿½·²¹ ·² °±¬»²¬·±³»¬»® ½±²-¬®«½¬·±² ·-
¾»¬©»»² îð ¿²¼ ì𠬫®²-ñ³³ò Ú·²¼ ¬¸» ®»-±´«¬·±² ´·³·¬¿¬·±² º±® ¿ ¬®¿²-´¿¬·±²¿´
¿²¼ ¿ ®±¬¿¬·±²¿´ °±¬»²¬·±³»¬»®ò Ю±°±-» ¿ ©¿§ ¬± ·²½®»¿-» ¬¸» ®»-±´«¬·±² ±º ¿
®±¬¿¬·±²¿´ °±¬»²¬·±³»¬»®ò
îòí Ü·-½«-- -±³» ±º ¬¸» °±--·¾´» °®±¾´»³- ·²ª±´ª»¼ ·² »´¿-¬·½ó®»-·-¬¿²½» -¬®¿·²ó
¹¿¹» -»²-±®- ¿²¼ ¬¸»·® -±´«¬·±²-ò
îòì ̸» »´»½¬®±³±¬·ª» º±®½» Ûfoi a lheimocouple is given by (2.21). Calculale
and plol Û foi condilions in which lhe iefeience souice is al O C and
lempeialuie vaiies fiom O C lo 5O C. The lheimocouple maleiial is coppei
conslanlan wilh ¿ 38 7³\/ C and ¾ O O82³\/ C
2
. How signincanl is lhe
second leim in youi calculalions? Nole lhal lhese calculaled cuives aie nol
exaclly salisned in lhe piaclical silualion. Thus an expeiimenlal calibialion
musl be measuied ovei lhe iange of inleiesl.
îòë Ë-·²¹ ¬¸» ®»-«´¬- ±º Ю±¾´»³ îòìô ½¿´½«´¿¬» ¬¸» -»²-·¬·ª·¬§ ¿ ¿¬ 37 Ý º±® ¬¸»
½±°°»®›½±²-¬¿²¬¿² ¬¸»®³±½±«°´»ò
Ú·¹«®» Ðîòï
Ð Î Ñ Þ Ô Û Ó Í èé
îòê Ý¿´½«´¿¬» ¬¸» ª¿´«» ±º ¬¸» ¬¸»®³·-¬±® ¬»³°»®¿¬«®» ½±»º•½·»²¬ ¿ º±® Ì
3OOÕ ¿²¼ ¾ 4OOO Õò
îòé Ú±® ¬¸» ÔÊÜÌ-¸±©²·²Ú·¹«®» îòêø½÷ô -µ»¬½¸ ¬¸» ª±´¬¿¹»- ½›»ô ¼›»ô ¿²¼½›¼
¿- ¬¸» ½±®» ·- ¼·-°´¿½»¼ ¬¸®±«¹¸ ·¬- ²±®³¿´ ®¿²¹»ò
îòè Ú±® Û¨¿³°´» îòïô ©¸¿¬ -·¦» -¸«²¬·²¹ ½¿°¿½·¬±® -¸±«´¼ ¾» ¿¼¼»¼ ¬± »¨¬»²¼
¬¸» ´±©ó½±®²»® º®»¯«»²½§ ¬± ðòðë ئô ¿- ·- ®»¯«·®»¼ ¬± ¼»¬»½¬ °«´-» ©¿ª»º±®³-á
ر© ·- ¬¸» -»²-·¬·ª·¬§ ½¸¿²¹»¼á
îòç Ü»-·¹² ¿ ½¸¿®¹» ¿³°´·•»® º±® ¿ °·»¦±»´»½¬®·½ -»²-±® ¬¸¿¬ ¸¿- ëðð °Ú
½¿°¿½·¬¿²½»ò ׬ -¸±«´¼ °¿-- º®»¯«»²½·»- º®±³ ðòðë ¬± ïðð ئ -± ¬¸¿¬ ·¬ ½¿²
¼»¬»½¬ ½¿®±¬·¼ °«´-»-ô ¿²¼ ·¬ -¸±«´¼ ²±¬ ¼®·º¬ ·²¬± -¿¬«®¿¬·±²ò
îòïð ͵»¬½¸ ¬§°·½¿´ ¬¸»®³·-¬±® · chaiacleiislics wilh and wilhoul a heal sink.
!xplain why lheie is a diffeience.
îòïï Ý¿´½«´¿¬» ¿²¼ -µ»¬½¸ ¿ ½«®ª» º±® ¬¸» ®¿¼·¿²¬ ±«¬°«¬ ±º ¬¸» -µ·² ¿¬ íðð Õ ¿¬
îðððô ëðððô ïðôðððô ¿²¼ îðôððð ²³ò
îòïî ͵»¬½¸ ¿² ±°¬·½¿´ -§-¬»³ «-·²¹ ½«®ª»¼ ³·®®±®- ·²-¬»¿¼ ±º ´»²-»- ¬¸¿¬ ½±«´¼
®»°´¿½» ¬¸» -§-¬»³ -¸±©² ·² Ú·¹«®» îòîðø¾÷ò
îòïí ͵»¬½¸ ¬¸» ½·®½«·¬ º±® ¿ °¸±¬± Ü¿®´·²¹¬±² ¬®¿²-·-¬±®ô ©¸·½¸ ·- ¬©±
½¿-½¿¼»¼ »³·¬¬»®›º±´´±©»® ¬®¿²-·-¬±®-ò Û-¬·³¿¬» ·¬- ´·²»¿®·¬§ ¿²¼ ®»-°±²-» ¬·³»ò
îòïì Ú±® ¬¸» -±´¿® ½»´´ -¸±©² ·² Ú·¹«®» îòîëô ©¸¿¬ ª¿´«» ´±¿¼ ®»-·-¬±® ©±«´¼
®»½»·ª» ¬¸» ³¿¨·³¿´ °±©»®á
îòïë Ú±® ¬¸» °¸±¬±³«´¬·°´·»® -¸±©² ·² Ú·¹«®» îòîìô ©¸»² Î
L
is highenoughfoi
adequale sensilivily, lhe sliay capacilyÎ
L
pioducl pioduces a lime conslanl
lhal is loo long. Design a ciicuil lhal is 1O limes faslei and has no loss in
sensilivily.
îòïê Ú±® Ú·¹«®» îòîïø¼÷ô °´±¬ ¬¸» ®»´¿¬·ª» ½±³¾·²¿¬·±² °®±¼«½¬ º±® Ù¿Ðô ؾÑô
ݼÍò
ÎÛÚÛÎÛÒÝÛÍ
Alihanka, 1., K. \aahloianla, and S.-! B|oikqvisl, Appaialus in medicine foi lhe moniloiing and/
oi iecoiding of lhe body movemenls of a peison on a bed, foi inslance of a palienl. \niled
Slales Palenl 4,32O,766, 1982.
Anonymous, Ó¿²«¿´ ±² ¬¸» Ë-» ±º ̸»®³±½±«°´»- ·² Ì»³°»®¿¬«®» Ó»¿-«®»³»²¬. Publicalion
47OA. Philadelphia: Ameiican Sociely foi Tesling and Maleiials, 1974.
Boiah, 1., !ye movemenl, measuiemenl lechniques foi.`` ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º
Ó»¼·½¿´ Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed. New Yoik: Wiley, 2OO6, \ol. 3, pp. 263286.
Bowman, L., and 1. D. Meindl, Capacilive sensois.`` ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º
Ó»¼·½¿´ Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±². New Yoik: Wiley, 1988, pp. 551556.
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ײ-¬®«³»²¬¿¬·±², 2nd. ed. New Yoik: Wiley, 2OO6, \ol. 6, pp. 355362.
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±º Ó»¼·½¿´ Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±² 2nd ed. New Yoik: Wiley, 2OO6, \ol. 4, pp.
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Î Û Ú Û Î Û Ò Ý Û Í èç
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çð î Þ ß Í × Ý Í Û Ò Í Ñ Î Í ß Ò Ü Ð Î × Ò Ý × Ð Ô Û Í
í
ßÓÐÔ×Ú×ÛÎÍ ßÒÜ Í×ÙÒßÔ
ÐÎÑÝÛÍÍ×ÒÙ
Ö±¸² Ùò É»¾-¬»®
Mosl bioelecliic signals aie small and iequiie amplincalion. Amplineis aie
also used foi inleifacing sensois lhal sense body molions, lempeialuie, and
chemical concenlialions. ¡n addilion lo simple amplincalion, lhe amplinei may
also modify lhe signal lo pioduce fiequency nlleiing oi nonlineai effecls. This
chaplei emphasizes lhe ±°»®¿¬·±²¿´ ¿³°´·B»® (op amp), which has ievolulion-
ized eleclionic ciicuil design. Mosl ciicuil design was foimeily peifoimed wilh
disciele componenls, iequiiing laboiious calculalions, many componenls, and
laige expense. Now a 2O-cenl op amp, a fewiesislois, and knowledge of Ohm`s
law aie all lhal is needed.
íòï ×ÜÛßÔ ÑÐ ßÓÐÍ
An ±° ¿³° is a high-gain dc diffeienlial amplinei. ¡l is noimally used in ciicuils
lhal have chaiacleiislics deleimined by exleinal negalive-feedback nelwoiks.
The besl way lo appioach lhe design of a ciicuil lhal uses op amps is nisl lo
assume lhal lhe op amp is ideal. Aflei lhe inilial design, lhe ciicuil is checked
lo deleimine whelhei lhe nonideal chaiacleiislics of lhe op amp aie impoilanl.
¡f lhey aie nol, lhe design is complele; if lhey aie, anolhei design check is
made, which may iequiie addilional componenls.
×ÜÛßÔ ÝØßÎßÝÌÛÎ×ÍÌ×ÝÍ
Iiguie3.1shows lhe equivalenl ciicuil foi a nonideal opamp. ¡l is a dc diffeienlial
amplinei, which means lhal any diffeienlial vollage,
d 2 1
, is mulliplied
by lhe veiy high gain ß lo pioduce lhe oulpul vollage
o
.
To simplify calculalions, we assume lhe following chaiacleiislics foi an
ideal op amp:
ïò ß (gain is innnily)
îò
o
O, when
1 2
(no offsel vollage)
çï
íò Î
d
(inpul impedance is innnily)
ìò Î
o
O (oulpul impedance is zeio)
ëò Bandwidlh = (no fiequency-iesponse limilalions) and no phase shifl
Lalei in lhe chaplei we shall examine lhe effecl on lhe ciicuil of chaiaclei-
islics lhal aie nol ideal.
Iiguie 3.2 shows lhe op-amp ciicuil symbol, which includes lwo diffeien-
lial inpul leiminals and one oulpul leiminal. All lhese vollages aie measuied
wilh iespecl lo lhe giound shown. Powei supplies, usually 15 \, musl be
connecled lo leiminals indicaled on lhe manufacluiei`s specincalion sheel
(1ung, 1986; Hoiowilz and Hill, 1989).
ÌÉÑ ÞßÍ×Ý ÎËÔÛÍ
Thioughoul lhis chaplei we shall use lwo basic iules (oi inpul leiminal
iesliiclions) lhal aie veiy helpful in designing op-amp ciicuils.
ÎËÔÛ ï ɸ»² ¬¸» ±°ó¿³° ±«¬°«¬ ·- ·² ·¬- ´·²»¿® ®¿²¹»ô ¬¸» ¬©± ·²°«¬ ¬»®³·²¿´-
¿®» ¿¬ ¬¸» -¿³» ª±´¬¿¹»ò
This is liue because if lhe lwo inpul leiminals weie nol al lhe same vollage, lhe
diffeienlial inpul vollage would be mulliplied by lhe innnile gain lo yield an
innnile oulpul vollage. This is absuid; mosl op amps use a powei supply of 15 \,
so
o
is iesliicled lo lhis iange. Aclually lhe op-amp specincalions guaianlee a
Ú·¹«®» íòï Ñ°ó¿³° »¯«·ª¿´»²¬ ½·®½«·¬ The lwo inpuls aie
l
and
2
. A
diffeienlial vollage belween lhem causes cuiienl ûow lhiough lhe diffeienlial
iesislance Î
d
. The diffeienlial vollage is mulliplied by ß, lhe gain of lhe op
amp, lo geneiale lhe oulpul-vollage souice. Any cuiienl ûowing lo lhe oulpul
leiminal
o
musl pass lhiough lhe oulpul iesislance Î
o
.
Ú·¹«®» íòî Ñ°ó¿³° ½·®½«·¬ -§³¾±´ ß vollage al
1
, lhe inveiling inpul, is
gieally amplined and inveiled lo yield
o
. A vollage al
2
, lhe noninveiling
inpul, is gieally amplined lo yield an in-phase oulpul al
o
.
çî í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
lineai oulpul iange of only 1O \, allhough some saluiale al aboul 13 \. A
single supply is adequale wilh some op amps, such as lhe LM358 (Hoiowilz and
Hill, 1989).
ÎËÔÛ î Ò± ½«®®»²¬ A±©- ·²¬± »·¬¸»® ·²°«¬ ¬»®³·²¿´ ±º ¬¸» ±° ¿³°ò
This is liue because we assume lhal lhe inpul impedance is innnily, and no
cuiienl ûows inlo an innnile impedance. !ven if lhe inpul impedance weie
nnile, Rule 1 lells us lhal lheie is no vollage diop acioss Î
d
; so lheiefoie, no
cuiienl ûows.
íòî ×ÒÊÛÎÌ×ÒÙ ßÓÐÔ×Ú×ÛÎÍ
Ý×ÎÝË×Ì
Iiguie 3.3(a) shows lhe basic inveiling-amplinei ciicuil. ¡l is widely used in
insliumenlalion. Nole lhal a poilion of
o
is fed back via Î
f
lo lhe negalive
inpul of lhe op amp. This piovides lhe inveiling amplinei wilh lhe many
advanlages associaled wilh lhe use of negalive feedback‰incieased band-
widlh, lowei oulpul impedance, and so foilh. ¡f
o
is evei fed back lo lhe
posilive inpul of lhe op amp, examine lhe ciicuil caiefully. !ilhei lheie is a
mislake, oi lhe ciicuil is one of lhe iaie ones in which a iegeneialive aclion is
desiied.
ÛÏËßÌ×ÑÒ
Nole lhal lhe posilive inpul of lhe op amp is al O \. Theiefoie, by Rule 1, lhe
negalive inpul of lhe op amp is also al O \. Thus no mallei whal happens lo lhe
iesl of lhe ciicuil, lhe negalive inpul of lhe op amp iemains al O \, a condilion
known as a ª·®¬«¿´ ¹®±«²¼.
Because lhe iighl side of Î
i
, is al O \and lhe lefl side is
i
, by Ohm`s lawlhe
cuiienl · lhiough Î
i
, is ·
i
Î
i
. By Rule 2, no cuiienl can enlei lhe op amp;
lheiefoie · musl also ûow lhiough Î
f
. This pioduces a vollage diop acioss Î
f
of
·Î
f
. Because lhe lefl end of Î
f
is al O \, lhe iighl end musl be
o
·Î
f i
Î
f
Î
i
oi
o
i
Î
f
Î
i
(3.1)
Thus lhe ciicuil inveils, and lhe ·²ª»®¬·²¹ó¿³°´·B»® gain (nol lhe op-amp gain)
is given by lhe ialio of Î
f
lo Î
i
.
ÔÛÊÛÎ ßÒßÔÑÙÇ
Iiguie 3.3(b) shows an easy way lo visualize lhe ciicuil`s behavioi. A levei is
foimed wilh aim lenglhs piopoilional lo iesislance values. Because lhe
í ò î × Ò Ê Û Î Ì × Ò Ù ß Ó Ð Ô × Ú × Û Î Í çí
negalive inpul is al O \, lhe fulcium is placed al O \, as shown. ¡f Î
f
is lhiee
limes Î
i
, as shown, any vaiialion of
i
iesulls in a lhiee-limes-biggei vaiialion
of
o
. The ciicuil in Iiguie 3.3(a) is a vollage-conliolled cuiienl souice (\CCS)
foi any load Î
f
(1ung, 1986). The cuiienl · lhiough Î
f
is
i

i
, so
i
conliols ·.
Cuiienl souices aie useful in elecliical impedance plelhysmogiaphy foi
passing a nxed cuiienl lhiough lhe body (Seclion 8.7).
×ÒÐËÌŠÑËÌÐËÌ ÝØßÎßÝÌÛÎ×ÍÌ×Ý
Iiguie 3.3(c) shows lhal lhe ciicuil is lineai only ovei a limiled iange of
i
.
When
o
exceeds aboul 13 \, il -¿¬«®¿¬»- (limils), and fuilhei incieases in
i
pioduce no change in lhe oulpul. The lineai swing of
o
is aboul 4 \ less lhan
lhe diffeience in powei-supply vollages. Allhough op amps usually have
Ú·¹«®» íòí (a) An inveiling amplinei. Cuiienl ûowing lhiough lhe inpul
iesisloi Î
i
also ûows lhiough lhe feedback iesisloi Î
f
. (b) A levei wilh aim
lenglhs piopoilional lo iesislance values enables lhe viewei lo visualize lhe
inpuloulpul chaiacleiislics easily. (c) The inpuloulpul plol shows a slope of
Î
f
Î
i
in lhe cenlial poilion, bul lhe oulpul saluiales al aboul 13 \.
çì í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
powei-supply vollages sel al 15 \, ieduced powei-supply vollages may be
used, wilh a coiiesponding ieduclion in lhe saluialion vollages and lhe lineai
swing of
o
.
ÍËÓÓ×ÒÙ ßÓÐÔ×Ú×ÛÎ
The inveiling amplinei may be exlended lo foim a ciicuil lhal yields lhe
weighled sum of seveial inpul vollages. !ach inpul vollage
i1
,
i2
, . . . ,

is
connecled lo lhe negalive inpul of lhe op amp by an individual iesisloi lhe
conduclance of which 1 Î

is piopoilional lo lhe desiied weighling.
ÛÈßÓÐÔÛ íòï The oulpul of a biopolenlial pieamplinei lhal measuies
lhe eleclio-oculogiam (!OG) (Seclion 4.7) is an undesiied dc vollage of
5 \ due lo elecliode half-cell polenlials (Seclion 5.1), wilh a desiied
signal of 1 \ supeiimposed. Design a ciicuil lhal will balance lhe dc
vollage lo zeio and piovide a gain of 1O foi lhe desiied signal wilhoul
saluialing lhe op amp.
ßÒÍÉÛÎ Iiguie !3.1(a) shows lhe design. We assume lhal
b
, lhe balancing
vollage available fiom lhe 5kÊ polenliomelei, is 1O \. The undesiied
vollage al
i
5 \. Ioi
o
O, lhe cuiienl lhiough Î
f
is zeio. Theiefoie
lhe sum of lhe cuiienls lhiough Î
i
and Î
b
, is zeio.
i
Î
i
b
Î
b
O
Î
b
Î
i b
1O
4
1O
5
2 1O
4
Ê
Ú·¹«®» Ûíòï (a) This ciicuil sums lhe inpul vollage
i
plus one-half of lhe
balancing vollage
b
. Thus lhe oulpul vollage
o
can be sel lo zeio even when
i
has a nonzeio dc componenl, (b) The lhiee wavefoims show
i
, lhe inpul
vollage;
i b
2 , lhe balanced-oul vollage; and
o
, lhe amplined oulpul
vollage. ¡f
i
weie diieclly amplined, lhe op amp would saluiale.
í ò î × Ò Ê Û Î Ì × Ò Ù ß Ó Ð Ô × Ú × Û Î Í çë
Ioi a gain of 1O, (3.1) iequiies Î
f
Î
i
1O oi Î
f
1OOkÊ. The ciicuil
equalion is
o
Î
º
i
Î
i
b
Î
b
o
1O
5 i
1O
4
b
2 1O
4
o
1O
·
b
2
The polenliomelei can balance oul any undesiied vollage in lhe iange 5 \, as
shown by Iiguie !3.1(b). Heie we have selecled iesislois of 1O kÊ lo 1OO kÊ
fiomlhe common iesislois used in eleclionic ciicuils lhal have values belween
1O Ê and 22 MÊ.
íòí ÒÑÒ×ÒÊÛÎÌ×ÒÙ ßÓÐÔ×Ú×ÛÎÍ
ÚÑÔÔÑÉÛÎ
Iiguie 3.4(a) shows lhe ciicuil foi a unily-gain followei. Because
i
exisls al lhe
posilive inpul of lhe op amp, by Rule 1
i
musl also exisl al lhe negalive inpul.
Bul
o
is also connecled lo lhe negalive inpul. Theiefoie
o i
, oi lhe oulpul
vollage follows lhe inpul vollage. Al nisl glance il seems nolhing is gained by
using lhis ciicuil; lhe oulpul is lhe same as lhe inpul. Howevei, lhe ciicuil is veiy
useful as a ¾«ºº»®, lo pievenl a high souice iesislance fiom being loaded down
by a low-iesislance load. By Rule 2, no cuiienl ûows inlo lhe posilive inpul, and
lheiefoie lhe souice iesislance in lhe exleinal ciicuil is nol loaded al all.
ÒÑÒ×ÒÊÛÎÌ×ÒÙ ßÓÐÔ×Ú×ÛÎ
Iiguie 3.4(b) shows how lhe followei ciicuil can be modined lo pioduce gain.
By Rule 1,
i
appeais al lhe negalive inpul of lhe op amp. This causes cuiienl
·
i
Î
i
, lo ûow lo giound. By Rule 2, none of · can come fiom lhe negalive
inpul; lheiefoie all musl ûowlhiough Î
f
. We can lhen calculale
o
· Î
f
Î
i
and solve foi lhe gain.
o
i
· Î
f
Î
i
·Î
i
Î
f
Î
i
Î
i
(3.2)
We nole lhal lhe ciicuil gain(nol lhe op-ampgain) is posilive, always giealei lhan
oi equal lo 1; and lhal if Î
i
= (open ciicuil), lhe ciicuil ieduces lo Iiguie 3.4(a).
Iiguie 3.4(c) shows how a levei makes possible an easy visualizalion of lhe
inpuloulpul chaiacleiislics. The fulciumis placed al lhe lefl end, because Î
i
is
giounded al lhe lefl end.
i
appeais belween lhe lwo iesislois, so il piovides an
inpul al lhe cenlial pail of lhe diagiam.
o
liavels lhiough an oulpul excuision
deleimined by lhe levei aims.
çê í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
Iiguie 3.4(d), lhe inpuloulpul chaiacleiislic, shows lhal a one-op-amp
ciicuil can have a posilive amplinei gain. Again saluialion is evidenl.
íòì Ü×ÚÚÛÎÛÒÌ×ßÔ ßÓÐÔ×Ú×ÛÎÍ
ÑÒÛóÑÐóßÓÐ Ü×ÚÚÛÎÛÒÌ×ßÔ ßÓÐÔ×Ú×ÛÎ
The iighl side of Iiguie 3.5(a) shows a simple one-op-amp diffeienlial amplinei.
Cuiienl ûows fiom
4
lhiough Î
3
and Î
4
lo giound. By Rule 2, no cuiienl ûows
inlo lhe posilive inpul of lhe op amp. Hence Î
3
and Î
4
, acl as a simple vollage-
dividei allenualoi, which is unaffecled by having lhe op amp allached oi by any
olhei changes in lhe ciicuil. The vollages in lhis pail of lhe ciicuil aie visualized
in Iiguie 3.5(b) by lhe single levei lhal is allached lo lhe fulcium (giound).
By Rule 1, whalevei vollage appeais al lhe posilive inpul also appeais al
lhe negalive inpul. Once lhis vollage is nxed, lhe lop half of lhe ciicuil
Ú·¹«®» íòì (a) A followei,
o i
. (b) A noninveiling amplinei,
i
appeais
acioss Î
i
, pioducing a cuiienl lhiough Î
i
lhal also ûows lhiough Î
f
. (c) Alevei
wilh aim lenglhs piopoilional lo iesislance values makes possible an easy
visualizalion of inpuloulpul chaiacleiislics. (d) The inpuloulpul plol shows
a posilive slope of Î
f
Î
i
Î
i
in lhe cenlial poilion, bul lhe oulpul saluiales
al aboul 13 \.
í ò ì Ü × Ú Ú Û Î Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í çé
behaves like an inveiling amplinei. Ioi example, if
4
is O \, lhe posilive
inpul of lhe op amp is O \ and lhe
3

o
ciicuil behaves exaclly like an
inveiling amplinei. Ioi olhei values of
4
, an inveiling ielalion is oblained
aboul some vollage inleimediale belween
4
and O \. The ielalionship can
be visualized in Iiguie 3.5(b) by noling lhal lhe lwo leveis behave like a paii
of scissois. The lhumb and nngei holes aie
4
and
3
, and lhe poinls aie al
o
and O \.
We solve foi lhe gain by nnding
5
.
5
4
Î
4
Î
3
Î
4
(3.3)
Ú·¹«®» íòë (a) The iighl side shows a one-op-amp diffeienlial amplinei, bul il
has low inpul impedance. The lefl side shows how lwo addilional op amps can
piovide high inpul impedance and gain. (b) Ioi lhe one-op-amp diffeienlial
amplinei, lwo leveis wilh aim lenglhs piopoilional lo iesislance values make
possible an easy visualizalion of inpuloulpul chaiacleiislics.
çè í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
Then, solving foi lhe cuiienl in lhe lop half, we gel
·
3 5
Î
3
5 o
Î
4
(3.4)
Subsliluling (3.3) inlo (3.4) yields
o
4 3
Î
4
Î
3
(3.5)
This is lhe equalion foi a diffeienlial amplinei. ¡f lhe lwo inpuls aie hooked
logelhei and diiven by a common souice, wilh iespecl lo giound, lhen lhe
½±³³±²ó³±¼» ª±´¬¿¹»
c
is
3 4
. !qualion (3.5) shows lhal lhe ideal oulpul
is O. The diffeienlial amplinei-ciicuil (nol op-amp) ½±³³±²ó³±¼» ¹¿·² Ù
c
is O.
¡n Iiguie 3.5(b), imagine lhe scissois lo be closed. No mallei how lhe inpuls
aie vaiied,
o
O.
¡f on lhe olhei hand
3 4
, lhen lhe diffeienlial vollage
4 3
pioduces an amplinei-ciicuil (nol op-amp) ¼·ºº»®»²¬·¿´ ¹¿·² Ù
d
lhal fiom
(3.5) is equal lo Î
4
Î
3
. This iesull can be visualized in Iiguie 3.5(b) by noling
lhal as lhe scissois open,
o
is geomeliically ielaled lo
4 3
in lhe same
ialio as lhe levei aims, Î
4
Î
3
.
No diffeienlial amplinei peifeclly ie|ecls lhe common-mode vollage. To
quanlify lhis impeifeclion, we use lhe leim ½±³³±²ó³±¼» ®»¶»½¬·±² ®¿¬·±
(CMRR), which is denned as
CMRR
Ù
d
Ù
c
(3.6)
This facloi may be lowei lhan 1OO foi some oscilloscope diffeienlial amplineis
and highei lhan 1O,OOO foi a high-qualily biopolenlial amplinei.
ÛÈßÓÐÔÛ íòî A blood-piessuie sensoi uses a foui-aclive-aim Whealslone
sliain gage biidge exciled wilh dc. Al full scale, each aim changes iesislance
by O.3'. Design an amplinei lhal will piovide a full-scale oulpul ovei lhe
op amp`s full iange of lineai opeialion. \se lhe minimal numbei of
componenls.
ßÒÍÉÛÎ Iiom (2.6), Ü
o i
ÜÎ Î 5 \ O OO3 O O15\. Gain 2O
O O15 1333. Assume Î 12O Ê. Then lhe Thevenin souice impedance
6O Ê. \se lhis lo ieplace Î
3
of Iiguie 3.5(a) iighl side. Then Î
4
Î
3
gain 6O Ê 1333 8O kÊ.
ÌØÎÛÛóÑÐóßÓÐ Ü×ÚÚÛÎÛÒÌ×ßÔ ßÓÐÔ×Ú×ÛÎ
The one-op-amp diffeienlial amplinei is quile salisfacloiy foi low-iesislance
souices, such as sliain-gage Whealslone biidges (Seclion 2.3). Bul lhe inpul
í ò ì Ü × Ú Ú Û Î Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í çç
iesislance is loo lowfoi high-iesislance souices. Oui nisl iecouise is lo add lhe
simple followei shown in Iiguie 3.4(a) lo each inpul. This piovides lhe
iequiied buffeiing. Because lhis solulion uses lwo addilional op amps, we
can also oblain gain fiom lhese buffeiing amplineis by using a noninveiling
amplinei, as shown in Iiguie 3.4(b). Howevei, lhis solulion amplines lhe
common-mode vollage, as well as lhe diffeienlial vollage, so lheie is no
impiovemenl in CMRR.
A supeiioi solulion is achieved by hooking logelhei lhe lwo Î
i
`s of lhe
noninveiling amplineis and eliminaling lhe conneclion lo giound. The iesull is
shown on lhe lefl side of Iiguie 3.5(a). To examine lhe effecls of common-mode
vollage, assume lhal
1 2
. By Rule 1,
1
, appeais al bolhnegalive inpuls lo lhe
op amps. This places lhe same vollage al bolh ends of Î
1
. Hence cuiienl lhiough
Î
1
is O. By Rule 2, no cuiienl can ûowfiomlhe op-amp inpuls. Hence lhe cuiienl
lhiough bolh Î
2
`s is O, so
1
appeais al bolh op-amp oulpuls and lhe Ù
c
is 1.
To examine lhe effecls when
1 2
, we nole lhal
1 2
appeais acioss
Î
1
. This causes a cuiienl lo ûow lhiough Î
1
lhal also ûows lhiough lhe iesisloi
sliing Î
2
, Î
1
, Î
2
. Hence lhe oulpul vollage
3 4
· Î
2
Î
1
Î
2
wheieas lhe inpul vollage
1 2
·Î
1
The diffeienlial gain is lhen
Ù
d
3 4
1 2

2
Î
1
Î
1
(3.7)
Since lhe Ù
c
is 1, lhe CMRR is equal lo lhe Ù
d
, which is usually much giealei
lhan 1. When lhe lefl and iighl halves of Iiguie 3.5(a) aie combined, lhe
iesulling lhiee-op-amp amplinei ciicuil is fiequenlly called an ·²-¬®«³»²¬¿¬·±²
¿³°´·B»®ò ¡l has high inpul impedance, a high CMRR, and a gain lhal can be
changed by ad|usling Î
1
. This ciicuil nnds wide use in measuiing biopolenlials
(Seclion 6.7), because il ie|ecls lhe laige 6O Hz common-mode vollage lhal
exisls on lhe body.
íòë ÝÑÓÐßÎßÌÑÎÍ
Í×ÓÐÔÛ
A compaialoi is a ciicuil lhal compaies lhe inpul vollage wilh some iefeience
vollage. The compaialoi`s oulpul ûips fiomone saluialion limil lo lhe olhei, as
lhe negalive inpul of lhe op amp passes lhiough O \. Ioi
i
giealei lhan lhe
compaiison level,
o
13\. Ioi
i
less lhan lhe compaiison level,
ïðð í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
o
13\. Thus lhis ciicuil peifoims lhe same funclion as a ͽ¸³·¬¬ ¬®·¹¹»®ô
which delecls an analog vollage level and yields a logic level oulpul. The
simplesl compaialoi is lhe op amp ilself, as shown in Iiguie 3.2. ¡f a iefeience
vollage is connecled lo lhe posilive inpul and
i
is connecled lo lhe negalive
inpul, lhe ciicuil is complele. The inpuls may be inleichanged lo inveil
lhe oulpul. The inpul ciicuil may be expanded by adding lhe lwo Î
1
iesislois
shown in Iiguie 3.6(a). This piovides a known inpul iesislance foi lhe ciicuil
and minimizes oveidiiving lhe op-amp inpul. Iiguie 3.6(b) shows lhal lhe
compaialoi ûips when
i ief
. To avoid building a sepaiale powei supply
foi
ief
, we can connecl
ief
lo lhe 15 \ powei supply and ad|usl lhe values of
lhe inpul iesislois so lhal lhe negalive inpul of lhe op amp is al O \when
i
is al
lhe desiied posilive compaiison level. When negalive compaiison levels aie
desiied,
ief
is connecled lo lhe 15 \ powei supply.
É×ÌØ ØÇÍÌÛÎÛÍ×Í
Ioi a simple compaialoi, if
i
is al lhe compaiison level and lheie is noise on
i
,
lhen
o
ûucluales wildly. To pievenl lhis, we can add hysleiesis lo lhe
compaialoi by adding Î
2
and Î
3
, as shown in Iiguie 3.6(a). The effecl of
lhis posilive feedback is illuslialed by lhe inpuloulpul chaiacleiislics shown
in Iiguie 3.6(b). To analyze lhis ciicuil, nisl assume lhal
ief
5 \ and
i
1O \. Then, because lhe op amp inveils and saluiales,
o
13 \.
Divide
o
by Î
2
and Î
3
so lhal lhe posilive inpul is al, say, 1 \. As
i
is
loweied, lhe compaialoi does nol ûip unlil
i
ieaches 3 \, which makes lhe
negalive inpul equal lo lhe posilive inpul, 1 \. Al lhis poinl,
o
ûips lo 13 \,
causing lhe posilive inpul lo change lo 1 \. Noise on
i
cannol cause
o
lo ûip
back, because lhe negalive inpul musl be iaised lo 1 \ lo cause lhe nexl ûip.
This iequiies
i
lo be iaised lo 7 \, al which level lhe ciicuil can ûip back lo
ils oiiginal slale. Iiom lhis example, we see lhal lhe widlh of lhe hysleiesis is
foui limes as gieal as lhe magnilude of lhe vollage acioss Î
3
. The widlh of lhe
hysleiesis loop can be vaiied by ieplacing Î
3
by a polenliomelei.
Ú·¹«®» íòê (a) Compaialoi. When Î
3
O
o
indicales whelhei
¡ ief
is
giealei oi less lhan O \. When Î
3
is laigei, lhe compaialoi has hysleiesis, as
shown in, (b) lhe inpuloulpul chaiacleiislic.
í ò ë Ý Ñ Ó Ð ß Î ß Ì Ñ Î Í ïðï
íòê ÎÛÝÌ×Ú×ÛÎÍ
Simple iesisloidiode ieclineis do nol woik well foi vollages below O.7 \,
because lhe vollage is nol sufncienl lo oveicome lhe foiwaid vollage diop of
lhe diode. This pioblem can be oveicome by placing lhe diode wilhin lhe
feedback loop of an op amp, lhus ieducing lhe vollage limilalion by a facloi
equal lo lhe gain of lhe op amp.
Iiguie 3.7(a) shows lhe ciicuil foi a full-wave piecision ieclinei (Giaeme,
1974b). Ioi
i
O, Ü
2
and Ü
3
conducl, wheieas Ü
1
and Ü
4
aie ieveise-biased.
The lop op amp is a noninveiling amplinei wilh a gain of 1/¨, wheie ¨ is a
fiaclion coiiesponding lo lhe polenliomelei selling. Because Ü
4
is nol con-
ducling, lhe lowei op amp does nol conliibule lo lhe oulpul.
Ú·¹«®» íòé (a) Iull-wave piecision ieclinei. Ioi
i
O, lhe noninveiling ampli-
nei al lhe lop is aclive, making
o
O. Ioi
i
O, lhe inveiling amplinei al lhe
bollomis aclive, making
o
O. Ciicuil gainmay be ad|usledwilh a single pol. (b)
¡npuloulpul chaiacleiislics show saluialion when
o
13\. (Repiinled wilh
peimission fiomÛ´»½¬®±²·½- Magazine, copyiighl ý Decembei 12, 1974; Penlon
Publishing, ¡nc.) (c) One-op-amp full-wave ieclinei. Ioi
i
O, lhe ciicuil
behaves like lhe inveiling amplinei ieclinei wilh a gain of O.5. Ioi
i
O,
lhe op amp disconnecls and lhe passive iesisloi chain yields a gain of O.5.
ïðî í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
Ioi
i
O Ü
1
and Ü
4
conducl, while Ü
2
and Ü
3
aie ieveise-biased. Al lhe
polenliomelei wipei
i
seives as lhe inpul lo lhe lowei op-amp inveiling
amplinei, which has a gain of 1 ¨. Because Ü
2
is nol conducling, lhe uppei op
amp does nol conliibule lo lhe oulpul. And because lhe polaiily of lhe gain
swilches wilh lhe polaiily of
i
,
o i
¨ .
The advanlage of lhis ciicuil ovei olhei full-wave ieclinei ciicuils (Wail,
1975, p. 173) is lhal lhe gain can be vaiied wilh a single polenliomelei and lhe
inpul iesislance is veiy high. ¡f only a half-wave ieclinei is needed, eilhei lhe
noninveiling amplinei oi lhe inveiling amplinei can be used sepaialely, lhus
iequiiing only one op amp. The peifecl ieclinei is fiequenlly used wilh an
inlegialoi lo quanlify lhe amplilude of elecliomyogiaphic signals (Seclion 6.8).
Iiguie 3.7(c) shows a one-op-amp full-wave ieclinei (Tompkins and
Webslei, 1988). \nlike olhei full-wave ieclineis, il iequiies lhe load lo iemain
conslanl, because lhe gain is a funclion of load.
íòé ÔÑÙßÎ×ÌØÓ×Ý ßÓÐÔ×Ú×ÛÎÍ
The logaiilhmic amplinei makes use of lhe nonlineai vollampeie ielalion of
lhe silicon planai liansisloi (1ung, 1986).
Ê
B!
O O6Olog
×
C
×
S
(3.8)
wheie
Ê
B!
base emillei vollage
×
C
collecloi cuiienl
×
S
ieveisesaluialioncuiienl 1O
13
Aal 27 C
The liansisloi is placed in lhe ¬®¿²-¼·±¼» connguialion shown in Iiguie
3.8(a), in which ×
C i
Î
i
. Then lhe oulpul
o
Ê
B!
is logaiilhmically ielaled
lo
i
as given by (3.8) ovei lhe appioximale iange 1O
7
A ×
C
1O
2
A. The
appioximale iange of
o
is O.36 lo O.66 \, so laigei ianges of
o
aie
somelimes oblained by lhe alleinale swilch posilion shown in Iiguie 3.8(a).
The iesisloi nelwoik feeds back only a fiaclion of
o
in oidei lo boosl
o
and
uses lhe same piinciple as lhal used in lhe noninveiling amplinei. Iiguie 3.8(b)
shows lhe inpuloulpul chaiacleiislics foi each of lhese ciicuils.
Because semiconduclois aie lempeialuie sensilive, accuiale ciicuils ie-
quiie lempeialuie compensalion. Anlilog (exponenlial) ciicuils aie made by
inleichanging lhe iesisloi and semiconducloi. These log and anlilog ciicuils
aie used lo mulliply a vaiiable, divide il, oi iaise il lo a powei; lo compiess
laige dynamic ianges inlo small ones; and lo lineaiize lhe oulpul of devices
wilh logaiilhmic oi exponenlial inpul-oulpul ielalions. ¡n lhe pholomelei
í ò é Ô Ñ Ù ß Î × Ì Ø Ó × Ý ß Ó Ð Ô × Ú × Û Î Í ïðí
(Seclion 11.1), lhe logaiilhmic conveilei can be used lo conveil liansmillance
lo absoibance.
íòè ×ÒÌÛÙÎßÌÑÎÍ
So fai in lhis chaplei, we have consideied only ciicuils wilh a ûal gain-veisus-
fiequency chaiacleiislic. Now lel us considei ciicuils lhal have a delibeiale
change in gain wilh fiequency. The nisl such ciicuil is lhe ·²¬»¹®¿¬±®. Iiguie 3.9
Ú·¹«®» íòè (a) Alogaiilhmic amplinei makes use of lhe facl lhal a liansisloi`s
\
B!
is ielaled lo lhe logaiilhm of ils collecloi cuiienl. Wilh lhe swilch lhiown
in lhe alleinale posilion, lhe ciicuil gain is incieased by 1O. (b) ¡npuloulpul
chaiacleiislics show lhal lhe logaiilhmic ielalion is oblained foi only one
polaiily; 1 and 1O gains aie indicaled.
Ú·¹«®» íòç ß ¬¸®»»ó³±¼» ·²¬»¹®¿¬±® Wilh S
1
open and S
2
closed, lhe dc
ciicuil behaves as an inveiling amplinei. Thus
o ic
and
o
can be sel lo any
desiied inilial condilion. Wilh S
1
closed and S
2
open, lhe ciicuil inlegiales.
Wilh bolh swilches open, lhe ciicuil holds
o
conslanl, making possible a
leisuiely ieadoul.
ïðì í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
shows lhe ciicuil foi an ·²¬»¹®¿¬±®ô which is oblained by closing swilch S
i
. The
vollage acioss an inilially unchaiged capaciloi is given by
1
Ý
¬
1
O
·¼¬ (3.9)
wheie · is lhe cuiienl lhiough Ý and ¬
1
is lhe inlegialion lime. Ioi lhe
inlegialoi, foi
i
posilive, lhe inpul cuiienl ·
i
Î ûows lhiough Ý in a
diieclion lo cause
o
lo move in a negalive diieclion. Thus
o
1
ÎÝ
¬
1
O
i
¼¬
ic
(3.1O)
This shows lhal
o
is equal lo lhe negalive inlegial of
i
, scaled by lhe facloi 1/
ÎÝ and added lo
ic
, lhe vollage due lo lhe inilial condilion. Ioi
o
O and
i
conslanl
o i
aflei an inlegialion lime equal lo ÎÝ. Because any ieal
inlegialoi evenlually diifls inlo saluialion, a means musl be piovided lo
iesloie
o
lo any desiied inilial condilion. ¡f an inilial condilion of
o
O \
is desiied, a simple swilch lo shoil oul Ý is sufncienl. Ioi moie veisalilily, S
1
is
opened and S
2
closed. This dc ciicuil lhen acls as an inveiling amplinei, which
makes
o ic
. Duiing inlegialion, S
1
is closed and S
2
open. Aflei lhe
inlegialion, bolh swilches may be opened lo hold lhe oulpul al lhe nnal
calculaled value, lhus peimilling lime foi a ieadoul. The ciicuil is useful foi
compuling lhe aiea undei a cuive, as lechnicians do when lhey calculale
caidiac oulpul (Seclion 8.2).
The fiequency iesponse of an inlegialoi is easily analyzed because lhe
foimula foi lhe inveiling amplinei gain (3.1) can be geneialized lo any inpul
and feedback impedances. Thus foi Iiguie 3.9, wilh S
1
closed,
Ê
o
¶ª
Ê
i
¶ª
Æ
f
Æ
i
1 ¶ªÝ
Î
1
¶ªÎÝ
1
¶ª¬
(3.11)
wheie ¬ ÎÝ ª 2°º , and º = fiequency. !qualion (3.11) shows lhal lhe
ciicuil gain decieases as Îincieases, Iiguie 3.1O shows lhe fiequency iesponse,
and (3.11) shows lhal lhe ciicuil gain is 1 when ª¬ 1.
ÛÈßÓÐÔÛ íòí The oulpul of lhe piezoelecliic sensoi shown in Iiguie
2.11(b) may be fed diieclly inlo lhe negalive inpul of lhe inlegialoi shown in
Iiguie 3.9, as shown in Iiguie !3.2. Analyze lhe ciicuil of lhis chaige
amplinei and discuss ils advanlages.
ßÒÍÉÛÎ Because lhe I!T-op-amp negalive inpul is a viilual giound, ·

·

O. Hence long cables may be used wilhoul changing sensoi sensilivily oi
í ò è × Ò Ì Û Ù Î ß Ì Ñ Î Í ïðë
lime conslanl, as is lhe case wilh vollage amplineis. Iiom Iiguie !3.2, cuiienl
geneialed by lhe sensoi, ·
s
Õ¼¨ ¼¬, all ûows inlo Ý, so, using (3.1O), we nnd
lhal
o
is
o
1
Ý
¬
1
O
Õ¼¨
¼¬
¼¬
µÈ
Ý
which shows lhal
o
is piopoilional lo ¨, even down lo dc. Like lhe
inlegialoi, lhe chaige amplinei slowly diifls wilh lime because of bias
Ú·¹«®» Ûíòî The chaige amplinei liansfeis chaige geneialed fiom a piezo-
elecliic sensoi lo lhe op-amp feedback capaciloi Ý.
Ú·¹«®» íòïð ¡nlegialoi
(¡); diffeienlialoi (D); low pass (LP), 1, 2, 3 seclion (pole); high pass (HP);
bandpass (BP). Coinei fiequencies º
½
foi high-pass, low-pass, and bandpass
nlleis.
ïðê í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
cuiienls iequiied by lhe op-amp inpul. A laige feedback iesislance Î
musl lheiefoie be added lo pievenl saluialion. This causes lhe ciicuil lo
behave as a high-pass nllei, wilh a lime conslanl ¬ ÎÝ. ¡l lhen iesponds
only lo fiequencies above º
c
1 2°ÎÝ and has no fiequency-iesponse
impiovemenl ovei lhe vollage amplinei. Common capaciloi values aie
1O pI lo 1 ³I.
íòç Ü×ÚÚÛÎÛÒÌ×ßÌÑÎÍ
¡nleichanging lhe inlegialoi`s Î and Ý yields lhe diffeienlialoi shown in
Iiguie 3.11. The cuiienl lhiough a capaciloi is given by
· Ý
¼
¼¬
(3.12)
¡f ¼
i
¼¬ is posilive, · ûows lhiough Îin a diieclion such lhal il yields a negalive
o
. Thus
o
ÎÝ
¼
i
¼¬
(3.13)
The fiequency iesponse of a diffeienlialoi is given by lhe ialio of feedback
lo inpul impedance.
Ê
o
¶ª
Ê
i
¶ª
Æ
f
Æ
i
Î
1 ¶ªÝ
¶ªÎÝ ¶ª¬ (3.14)
!qualion (3.14) shows lhal lhe ciicuil gain incieases as º incieases and lhal il is
equal lo unily when ª¬ 1. Iiguie 3.1O shows lhe fiequency iesponse.
\nless specinc pievenlive sleps aie laken, lhe ciicuil lends lo oscillale.
The oulpul also lends lo be noisy, because lhe ciicuil emphasizes high
fiequencies. A diffeienlialoi followed by a compaialoi is useful foi delecling
Ú·¹«®» íòïï ß¼·ºº»®»²¬·¿¬±® The dashed lines indicale lhal a small capaciloi
musl usually be added acioss lhe feedback iesisloi lo pievenl oscillalion.
í ò ç Ü × Ú Ú Û Î Û Ò Ì × ß Ì Ñ Î Í ïðé
an evenl lhe slope of which exceeds a given value‰foi example, deleclion of
lhe R wave in an elecliocaidiogiam.
íòïð ßÝÌ×ÊÛ Ú×ÔÌÛÎÍ
ÔÑÉóÐßÍÍ Ú×ÔÌÛÎ
Iiguie 1.9(a) shows a low-pass nllei lhal is useful foi allenualing high-
fiequency noise. A low-pass aclive nllei can be oblained by using lhe one-
op-amp ciicuil shown in Iiguie 3.12(a). The advanlages of lhis ciicuil aie lhal
Ú·¹«®» íòïî (a) A low-pass nllei allenuales high fiequencies.
(b) Ahigh-pass nllei allenuales low fiequencies and blocks dc. (c) Abandpass
nllei allenuales bolh low and high fiequencies.
ïðè í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
il is capable of gain and lhal il has a veiy lowoulpul impedance. The fiequency
iesponse is given by lhe ialio of feedback lo inpul impedance.
Ê
o
¶ª
Ê
i
¶ª
Æ
f
Æ
i
Î
f
¶ªÝ
f
1 ¶ªÝ
f
Î
f
Î
i
Î
f
1 ¶ªÎ
f
Ý
f
Î
i
Î
f
Î
i
1
1 ¶ª¬
(3.15)
wheie ¬ Î
f
Ý
f
. Nole lhal (3.15) has lhe same foimas (1.23). Iiguie 3.1O shows
lhe fiequency iesponse, which is similai lo lhal shown in Iiguie 1.8(d). Ioi
ª 1 ¬, lhe ciicuil behaves as an inveiling amplinei (Iiguie 3.3), because lhe
impedance of Ý
f
is laige compaied wilh Î
f
. Ioi ª 1 ¬, lhe ciicuil behaves as
an inlegialoi (Iiguie 3.9), because Ý
f
is lhe dominanl feedback impedance.
The ½±®²»® º®»¯«»²½§ º
c
, which is denned by lhe inleiseclion of lhe lwo
asymploles shown, is given by lhe ielalion ª¬ 2°º
c
¬ 1. When a designei
wishes lo limil lhe fiequency of a wide-bandwideband amplinei, il is nol
necessaiy lo add a sepaiale slage, as shown in Iiguie 3.12(a), bul only lo add
lhe coiiecl size Ý
f
lo lhe exisling wide-band amplinei.
Ø×ÙØóÐßÍÍ Ú×ÔÌÛÎ
Iiguie 3.12(b) shows a one-op-amp high-pass nllei. Such a ciicuil is useful foi
amplifying a small ac vollage lhal iides on lop of a laige dc vollage, because Ý
i
,
blocks lhe dc. The fiequency-iesponse equalion is
Ê
o
¶ª
Ê
i
¶ª
Æ
f
Æ
i
Î
f
1 ¶ªÝ
i
Î
i
¶ªÎ
f
Ý
i
1 ¶ªÝ
i
Î
i
Î
f
Î
i
¶ª¬
1 ¶ª¬ (3.16)
wheie ¬ Î
i
Ý
i
. Iiguie 3.1O shows lhe fiequency iesponse. Ioi ª 1 ¬, lhe
ciicuil behaves as a diffeienlialoi (Iiguie 3.11), because Ý
i
: is lhe dominanl
inpul impedance. Ioi ª 1 ¬, lhe ciicuil behaves as an inveiling amplinei,
because lhe impedance of Î
i
is laige compaied wilh lhal of Ý
i
. The coinei
fiequency º
c
, which is denned by lhe inleiseclion of lhe lwo asymploles shown,
is given by lhe ielalion ª¬ 2°º
c
¬ 1.
ÞßÒÜÐßÍÍ Ú×ÔÌÛÎ
A seiies combinalion of lhe low-pass nllei and lhe high-pass nllei iesulls in a
¾¿²¼°¿-- B´¬»®, which amplines fiequencies ovei a desiied iange and allenu-
ales highei and lowei fiequencies. Iiguie 3.12(c) shows lhal lhe bandpass
funclion can be achieved wilh a one-op-amp ciicuil. Iiguie 3.1O shows lhe
fiequency iesponse. The coinei fiequencies aie denned by lhe same ielalions
as lhose foi lhe low-pass and lhe high-pass nlleis. This ciicuil is useful foi
í ò ï ð ß Ý Ì × Ê Û Ú × Ô Ì Û Î Í ïðç
amplifying a ceilain band of fiequencies, such as lhose iequiied foi iecoiding
heail sounds oi lhe elecliocaidiogiam.
íòïï ÚÎÛÏËÛÒÝÇ ÎÛÍÐÑÒÍÛ
\p unlil now, we have found il useful lo considei lhe op amp as ideal. Now we
shall examine lhe effecls of seveial nonideal chaiacleiislics, slailing wilh lhal
of fiequency iesponse.
ÑÐÛÒóÔÑÑÐ Ùß×Ò
Because lhe op amp iequiies veiy high gain, il has seveial slages. !ach of lhese
slages has sliay oi |unclion capacilance lhal limils ils high-fiequency iesponse
in lhe same way lhal a simple ÎÝ low-pass nllei ieduces high-fiequency gain.
Al high fiequencies, each slage has a 1 slope on a loglog plol of gain veisus
fiequency, and each has a 9Oè phase shifl. Thus a lhiee-slage op amp, such as
lype 7O9, ieaches a slope of 3, as shown by lhe dashed cuive in Iiguie 3.13.
Ú·¹«®» íòïí Ñ°ó¿³°º®»¯«»²½§½¸¿®¿½¬»®·-¬·½- !aily op amps (such as lhe 7O9)
weie uncompensaled, had a gain giealei lhan 1 when lhe phase shifl was equal lo
18Oè, and lheiefoie oscillaled unless compensalion was added exleinally. A
populai op amp, lhe 411, is compensaled inleinally; so foi a gain giealei lhan 1,
lhe phase shifl is limiled lo 9Oè. When feedback iesislois aie added lo build an
amplinei ciicuil, lhe loop gain on lhis loglog plol is lhe diffeience belween lhe
op-amp gain and lhe amplineiciicuil gain.
ïïð í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
The phase shifl ieaches 27Oè, which is quile salisfacloiy foi a compaialoi,
because feedback is nol employed. Ioi an amplinei, if lhe gain is giealei lhan 1
when lhe phase shifl is equal lo 18Oè (lhe closed-loop condilion foi oscilla-
lion), lheie is undesiiable oscillalion.
ÝÑÓÐÛÒÍßÌ×ÑÒ
Adding an exleinal capaciloi lo lhe leiminals indicaled on lhe specincalion
sheel moves one of lhe ÎÝ nllei coinei fiequencies lo a veiy low fiequency.
This compensales lhe uncompensaled op amp, iesulling in a slope of 1 and a
maximal phase shifl of 9Oè. This is done wilh an inleinal capaciloi in lhe 411,
iesulling in lhe solid cuive shown in Iiguie 3.13. This op amp does nol
oscillale foi any amplinei we have desciibed. This op amp has veiy high dc
gain, bul lhe gain is piogiessively ieduced al highei fiequencies, unlil il is only
1 al 4 MHz.
ÝÔÑÍÛÜóÔÑÑÐ Ùß×Ò
¡l mighl appeai lhal lhe op amp has veiy pooi fiequency iesponse, because ils
gain is ieduced foi fiequencies above 4O Hz. Howevei, an amplinei ciicuil is
nevei buill using lhe op-amp open loop, so we shall lheiefoie discuss only lhe
ciicuil closed-loop iesponse. Ioi example, if we build an amplinei ciicuil wilh
a gain of 1O, as shown in Iiguie 3.13, lhe fiequency iesponse is ûal up lo 4OO
kHz and is ieduced above lhal fiequency only because lhe amplinei-ciicuil
gain can nevei exceed lhe op-amp gain. We nnd lhis an advanlage of using
negalive feedback, in lhal lhe fiequency iesponse is gieally exlended.
ÔÑÑÐ Ùß×Ò
The loop gain foi an amplinei ciicuil is oblained by bieaking lhe feedback loop
al any poinl in lhe loop, in|ecling a signal, and measuiing lhe gain aiound lhe
loop. Ioi example, in a unily-gain followei |Iiguie 3.4(a)j we bieak lhe
feedback loop and lhen lhe in|ecled signal enleis lhe negalive inpul, aflei
which il is amplined by lhe op-amp gain. Theiefoie, lhe loop gain equals lhe
op-amp gain. To measuie loop gain in an inveiling amplinei wilh a gain of 1
|Iiguie 3.3(a)j, assume lhal lhe amplinei-ciicuil inpul is giounded. The
in|ecled signal is divided by 2 by lhe allenualoi foimed of Î
f
and Î
i
, and is
lhen amplined by lhe op-amp gain. Thus lhe loop gain is equal lo (op-amp
gain)/2.
Iiguie 3.13 shows lhe loop-gain concepl foi a noninveiling amplinei. The
amplinei-ciicuil gain is 1O. On lhe loglog plol, lhe diffeience belween lhe op-
amp gain and lhe amplinei-ciicuil gain is lhe loop gain. Al low fiequencies, lhe
loop gain is high and lhe closed-loop amplinei-ciicuil chaiacleiislics aie
deleimined by lhe feedback iesislois. Al high fiequencies, lhe loop gain is
low and lhe amplinei-ciicuil chaiacleiislics follow lhe op-amp chaiacleiislics.
High loop gain is good foi accuiacy and slabilily, because lhe feedback
iesislois can be made much moie slable lhan lhe op-amp chaiacleiislics.
í ò ï ï Ú Î Û Ï Ë Û Ò Ý Ç Î Û Í Ð Ñ Ò Í Û ïïï
Ùß×ÒŠÞßÒÜÉ×ÜÌØ ÐÎÑÜËÝÌ
The gainbandwidlh pioducl of lhe op amp is equal lo lhe pioducl of gain and
bandwidlh al a pailiculai fiequency. Thus in Iiguie 3.13 lhe unily-gain
bandwidlh pioducl is 4 MHz, a lypical value foi op amps. Nole lhal along
lhe enliie cuive wilh a slope of 1, lhe gain-bandwidlh pioducl is slill conslanl,
al 4 MHz. Thus, foi any amplinei ciicuil, we can oblain ils bandwidlh by
dividing lhe gainbandwidlh pioducl by lhe amplinei-ciicuil gain. Ioi highei-
fiequency applicalions, op amps such as lhe OP-37! aie available wilh gain
bandwidlh pioducls of 6O MHz.
ÍÔÛÉ ÎßÌÛ
Small-signal iesponse follows lhe amplinei-ciicuil fiequency iesponse pie-
dicled by Iiguie 3.13. Ioi laige signals lheie is an addilional limilalion. When
iapid changes in oulpul aie demanded, lhe capaciloi added foi compensalion
musl be chaiged up fiom an inleinal souice lhal has limiled cuiienl capabilily
×
max
. The change invollage acioss lhe capaciloi is lhen limiled, ¼ ¼¬ ×
max
Ý,
and ¼
o
¼¬ is limiled lo a maximal slew iale (15 \/³s foi lhe 411). ¡f lhis slew
iale Í
i
is exceeded by a laige-amplilude, high-fiequency sine wave, disloilion
occuis. Thus lheie is a limilalion on lhe sine-wave º«´´ó°±©»® ®»-°±²-», oi
maximal fiequency foi ialed oulpul,
º
p
Í
i
2°Ê
oi
(3.17)
wheie Ê
oi
is lhe ialed oulpul vollage (usually 1O \). ¡f lhe slew iale is loo slow
foi fasl swilching of a compaialoi, an uncompensaled op amp can be used,
because compaialois do nol conlain lhe negalive-feedback palh lhal may
cause oscillalions.
íòïî ÑÚÚÍÛÌ ÊÑÔÌßÙÛ
Anolhei nonideal chaiacleiislic is lhal of offsel vollage. The lwo op-amp
inpuls diive lhe bases of liansislois, and lhe base-lo-emillei vollage diop may
be slighlly diffeienl foi each. Thus, so lhal we can oblain
o
O, lhe vollage
1 2
musl be a few millivolls. This offsel vollage is usually nol impoilanl
when
i
is 1 lo 1O \. Bul when
i
is on lhe oidei of millivolls, as when
amplifying lhe oulpul fiom lheimocouples oi sliain gages, lhe offsel vollage
musl be consideied.
ÒËÔÔ×ÒÙ
The offsel vollage may be ieduced lo zeio by adding an exleinal nulling pol lo
lhe leiminals indicaled on lhe specincalion sheel. Ad|uslmenl of lhis pol
ïïî í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
incieases emillei cuiienl lhiough one of lhe inpul liansislois and loweis il
lhiough lhe olhei. This alleis lhe base-lo-emillei vollage of lhe lwo liansislois
unlil lhe offsel vollage is ieduced lo zeio.
ÜÎ×ÚÌ
!ven lhough lhe offsel vollage may be sel lo O al 25 èC, il does nol iemain
lheie if lempeialuie is nol conslanl. Tempeialuie changes lhal affecl lhe
base-lo-emillei vollages may be due lo eilhei enviionmenlal changes oi lo
vaiialions in lhe dissipalion of powei in lhe chip lhal iesull fiom ûuclualing
oulpul vollage. The effecls of lempeialuie may be specined as a maximal
offsel vollage change in volls pei degiee Celsius oi a maximal offsel vollage
change ovei a given lempeialuie iange, say 25 èClo 85 èC. ¡f lhe diifl of an
inexpensive op amp is loo high foi a given applicalion, lighlei specincalions
O 1 ³\/ C aie available wilh lempeialuie-conliolled chips. An alleinalive
lechnique modulales lhe dc as in choppei-slabilized and vaiacloi op amps
(Tobey »¬ ¿´., 1971).
ÒÑ×ÍÛ
All semiconducloi |unclions geneiale noise, which limils lhe deleclion of small
signals. Op amps have liansisloi inpul |unclions, which geneiale bolh noise-
vollage souices and noise-cuiienl souices. These can be modeled as shown in
Iiguie 3.14. Ioi low souice impedances, only lhe noise vollage
n
is impoilanl;
il is laige compaied wilh lhe ·
n
Îdiop caused by lhe cuiienl noise ·
n
. The noise
is iandom, bul lhe amplilude vaiies wilh fiequency. Ioi example, al low
Ú·¹«®» íòïì Ò±·-» -±«®½»- ·² ¿² ±° ¿³° The noise-vollage souice
n
is in
seiies wilh lhe inpul and cannol be ieduced. The noise added by lhe noise-
cuiienl souices in can be minimized by using small exleinal iesislances.
í ò ï î Ñ Ú Ú Í Û Ì Ê Ñ Ô Ì ß Ù Û ïïí
fiequencies lhe noise powei densily vaiies as 1 º (ûickei noise), so a laige
amounl of noise is piesenl al low fiequencies. Al lhe midfiequencies, lhe noise
is lowei and can be specined in iool-mean-squaie (ims) unils of \ Hz
1 2
. ¡n
addilion, some silicon planai-diffused bipolai inlegialed-ciicuil op amps
exhibil buisls of noise, called °±°½±®² ²±·-» (Wail »¬ ¿´., 1975).
íòïí Þ×ßÍ ÝËÎÎÛÒÌ
Because lhe lwoop-ampinpuls diive liansislois, base oi gale cuiienl musl ûow
all lhe lime lo keep lhe liansislois luined on. This is called ¾·¿- ½«®®»²¬, which
foi lhe 411 is aboul 2OO pA. This bias cuiienl musl ûow lhiough lhe feedback
nelwoik. ¡l causes eiiois piopoilional lo feedback-elemenl iesislances. To
minimize lhese eiiois, small feedback iesislois, such as lhose wilh iesislances
of 1O kÊ, aie noimally used. Smallei values should be used only aflei a check lo
deleimine lhal lhe cuiienl ûowing lhiough lhe feedback iesisloi, plus lhe
cuiienl ûowing lhiough all load iesislois, does nol exceed lhe op-amp oulpul
cuiienl ialing (2O mA foi lhe 411).
Ü×ÚÚÛÎÛÒÌ×ßÔ Þ×ßÍ ÝËÎÎÛÒÌ
The diffeience belween lhe lwo inpul bias cuiienls is much smallei lhaneilhei
of lhe bias cuiienls alone. A degiee of cancellalion of lhe effecls of bias
cuiienl can be achieved by having each bias cuiienl ûow lhiough lhe same
equivalenl iesislance. This is accomplished foi lhe inveiling amplinei and lhe
noninveiling amplinei by adding, in seiies wilh lhe posilive inpul, a compen-
salion iesisloi lhe value of which is equal lo lhe paiallel combinalion of Î
i
and
Î
f
. Theie slill is an eiioi, bul il is now deleimined by lhe diffeience in bias
cuiienl.
ÜÎ×ÚÌ
The inpul bias cuiienls aie liansisloi base oi gale cuiienls, so lhey aie
lempeialuie sensilive, because liansisloi gain vaiies wilh lempeialuie. How-
evei, lhe changes in gain of lhe lwo liansislois lend lo liack logelhei, so lhe
addilional compensalion iesisloi lhal we have desciibed minimizes lhe
pioblem.
ÒÑ×ÍÛ
Iiguie 3.14 shows how vaiialions in bias cuiienl conliibule lo oveiall noise.
The noise cuiienls ûow lhiough lhe exleinal equivalenl iesislances so lhal lhe
lolal ims noise vollage is
2
n
·
n
Î
1
2
·
n
Î
2
2
4µÌÎ
1
4µÌÎ
2
BW
1 2
(3.18)
ïïì í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
wheie
Î
1
andÎ
2
equivalenl souice iesislances
n
meanvalue of lhe ims noise vollage in\ Hz
1 2
acioss lhe fiequency iange of inleiesl
·
n
meanvalue of lhe ims noise cuiienl inA Hz
1 2
acioss lhe fiequency iange of inleiesl
µ Bollzmann`s conslanl Appendix
T lempeialuie K
BW noise bandwidlh Hz
The specincalion sheel piovides values of
n
and ·
n
(somelimes
2
n
and ·
2
n
),
lhus making il possible locompaie diffeienl opamps. ¡f lhe souice iesislances aie
1O kÊ, bipolai-liansisloi op amps yield lhe lowesl noise. Ioi laigei souice
iesislances, low-inpul-cuiienl amplineis such as lhe neld-effecl liansisloi (I!T)
inpul slage aie besl because of lheii lowei cuiienl noise. Aiy (1977) piesenls
design faclois and peifoimance specincalions foi a low-noise amplinei.
Ioi ac amplineis, lhe lowesl noise is oblained by calculaling lhe chaiac-
leiislic noise iesislance Î
n n
·
n
and selling il equal lo lhe equivalenl souice
iesislance Î
2
(foi lhe noninveiling amplinei). This is accomplished by inseiling
a liansfoimei wilh luins ialio 1 : Ò, wheie Ò Î
n
Î
2
1 2
, belween lhe souice
and lhe op amp (1ung, 1986).
íòïì ×ÒÐËÌ ßÒÜ ÑËÌÐËÌ ÎÛÍ×ÍÌßÒÝÛ
×ÒÐËÌ ÎÛÍ×ÍÌßÒÝÛ
The op-amp diffeienlial-inpul iesislance Î
d
is shown in Iiguies 3.1 and 3.15.
Ioi lhe I!T-inpul 411, il is 1 TÊ, wheieas foi B1T-inpul op amps, il is aboul
2 MÊ, which is compaiable lo lhe value of some feedback iesislois used.
Howevei, we shall see lhal ils value is usually nol impoilanl because of lhe
benenls of feedback. Considei lhe followei shown in Iiguie 3.15. ¡n oidei lo
calculale lhe amplinei-ciicuil inpul iesislance Î
ai
, assume a change in inpul
vollage
i
. Because lhis is a followei,
Ü
o
ßÜ
d
ß Ü
i
Ü
o
ßÜ
i
ß 1
Ü·
i
Ü
d
Î
d
Ü
i
Ü
o
Î
d
Ü
i
ß 1 Î
d
Î
ai
Ü
i
Ü·
i
ß 1 Î
d
ßÎ
d
(3.19)
í ò ï ì × Ò Ð Ë Ì ß Ò Ü Ñ Ë Ì Ð Ë Ì Î Û Í × Í Ì ß Ò Ý Û ïïë
Thus lhe amplinei-ciicuil inpul iesislance Î
ai
is aboul 1O
5
2 MÊ 2OO GÊ.
This value cannol be achievedin piaclice, because suiface leakage palhs inlhe op-
amp sockel lowei il consideiably. ¡n geneial, all noninveiling amplineis have a
veiy high inpul iesislance, which is equal lo Î
d
limes lhe loop gain. This is nol lo
say lhal veiy laige souice iesislances can be used, because lhe bias cuiienl usually
causes muchlaigei pioblems lhanlhe amplinei-ciicuil inpul impedance. Ioi laige
souice iesislances, I!T op amps such as lhe 411 aie helpful.
The inpul iesislance of an inveiling amplinei is easy lo deleimine. Because
lhe negalive inpul of lhe op amp is a viilual giound,
Î
ai
Ü
i
Ü·
i
Î
i
(3.2O)
Thus lhe amplinei-ciicuil inpul iesislance Î
ai
is equal lo Î
i
, lhe inpul iesisloi.
Because Î
i
is usually a small value, lhe inveiling amplinei has small inpul
iesislance.
ÑËÌÐËÌ ÎÛÍ×ÍÌßÒÝÛ
The op-amp oulpul iesislance Î
o
is shown in Iiguies 3.1 and 3.15. ¡l is aboul
4O Ê foi lhe lypical op amp, which may seem laige foi some applicalions.
Howevei, ils value is usually nol impoilanl because of lhe benenls of feedback.
Considei lhe followei shown in Iiguie 3.15. ¡n oidei lo calculale lhe amplinei-
ciicuil oulpul iesislance Î
ao
, assume lhal load iesisloi Î
L
is allached lo lhe
oulpul, causing a change in oulpul cuiienl Ü·
o
. Because ·
o
ûows lhiough Î
o
,
lheie is an addilional vollage diop Ü·
o
Î
o
.
Ü
d
Ü
o
ßÜ
d
Ü·
o
Î
o
ßÜ
o
Ü·
o
Î
o
ß 1 Ü
o
Ü·
o
Î
o
Î
ao
Ü
o
Ü·
o
Î
o
ß 1
Î
o
ß
(3.21)
Ú·¹«®» íòïë The amplinei inpul impedance is much highei lhan lhe op-amp
inpul impedance Î
d
. The amplinei oulpul impedance is much smallei lhan lhe
op-amp oulpul impedance Î
o
.
ïïê í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
Thus lhe amplinei-ciicuil oulpul iesislance Î
ao
is aboul 4O 1O
5
O OOO4 Ê,
a value negligible in mosl ciicuils. ¡n geneial, all noninveiling and invei-
ling amplineis have an oulpul iesislance lhal is equal lo Î
o
divided by
lhe loop gain. This is nol lo say lhal veiy small load iesislances can be
diiven by lhe oulpul. ¡f Î
L
shown in Iiguie 3.15 is smallei lhan 5OO Ê, lhe
op amp saluiales inleinally, because lhe maximal cuiienl oulpul foi a
lypical op amp is 2O mA. This maximal cuiienl oulpul musl also be
consideied when diiving laige capacilances Ý
L
al a high slew iale. Then
lhe oulpul cuiienl
·
o
Ý
L
¼
o
¼¬
(3.22)
The Î
o
Ý
L
combinalion also acls as a low-pass nllei, which inlioduces
addilional phase shifl aiound lhe loop and can cause oscillalion. The cuie
is lo add a small iesisloi belween
o
and Ý
L
, lhus isolaling Ý
L
fiom lhe
feedback loop.
To achieve laigei cuiienl oulpuls, lhe ½«®®»²¬ ¾±±-¬»® is used. An oidinaiy
op amp diives high-powei liansislois (on heal sinks if iequiied). Then we can
use lhe enliie ciicuil as an op amp by connecling leiminals
1
,
2
, and
o
lo
exleinal feedback nelwoiks. This places lhe booslei seclion wilhin lhe feed-
back loop and keeps disloilion low.
íòïë ÐØßÍÛóÍÛÒÍ×Ì×ÊÛ ÜÛÓÑÜËÔßÌÑÎÍ
Iiguie 2.7 shows lhal a lineai vaiiable diffeienlial liansfoimei iequiies a
phase-sensilive demodulaloi lo yield a useful oulpul signal. A phase-sensilive
demodulaloi does nol measuie phase bul yields a full-wave-ieclined oulpul of
lhe in-phase componenl of a sine wave. ¡ls oulpul is piopoilional lo lhe
amplilude of lhe inpul, bul il changes sign when lhe phase shifls by 18Oè.
Iiguie 3.16 shows lhe funclional opeialion of a phase-sensilive de-
modulaloi. Iiguie 3.16(a) shows a swilching funclion lhal is deiived fiom a
½¿®®·»® ±-½·´´¿¬±® and causes lhe double-pole double-lhiow swilch in Iiguie
3.16(b) lo be in lhe uppei posilion foi 1 and in lhe lowei posilion foi 1. ¡n
effecl, lhis mulliplies lhe inpul signal
i
by lhe swilching funclion shown in
Iiguie 3.16(a). The in-phase sine wave in Iiguie 3.16(c) is demodulaled by lhis
swilch lo yield lhe full-wave-ieclined posilive signal in Iiguie 3.16(d). The sine
wave in Iiguie 3.16(e) is 18Oè oul of phase, so il yields lhe negalive signal in
Iiguie 3.16(f).
Amplinei sliay capacilance may cause an undesiiable ¯«¿¼®¿¬«®» ª±´¬¿¹»
lhal is shifled9Oè, as shown inIiguie 3.16(g). The demodulaled signal in Iiguie
3.16(h) aveiages lo zeio when passed lhiough a low-pass nllei and is ie|ecled.
The dc signal shown in Iiguie 3.16(i) is demodulaled lo lhe wave shown in
Iiguie 3.16(|) and is ie|ecled. Any fiequency componenl nol locked lo lhe
í ò ï ë Ð Ø ß Í Û ó Í Û Ò Í × Ì × Ê Û Ü Û Ó Ñ Ü Ë Ô ß Ì Ñ Î Í ïïé
caiiiei fiequency is similaily ie|ecled. Because lhe phase-sensilive de-
modulaloi has excellenl noise-ie|eclion capabililies, il is fiequenlly used lo
demodulale lhe suppiessed-caiiiei wavefoims oblained fiom lineai vaiiable
diffeienlial liansfoimeis (L\DTs) and lhe ac-exciled sliain-gage Whealslone
biidge (Seclion 2.3). A caiiiei syslem and phase-sensilive demodulaloi aie
also essenlial foi opeialion of lhe elecliomagnelic blood ûowmelei (Seclion
8.3). The noise-ie|eclion capabilily may be impioved by placing a luned
amplinei befoie lhe phase-sensilive demodulaloi, lhus foiming a lock-in
amplinei (Aionson, 1977).
Ú·¹«®» íòïê Ú«²½¬·±²¿´ ±°»®¿¬·±²±º ¿°¸¿-»ó-»²-·¬·ª»¼»³±¼«´¿¬±® (a) Swilch-
ing funclion. (b) Swilchswilch. (c), (e), (g), (i) Seveial seveial inpul vollages. (d),
(f), (h), (|) Coiiesponding coiiesponding oulpul vollages.
ïïè í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
A piaclical phase-sensilive demodulaloi is shown in Iiguie 3.17. This ®·²¹
¼»³±¼«´¿¬±® opeiales wilh lhe following aclion, piovided lhal
c
is moie lhan
lwice
i
¡f lhe caiiiei wavefoim
i
is posilive al lhe black dol, diodes D
1
and D
2
aie foiwaid-biased and D
3
and D
4
aie ieveise-biased. By symmeliy, poinls A
and B aie al lhe same vollage. ¡f lhe inpul wavefoim
i
, is posilive al lhe black
dol, lhis liansfoims lo a vollage
DB
lhal appeais al
o
, as shown in lhe nisl half
of Iiguie 3.16(d).
Duiing lhe second half of lhe cycle, diodes Ü
3
and Ü
4
aie foiwaid-biased
and Ü
1
and Ü
2
aie ieveise-biased. By symmeliy, poinls A and C aie al lhe
same polenlial. The ieveised polaiily of
i
yields a posilive
DC
, which appeais
al
o
. Thus
o
is a full-wave-ieclined wavefoim. ¡f
i,
changes phase by 18Oè, as
shown in Iiguie 3.16(e),
o
changes polaiily. To eliminale iipple, lhe oulpul is
usually low-pass nlleied by a nllei lhe coinei fiequency of which is aboul one-
lenlh of lhe caiiiei fiequency.
The iing demodulaloi has lhe advanlage of having no moving pails. Also,
because liansfoimei coupling is used,
i
,
c
, and
c
can all be iefeienced lo
diffeienl dc levels. The availabilily of lype 1495 solid-slale double-balanced
demodulalois on a single chip (1ung, 1986) makes il possible lo eliminale lhe
bulky liansfoimeis bul iequiies moie caie in biasing
i
,
c
, and
o
al diffeienl
dc levels.
ÛÈßÓÐÔÛ íòì (a) Ioi Iiguie 3.17, assume lhal lhe caiiiei fiequency is
3 kHz. Design lhe ÎÝ oulpul low-pass nllei lo have a coinei fiequency of
2O Hz and a ieasonable value capaciloi (1OO nI). \se (b) a one-seclion aclive
nllei.
Ú·¹«®» íòïé ß ®·²¹ ¼»³±¼«´¿¬±® This phase-sensilive delecloi pioduces a
full-wave-ieclined oulpul
o
lhal is posilive when lhe inpul vollage
i
is in phase
wilh lhe caiiiei vollage
c
and negalive when
i
is 18Oè oul of phase wilh
c
.
í ò ï ë Ð Ø ß Í Û ó Í Û Ò Í × Ì × Ê Û Ü Û Ó Ñ Ü Ë Ô ß Ì Ñ Î Í ïïç
ßÒÍÉÛÎ (a) See Iiguie 1.6(a)
2°ºÎÝ 1
Î 1 2°ºÝ 1 2°2O O OOOOOO1 8OkÊ
(b) See Iiguie 3.12(a)
Ý
f
O 1³I Î
i
8OkÊ Î
º
8OkÊ
íòïê Ì×ÓÛÎÍ
¡n eleclionic design, lheie is oflen a need lo geneiale signals lhal iepeal
al iegulai inleivals. One lype of signal is lhe squaie wave, shown in Iiguie
3.18.
The vollage of a squaie wave is high foi a nxed amounl of lime, Ì
h
, lhen il
diops lo a lowei vollage foi a lenglh of lime Ì
l
. This pallein of alleinaling high
and low cycles conlinuously iepeals. The lolal peiiod of lhe squaie wave, lhe
lime il lakes lo iepeal, is lhus
Ì Ì
h
Ì
l
(3.23)
The duly cycle of a squaie wave is denned as lhe peicenlage of lhe lime
lhal lhe squaie wave is al ils highei oulpul vollage. Thus
Duly cycle
Ì
h
Ì
1OO (3.24)
Ioi example, a squaie wave in which Ì
h
Ì
l
is said lo have a 5O' duly
cycle.
Theie aie many ways lo geneiale squaie waves. Digilal syslems use squaie
waves wilh 5O' duly cycles as clocks lo synchionize digilal logic; lhus, lheie
Ú·¹«®» íòïè A squaie wave of peiiod Ì oscillales belween lwo values.
ïîð í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
aie many commeicially available clock geneialoi chips lhal yield squaie waves
wilh 5O' duly cycles.
Many limes, howevei, we wanl lo geneiale squaie waves wilh duly cycles
olhei lhan 5O'. A populai means of doing lhis is wilh a 555 limei. The 555
limei is an 8-pin inlegialed ciicuil, as shown in Iiguie 3.19(a). The 555 limeis
foim lhe coie of many diffeienl kinds of liming ciicuils. One populai conngu-
ialion is shown in Iiguie 3.19(b). When poweied, lhis ciicuil oscillales
inleinally, alleinalely chaiging and dischaiging capaciloi Ý. Iiguie 3.19(c)
shows lhe oulpul of lhe ciicuil. Nole lhal lhe duly cycle of lhis ciicuil is always
giealei lhan 5O' because Î
a
musl be nonzeio. To gel squaie waves wilh duly
cycles less lhan 5O', lhe oulpul of lhis ciicuil may be fed inlo an inveiling
amplinei oi logic inveilei.
Ú·¹«®» íòïç ̸» ëëë ¬·³»® (a) Pinoul foi lhe 555 limei ¡C. (b) A populai
ciicuil lhal ulilizes a 555 limei and foui exleinal componenls cieales a squaie
wave wilh duly cycle 5O'. (c) The oulpul fiom lhe 555 limei ciicuil shown
in (b).
í ò ï ê Ì × Ó Û Î Í ïîï
This melhod of geneialing squaie waves is simple andiequiies only a small
inlegialed ciicuil (¡C) and foui exleinal componenls. The ciicuil of Iiguie
3.19(b), howevei, is nol veiy useful foi piecision liming applicalions, because
of lhe difncully of ciealing piecision capacilois. \sing lypical off-lhe-shelf
componenls, lhe peiiod may vaiy by as much as 25' fiom lhe nominal values.
\sing vaiiable iesislances foi Î
a
and Î
b
, which allows nne-luning of lhe lime
conslanls, can minimize lhis.
ÛÈßÓÐÔÛ íòë Design a limei foi a neive slimulaloi lhal slimulales foi 2OO
³s eveiy 5O ms.
ßÒÍÉÛÎ \se lhe ciicuil shown in Iiguie 3.19(b). Iiom Iiguie 3.19(c)
Ì
l
ln O 5 Î
b
Ý
Î
b
Ì
1
ln O 5 Ý 2OO ³s O 693 O 1 ³I 2886 Ê
Ì
h
ln O 5 Î
l
Î
h
Ý
Î
h
Î
l
Ì
h
ln O 5 Ý 2886 5O ms O 693 O 1 ³I 717 kÊ
\se 74O4 TTL chip oi 4O49 CMOS chip logic gale inveilei lo yield 5 \ foi
2OO ³s.
íòïé Ó×ÝÎÑÝÑÓÐËÌÛÎÍ ×Ò ÓÛÜ×ÝßÔ ×ÒÍÌÎËÓÛÒÌßÌ×ÑÒ
The eleclionic devices lhal we have desciibed so fai in lhis chaplei aie useful
foi acquiiing a medical signal and peifoiming some inilial piocessing, such as
nlleiing oi demodulalion. Miciocompuleis can fiequenlly ieplace analog
ciicuils by peifoiming lhe signal-piocessing funclions of compaialoi, limilei,
ieclinei, logaiilhmic amplinei, inlegialoi, diffeienlialoi, aclive nllei, and
phase-sensilive demodulaloi in soflwaie (Tompkins, 1993; Rillei »¬ ¿´.,
2OO5). The geneialized insliumenlalion syslem shown in Iiguie 1.1 also
indicales addilional signal piocessing, dala sloiage, and conliol and/oi feed-
back capabilily. Tiadilionally, lhis addilional piocessing was handled eilhei by
using ielalively simple digilal-eleclionic ciicuils oi, if a signincanl amounl of
piocessing was iequiied, by connecling lhe insliumenl lo a compulei.
The developmenl of miciocompuleis has ledlo lhe combining of a medical
insliumenl wilh a signal-piocessing capabilily sufncienl lo peifoim funclions
noimally done by an opeialoi oi a compulei. This compuling funclion can
ceilainly be implemenled. Bul fiom lhe poinl of view of medical insliumen-
lalion, il is moie insliuclive lo view lhe miciocompulei as a micioconliollei.
The use of a miciocompulei geneially iesulls in fewei ¡C packages. This
ieduced complexily, logelhei wilh lhe capabilily foi self-calibialion and
ïîî í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
deleclion of eiiois, enhances lhe ieliabilily of lhe insliumenl. The mosl useful
applicalions of miciocompuleis foi medical insliumenlalion involve lhis
conliollei funclion. Miciocompuleis can piovide self-calibialion foi measuie-
menl syslems, aulomalic sequencing of evenls, and an easy way lo enlei such
palienl dala as heighl, weighl, and sex foi calculaling expecled oi noimal
peifoimance. All lhese funclions aie made possible by lhe basic sliucluie of
lhe miciocompulei syslem. Iuilhei developmenl has iesulled in chip-based
syslems. Ioi inslance digilal nlleis aie now diieclly haid coded onlo dedicaled
chips which iesull in signincanl compulalional savings The Lab\¡!W PC-
based syslem piovides modulai soflwaie-based insliumenls foi dala acquisi-
lion. ¡l peimils giaphical syslem design of embedded applicalions foi micio-
piocessoi and micioconliollei devices. Thus lhe Lab\¡!W developed
soflwaie can be used in many new medical insliumenls aflei lhe puichase
of one Lab\¡!W syslem lhal includes lhe Miciopiocessoi SDK loolkil.
(hllp://www.ni.com/labview/; Tompkins and Webslei, 1981; Tompkins and
Webslei, 1988; Caii and Biown, 2OO1).
ÐÎÑÞÔÛÓÍ
íòï ø¿÷ Ü»-·¹² ¿² ·²ª»®¬·²¹ ¿³°´·•»® ©·¬¸ ¿² ·²°«¬ ®»-·-¬¿²½» ±º îð µÊ ¿²¼ ¿
¹¿·² ±º ïðò ø¾÷ ײ½´«¼» ¿ ®»-·-¬±® ¬± ½±³°»²-¿¬» º±® ¾·¿- ½«®®»²¬ò ø½÷ Ü»-·¹² ¿
-«³³·²¹ ¿³°´·•»® -«½¸ ¬¸¿¬
±
1O
1
2
2
O 5
3
ò
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½±«°´»¼ ±²»ó±°ó¿³° ½·®½«·¬ ¬¸¿¬ ©·´´ ¿³°´·º§ ¬¸» ïðð ³Ê ¬± ëð ³Ê ·²°«¬ ®¿²¹»
¬± ¸¿ª» ¬¸» ³¿¨·³¿´ ¹¿·² °±--·¾´» ©·¬¸±«¬ »¨½»»¼·²¹ ¬¸» ¬§°·½¿´ ¹«¿®¿²¬»»¼
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½·®½«·¬ ¬¸¿¬ ©·´´ ¿³°´·º§ ¬¸» ïðð ³Ê ÛÑÙ ¬± ¸¿ª» ¬¸» ³¿¨·³¿´ ¹¿·² °±--·¾´»
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íòì Ü»-·¹² ¿ ²±²·²ª»®¬·²¹ ¿³°´·•»® ¸¿ª·²¹ ¿ ¹¿·² ±º ïð ¿²¼ Î
i
of Iiguie 3.4(b)
equal lo 2O kÊ. ¡nclude a iesisloi lo compensale foi bias cuiienl.
íòë ß² ±°ó¿³° ¼·ºº»®»²¬·¿´ ¿³°´·•»® ·- ¾«·´¬ «-·²¹ º±«® ·¼»²¬·½¿´ ®»-·-¬±®-ô »¿½¸
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íòê Ü»-·¹² ¿ ¬¸®»»ó±°ó¿³° ¼·ºº»®»²¬·¿´ ¿³°´·•»® ¸¿ª·²¹ ¿ ¼·ºº»®»²¬·¿´ ¹¿·² ±º ë
·² ¬¸» •®-¬ -¬¿¹» ¿²¼ ê ·² ¬¸» -»½±²¼ -¬¿¹»ò
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º®±³ 𠬱 î Êò
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©¸·½¸ ¿®» ²±¬ ¬¸» -¿³» °±·²¬ ¿- ·² ³±-¬ ±°ó¿³° ½·®½«·¬-ò
Ð Î Ñ Þ Ô Û Ó Í ïîí
íòç Ë-·²¹ ¬¸» °®·²½·°´» -¸±©² ·² Ú·¹«®» íòèô ¼»-·¹² ¿ -·¹²¿´ ½±³°®»--±®
º±® ©¸·½¸ ¿² ·²°«¬óª±´¬¿¹» ®¿²¹» ±º ïð Ê §·»´¼- ¿² ±«¬°«¬óª±´¬¿¹» ®¿²¹» ±º
ì Êò
íòïð Ü»-·¹² ¿² ·²¬»¹®¿¬±® ©·¬¸ ¿² ·²°«¬ ®»-·-¬¿²½» ±º ï ÓÊò Í»´»½¬ ¬¸»
½¿°¿½·¬±® -«½¸ ¬¸¿¬ ©¸»²
·
1O Ê
±
¬®¿ª»´- º®±³ 𠬱 ïð Ê ·² ðòï -ò
íòïï ײ Ю±¾´»³ íòïðô ·º
·
O ¿²¼ ±ºº-»¬ ª±´¬¿¹» »¯«¿´- ë ³Êô ©¸¿¬ ·- ¬¸»
½«®®»²¬ ¬¸®±«¹¸ Î? How long will il lake foi
o
lo diifl fiom O \ lo saluialion?
!xplain how lo cuie lhis diifl pioblem.
íòïî ײ Ю±¾´»³ íòïðô ·º ¾·¿- ½«®®»²¬ ·- îðð °ßô ¸±© ´±²¹ ©·´´ ·¬ ¬¿µ» º±®
o
lo
diifl fiom O \ lo saluialion? !xplain how lo cuie lhis diifl pioblem.
íòïí Ü»-·¹² ¿ ¼·ºº»®»²¬·¿¬±® º±® ©¸·½¸
±
1OÊ ©¸»² ¼
·
¼¬ 1OOÊ/-ò
íòïì Ü»-·¹² ¿ ±²»ó-»½¬·±² ¸·¹¸ó°¿-- •´¬»® ©·¬¸ ¿ ¹¿·² ±º îð ¿²¼ ¿ ½±®²»®
º®»¯«»²½§ ±º ðòðë ئò Ý¿´½«´¿¬» ·¬- ®»-°±²-» ¬± ¿ -¬»° ·²°«¬ ±º ï ³Êò
íòïë Ü»-·¹² ¿ ±²»ó±°ó¿³° ¸·¹¸ó°¿-- ¿½¬·ª» •´¬»® ©·¬¸ ¿ ¸·¹¸óº®»¯«»²½§ ¹¿·² ±º
ïð ø²±¬ ›ïð÷ô ¿ ¸·¹¸óº®»¯«»²½§ ·²°«¬ ·³°»¼¿²½» ±º ïð ÓÊô ¿²¼ ¿ ½±®²»®
º®»¯«»²½§ ±º ïð ئò
íòïê Ú·²¼ Ê
±
¶ª Ê
·
¶ª º±® ¬¸» ¾¿²¼°¿-- •´¬»® -¸±©² ·² Ú·¹«®» íòïîø½÷ò
íòïé Ú·¹«®» êòïê -¸±©- ¬¸¿¬ ¬¸» º®»¯«»²½§ ®¿²¹» ±º ¬¸» ßßÐ ·- 1
)
1O lo 1O µØ¦ò
Ü»-·¹² ¿ ±²»ó±°ó¿³° ¿½¬·ª» ¾¿²¼°¿-- •´¬»® ¬¸¿¬ ¸¿- ¿ ³·¼¾¿²¼ ·²°«¬ ·³°»¼¿²½»
±º ¿°°®±¨·³¿¬»´§ ïð µÊô ¿ ³·¼¾¿²¼ ¹¿·² ±º ¿°°®±¨·³¿¬»´§ ïô ¿²¼ ¿ º®»¯«»²½§
®»-°±²-» º®±³ ï ¬± ïð µØ¦ ø½±®²»® º®»¯«»²½·»-÷ò
íòïè Ú·¹«®» êòïê -¸±©- ¬¸» ³¿¨·³¿´ -·²¹´»ó°»¿µ -·¹²¿´ ¿²¼ º®»¯«»²½§
®¿²¹» ±º ¬¸» ÛÓÙò Ü»-·¹² ¿ ±²»ó±°ó¿³° ¾¿²¼°¿-- •´¬»® ½·®½«·¬ ¬¸¿¬ ©·´´
¿³°´·º§ ¬¸» ÛÓÙ ¬± ¸¿ª» ¬¸» ³¿¨·³¿´ ¹¿·² °±--·¾´» ©·¬¸±«¬ »¨½»»¼·²¹ ¬¸»
¬§°·½¿´ ¹«¿®¿²¬»»¼ ´·²»¿® ±«¬°«¬ ®¿²¹» ¿²¼ ©·´´ °¿-- ¬¸» ®¿²¹» ±º º®»¯«»²½·»-
-¸±©²ò
íòïç Ë-·²¹ ìïï ±° ¿³°-ô »¨°´¿·² ¸±© ¿² ¿³°´·•»® ©·¬¸ ¿ ¹¿·² ±º ïðð ¿²¼ ¿
¾¿²¼©·¼¬¸ ±º ïðð µØ¦ ½¿² ¾» ¼»-·¹²»¼ò
íòîð λº»® ¬± Ú·¹«®» íòïíò ׺ ¬¸» ¿³°´·•»® ¹¿·² ·- ïðððô ©¸¿¬ ·- ¬¸» ´±±° ¹¿·² ¿¬
ïðð ئá
íòîï Ú±® ¬¸» ¼·ºº»®»²¬·¿¬±® -¸±©² ·² Ú·¹«®» íòïïô ¹®±«²¼ ¬¸» ·²°«¬ô ¾®»¿µ ¬¸»
º»»¼¾¿½µ ´±±° ¿¬ ¿²§ °±·²¬ô ¿²¼ ¼»¬»®³·²» ¬¸» °¸¿-» -¸·º¬ ·² »¿½¸ -»½¬·±²ò
Û¨°´¿·² ©¸§ ¬¸» ½·®½«·¬ ¬»²¼- ¬± ±-½·´´¿¬»ò
íòîî Ú±® Ю±¾´»³ íòîïô ½¿´½«´¿¬» ¬¸» ¿³°´·•»® ·²°«¬ ¿²¼ ±«¬°«¬ ®»-·-¬¿²½»- ¿¬
ïðð ئô º±® ·²ª»®¬·²¹ ¿²¼ ²±²·²ª»®¬·²¹ ¿³°´·•»®-ò
íòîí Ú±® Ú·¹«®» íòïëô ©¸¿¬ ·- ¬¸» ³¿¨·³¿´ ½¿°¿½·¬·ª» ´±¿¼ Ý
L
lhal can be
connecled lo a 411 wilhoul degiading lhe noimal slew iale 15\/³s al lhe
maximal cuiienl oulpul (2O mA)?
íòîì Ú±® Ú·¹«®» íòïéô ·º ¬¸» º±®©¿®¼ ¼®±° ±º Ü
ï
·- ïðû ¸·¹¸»® ¬¸¿² ¬¸¿¬ ±º ¬¸»
±¬¸»® ¼·±¼»-ô ©¸¿¬ ½¸¿²¹» ±½½«®- ·²
o
?
íòîë Ù·ª»² ¿² ±-½·´´¿¬±® ¾´±½µô ¼»-·¹² ø-¸±© ¬¸» ½·®½«·¬ ¼·¿¹®¿³ º±®÷
¿² ÔÊÜÌô °¸¿-»ó-»²-·¬·ª» ¼»³±¼«´¿¬±® ¿²¼ ¿ •®-¬ó±®¼»® ´±©ó°¿-- •´¬»®
©·¬¸ ¿ ½±®²»® º®»¯«»²½§ ±º ïðð ئò ͵»¬½¸ ©¿ª»º±®³- ¿¬ »¿½¸ -·¹²·•½¿²¬
´±½¿¬·±²ò
ïîì í ß Ó Ð Ô × Ú × Û Î Í ß Ò Ü Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í × Ò Ù
ÎÛÚÛÎÛÒÝÛÍ
Aionson, M. H., Lock-in and caiiiei amplineis.`` Ó»¼ò Û´»½¬®±²ò Ü¿¬¿, 8(3), 1977, C1C16.
Aiy, 1. P., A head-mounled 24-channel evoked polenlial pieamplinei employing low-noise
opeialional amplineis.`` ×ÛÛÛ Ì®¿²-ò Þ·±³»¼ò Û²¹ò, BM!-24, 1977, 293297.
Caii, 1. 1., and 1. M. Biown, ײ¬®±¼«½¬·±² ¬± Þ·±³»¼·½¿´ Û¯«·°³»²¬ Ì»½¸²±´±¹§, 4lh ed., \ppei
Saddle Rivei, N1: Pienlice-Hall, 2OO1.
Iianco, S., Ü»-·¹² ©·¬¸ Ñ°»®¿¬·±²¿´ ß³°´·B»®- ¿²¼ ß²¿´±¹ ײ¬»¹®¿¬»¼ Ý·®½«·¬-. 3id ed., New Yoik:
McGiaw-Hill, 2OO2.
Giaeme, 1. G., Reclifying wide-iange signals wilh piecision, vaiiable gain.`` Û´»½¬®±²., Dec. 12,
1974, 45(25), 1O71O9.
Hoiowilz, P., and W. Hill, ̸» ß®¬ ±º Û´»½¬®±²·½-, 2nd ed. Cambiidge, !ngland: Cambiidge
\niveisily Piess, 1989.
1ung, W. G., ïÝ Ñ°óß³° ݱ±µ¾±±µ, 3id ed. ¡ndianapolis: Howaid W. Sams, 1986.
Rillei, A. B., S. Reisman, and B. B. Michniak, Þ·±³»¼·½¿´ Û²¹·²»»®·²¹ Ю·²½·°´»-. Boca Ralon:
CRC Piess, 2OO5.
Shepaid, R. R., Aclive nlleis: Pail 12, Shoil culs lo nelwoik design.`` Û´»½¬®±²., Aug. 18, 1969,
42(17), 8292.
Tobey, G. !., 1. G. Giaeme, and L. P. Huelsman, Ñ°»®¿¬·±²¿´ ß³°´·B»®-æ Ü»-·¹² ¿²¼ ß°°´·½¿¬·±².
New Yoik: McGiaw-Hill, 1971.
Tompkins, W. 1. (ed.), Þ·±³»¼·½¿´ Ü·¹·¬¿´ Í·¹²¿´ Ю±½»--·²¹æ ÝóÔ¿²¹«¿¹» Û¨¿³°´»- ¿²¼ Ô¿¾±®¿ó
¬±®§ Û¨°»®·³»²¬- º±® ¬¸» ×ÞÓ ÐÝ. !nglewood Cliffs, N1: Pienlice Hall, 1993.
Tompkins, W. 1., and 1. G. Webslei (eds.), Ü»-·¹² ±º Ó·½®±½±³°«¬»®óÞ¿-»¼ Ó»¼·½¿´ ײ-¬®«³»²ó
¬¿¬·±². !nglewood Cliffs, N1: Pienlice-Hall, 1981.
Tompkins, W. 1., and 1. G. Webslei (eds.), ײ¬»®º¿½·²¹ Í»²-±®- ¬± ¬¸» ×ÞÓ ÐÝ. !nglewood Cliffs,
N1: Pienlice-Hall, 1988.
Wail, 1. \., L. P. Huelsman, and G. A. Koin, ײ¬®±¼«½¬·±² ¬± Ñ°»®¿¬·±²¿´ ß³°´·B»® ̸»±®§ ¿²¼
ß°°´·½¿¬·±²-. New Yoik: McGiaw-Hill, 1975.
Î Û Ú Û Î Û Ò Ý Û Í ïîë
ì
ÌØÛ ÑÎ×Ù×Ò ÑÚ Þ×ÑÐÑÌÛÒÌ×ßÔÍ
Ö±¸² Éò Ý´¿®µ Ö®ò
This chaplei deals wilh lhe genesis of vaiious bioelecliic signals lhal aie
iecoided ioulinely in modein clinical piaclice. Given adequale moniloiing
equipmenl, many foims of bioelecliic phenomena can be iecoided wilh ielalive
ease. These phenomena include lhe elecliocaidiogiam (!CG), eleclioence-
phalogiam (!!G), eleclioneuiogiam (!NG), elecliomyogiam (!MG), and
eleclioielinogiam (!RG).
!ngineeis geneially have a good physical insighl inlo lhe naluie of
elecliomagnelic nelds pioduced by bioelecliic souices, and, because of lheii
compiehensive undeislanding of lhe physical pioblem, lhey may conliibule lo
lhe solulion of biological pioblems.
This chaplei begins by inlioducing bioelecliic phenomena al lhe cellulai
level. ¡l pioceeds lo discuss volume-conducloi polenlial disliibulions of simple
bioelecliic souices, and giadually moie analomically complex ones. The
volume-conducloi elecliic neld pioblem piovides lhe link (mapping) belween
micioscopic elecliical aclivily geneialed wilhin lhe bioelecliic souice, lhe ûow
of aclion cuiienl lhiough lhe conducling medium, and lhe macioscopic polen-
lial disliibulion pioduced al lhe suiface of lhe body. We conlinue wilh a
discussion of lhe funclional oiganizalion of lhe peiipheial neivous syslem
(oulside lhe biain and spinal coid), which leads lo a discussion of lhe !NGand
!MG. Iinally, olhei bioelecliic souices (and associaled neld polenlials) aie
discussed including lhe aclive heail (!CG), ielina (!RG), and biain (!!G).
ìòï ÛÔÛÝÌÎ×ÝßÔ ßÝÌ×Ê×ÌÇ ÑÚ ÛÈÝ×ÌßÞÔÛ ÝÛÔÔÍ
Bioelecliic polenlials aie pioduced as a iesull of elecliochemical aclivily of a
ceilain class of cells, known as »¨½·¬¿¾´» ½»´´-, lhal aie componenls of neivous,
musculai, oi glandulai lissue. !lecliically lhey exhibil a®»-¬·²¹°±¬»²¬·¿´ and, when
appiopiialely slimulaled, an ¿½¬·±² °±¬»²¬·¿´ô as lhe following paiagiaphs explain.
ÌØÛ ÎÛÍÌ×ÒÙ ÍÌßÌÛ
The individual excilable cell mainlains a sleady elecliical polenlial diffeience
belween ils inleinal and exleinal enviionmenls. This iesling polenlial of lhe
ïîê
inleinal medium lies in lhe iange 4O lo 9O m\, ielalive lo lhe exleinal
medium.
Iiguie 4.1(a) shows how lhe iesling polenlial is usually measuied. A
miciomanipulaloi advances a micioelecliode (see Seclion 5.8) close lo lhe
suiface of an excilable cell and lhen, by small movemenls, pushes il lhiough
lhe cell membiane. Ioi lhe membiane lo seal piopeily aiound lhe penelialing
lip, lhe diamelei of lhe lip musl be small ielalive lo lhe size of lhe cell in which
il is placed. Iiguie 4.1(b) shows a lypical elecliical iecoiding fiom a single
neive nbei, including lhe dc offsel polenlial (iesling polenlial) lhal occuis
upon penelialion of lhe membiane. ¡l also shows lhe liansienl disluibance of
membiane polenlial (lhe aclion polenlial) when an adequale slimulus is given.
The cell membiane is a veiy lhin (7 lo 15 nm) lipopiolein complex lhal is
essenlially impeimeable lo inliacellulai piolein and olhei oiganic anions A .
The membiane in lhe iesling slale is only slighlly peimeable lo Na and ialhei
Ú·¹«®» ìòï λ½±®¼·²¹ ±º ¿½¬·±²°±¬»²¬·¿´ ±º ¿² ·²ª»®¬»¾®¿¬» ²»®ª» ¿¨±² (a) An
eleclionic slimulaloi supplies a biief pulse of cuiienl lo lhe axon, sliong
enough lo excile lhe axon. Aiecoiding of lhis aclivily is made al a downslieam
sile via a penelialing miciopipelle. (b) The movemenl ailifacl is iecoided as
lhe lip of lhe miciopipelle diives lhiough lhe membiane lo iecoid iesling
polenlial. A shoil lime lalei, an elecliical slimulus is deliveied lo lhe axon; ils
neld effecl is iecoided inslanlaneously al downslieammeasuiemenl sile as lhe
slimulus ailifacl. The aclion polenlial howevei, pioceeds along lhe axon wilh a
conslanl conduclion velocily. The lime peiiod Ô is lhe ´¿¬»²¬ °»®·±¼ oi
liansmission lime fiom slimulus lo iecoiding sile.
ì ò ï Û Ô Û Ý Ì Î × Ý ß Ô ß Ý Ì × Ê × Ì Ç Ñ Ú Û È Ý × Ì ß Þ Ô Û Ý Û Ô Ô Í ïîé
fieely peimeable lo K and Cl . The peimeabilily of lhe iesling membiane lo
polassium ion Ð
K
is appioximalely 5O lo 1OO limes laigei lhan ils peime-
abilily lo sodium ion Ð
Na
.
Typically, lhe K concenlialion of lhe inleinal medium (cylosol) is 14O
mmol/lilei, wheieas lhal of lhe exleinal (balhing) medium is 2.5 mmol/lilei.
The concenlialion diffeience cieales a diffusion giadienl lhal is diiecled
oulwaid acioss lhe membiane. The movemenl of lhe K along lhis diffusion
giadienl (while lhe nondiffusible anion componenl slays wilhin lhe cell) is in
such a diieclion as lo make lhe inleiioi of lhe cell moie negalive ielalive lo lhe
exleinal medium (lhal is, posilive chaige is iemoved fiom lhe inleiioi).
Consequenlly, a liansmembiane polenlial diffeience is eslablished. !leclii-
cally lhe membiane can be desciibed as a leaky capaciloi, since sliucluially il is
compiised of a lhin dielecliic maleiial (lhe lipopiolein complex) lhal acls as a
chaige sepaialoi, and yel il has liansmembiane ion channels (poies) of
diffeienl lypes, some of which allow a leakage ûow of ions acioss lhe
membiane al iesl. The elecliic neld suppoiled by lhe membiane capaciloi
al iesl is diiecled inwaid fiom posilive lo negalive acioss lhe membiane. ¡l
lends lo inhibil lhe oulwaidûowof posilively chaiged ions (such as K ), as well
as lhe inwaid ûow of negalively chaiged ions (such as Cl ). Thus lhe
diffusional and elecliical foices acling acioss lhe membiane aie opposed lo
one anolhei, and a balance is ullimalely achieved. The membiane polenlial al
which such an equilibiium occuis (consideiing K lo be lhe main ionic species
involved in lhe iesling slale; lhal is, Ð
K
Ð
Na
) is called lhe »¯«·´·¾®·«³
°±¬»²¬·¿´ foi lhe K Û
K
. ¡l is measuied in volls and is calculaled fiom lhe
Neinsl equalion,
Û
K
ÎÌ
²Ú
ln
K
o
K
i
O O615 log
1O
K
o
K
i
\ (4.1)
al 37 C (body lempeialuie). Heie ² is lhe valence of lhe K , |Kj
i
and |Kj
o
aie
lhe inliacellulai and exliacellulai concenlialions of K in moles pei lilei,
iespeclively, Î is lhe univeisal gas conslanl (Appendix), Ì is absolule lem-
peialuie in K, and Ú is lhe Iaiaday conslanl (Appendix). !qualion (4.1)
piovides a ieasonably good appioximalion lo lhe polenlial of lhe iesling
membiane, which indicales lhal lhe iesling membiane is effeclively a °±¬¿-ó
-·«³ ³»³¾®¿²». A moie accuiale expiession foi lhe membiane equilibiium
polenlial Û, which accounls foi lhe inûuence of olhei ionic species in lhe
inleinal and exleinal media was nisl developed by Goldman (1943) and lalei
modined by Hodgkin and Kalz (1949), who assumed a conslanl elecliic neld
acioss lhe membiane:
Û
ÎÌ
Ú
ln
Ð
K
K
o
Ð
Na
Na
o
Ð
Cl
Cl
i
Ð
K
K
i
Ð
Na
Na
i
Ð
Cl
Cl
o
(4.2)
Heie Ûis lhe equilibiium liansmembiane (iesling) polenlial when nel cuiienl
lhiough lhe membiane is zeio and Ð
M
is lhe °»®³»¿¾·´·¬§ ½±»ºB½·»²¬ of lhe
ïîè ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
membiane foi a pailiculai ionic species M. ¡l is called lhe Ù±´¼³¿²Pر¼¹µ·²P
Õ¿¬¦ (GHK) º±®³«´¿¬·±².
ÛÈßÓÐÔÛ ìòï Ioi fiog skelelal muscle, lypical values foi lhe inliacellulai
and exliacellulai concenlialions of lhe ma|oi ion species (in millimoles pei
lilei) aie as follows.
Assuming ioom lempeialuie (2O C) and lypical values of peimeabilily co-
efncienl foi fiog skelelal muscle (Ð
Na
2 1O
8
cm/s, Ð
K
2 1O
6
cm/s, and
Ð
Cl
4 1O
6
cm/s), calculale lhe equilibiium iesling polenlial foi lhis mem-
biane, using lhe Goldman equalion.
ßÒÍÉÛÎ Iiom (4.2),
Û O O581 log
1O
Ð
K
4 Ð
Na
145 Ð
Cl
4
Ð
K
155 Ð
Na
12 Ð
Cl
12O
O O581 log
1O
26 9 1O
6
79O 24 1O
6
85 3 m\
which is close lo lypical measuied values foi lhe iesling membiane polenlial in
fiog skelelal muscle.
Mainlaining lhe sleady-slale ionic imbalance belween lhe inleinal and
exleinal media of lhe cell iequiies conlinuous aclive lianspoil of ionic species
againsl lheii elecliochemical giadienls. The aclive lianspoil mechanism is
localed wilhin lhe membiane and is iefeiied lo as lhe -±¼·«³P°±¬¿--·«³
°«³°. ¡l aclively lianspoils Na oul of lhe cell and K inlo lhe cell in lhe ialio
3Na 2K . The associaled pump cuiienl ·
NaK
is a nel oulwaid cuiienl lhal
lends lo inciease lhe negalivily of lhe inliacellulai polenlial. !neigy foi lhe
pump is piovided by a common souice of cellulai eneigy, adenosine lii-
phosphale (ATP) pioduced by milochondiia in lhe cell.
Thus lhe faclois inûuencing lhe ûow of ions acioss lhe membiane aie
(1) diffusion giadienls, (2) lhe inwaidly diiecled elecliic neld, (3) membiane
sliucluie (availabilily of poies), and (4) aclive lianspoil of ions againsl an
eslablished elecliochemical giadienl. The chaige sepaialed by lhe cell membiane
andlhesliucluieof lhis membiane (Ð
K
, Ð
Na
, Ð
Cl
) accounl foi lheiesling polenlial.
K diffuses oulwaidly accoiding lo ils concenlialion giadienl, wheieas lhe
nondiffusible oiganic anion componenl iemains wilhin lhe cell, ciealing a
polenlial diffeience acioss lhe membiane. !leclioneulialily is mainlained wilhin
lhe bulk inleinal and exleinal media, bul due lo lhe membiane capacilance, lheie
Í°»½·»- ײ¬®¿½»´´«´¿® Û¨¬®¿½»´´«´¿®
Na 12 145
K 155 4
Cl 4 12O
ì ò ï Û Ô Û Ý Ì Î × Ý ß Ô ß Ý Ì × Ê × Ì Ç Ñ Ú Û È Ý × Ì ß Þ Ô Û Ý Û Ô Ô Í ïîç
is a monolayei of calions disliibuled on lhe oulei membiane suiface and a
monolayei of anions along lhe innei suiface. The numbei of ions iesponsible foi
lhe membiane polenlial, howevei, is veiy small ielalive lo lhe lolal numbei
piesenl in lhe bulk media. The Na inûux does nol compensale foi lhe K efûux
because, in lhe iesling slale, Ð
Na
Ð
K
. Chloiide ion diffuses inwaid down ils
concenlialion giadienl, bul ils movemenl is balanced by lhe elecliical giadienl.
ÛÈßÓÐÔÛ ìòî The gianl axon of lhe squid is fiequenlly used in eleclio-
physiological invesligalions because of ils size. Typically il has a diamelei of
1OOO ³m, a membiane lhickness of 7.5 nm, a specinc membiane capacily of
1 ³I/cm
2
, and a iesling liansmembiane polenlial
m
of 7O m\. Assume a
unifoim neld wilhin lhe membiane and calculale lhe magnilude and diiec-
lion of lhe elecliic neld inlensily Û wilhin lhe membiane.
ßÒÍÉÛÎ The membiane is quile lhin, seives as a chaige sepaialoi, and can
be iepiesenled by a paiallel-plale capaciloi wilh Û diiecled inwaid.
Û
m
¼
7O 1O
3
7 5 1O
9
9 33 1O
6
\/m
ÌØÛ ßÝÌ×ÊÛ ÍÌßÌÛ
Anolhei piopeily of an excilable cell is ils abilily lo conducl anaclion polenlial
|Iiguie 4.1(b)j when adequalely slimulaled. An ¿¼»¯«¿¬» -¬·³«´«- is one lhal
biings aboul lhe depolaiizalion of a cell membiane lhal is sufncienl lo exceed
ils lhieshold polenlial and lheieby elicil an all-oi-none aclion polenlial (biief
liansienl disluibance of lhe membiane polenlial), which liavels in an un-
allenualed fashion and al a conslanl conduclion velocily along lhe membiane.
Because of lhe sleady iesling polenlial, lhe cell membiane is said lo be
°±´¿®·¦»¼. A lessening of lhe magnilude of lhis polaiizalion is called ¼»ó
°±´¿®·¦¿¬·±², wheieas an inciease in magnilude is iefeiied lo as ¸§°»®ó
°±´¿®·¦¿¬·±². The all-oi-none piopeily of lhe aclion polenlial means lhal
lhe membiane polenlial goes lhiough a veiy chaiacleiislic cycle: a change
in polenlial fiom lhe iesling level of a ceilain amounl foi a nxed duialion of
lime. Ioi a neive nbei, Ü 12Om\ and lhe duialion is appioximalely 1 ms.
Iuilhei incieases in inlensily oi duialion of slimulus beyond lhal iequiied foi
exceeding lhe lhieshold level pioduce only lhe same iesull.
The oiigin of lhe aclion polenlial lies in lhe vollage- and lime-dependenl
naluie of lhe membiane peimeabililies (oi equivalenlly, in elecliical leims,
membiane conduclivilies) lo specinc ions, nolably Na and K . As lhe
¬®¿²-³»³¾®¿²» °±¬»²¬·¿´ (
m
) is depolaiized, lhe membiane peimeabilily lo
sodium Ð
Na
(oi, equivalenlly, lhe conduclance of lhe membiane lo sodium
¹
Na
) is signincanlly incieased. As a iesull, Na iushes inlo lhe inleinal medium
of lhe cell, biinging aboul fuilhei depolaiizalion, which in luin biings aboul a
fuilhei inciease in ¹
Na
(i.e., ¹
Na
is dependenl on liansmembiane polenlial). ¡f
lhe membiane polenlial lhieshold is exceeded, lhis piocess is self-iegeneialive
ïíð ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
and leads lo ®«²¿©¿§ depolaiizalion. \ndei lhese condilions,
m
lends lo
appioach lhe equilibiiumNeinsl polenlial of sodium, Û
Na
, which has a value of
aboul 6Om\.
Howevei,
m
nevei achieves lhis level because of lwo faclois: (1) ¹
Na
is nol
only vollage dependenl bul also lime dependenl, and (as shown in Iiguie 4.2) il
is ielalively shoil-lived compaied wilh lhe aclion polenlial. (2) Theie is a
delayed inciease in ¹
K
lhal acls as a hypeipolaiizing inûuence, lending lo
iesloie
m
lo iesling levels (Iiguie 4.2). As
m
ullimalely ieluins lo lhe iesling
level, ¹
K
is slill elevaled wilh iespecl lo ils iesling value and ieluins slowly
along an exponenlial lime couise. Since K conlinue lo leave lhe cell duiing
lhis lime, lhe membiane hypeipolaiizes and an undeishool is pioduced in lhe
liansmembiane polenlial wavefoim (
m
).
The calculaled ¹
Na
and ¹
K
wavefoims of Iiguie 4.2 aie based on ª±´¬¿¹»ó
½´¿³° dala fiom squid axon. ¡n vollage-clamp expeiimenls, liansmembiane
polenlial
m
is held al piesciibed levels via a negalive-feedback conliol ciicuil.
Ú·¹«®» ìòî Model-geneialed liansmembiane polenlial
m
and membiane
ionic conduclance changes foi sodium (g
Na
) and polassium (g
K
) duiing lhe
aclion polenlial. These wavefoims aie oblained by solving lhe diffeienlial
equalions developed by Hodgkin and Huxley foi lhe gianl axon of lhe squid al
a balhing medium lempeialuie of 18 5 C. Û
Na
and Û
K
aie lhe Neinsl
»¯«·´·¾®·«³ °±¬»²¬·¿´- foi Na and K acioss lhe membiane. (Modined
fiom A. L. Hodgkin and A. I. Huxley, A quanlilalive desciiplion of
membiane cuiienl and ils applicalion lo conduclion and excilalion in neive.``
Ö±«®²¿´ ±º и§-·±´±¹§ô 1952, 117, 53O.)
ì ò ï Û Ô Û Ý Ì Î × Ý ß Ô ß Ý Ì × Ê × Ì Ç Ñ Ú Û È Ý × Ì ß Þ Ô Û Ý Û Ô Ô Í ïíï
Membiane cuiienls in iesponse lo slep changes in
m
aie sludied in oidei lo
deleimine lhe vollage- and lime-dependenl naluie of ¹
Na
and ¹
K
.
Iiguie 4.3 shows a nelwoik equivalenl ciicuil desciibing lhe elecliical
behavioi of a small unil aiea of membiane. The enliie neive axon membiane
can be chaiacleiized in a disliibuled fashion by ulilizing an ileialive sliucluie
of lhis same basic foim.
ÛÈßÓÐÔÛ ìòí Suppose lhal lhe elecliical piopeilies of an elongaled
excilable cell of cylindiical geomeliy (such as a neive oi skelelal muscle
nbei) can be modeled faiily accuialely wilh a disliibuled paiamelei cable``
model such as lhal of Iiguie 4.3. Whal should lhe lempoial-membiane
polenlial iesponse lo biief squaie pulses of slimulaling cuiienl look like al
some nxed dislance fiom a pailiculai slimulaling elecliode? As lhe sepaia-
lion dislance belween lhe pailiculai slimulaling elecliode and lhe exploiing
miciopipelle is piogiessively incieased, in whal mannei should lhe amplilude
of lhe sublhieshold iesponse change?
ßÒÍÉÛÎ Iiguie 4.3 shows lhal each seclion of lhe disliibuled paiamelei
model foims an ÎÝ low-pass nllei. Mulliple seclions foim mulliple low-pass
Ú·¹«®» ìòí Ü·¿¹®¿³ ±º ²»¬©±®µ »¯«·ª¿´»²¬ ½·®½«·¬ ±º ¿ -³¿´´ ´»²¹¬¸ øÜÜ ÷ ±º ¿
½§´·²¼®·½¿´ ½»´´ ø«²³§»´·²¿¬»¼ ²»®ª» B¾»® ±® -µ»´»¬¿´ ³«-½´» B¾»®÷ The mem-
biane piopei is chaiacleiized by specinc membiane capacilance Ý
m
(³I/cm
2
)
and specinc membiane conduclances ¹
Na
, ¹
K
, and ¹
Cl
in millisiemens/cm
2
(mS/
cm
2
). Heie an aveiage specinc leakage conduclance is included lhal coiie-
sponds lo ionic cuiienl fiom souices olhei lhan Na and K (e.g., Cl ). This
leimis usually neglecled. The cell cyloplasmis consideied simply iesislive, as is
lhe exleinal balhing medium; lhese media may lhus be chaiacleiized by lhe
iesislance pei unil lenglh ®
i
, and ®
o
(Ê/cm), iespeclively. Heie ·
m
is lhe
liansmembiane cuiienl pei unil lenglh (A/cm), and
i
and
o
aie lhe inleinal
and exleinal polenlials al poinl ¦, iespeclively. Tiansmembiane polenlial al
eachpoinl in¦ is given by
m
i o
. (Modined fiomA. L. HodgkinandA. I.
Huxley, Aquanlilalive desciiplion of membiane cuiienl and ils applicalion lo
conduclion and excilalion in neive.`` Ö±«®²¿´ ±º и§-·±´±¹§, 1952, 117, 5O1.)
ïíî ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
nlleis. Thus lhe iesponse due lo lhe slimulaling squaie-wave pulse is piogies-
sively smoolhed and allenualed as lhe sepaialion dislance incieases.
When an excilable membiane pioduces an aclion polenlial in iesponse lo
an adequale slimulus, lhe abilily of lhe membiane lo iespond lo a second
slimulus of any soil is maikedly alleied. Duiing lhe inilial poilion of lhe aclion
polenlial, lhe membiane cannol iespond lo any slimulus, no mallei how
inlense. This inleival is iefeiied lo as lhe ¿¾-±´«¬» ®»º®¿½¬±®§ °»®·±¼. ¡l is
followed by lhe ®»´¿¬·ª» ®»º®¿½¬±®§ °»®·±¼ô wheiein an aclion polenlial can be
eliciled by an inlense supeilhieshold slimulus (Iiguie 4.2). The exislence of
lhe iefiacloiy peiiod pioduces an uppei limil lo lhe fiequency al which an
excilable cell may be iepelilively dischaiged. Ioi example, if a neive axon has
an absolule iefiacloiy peiiod of 1 ms, il has an uppei limil of iepelilive
dischaige of less lhan 1OOO impulses/s.
Ioi an aclion polenlial piopagaling along a single unmyelinaled neive
nbei, lhe iegion of lhe nbei undeigoing a liansilion inlo lhe aclive slale (lhe
¿½¬·ª» ®»¹·±²) al an inslanl of lime is usually small ielalive lo lhe lenglh of lhe
nbei. Iiguie 4.4(a) shows schemalically lhe chaige disliibulion along lhe nbei
Ú·¹«®» ìòì (a) Chaige disliibulion in lhe vicinily of lhe aclive iegion of an
unmyelinaled nbei conducling an impulse. (b) Local ciicuil cuiienl ûow in lhe
myelinaled neive nbei.
ì ò ï Û Ô Û Ý Ì Î × Ý ß Ô ß Ý Ì × Ê × Ì Ç Ñ Ú Û È Ý × Ì ß Þ Ô Û Ý Û Ô Ô Í ïíí
in lhe vicinily of lhe aclive iegion. Nole lhal lhe diieclionof piopagalion of lhe
aclion polenlial (consideied fiozen in lime) is lo lhe lefl, and lhe membiane
lying ahead of lhe aclive iegion is polaiized, as in lhe iesling slale. A ieveisal
of polaiily is shown wilhin lhe aclive iegion because of depolaiizalion of lhe
membiane lo posilive values of polenlial. The membiane lying behind lhe
aclive zone is iepolaiized membiane.
Iiom lhe indicaled chaige disliibulion, -±´»²±·¼¿´ (closed-palh) cuiienl
ûows in lhe pallein shown in Iiguie 4.4(a). ¡n lhe iegion ahead of lhe aclive
zone, lhe ohmic polenlial diop acioss lhe membiane caused by lhis solenoidal
cuiienl ûowing oulwaid lhiough lhe membiane is of such a polaiily as lo
ieduce lhe magnilude of
m
i.e., depolaiize lhe membiane. When
m
is
depolaiized lo lhe lhieshold level (aboul 2O m\ moie posilive lhan lhe iesling
polenlial), lhis iegion becomes aclivaled as well. The same cuiienl pallein
ûowing behind lhe aclive iegion is ineffeclive in ie-exciling lhe membiane,
which is in lhe iefiacloiy slale. The naluie of lhis piocess is lheiefoie self-
excilaloiy, each new inciemenl of membiane being bioughl lo lhe lhieshold
level by lines of cuiienl fiom lhe aclive souice iegion. The membiane slays in
lhe aclive slale foi only a biief peiiod of lime and ullimalely iepolaiizes
complelely. ¡n lhis way, lhe aclion polenlial piopagales down lhe lenglh of lhe
nbei in an unallenualed fashion, lhe signal being buill up al each poinl along
lhe way.
Mosl neuions in inveilebiales aie unmyelinaled, bul mosl veilebiale
neuions aie myelinaled. Thal is, lhe axon is insulaled by a shealh of myelin,
a lipopiolein complex foimed fiom successive wiappings of lhe axon by a
special suppoil cell found along neive nbeis. ¡n peiipheial neives‰lhose lhal
lie oulside lhe cenlial neivous syslem (CNS)‰lhis suppoil cell is known as a
ͽ¸©¿²² ½»´´. ¡n myelinaled CNS neuions, lhis funclion is seived by a special
glial cell known as an ±´·¹±¼»²¼®±¹´·±½§¬». The myelin shealh is inleiiupled al
iegulai inleivals (1 lo 2 mm, depending on lhe species) by nodes of Ranviei; a
single Schwann cell lhus piovides lhe insulaling myelin shealh coveiing of lhe
axon belween lwo successive nodes of Ranviei |Iiguie 4.4(b)j. The lighlly
wiapped membianes of lhe Schwann cell closely adheie lo lhe axon membiane
and inciease ils lhickness by a facloi of 1OO. This subslanlially decieases lhe
capacilance of lhe modinedmembiane and incieases lhe liansveise impedance
lo cuiienl ûow in lhe inleinodal iegion of lhe nbei. Sodium ion channels aie
disliibuled in a nonunifoim mannei in myelinaled nbeis, being densely
clusleied al lhe nodes of Ranviei and veiy spaisely disliibuled in lhe inlei-
nodal iegion. Mulliple lypes of polassiumchannels (fasl-galed, slow-galed) aie
disliibuled in lhe paianodal iegions lying ad|acenl lo each node of Ranviei.
These channels aie disliibuled lo a lessei exlenl lhioughoul lhe iemaindei of
lhe inleinodal iegion in bolh amphibian and mammalian species.
Once lhe myelinaled neive nbei is aclivaled, conduclion pioceeds lhiough
a piocess of local ciicuil cuiienl ûow, much as in lhe case of lhe unmyelinaled
neive nbei desciibed eailiei |Iiguie 4.4(a)j. Theie aie diffeiences, howevei, in
lhal lhe souices foi aclion cuiienl ûow aie localized al lhe nodes of Ranviei
and aie lheiefoie nol unifoimly disliibuled along lhe axonal membiane, as in
ïíì ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
lhe case of lhe unmyelinaled nbei. Myelinalion of lhe inleinode ieduces
leakage cuiienls, decieases membiane capacilance, and impioves lhe lians-
mission piopeilies of lhe cable-like myelinaled nbei. Local ciicuil cuiienls
emanaling fiom an aclive node have an exponenlially diminishing magnilude
ovei an axial dislance spanning seveial inleinodal lenglhs. Accoidingly, lhey
conliibule lo a diop in nodal polenlial as cuiienl passes oulwaid lhiough a
given inaclive nodal membiane |Iiguie 4.4(b)j.
Thus myelinaled neive nbei conduclion pioceeds via iapid, sequenlial
aclivalion of lhe nodes of Ranviei, and local ciicuil cuiienl piovides lhe
undeilying mechanism foi biinging lhe nodal membiane vollage lo lhieshold.
This piocess is fiequenlly called -¿´¬¿¬±®§ ½±²¼«½¬·±² (fiom lhe Lalin -¿´¬¿®»,
lo leap oi dance``), because aclion polenlials appeai lo leap fiom node lo
node. Ioi an axon of a given diamelei, myelinalion impioves lhe conduclion
iale by a facloi of appioximalely 2O. By ieason of ils sliucluie, lhe myelinaled
neive nbei iepiesenls a moie complicaled bioelecliic aclion cuiienl souice
lhan lhe unmyelinaled neive nbei. Malhemalical modeling sludies of conduc-
lion in bolh unmyelinaled and myelinaled neive nbeis have appeaied in lhe
lileialuie (Mooie »¬ ¿´., 1978; Waxman and Biill, 1978; Hallei and Claik, 1991;
Mofnl »¬ ¿´., 2OO4).
ìòî ÊÑÔËÓÛóÝÑÒÜËÝÌÑÎ Ú×ÛÔÜÍ
A fundamenlal pioblem in elecliophysiology is lhal of lhe single aclive cell
immeised in a volume conducloi (a sall solulion simulaling lhe composilion of
body ûuids). A sludy of lhis simple pioblem lends consideiable insighl inlo
olhei, moie complex volume-conducloi-neld pioblems, including lhe !NG,
!MG, and !CG.
The pioblem consisls of lwo pails: (1) lhe bioelecliic souice and (2) ils
balhing medium oi elecliical load. The bioelecliic souice is lhe aclive cell,
which behaves elecliically as a conslanl-cuiienl souice, deliveiing ils sole-
noidal aclivalion cuiienl lo lhe iesislive balhing medium ovei a laige iange
of loading condilions. We considei lhe single aclive unmyelinaled neive nbei
(bioelecliic souice) balhed by a volume conducloi (specinc iesislivily ®)
whose dimensions aie laige ielalive lo lhe spalial exlenl of lhe elecliic neld
suiiounding lhe neive nbei (innnile volume conducloi). The lines of sole-
noidal cuiienl ûow emanaling fiom lhe aclive nbei inlo lhe balhing medium
and ieluining lo lhe nbei aie indicaled schemalically in Iiguie 4.4(a). This
pallein of cuiienl ûow is consislenl wilh lhe chaige disliibulion shown in
Iiguie 4.4(a).
We assume lhal lhe aclion polenlial liavels down lhe nbei al a conslanl
conduclion velocily. Hence, lhe lempoial wavefoim
m
(¬) can be conveiled
easily lo a spalial disliibulion
m
(¦), wheie ¦ is lhe axial dislance along lhe
nbei. Ioi a simple monophasic aclion polenlial, lhe associaled polenlial
wavefoim al lhe oulei suiface of lhe membiane is (1) liiphasic in naluie,
ì ò î Ê Ñ Ô Ë Ó Û ó Ý Ñ Ò Ü Ë Ý Ì Ñ Î Ú × Û Ô Ü Í ïíë
(2) of giealei spalial exlenl lhan lhe aclion polenlial, and (3) much smallei in
peak-lo-peak magnilude. The magnilude of lhe neld polenlial in a laige
balhing medium falls off exponenlially wilh incieasing iadial dislance fiom
lhe aclive nbei (polenlial zeio wilhin nfleen nbei iadii). Iield polenlial
magnilude al lhe nbei suiface depends on lhe amounl of aclive cell membiane
suiface aiea (bioelecliic souice) conliibuling lo lhe signal and is usually on lhe
oidei of lens of miciovolls (³\).
Changes in lhe piopeilies of lhe volume conducloi can also have an
effecl on lhe neld polenlial magnilude. ¡f ils specinc iesislivily (®) is
incieased, lhe magnilude of lhe neld polenlial measuied al lhe oulei
membiane suiface incieases, as il would if lhe volume conducloi is made
smallei. ¡n each case, lhe exliacellulai load iesislance lo cuiienl ûow fiom
lhe conslanl aclion cuiienl geneialoi (membiane) is giealei. Iiom Ohm`s
law, polenlial is incieased |by changing maleiial piopeilies of volume
conducloi (®) oi ils dimensionsj.
¡f inslead, we considei lhe souice lo be an aclive neive liunk wilh ils
lhousands of componenl neive nbeis simullaneously aclivaled, lhe exliacel-
lulai neld polenlial iecoided in an innnile homogeneous balhing medium can
appeai quile similai lo lhe liiphasic iesponse of lhe single nbei |Iiguie 4.5(b)j.
Ú·¹«®» ìòë !xliacellulai neld polenlials (aveiage of 128 iesponses) weie
iecoided al lhe suiface of an aclive (1 mm-diamelei) fiog scialic neive
in an exlensive volume conducloi. The polenlial was iecoided wilh (a)
bolh moloi and sensoiy componenls exciled Í
m
Í
s
, (b) only moloi
neive componenls exciled (Í
m
), and (c) only sensoiy neive componenls
exciled (Í
s
).
ïíê ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
Heie, lhe exliacellulai neldpolenlial is foimed fiomlhe supeiimposed elecliic
nelds of individual aclive nbeis wilhin lhe neive liunk. The exliacellulai
polenlial iecoided al a neld poinl in lhe volume conducloi is liiphasic, low-
miciovoll iange in amplilude, and il diminishes in amplilude and high-fie-
quency conlenl as neld poinl is moved lo laigei iadial dislances fiom lhe
suiface of lhe liunk. The fiog scialic neive ulilized in lhis expeiimenl is a
ialhei complex bioelecliic souice, consisling of laige diamelei moloi nbeis
iunning fiom lhe spinal coid lo lhe leg muscles, as well as laige and small
sensoiy nbeis iunning fiom sensoiy ieceplois in lhe leg and skin lo lhe spinal
coid. ¡n Iiguie 4.5(a), lhe enliie neive liunk (conlaining bolh moloi and
sensoiy nbeis of diffeienl diameleis) was simullaneously exciled by a biief
supialhieshold elecliic slimulus.
¡l is possible, howevei, lo excile lhe moloi and sensoiy componenls of lhe
liunk sepaialely by isolaling lhe neive liunk in lhe vicinily of lhe spinal coid.
Heie lhe neive liunk divides inlo a sensoiy bianch (lhe ¼±®-¿´ ®±±¬) and a
moloi bianch (lhe ª»²¬®¿´ ®±±¬). The iesulls of sepaiale moloi and sensoiy
slimulalion aie shown in Iiguie 4.5(b) and (c). Slimulalion of lhe many laige-
diamelei moloi nbeis in lhe liunk piovides lhe laigesl exliacellulai iesponse
(laigesl aclive membiane suiface aiea), wheieas slimulalion of lhe sensoiy
iool exciles al leasl lwo gioups of sensoiy nbeis‰a gioup of laigei, fasl
conducling nbeis (gioup ¡) and a gioup of smallei, slowei nbeis (gioup ¡¡).
Obseiving lhe exliacellulai wavefoim pioduced by combined slimulalion
|Iiguie 4.5(a)j, we cansee lhe appioximale supeiposilionof moloi andsensoiy
iesponses.
The volume-conducloi load of lhe aclive neive liunk can also be alleied
and made moie complicaled. A ielalively simple vaiialion is lo inciease lhe ®
of lhe balhing medium oi deciease lhe iadial exlenl of lhe volume conducloi,
oi bolh. These alleialions pioduce laigei exliacellulai polenlials due lo lhe
conslanl naluie of lhe bioelecliic cuiienl souice. \llimalely, lhe volume-
conducloi load can consisl of a nonhomogeneous mullilayeied conducling
medium conlaining skelelal muscle, blood vessels and bone (leg oi aim).
Ú·¹«®» ìòë (ݱ²¬·²«»¼)
ì ò î Ê Ñ Ô Ë Ó Û ó Ý Ñ Ò Ü Ë Ý Ì Ñ Î Ú × Û Ô Ü Í ïíé
Cuiienl ûow palleins aie alleied in lhis case due lo iegional diffeiences in
specinc iesislivily (e.g., bone and blood) and skelelal muscle nbei oiienlalion.
Skelelal muscle conslilules an ¿²·-±¬®±°·½ conducling medium (specinc iesis-
livily diffeienl in each cooidinale diieclion) and exhibils piefeienlial conduc-
lion in lhe diieclion of nbei oiienlalion. Regaidless, homogeneous volume-
conducloi models using bulk anisoliopic piopeilies of lhe passive conducling
mediumcan seive as useful appioximalions lo lhe neldpolenlial disliibulion in
such media, lending insighl inlo lhe inleipielalion of iecoided wavefoims.
The foiegoing discussion may be consideied an explanalion of lhe eleclio-
genesis of lhe !NG, which is commonly iecoided fiomlhe suiface of an aim, a
leg, oi lhe face. The concepls inlioduced heie apply diieclly lo lhe inleipiela-
lion of many bioelecliic phenomena including lhose associaled wilh lhe
neivous syslem (e.g., evoked polenlial iecoidings fiom nbei liacls in lhe
spinal coid and sensoiy cenleis in lhe biain), as well as aclive skelelal muscle
(!MG), caidiac muscle (!CG), and smoolh muscle (!GG).
ìòí ÚËÒÝÌ×ÑÒßÔ ÑÎÙßÒ×ÆßÌ×ÑÒ ÑÚ ÌØÛ ÐÛÎ×ÐØÛÎßÔ
ÒÛÎÊÑËÍ ÍÇÍÌÛÓ
ÌØÛ ÎÛÚÔÛÈ ßÎÝ
The spinal neivous syslem is funclionally oiganized on lhe basis of whal is
commonly called lhe ®»A»¨ ¿®½ |Iiguie 4.6(a)j. The componenls of lhis aic aie
as follows:
ïò A-»²-» ±®¹¿²ô consisling of many individual sense ieceplois lhal iespond
piefeienlially lo an enviionmenlal slimulus of a pailiculai kind, such as
piessuie, lempeialuie, louch, oi pain.
îò A-»²-±®§ ²»®ª»ô conlaining many individual neive nbeis lhal peifoimlhe
lask of liansmilling infoimalion (encoded in lhe foim of aclion polenlial
fiequency) fioma peiipheial sense ieceploi lo olhei cells lying wilhin lhe
cenlial syslem (biain and spinal coid).
íò The CNS, which in lhis case seives as a cenlial inlegialing slalion. Heie
infoimalion is evalualed, and, if waiianled, a moloi`` decision is imple-
menled. Thal is, aclion polenlials aie inilialed in moloi-neive nbeis
associaled wilh lhe moloi-neive liunk.
ìò A ³±¬±® ²»®ª»ô seiving as a communicalion link belween lhe CNS and
peiipheial muscle.
ëò The »ºº»½¬±® ±®¹¿²ô which consisls, in lhis case, of skelelal muscle nbeis
lhal conliacl (shoilen) in iesponse lo lhe diiving slimuli (aclion polen-
lials) conducled by moloi-neive nbeis.
The simplesl example of lhe behavioi of lhe ieûex aic is lhe knee-|eik ieûex,
in which lhe palellai lendon below lhe knee is given a slighl lap lhal slielches
ïíè ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
specialized lenglh ieceplois, called ³«-½´» -°·²¼´»-ô wilhin lhe muscle and
subsequenlly exciles lhem. This excilalion iesulls in aclion polenlials lhal
piopagale along lhe sensoiy neive lhal enleis lhe spinal coid and communicales
wilh CNS cells, specincally moloneuions. The iesullanl moloi aclivily ieûexly
biings aboul conliaclion of lhe muscle lhal was inilially slimulaled, and lhe
shoilening muscle |eiks lhe limb, pioducing lhe well-known knee-|eik iesponse.
Nole lhal lhe inilial slimulus lo lhe muscle was a slielch, wheieas lhe iesponse
was a conliaclion of lhe muscle. This simple ieûex aic has many of lhe fealuies of
a negalive-feedback loop, in which lhe conliol vaiiable is muscle lenglh |Iiguie
4.6(b)j. The CNS acls as lhe conliollei, lhe muscle spindle as a feedback lenglh
sensoi, and lhe musclelimb syslem as lhe piocess lo be conliolled.
ÖËÒÝÌ×ÑÒßÔ ÌÎßÒÍÓ×ÍÍ×ÑÒ
Wilhin lhe ieûex aic lheie aie inleicommunicaling links belween neuions
(neuioneuio |unclions) called -§²¿°-»-, as well as communicaling links
belween neuions and muscle nbeis called ²»«®±³«-½«´¿® ¶«²½¬·±²-. These
occui al small, specialized iegions of lhe muscle nbei iefeiied lo as an »²¼ó
°´¿¬» ®»¹·±²-ò The |unclional liansmission piocess in each of lhese cases is
elecliochemical in naluie. Theie is a pie|unclional nbei involved in lhe
Ú·¹«®» ìòê ͽ¸»³¿¬·½ ¼·¿¹®¿³±º ¿ ³«-½´»ó´»²¹¬¸½±²¬®±´ -§-¬»³º±® ¿ °»®·°¸»®¿´
³«-½´» ø¾·½»°-÷ (a) analomical diagiam of limb syslem, showing inleicon-
neclions and (b) block diagiam of conliol syslem.
ì ò í Ú Ë Ò Ý Ì × Ñ Ò ß Ô Ñ Î Ù ß Ò × Æ ß Ì × Ñ Ò ïíç
neuiomusculai |unclion lhal, when depolaiized, ieleases a neuioliansmillei
subslance ¿½»¬§´½¸±´·²» (ACh), which diffuses acioss a veiy small ûuid-nlled
gap iegion appioximalely 2O nm in lhickness. The ûuid nlling lhe gap is
assumed lo be oidinaiy inleislilial body ûuid. Once ACh ieaches lhe posl|unc-
lional membiane, il combines wilh a membiane ieceploi complex lhal
aclivales an ion channel, which leads lo a ielalively biief liansienl de-
polaiizalion of lhe posl|unclional membiane and subsequenlly lo lhe inilialion
of an aclion polenlial lhal piopagales away fiom lhe |unclional iegion. The
elecliochemical liansmission piocess al lhe |unclion involves a lime delay on
lhe oidei of O.5 lo 1.O ms. Moie delailed desciiplions of inleineuional and
neuiomusculai liansmission aie available in geneial physiology lexls (e.g.,
Levilan and Kaczmaiek, 2OO2).
Anolhei lime delay associaled wilh lhe neuiomusculai syslem is lhe delay
belween elecliical aclivalion of lhe musculaluie and lhe onsel of mechanical
conliaclion. This delay, which is iefeiied lo as »¨½·¬¿¬·±²P½±²¬®¿½¬·±² ¬·³», is a
piopeily of lhe muscle ilself. When lhe muscle is iepealedly slimulaled, lhe
mechanical iesponse summales. Al high slimulalion iales, lhe mechanical
iesponses fuse inlo one conlinuous conliaclion called a ¬»¬¿²«- (oi ¬»¬¿²·½
½±²¬®¿½¬·±²).
ìòì ÌØÛ ÛÔÛÝÌÎÑÒÛËÎÑÙÎßÓ
Conduclion velocily in a peiipheial neive is measuied by slimulaling a moloi
neive al lwo poinls a known dislance apail along ils couise. Subliaclion of lhe
shoilei lalency fiom lhe longei lalency (Iiguie 4.7) gives lhe conduclion lime
Ú·¹«®» ìòé Measuiemenl of neuial conduclion velocily via measuiemenl of
lalency of evoked elecliical iesponse in muscle. The neive was slimulaled al
lwo diffeienl siles a known dislance Ü apail.
ïìð ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
along lhe segmenl of neive belween lhe slimulaling elecliodes. Knowing lhe
sepaialion dislance, we can deleimine lhe conduclion velocily of lhe neive,
which has polenlial clinical value since, e.g., conduclion velocily in a iegen-
eialing neive nbei is slowed following neive in|uiy (Sink|aei »¬ ¿´., 2OO6).
Skelelal muscle nbeis (7O ³m diamelei) aie much laigei lhan myelinaled
neive nbeis (2 lo2O ³m); hence lhe amplilude of neld polenlials iecoided fiom
aclive neive liunks aie much smallei lhan neld polenlials iecoided fiom
gioups of aclive muscle nbeis (laigei aclive membiane suiface aiea). Such
polenlials can be iecoided wilh eilhei concenliic needle elecliodes oi suiface
elecliodes (Chap. 5). Neive neld polenlials can also be evoked by applying
slimuli lo mixed`` neives lhal conlain bolh moloi and sensoiy componenls
(such as lhe ulnai neive of lhe aim), in which case lhe iesullanl neld polenlials
aie deiived fiom bolh lypes of aclive nbeis. Howevei, neld polenlials can also
be eliciled fiom puiely sensoiy neives (e.g., lhe suial neive in lhe leg) oi fiom
sensoiy componenls of a mixed neive, wheiein slimulalion is applied in a
mannei lhal does nol excile lhe moloi componenls of lhe neive. ¡n geneial, lhe
sludy of evoked neld polenlials fiom sensoiy neives has been shown lo be of
consideiable value in diagnosing peiipheial neive disoideis.
Allhoughmeasuiemenls of conduclion velocily andlalency aie mosl useful
in lhe assessmenl of peiipheial neive funclion, lhe chaiacleiislics of lhe neld
polenlials evoked in muscle, as slimulaled by ils aclive moloi neive, aie also
impoilanl. When consideiing evoked muscle polenlials, lhe duialion of lhe
iesponse is fiequenlly of inleiesl, since slowed conduclion in a fewmoloi neive
nbeis may lead lo lale aclivalion of a poilion of lhe muscle. The inlegialed neld
polenlial lhus iecoided may appeai piolonged and polyphasic. ¡f lhe compo-
nenl moloi nbeis of lhe muscle have a unifoim conduclion velocily, lheie will
be a supeiposilion of lhe iecoided neld polenlials iesulling in a laigei ampli-
lude, shoilei duialion liiphasic iesponse. Slowed conduclion in some of lhe
moloi nbeis may lead lo pailial fiaclionalion of lhe inlegialed neld polenlial
wavefoim wilh a deciease in ils magnilude and a bioadening of ils duialion.
Ú×ÛÔÜ ÐÑÌÛÒÌ×ßÔÍ ÑÚ ÍÛÒÍÑÎÇ ÒÛÎÊÛÍ
!xliacellulai neld iesponses fiom sensoiy neives can be easily measuied fiom
lhe median oi ulnai neives of lhe aim by using iing-slimulaling elecliodes
applied lo lhe nngeis (Iiguie 4.8). Recoiding al lwo siles a known dislance
apail along lhe couise of lhe neive enables one lo compule lhe conduclion
velocily of lhe sensoiy neive. ¡n lhe case of lhe ulnai neive (ioughly, il supplies
lhe lhiid and fouilh nngeis), evoked neuial polenlials can be iecoided fiom
diffeienl siles along lhe couise of lhe neive as high as lhe aimpil. ¡n lhe case of
lhe median neive (ioughly, il supplies lhe index and lhe second nngeis), neld
polenlials can be iecoided fiom lhe neive al and above lhe elbow.
Long pulses cause muscle conliaclions, limb movemenl, and undesiied
signals (¿®¬·º¿½¬-). These aie avoided by posilioning lhe limb in a comfoilable,
ielaxed posluie and applying a biief, inlense slimulus (squaie pulse of
appioximalely 1OO \ amplilude wilh a duialion of 1OO lo 3OO ³s). Such a
ì ò ì Ì Ø Û Û Ô Û Ý Ì Î Ñ Ò Û Ë Î Ñ Ù Î ß Ó ïìï
slimulus exciles lhe laige, iapidly conducling sensoiy neive nbeis bul nol small
pain nbeis oi suiiounding muscle. To minimize ailifacls caused by slimuli, we
use a slimulus isolalion unil (isolalion liansfoimei, diode-biidge ciicuil,
oplical couplei, and so on) lo isolale lhe bipolai slimulaling elecliodes
fiom giound. A palienl giound is placed al lhe wiisl belween lhe slimulaling
and iecoiding elecliodes lo piovide a giound poinl foi lhe passive elecliic neld
coupling fiom lhe slimulaling elecliodes. The skin should be abiaded undei
bolh lhe slimulaling and iecoiding elecliodes (Seclion 5.5) lo ieduce skin
iesislance and ensuie good conlacl.
Clinically, neld polenlials aie iecoided using high-gain, high-inpul-imped-
ance diffeienlial pieamplineis wilh good common-mode ie|eclion capabilily
and low inheienl amplinei noise (Seclion 6.5). Iiguie 4.8 shows lhal lhe
measuied !NGs aie on lhe oidei of 1O ³\, and powei-line inleifeience is
somelimes a pioblemeven wilh good amplinei common-mode piopeilies. The
inpul leads should be piopeily lwisled logelhei and shielded. ¡n addilion, if
waiianled, lhe sub|ecl could be placed in an adequalely shielded ioomoi cage.
A fuilhei slep we can use lo enhance lhe signal-lo-noise ialio in lhe
piesence of iandom noise (foi lhe mosl pail geneialed by lhe amplinei) is lo
use a -·¹²¿´ ¿ª»®¿¹»® (Seclion 6.8).
ÓÑÌÑÎóÒÛÎÊÛ ÝÑÒÜËÝÌ×ÑÒ ÊÛÔÑÝ×ÌÇ
ײ ª·ª± measuiemenl of lhe conduclion velocily of a moloi neive may be
oblained as shown in Iiguie 4.7. Ioi example, lhe peioneal neive of lhe lefl leg
may be slimulaled nisl behind lhe knee and second behind lhe ankle. A
Ú·¹«®» ìòè Sensoiy neive aclion polenlials evoked fiom median neive of a
heallhy sub|ecl al elbow and wiisl aflei slimulalion of index nngei wilh iing
elecliodes. The polenlial al lhe wiisl is liiphasic and of much laigei magnilude
lhan lhe delayed polenlial iecoided al lhe elbow. Consideiing lhe median
neive lo be of lhe same size and shape al lhe elbow as al lhe wiisl, we nnd lhal
lhe diffeience in magnilude and waveshape of lhe polenlials is due lo lhe size
of lhe volume conducloi al each localion and lhe iadial dislance of lhe
measuiemenl poinl fiom lhe neuial souice. (Iiom 1. A. R. Lenman and A.
!. Rilchie, Ý´·²·½¿´ Û´»½¬®±³§±¹®¿°¸§ô 2nd ed., Philadelphia: Lippincoll, 1977.
Repioduced by peimission of lhe aulhois.)
ïìî ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
musculai iesponse is oblained fiomlhe side of lhe fool, using suiface oi needle
elecliodes.
ÎÛÚÔÛÈÔÇ ÛÊÑÕÛÜ Ú×ÛÔÜ ÐÑÌÛÒÌ×ßÔÍ
When a peiipheial neive is slimulaled and an evoked neld polenlial is iecoided
in lhe muscle il supplies, il is somelimes possible lo iecoid a second polenlial
lhal occuis lalei lhan lhe inilial iesponse. As lhe neuial slimulus sile is bioughl
piogiessively closei lo lhe muscle, lhe lalency of lhe nisl iesponse decieases,
wheieas lhe lalency of lhe second iesponse is incieased. This behavioi of lhe
second iesponse indicales lhal lo aclivale lhe muscle, lhe slimulus musl liavel
along lhe neive lowaid lhe cenlial neivous syslem (pioximally) foi some
dislance befoie ullimalely liaveling in lhe opposile diieclion (dislally). The
lalency of lhe second iesponse is such lhal lhe aclivily could have liaveled
pioximally along sensoiy neives as fai as lhe spinal coid lo elicil a spinal ieûex.
¡f lhe posleiioi libial neive in lhe leg is slimulaled, a lale polenlial can be
evoked fiom lhe liiceps suial muscle (Iiguie 4.9). This long lalency iesponse
has a low lhieshold and appeais al slimulus inlensilies lhal aie well below lhe
levels iequiied lo elicil lhe convenlional (shoil-lalency) Ó ©¿ª». This long-
lalency polenlial‰known as lhe Øwave‰was discoveied by Hoffman (Iiguie
4.9). ¡ls lalency indicales lhal il is a spinal ieûex. ¡l is, in facl, lhe elecliical
homolog of lhe simple ankle-|eik`` ieûex.
Thus, when a mixed peiipheial neive such as lhe posleiioi libial neive is
slimulaled by a slimulus of low inlensily, only nbeis of laige diamelei aie
slimulaled because lhey have lhe lowesl lhieshold. These laige nbeis aie sensoiy
Ú·¹«®» ìòç ̸» Ø ®»A»¨ The foui liaces show polenlials evoked by slimula-
lion of lhe medial poplileal neive wilh pulses of incieasing magnilude (lhe
slimulus ailifacl incieases wilh slimulus magnilude). The lalei polenlial oi H
wave is a low-lhieshold iesponse, maximally evoked by a slimulus loo weak lo
evoke lhe musculai iesponse (Mwave). As lhe M wave incieases in magnilude,
lhe H wave diminishes. (Iiom 1. A. R. Lenman and A. !. Rilchie, Ý´·²·½¿´
Û´»½¬®±³§±¹®¿°¸§, 2nd ed., Philadelphia: Lippincoll, 1977; iepioduced by
peimission of lhe aulhois.)
ì ò ì Ì Ø Û Û Ô Û Ý Ì Î Ñ Ò Û Ë Î Ñ Ù Î ß Ó ïìí
nbeis fiom muscle spindles lhal conducl lowaid lhe CNS and ullimalely connecl
wilhmoloi nbeis inlhespinal coidviaasinglesynapse. Themoloneuions dischaige
andpioduceaiesponseinlhegasliocnemius muscleof lheleg(lheHwave). Wilha
slimulus of medium inlensily, smallei moloi nbeis in lhe mixed neive aie
slimulaled in addilion lo lhe sensoiy nbeis, pioducing a diiecl, shoil-lalency
muscle iesponse, lhe M wave (Iiguie 4.9). Wilh slill sliongei slimuli, impulses
conducledcenliallyalonglhemoloi nbeis mayinleifeiewilhlhepioduclionof lhe
Hwave (lheseexciledmoloi nbeis aieinlheii iefiacloiypeiiod) solhal only anM
wave is pioduced (Iiguie 4.9). The amplilude of lhe H iesponse depends on lhe
numbei of moloneuions dischaiged. ¡ls amplilude is also somewhal vaiiable as a
iesull of ûuclualing backgiound neuial condilions wilhin lhe spinal coid. These
neuial disluibances aie piovided by lhe aclivily of olhei spinal and highei cenlei
neuions impinging on lhe moloneuion(s) involved in lhe ieûex.
ìòë ÌØÛ ÛÔÛÝÌÎÑÓÇÑÙÎßÓ
Skelelal muscle is oiganized funclionally on lhe basis of lhe ³±¬±® «²·¬ (see
Iiguie 4.1O), which consisls of a single moloi neive nbei and lhe bundle of
Ú·¹«®» ìòïð Diagiam of a single moloi unil (SM\), which consisls of a single
moloneuion and lhe gioup of skelelal muscle nbeis lhal il inneivales. Lenglh
liansduceis |muscle spindles, Iiguie 4.6(a)j in lhe muscle aclivale sensoiy
neive nbeis whose cell bodies aie localed in lhe doisal iool ganglion. These
bipolai neuions send axonal pio|eclions lo lhe spinal coid lhal divide inlo a
descending and an ascending bianch. The descending bianch enleis inlo a
simple ieûex aic wilh lhe moloi neuion, wheieas lhe ascending bianch conveys
infoimalion iegaiding cuiienl muscle lenglh lo highei cenleis in lhe CNS via
ascending neive nbei liacls in lhe spinal coid and biain slem. These ascending
palhways aie discussed in Seclion 4.8.
ïìì ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
muscle nbeis lo which il is allached. The moloi unil is lhe smallesl unil lhal
can be aclivaled by a volilional effoil, in which case all consliluenl muscle
nbeis aie aclivaled synchionously. The componenl nbeis of lhe moloi unil
exlend lenglhwise in loose bundles along lhe muscle. ¡n cioss seclion,
howevei, lhe nbeis of a given moloi unil aie inleispeised wilh nbeis of
olhei moloi unils. Thus, lhe aclive muscle nbeis of lhe -·²¹´» ³±¬±® «²·¬
(SM\) conslilule a disliibuled bioelecliic souice localed in a volume
conducloi lhal consisls of all olhei nbeis wilhin lhe muscle (aclive and
inaclive), blood vessels and conneclive lissue. The evoked neld polenlial
fiom lhe aclive nbeis of an SM\ has a liiphasic foim of biief duialion (3 lo
15 ms) and an amplilude of 2O lo 2OOO ³\, depending on lhe size of lhe moloi
unil. The fiequency of dischaige usually vaiies fiom 6 lo 3O pei second (De
Luca, 2OO6).
One of lhe disadvanlages of iecoiding lhe !MG by using lhe conve-
nienl suiface elecliodes is lhal lhey can be used only wilh supeincial
muscles and aie sensilive lo elecliical aclivily ovei loo wide an aiea.
\aiious lypes of monopolai, bipolai, and mullipolai inseilion-lype eleclio-
des aie commonly used in elecliomyogiaphy foi iecoiding fiom deep
muscles and fiom SM\s. These lypes of elecliodes geneially iecoid local
aclivily fiom small iegions wilhin lhe muscle in which lhey aie inseiled.
Oflen a simple nne-lipped monopolai needle elecliode can be used lo
iecoid SM\ neld polenlials even duiing poweiful volunlaiy conliaclions.
Bipolai iecoidings aie also employed. \aiious lypes of elecliodes aie
discussed in Chaplei 5.
Iiguie 4.11 shows moloi unil polenlials fiomlhe noimal doisal inleiosseus
muscle undei giaded levels of conliaclion. Al high levels of effoil, many
supeiimposed moloi unil iesponses give iise lo a complicaled iesponse (lhe
·²¬»®º»®»²½» °¿¬¬»®²) in which individual unils can no longei be dislinguished.
¡n inleipieling Iiguie 4.11, nole lhal when a muscle conliacls piogiessively
undei volilion, aclive moloi unils inciease lheii iale of niing and new
(pieviously inaclive) moloi unils aie also ieciuiled.
The shape of SM\ polenlials is consideiably modined by disease. ¡n
peiipheial neuiopalhies, pailial deneivalion of lhe muscle fiequenlly
occuis and is followed by iegeneialion. Regeneialing neive nbeis
conducl moie slowly lhan heallhy axons. ¡n addilion, in many foims of
peiipheial neuiopalhy, lhe excilabilily of lhe neuions is changed and
lheie is widespiead slowing of neive conduclion. One effecl of lhis is
lhal neuial impulses aie moie difncull lo iniliale and lake longei in liansil
lo lhe muscle, geneially causing scallei oi desynchionizalion in lhe !MG
pallein.
A numbei of malhemalical modeling sludies of single-nbei and mulli-
ple-nbei (single moloi unil) aclion polenlials have appeaied in lhe lileia-
luie (Nandedkai »¬ ¿´òô 1985; Ganapalhy »¬ ¿´òô 1987), as well as delailed
volume-conducloi-based simulalions of suiface !MGsignals (Duchene and
Hogiel, 2OOO; Iaiina »¬ ¿´., 2OO4). Signal piocessing melhods have been
ì ò ë Ì Ø Û Û Ô Û Ý Ì Î Ñ Ó Ç Ñ Ù Î ß Ó ïìë
employed in lhe analysis of suiface !MGs and SM\ signals (Reuchei »¬ ¿´.,
1987; Iaiina »¬ ¿´., 2OO3), as have aulomalic lechniques foi lhe deleclion,
decomposilion, and analysis of !MG signals (Mambiilo and De Luca, 1984;
Slashuk 2OO1).
Ú·¹«®» ìòïï Moloi unil aclion polenlials fiom noimal doisal inleiosseus
muscle duiing piogiessively moie poweiful conliaclions. (c) ¡n lhe inleifei-
ence pallein, individual unils can no longei be cleaily dislinguished. (d)
¡nleifeience pallein duiing veiy sliong musculai conliaclion. Time scale is
1O ms pei dol. (Iiom 1. A. R. Lenman and A. !. Rilchie, Ý´·²·½¿´ Û´»½¬®±ó
³§±¹®¿°¸§ô 2nd ed., Philadelphia: Lippincoll, 1977; iepioduced by peimission
of lhe aulhois.)
ïìê ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
ìòê ÌØÛ ÛÔÛÝÌÎÑÝßÎÜ×ÑÙÎßÓ
ßÒßÌÑÓÇ ßÒÜ ÚËÒÝÌ×ÑÒ ÑÚ ÌØÛ ØÛßÎÌ
The heail seives as a foui-chambeied pump foi lhe ciiculaloiy syslem (Iiguie
4.12). ¡ls main pumping funclion is supplied by lhe venliicles. The aliia aie
meiely anlechambeis lo sloie blood duiing lhe lime lhe venliicles aie pump-
ing. The iesling oi nlling phase of lhe heail cycle is iefeiied lo as ¼·¿-¬±´»ô
wheieas lhe conliaclile oi pumping phase is called -§-¬±´». The smoolh,
ihylhmic conliaclion of lhe aliia and venliicles has an undeilying elecliical
piecuisoi in lhe foimof a well-cooidinaled seiies of elecliical evenls lhal lakes
place wilhin lhe heail. Thal lhis sel of elecliical evenls is inliinsic lo lhe heail
ilself is well demonslialed when lhe heail (pailiculaily lhal of cold-blooded
veilebiales such as lhe fiog oi luille) is iemoved fiomlhe body and placed in a
nuliienl medium (such as glucose-Ringei solulion). The heail conlinues lo
beal ihylhmically foi many houis. Thus, lhe cooidinaled conliaclion of lhe
aliia and venliicles is sel up by a specinc pallein of elecliical aclivalion in lhe
musculaluie of lhese sliucluies. ¡n humans, lhese elecliical aclivalion palleins
in lhe walls of lhe aliia and venliicles aie inilialed by a cooidinaled seiies of
evenls wilhin lhe -°»½·¿´·¦»¼ ½±²¼«½¬·±² -§-¬»³ of lhe heail (Iiguie 4.12).
¡n ielalion lo lhe heail as a whole, lhe specialized conduclion syslem is
veiy small and conslilules only a minule poilion of lhe lolal mass of lhe heail.
The wall of lhe lefl venliicle (Iiguie 4.12) is 2.5 lo 3.O limes as lhick as lhe iighl
venliiculai wall, and lhe inliavenliiculai seplum is neaily as lhick as lhe lefl
venliiculai wall. Thus, lhe ma|oi poilion of lhe muscle mass of lhe venliicles
consisls of lhe fiee walls of lhe iighl and lefl venliicles and lhe seplum.
Consideiing lhe heail as a bioelecliic souice, lhe souice slienglh al each
inslanl can be expecled lo be diieclly ielaled lo lhe aclive muscle mass al lhal
momenl (i.e., lo lhe numbei of aclive myocaidial cells). Hence, lhe aclive fiee
walls of lhe aliia and venliicles and lhe inleivenliiculai seplum can be
consideied lhe ma|oi aclion cuiienl souices iesponsible foi lhe pioduclion
of exleinal neld polenlials iecoided fiom lhe heail (e.g., iecoided wilhin lhe
lhoiacic volume-conducloi medium oi al lhe suiface of lhe body).
ÛÔÛÝÌÎ×ÝßÔ ÞÛØßÊ×ÑÎ ÑÚ ÝßÎÜ×ßÝ ÝÛÔÔÍ
The heail compiises seveial diffeienl lypes of lissues (SA and A\ nodal lissue;
aliial, Puikin|e, and venliiculai lissue). Repiesenlalive cells of each lype of lissue
diffei analomically lo a consideiable degiee. They aie all elecliically excilable,
and each lype of cell exhibils ils own chaiacleiislic aclion polenlial (Iiguie 4.13).
ÌØÛ ÊÛÒÌÎ×ÝËÔßÎ ÝÛÔÔ
The venliiculai myocaidiumis composed of millions of individual caidiac cells
(15 15 15O³m long). Iiguie 4.14 is a diawing of a small seclion of caidiac
muscle as seen undei lighl micioscopy. The individual cells aie ielalively long
ì ò ê Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ó ïìé
and lhin, and allhough lhey iun geneially paiallel lo one anolhei, lheie is
consideiable bianching and inleiconnecling (¿²¿-¬±³±-·²¹). The cells aie
suiiounded by a plasma membiane lhal makes end-lo-end conlacl wilh
ad|acenl cells al a dense sliucluie known as lhe ·²¬»®½¿´¿¬»¼ ¼·-µ
Ú·¹«®» ìòïî Ü·-¬®·¾«¬·±² ±º -°»½·¿´·¦»¼ ½±²¼«½¬·ª» ¬·--«»- ·² ¬¸» ¿¬®·¿ ¿²¼ ª»²¬®·ó
½´»-ô -¸±©·²¹ ¬¸» ·³°«´-»óº±®³·²¹ ¿²¼ ½±²¼«½¬·±² -§-¬»³ ±º ¬¸» ¸»¿®¬ The
ihylhmic caidiac impulse oiiginales in pacemaking cells in lhe sinoaliial
(SA) node, localed al lhe |unclion of lhe supeiioi vena cava and lhe iighl
aliium. Nole lhe lhiee specialized palhways (anleiioi, middle, and posleiioi
inleinodal liacls) belweenlhe SAandaliiovenliiculai (A\) nodes. Bachmann`s
bundle (inleialiial liacl) comes off lhe anleiioi inleinodal liacl leading lo lhe
lefl aliium. The impulse passes fiom lhe SA node in an oiganized mannei
lhiough specialized conducling liacls in lhe aliia lo aclivale nisl lhe iighl and
lhen lhe lefl aliium. Passage of lhe impulse is delayed al lhe A\ node befoie il
conlinues inlo lhe bundle of His, lhe iighl bundle bianch, lhe common lefl
bundle bianch, lhe anleiioi and posleiioi divisions of lhe lefl bundle bianch, and
lhe Puikin|e nelwoik. The iighl bundle bianch iuns along lhe iighl side of lhe
inleivenliiculai seplum lo lhe apex of lhe iighl venliicle befoie il gives off
signincanl bianches. The lefl common bundle ciosses lo lhe lefl side of lhe
seplum and splils inlo lhe anleiioi division (which is lhin and long and goes
undei lhe aoilic valve in lhe oulûow liacl lo lhe anleiolaleial papillaiy muscle)
and lhe posleiioi division (which is wide and shoil and goes lo lhe posleiioi
papillaiy muscle lying inlhe inûowliacl). (IiomB. S. Lipman, !. Massie, andR.
!. Kleigei, Ý´·²·½¿´ ͽ¿´¿® Û´»½¬®±½¿®¼·±¹®¿°¸§. Copyiighl ý1972 by Yeaibook
Medical Publisheis, ¡nc., Chicago. \sed wilh peimission.)
ïìè ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
(Iiguie 4.14). !ach nbei conlains many conliaclile ³§±B¾®·´- lhal follow lhe axis
of lhe cell fiom one end (inleicalaled disk) lo lhe olhei. These myonbiils
conslilule lhe conliaclile machineiy`` of lhe nbei. The componenl cells of
caidiac lissue aie in inlimale conlacl al lhe inleicalaled disks, bolh elecliically
and mechanically, so lhe heail muscle funclions as a unil (a º«²½¬·±²¿´ -§²½§¬·«³).
Piioi lo excilalion, lhe lypical venliiculai cell has a iesling polenlial of
appioximalely 85 m\. The inilial iapid depolaiizalion phase has a iale of iise
lhal is usually giealei lhan 15O \/s. This phase is followed by an inilial iapid
iepolaiizalion lhal leads lo a mainlained depolaiizing plaleau iegion lasling
appioximalely 2OO lo 3OO ms. A nnal iepolaiizalion phase iesloies membiane
polenlial lo lhe iesling level and is mainlained foi lhe iemaindei of lhe caidiac
Ú·¹«®» ìòïí λ°®»-»²¬¿¬·ª» »´»½¬®·½ ¿½¬·ª·¬§ º®±³ ª¿®·±«- ®»¹·±²- ±º ¬¸» ¸»¿®¬
The bollom liace is a scalai !CG, which has a lypical ÇRS amplilude of 1 lo 3
m\. (Copyiighl ý 1969 C¡BA Phaimaceulical Company, Division of C¡BA-
G!¡GY Coip. Repioduced, wilh peimission, fiom ̸» Ý·¾¿ ݱ´´»½¬·±² ±º
Ó»¼·½¿´ ×´´«-¬®¿¬·±²-ô Iiank H. Nellei, M.D. All iighls ieseived.)
Ú·¹«®» ìòïì ̸» ½»´´«´¿® ¿®½¸·¬»½¬«®» ±º ³§±½¿®¼·¿´ B¾»®- Nole lhe cenlioid
nuclei and liansveise inleicalaled disks belween cells.
ì ò ê Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ó ïìç
cycle. The duialion of lhe aclion polenlial wavefoim is colleclively iefeiied lo
as »´»½¬®·½¿´ -§-¬±´»å lhe iesling phase is iefeiied lo as »´»½¬®·½¿´ ¼·¿-¬±´».
Mosl models of membiane excilabilily lhal have been used in caidiac
elecliophysiology aie of lhe HodgkinHuxley (HH) lype (Hodgkin and Huxley,
1952). The HH foimalism was nisl applied lo Puikin|e nbeis of lhe specialized
conduclion syslem by Noble (1962). This model was lalei exlensively ievised by
McAllislei »¬ ¿´. (1975), and vaiialions have been used in simulalions of lhe
elecliophysiological iesponses of venliiculai (Beelei and Reulei, 1977) and SA
pacemakei cells (Yanagihaia »¬ ¿´., 198O). These models howevei, weie based on
mullicellulai vollage clamp dala lhal was appioximale and conlained expei-
imenlal eiioi. The discoveiy of (1) enzymalic dispeision lechniques suilable foi
lhe pioduclion of isolaled caidiac cells and (2) palch clamp elecliode lechniques
made quanlilalive whole-cell vollage clamping of individual cells possible (eaily
198Os). Cuiienlvollage chaiacleiislics of diffeienl lypes of ion channels could
nowbe measuied accuialely and by lhe 199Os seveial good malhemalical models
of diffeienl caidiac cell lypes weie available. ¡mpoilanlly, lhese models con-
lained desciiplions foi ion pumps (e.g., Na /K ATPase, Ca
2
ATPase) and
exchangeis (e.g., Na Ca
2
, Na H exchangeis), as well as, bellei ûuid
compailmenl models desciibing ionic conlenl of lhe inleinal medium, lhe
saicoplasmic ieliculum (SR), and exliacellulai iesliicled diffusion spaces in
lhe inlia- and exliacellulai media. The seminal model inilialing lhese exlensive
changes in caidiac cell modeling was lhe Puikin|e nbei model developed by
DiIiancesco and Noble (1985). ¡l slill ulilized some ion channel dala deiived
fiom mullicellulai vollage clamp expeiimenls, bul neveilheless poinled lhe way
lo lhe developmenl of modein day caidiac cell models foi all cell lypes: SAnode
(Wildeis »¬ ¿´., 1991; Demii »¬ ¿´., 1994); aliial cell (Nygien »¬ ¿´., 1998);
venliiculai cell (Luo and Rudy, 1994; Puglisi and Beis, 2OO1).
ÊÛÒÌÎ×ÝËÔßÎ ßÝÌ×ÊßÌ×ÑÒ
¡nvesligalois have conducled sludies of venliiculai aclivalion on expeiimenlal
animals using mulliple plunge-lype`` elecliodes inseiled inlo many siles in lhe
heail (Spach »¬ ¿´., 1972) (see Iiguie 4.15). The lime of aiiival of elecliical
aclivalion is noled, and ·-±½¸®±²±«- (synchionously exciled) excilalion sui-
faces can be mapped. Iiguie 4.15 shows a plol of isochionous lines of aclivalion
foi lhe peifused heail of a human who died fiom a noncaidiac condilion. Nole
lhal aclivalion nisl lakes place on lhe seplal suiface of lhe lefl venliicle (5 ms
inlo lhe ÇRS complex) and lhal lhe aclivily spieads wilh incieasing lime in a
diieclion fiom lefl lo iighl acioss lhe seplum. Al 2O ms, seveial iegions of lhe
iighl and lefl venliicles aie simullaneously aclive. As lime incieases, excilalion
spieads and lends lo become moie conûuenl. Ioi example, al 3O ms a neaily
closed aclivalion suiface is seen. !xcilalion lhen pioceeds in a ielalively
unifoim fashion in an »°·½¿®¼·¿´ (oulside lhe heail) diieclion. The apex of
lhe heail is aclivaled ioughly in lhe peiiod3O lo 4O ms, along wilh olhei siles on
lhe iighl and lefl venliiculai walls wheie bieaklhiough`` of aclivalion has
occuiied. IiombolhIiguie 4.15 and dala laken in olhei planes, we can see lhal
lhe posleiioi-basal iegion of lhe heail is lhe lasl iegion aclivaled.
ïëð ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
The isochionous elecliomolive suiface piopagales lhiough lhe myocai-
dium in an oulwaid diieclion fiom lhe »²¼±½¿®¼·«³ (lhe inside of lhe heail).
The seal of lhis elecliomolive suiface is, of couise, lhe individual caidiac cell.
¡n a localized iegion of lhe heail, howevei, many of lhese cells aie aclive
simullaneously because of lhe high degiee of elecliical inleiaclion belween
cells. The analomical subsliale foi lhis elecliical inleiaclion is lhe high degiee
of bianching of individual caidiac cells and lhe low iesislance of lhe inleica-
laled disks al lhe |unclions belween cells (Baii »¬ ¿´., 1965).
ÞÑÜÇóÍËÎÚßÝÛ ÐÑÌÛÒÌ×ßÔÍ
The pieceding seclion deall wilh lhe sequence of evenls involved in elecliical
aclivalion of lhe venliicle. This aclivalion sequence leads lo lhe pioduclion of
closed-line aclion cuiienls lhal ûow in lhe lhoiacic volume conducloi (con-
sideied a puiely passive medium conlaining no elecliic souices oi sinks).
Polenlials measuied al lhe oulei suiface of lhis medium‰lhal is, on lhe body
suiface‰aie iefeiied lo as »´»½¬®±½¿®¼·±¹®¿³- (!CGs).
¡n lhe elecliocaidiogiaphic pioblem, lhe heail is viewed as an elecliical
equivalenl geneialoi. A common assumplion is lhal, al each inslanl of lime in
lhe sequence of venliiculai aclivalion, lhe elecliical aclivily of lhe heail can be
iepiesenled by a nel equivalenl cuiienl dipole localed al a poinl lhal we call
Ú·¹«®» ìòïë ×-±½¸®±²±«- ´·²»- ±º ª»²¬®·½«´¿® ¿½¬·ª¿¬·±² ±º ¬¸» ¸«³¿² ¸»¿®¬
Nole lhe neaily closed aclivalion suiface al 3O ms inlo lhe ÇRS complex.
(Modined fiom The Biophysical basis foi elecliocaidiogiaphy,`` R. Plonsey.
¡n ÝÎÝ Ý®·¬·½¿´ λª·»©- ·² Þ·±»²¹·²»»®·²¹ô 1(1), 1971, 5. ý The Chemical
Rubbei Co., 1971. \sed by peimission of The Chemical Rubbei Co. Based on
dala by D. Duiiei, Tolal excilalion of lhe isolaled human heail.`` Ý·®½«´¿¬·±²ô
41, 197O, 899912, by peimission of lhe Ameiican Heail Associalion, ¡nc.)
ì ò ê Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ó ïëï
lhe elecliical cenlei of lhe heail. This cenlei is assumed lo lie wilhin lhe
analomical boundaiies of lhe heail. The magnilude and oiienlalion of lhe nel
equivalenl dipole can change wilh lime.
Iiguie 4.15 shows lhal seveial iegions of bolh venliicles may be aclive
simullaneously. Consideiing lime fiozen, we iepiesenl lhe elecliical aclivily of
each aclive iegion as a local cuiienl dipole and calculale a nel equivalenl
dipole fiom lhis disliibulion al lhe elecliical cenlei. ¡n lhe nexl inslanl, new
aieas can aclivale, olheis de-aclivale, and local cuiienl slienglhs change
accoiding lo lhe aclive muscle mass. We calculale anolhei nel dipole equiv-
alenl al lhe elecliical cenlei and pioceed. This appioach can be applied lo lhe
analysis since lhe volume-conducloi-neld pioblem has been shown lo be
quasislalic (Plonsey, 1969). The lhoiacic medium can be consideied lhe
iesislive load of lhis equivalenl caidiac geneialoi. Wilh caidiac aclivily, a
neld polenlial disliibulion is sel up in lhe lhoiacic volume conducloi wheie lhe
magnilude of polenlial decieases wilh incieasing dislance fiom lhe souice.
Ohmic polenlial diops can be measuied belween suiface poinls (e.g., belween
poinls A and B in Iiguie 4.16) oi belween a single suiface poinl and an
assigned iefeience poinl. The geneial volume-conducloi pioblem is illuslialed
in a highly schemalic fashion in Iiguie 4.16 in leims of cuiienl souice and
lumped iesislive load.
A scalai lead`` gives lhe magnilude of a single body-suiface polenlial
diffeience plolled veisus lime. Iiguie 4.13 (bollom) shows a lypical scalai
elecliocaidiogiaphic lead, wheie lhe signincanl fealuies of lhe wavefoim aie
lhe (1) individual waves (P, Ç, R, S, and T), (2) wave duialions, and (3) specinc
lime inleivals (e.g., lhe PR, ST, and ÇT inleivals). This nguie also shows
lhe lempoial ielalionship belween single liansmembiane cellulai aclivilies in
Ú·¹«®» ìòïê ̸» »´»½¬®±½¿®¼·±¹®¿°¸·½ °®±¾´»³ Poinls ß and Þ aie aibiliaiy
obseivalion poinls on lhe loiso, Î
ßÞ
is lhe iesislance belween lhem, and Î
T1
,
Î
T2
aie lumped lhoiacic medium iesislances. The bipolai !CG scalai lead
vollage Ú
ßÞ
= Ú
ß
Ú
Þ
, wheie lhese vollages aie bolh measuied wilh iespecl
lo an indiffeienl iefeience polenlial.
ïëî ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
vaiious iegions of lhe heail (aliia, venliicles, and specialized conduclion
syslem) and lhis lypical !CG wavefoim.
Cleaily lhe P wave is pioduced by aliial depolaiizalion, lhe ÇRS complex
piimaiily by venliiculai depolaiizalion, and lhe T wave by venliiculai ie-
polaiizalion. The manifeslalions of aliial iepolaiizalion aie noimally masked
by lhe ÇRScomplex. The PRandSTinleivals aie noimally al zeio polenlial,
lhe PRinleival being caused mainly by conduclion delay in lhe A\node. The
ST segmenl is ielaled lo lhe aveiage duialion of lhe plaleau iegions of
individual venliiculai cells. A small addilional wave, called lhe \ wave, is
somelimes iecoided lempoially aflei lhe T wave. ¡l is nol always piesenl and is
believed lo be lhe iesull of slow iepolaiizalion of venliiculai papillaiy muscles.
Seclion 6.2 desciibes lhe 12 slandaid leads lhal conslilule a diagnoslic
!CG, so lhey will nol be consideied fuilhei heie.
ÒÑÎÓßÔ ßÒÜ ßÞÒÑÎÓßÔ ÝßÎÜ×ßÝ ÎØÇÌØÓÍ
!achbeal of lhenoimal humanheail oiiginales inlhe SAnode. The noimal heail
iale is appioximalely 7O beals pei minule (bpm). The iale is slowed(¾®¿¼§½¿®¼·¿)
duiing sleep and is acceleialed (¬¿½¸§½¿®¼·¿) by emolion, exeicise, fevei, and
many olhei slimuli. Delailed aspecls of lhe conliol lhal lhe neivous syslem has
ovei heail iale aie beyond lhe scope of lhis book; lhe ieadei inleiesled in fuilhei
discussionis iefeiiedloRowell (1993). Because many pails of lhe heail possess an
inheienl ihylhmicily (e.g., nodal lissue, Puikin|e nbeis of lhe specialized conduc-
lion syslem, and aliial lissues), any pail undei abnoimal condilions can become
lhe dominanl caidiac pacemakei. This can happen when lhe aclivily of lhe SA
node is depiessed, when lhe bundle of His is inleiiupled oi damaged, oi when an
abnoimal (eclopic) focus oi sile in lhe aliia oi in specialized conduclion-syslem
lissue in lhe venliicles dischaiges al a iale faslei lhan lhe SA node.
When lhe bundle of His is inleiiupled complelely, lhe venliicles beal al
lheii own slowinheienl iale (lhe ·¼·±ª»²¬®·½«´¿® ®¸§¬¸³). The aliia conlinue lo
beal independenlly al lhe noimal sinus iale, and complele oi lhiid-degiee
block is said lo occui |Iiguie 4.17(a)j. The idiovenliiculai iale in human beings
is appioximalely 3O lo 45 bpm.
When lhe His bundle is nol complelely inleiiupled, incomplele heail
block is piesenl. ¡n lhe case of B®-¬ó¼»¹®»» ¸»¿®¬ ¾´±½µ, all aliial impulses ieach
lhe venliicles, bul lhe PR inleival is abnoimally piolonged because of an
inciease in liansmission lime lhiough lhe affecled iegion |Iiguie 4.17(b)j. ¡n
lhe case of -»½±²¼ó¼»¹®»» ¸»¿®¬ ¾´±½µ, nol all aliial impulses aie conducled lo
lhe venliicles. Theie may be, foi example, one venliiculai beal eveiy second oi
lhiid aliial beal (2:1 block, 3:1 block, and so on).
¡n anolhei foimof incomplele heail block involving lhe A\node, lhe PR
inleival piogiessively lenglhens unlil lhe aliial impulse fails lo conducl lo lhe
venliicle (É»²½µ»¾¿½¸ °¸»²±³»²±²). The nisl conducled beal aflei lhe pause
(oi diopped beal) has a shoilei PR inleival (somelimes of noimal lenglh)
lhan any subsequenl PR inleival. Then lhe piocess of lhe lenglhening of lhe
PRinleival begins anew, piogiessing ovei seveial caidiac cycles unlil anolhei
ì ò ê Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ó ïëí
beal is diopped. The elecliocaidiogiaphic sequence slailing wilh lhe venliic-
ulai pause and ending wilh lhe nexl blocked aliial beal conslilules a É»²½µó
»¾¿½¸ °»®·±¼. The ialio of lhe numbei of P waves lo ÇRS complexes
deleimines lhe block (foi example, 6:5 oi 5:4 Wenckebach peiiods).
When one bianch of lhe bundle of His is inleiiupled, causing iighl- oi lefl-
bundle-bianch block, excilalion pioceeds noimally down lhe inlacl bundle and
lhen sweeps back lhiough lhe musculaluie lo aclivale lhe venliicle on lhe
blocked side. The venliiculai iale is noimal, bul lhe ÇRS complexes aie
piolonged and defoimed.
ßÎÎØÇÌØÓ×ßÍ
A poilion of lhe myocaidium (oi lhe A\ node oi specialized conduclion
syslem) somelimes becomes iiiilable`` and dischaiges independenlly. This
sile is lhen iefeiied lo as an »½¬±°·½ º±½«-. ¡f lhe focus dischaiges only once, lhe
iesull is a beal lhal occuis befoie lhe nexl expecled noimal beal, and lhe
Ú·¹«®» ìòïé ߬®·±ª»²¬®·½«´¿® ¾´±½µ (a) Complele heail block. Cells in lhe
A\ node aie dead and aclivily cannol pass fiom aliia lo venliicles. Aliia and
venliicles beal independenlly, venliicles being diiven by an eclopic (olhei-
lhan-noimal) pacemakei. (b) A\block wheiein lhe node is diseased (examples
include iheumalic heail disease and viial infeclions of lhe heail). Allhough
each wave fiom lhe aliia ieaches lhe venliicles, lhe A\ nodal delay is gieally
incieased. This is nisl-degiee heail block. (Adapled fiom Biendan Phibbs, The
Human Heail, 3id ed., Sl. Louis: The C.\. Mosby Company, 1975.)
ïëì ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
caidiac ihylhm is lheiefoie liansienlly inleiiupled. (Wilh iespecl lo aliial,
nodal, oi venliiculai »½¬±°·½ ¾»¿¬, see Iiguie 4.18.) ¡f lhe focus dischaiges
iepelilively al a iale lhal exceeds lhal of lhe SAnode, il pioduces iapid iegulai
lachycaidia. |Wilh iespecl lo aliial, nodal, oi venliiculai paioxysmal lachy-
caidia oi aliial ûullei, see Iiguie 4.19(a) and (b).j A iapidly and iiiegulaily
dischaiging focus oi, moie likely, a gioup of foci in lhe aliia oi venliicles may
Ú·¹«®» ìòïè Ò±®³¿´ ÛÝÙ º±´´±©»¼ ¾§ ¿² »½¬±°·½ ¾»¿¬ An iiiilable focus, oi
eclopic pacemakei, wilhin lhe venliicle oi specialized conduclion syslem may
dischaige, pioducing an exlia beal, oi exliasyslole, lhal inleiiupls lhe noimal
ihylhm. This exliasyslole is also iefeiied lo as a °®»³¿¬«®» ª»²¬®·½«´¿®
½±²¬®¿½¬·±² (P\C). (Adapled fiom Biendan Phibbs, The Human Heail, 3id
ed., Sl. Louis: The C.\. Mosby Company, 1975.)
Ú·¹«®» ìòïç (a) Paioxysmal lachycaidia. An eclopic focus may iepelilively
dischaige al a iapid iegulai iale foi minules, houis, oi even days. (b) Aliial
ûullei. The aliia begin a veiy iapid, peifeclly iegulai ûapping`` movemenl,
bealing al iales of 2OO lo 3OO bpm. (Adapled fiom Biendan Phibbs, ̸»
Ø«³¿² Ø»¿®¬, 3id ed., Sl. Louis: The C.\. Mosby Company, 1975.)
ì ò ê Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ó ïëë
be lhe undeilying mechanism iesponsible foi aliial oi venliiculai nbiillalion
|Iiguie 4.2O(a) and (b)j.
ÛÈßÓÐÔÛ ìòì Piemaluie venliiculai conliaclions can be idenlined be-
cause (1) lhey aiiive eaily, (2) lhe following beal occuis al lhe noimal lime,
because il is geneialed by lhe SA node, and (3) lhe ÇRS widlh is giealei
lhan lhe noimal 8O ms. Desciibe a soflwaie algoiilhm lo delecl and counl
P\Cs by using all lhese ciileiia.
ßÒÍÉÛÎ Theie will be slighl vaiialions in widlh and RR inleival of ÇRS
complexes. A P\C is wide. \se unnlleied !CG lo deleimine aveiage widlh
AW aveiage of 1O . The algoiilhm should lesl lhal widlh É
¬
1 3AW
¬ 1
.
\se naiiowband nllei plus lhieshold lo deleimine lime of each R wave.
Deleimine aveiage RR inleival AR R aveiage of 1O . A P\C occuis
eaily. The algoiilhm should lesl lhal lhe R R
¬ 1
inleival O.8 AR R
¬ 2
. A
P\C is followed by a compensaloiy pause. The algoiilhm should lesl lhal
R R
¬ 1
R R
¬
is appioximalely 2 AR R
¬ 2
. All lhiee lesls should be
posilive lo yield a P\C.
Rhylhm disluibances can aiise fiom souices olhei lhan eclopic foci oi
compeling pacemakeis. A feasible alleinalive is a ½·®½«- ®»ó»¨½·¬¿¬·±² ±®
Ú·¹«®» ìòîð (a) Aliial nbiillalion. The aliia slop lheii iegulai beal and begin a
feeble, uncooidinaled lwilching. Concomilanlly, low-amplilude, iiiegulai
waves appeai in lhe !CG, as shown. This lype of iecoiding can be cleaily
dislinguished fiom lhe veiy iegulai !CG wavefoim conlaining aliial ûullei.
(b) \enliiculai nbiillalion. Mechanically lhe venliicles lwilch in a feeble,
uncooidinaled fashion wilh no blood being pumped fiom lhe heail. The
!CGis likewise veiy uncooidinaled, as shown. (Adapled fiomBiendan Phibbs,
̸» Ø«³¿² Ø»¿®¬, 3id ed., Sl. Louis: The C.\. Mosby Company, 1975.)
ïëê ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
®»ó»²¬®¿²¬ mechanism (Allessie »¬ ¿´., 1973). This concepl assumes a iegion of
depiessed conduclivily wilhin lhe aliium, Puikin|e syslem, oi venliicle. ¡l is
lheiefoie ·-½¸»³·½ (dencienl in ils blood supply) ielalive lo suiiounding
noimal lissue. This biings aboul pionounced elecliophysiological changes
in lhe ischemic zone and a decieased velocily of conduclion (see Iiguie 4.21).
Piopagalion in lhis aiea is slowenough lo peimil olhei aieas lo iecovei fiom
inilial excilalion and be ie-enleied by lhe slowly emeiging impulse. The ie-
enlianl impulse may in luin ie-excile lhe aiea of slow conduclion lo complele a
ciicus-movemenl loop. ¡nleimillenl eslablishmenl of a ie-enlianl ciicuil would
iesull in occasional eclopic beals (»¨¬®¿-§-¬±´»-), and conlinuous piopagalion of
impulses in lhe eslablished ciicuil would undeilie an episode of lachyaiihylhmia.
ßÔÌÛÎßÌ×ÑÒ ÑÚ ÐÑÌÛÒÌ×ßÔ ÉßÊÛÚÑÎÓÍ ×Ò ×ÍÝØÛÓ×ß
Of pailiculai inleiesl in Iiguie 4.21 is lhe change in lhe inliacellulai and
exliacellulai polenlial wavefoims in ischemia. Nole pailiculaily lhal in lale
ischemia (ischemia lhal occuis seveial minules aflei induced coionaiy occlu-
sion), lheie aie decieases in lhe magniludes of lhe iesling polenlial, lhe
velocily of lhe upslioke, and lhe heighl and duialion of lhe aclion polenlial.
(A deciease in upslioke velocily is indicalive of a loweied velocily of
conduclion of lhe aclion-polenlial wave fionl lhiough lhis ischemic iegion.)
The slope of lhe polenlial duiing lhe plaleau phase of lhe aclion polenlial is
also alleied in ischemia (incieased). These changes in lhe aclion-polenlial
Ú·¹«®» ìòîï (a) Aclion polenlials iecoided fiom noimal (solid lines) and
ischemic (dashed lines) myocaidium in a dog. Conliol is befoie coionaiy
occlusion. (b) Duiing lhe conliol peiiod piioi lo coionaiy occlusion, lheie is no
!CGST segmenl shifl; aflei ischemia, lheie is such a shifl. (Iiom Andiew G.
Wallace, !lecliophysiology of lhe myocaidium.`` ¡n Ý´·²·½¿´ Ý¿®¼·±ó
°«´³±²¿®§ и§-·±´±¹§, 3id ed. New Yoik: Giune & Sliallon, 1969; used
wilh peimission of Giune & Sliallon. Based on dala by W. !. Sampson
and H. M. Schei, Mechanism of ST segmenl alleialion duiing acule
myocaidial in|uiy,`` 196O, Ciiculalion Reseaich, 8, by peimission of The
Ameiican Heail Associalion.)
ì ò ê Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ó ïëé
wavefoimbiing aboul changes in lhe exliacellulai neld polenlials pioduced by
individual caidiac cells. The aclion cuiienl conliibulions of noimal and
ischemic cells supeiimpose in lhe lineai volume-conducloi medium lo biing
aboul alleied foims of lhe venliiculai poilion of lhe !CG (ÇRS complex, ST
segmenl, and T wave, as shown in Iiguies 4.13 and 4.21).
Occlusion of lhe blood supply lo a given myocaidial iegion biings aboul
ielalively iapid elecliolylic ad|uslmenls in lhe affecled iegion. Specincally,
lheie is a loss of K andan uplake of Na wilhin lhe ischemic cell. Ca
2
andH
also accumulale wilhin lhe cell, and walei shifls inwaid as well. These ionic
shifls pioduce membiane depolaiizalion and aie indicalive of lhe depiessed
aclivily of lhe Na K pump, which is melabolically dependenl. Changes in
lhe cell iesling polenlial and lhe aclion polenlial wavefoim in ischemia aie
simply exleinal manifeslalions of lhe undeilying elecliochemical changes
bioughl aboul by an inadequale oxygen (blood) supply.
ìòé ÌØÛ ÛÔÛÝÌÎÑÎÛÌ×ÒÑÙÎßÓ
ßÒßÌÑÓÇ ÑÚ Ê×Í×ÑÒ
The noimal eye is an appioximalely spheiical oigan aboul 24 mm in diamelei
(Iiguie 4.22). The ielina, localed al lhe back of lhe eye, is lhe sensoiy poilion
of lhe eye.
Ú·¹«®» ìòîî The lianspaienl conlacl lens conlains one elecliode, shown heie
on hoiizonlal seclion of lhe iighl eye. Refeience elecliode is placed on lhe
iighl lemple.
ïëè ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
The lighl-liansmilling pails of lhe eye aie lhe coinea, anleiioi chambei,
lens, and vilieous chambei, named in lhe oidei in which lhese sliucluies aie
liaveised by lighl. A lianspaienl ûuid, lhe ¿¯«»±«- ¸«³±®, is found in lhe
anleiioi chambei. The vilieous chambei is nlled by a lianspaienl gel, lhe
ª·¬®»±«- ¾±¼§. The aqueous humoi piovides a nuliienl lianspoil medium, bul il
is also of fuilhei oplical signincance. ¡l is noimally mainlained al a piessuie (2O
lo 25 mm Hg) lhal is adequale lo inûale lhe eye againsl ils iesislive oulei coals
(lhe scleia and choioid). This makes possible lhe piecise geomeliical conngu-
ialion of lhe ielina and lhe oplical palhway lhal is necessaiy lo ensuie
foimalion of a cleai visual image. ¡n addilion, lhe aqueous humoi is lhe
essenlial link belween lhe ciiculaloiy syslem and lhe lens and coinea, which
lhemselves lack blood vessels. To salisfy lhe iespiialoiy and nuliilive iequiie-
menls of lhese lwo sliucluies, lheie is a conlinual movemenl of ûuid and solule
maleiial belween lhe aqueous humoi and conliguous blood vessels. ¡nleifei-
ence wilh lhis ûow, in palhological condilions, nol only leads lo damage of lhe
lens and coinea bul may also iesull in lhe developmenl of piessuies wilhin lhe
eye lhal aie high enough lo in|uie lhe ielina. Ù´¿«½±³¿ is lhe leim applied lo
lhis high-piessuie condilion.
¡n consideiing lhe neuial oiganizalion of lhe ielina, we need examine only
nve lypes of neive cells: °¸±¬±®»½»°¬±®- and ¾·°±´¿®ô ¸±®·¦±²¬¿´ô ¿³¿½®·²»ô and
¹¿²¹´·±² cells. The ganglion cells, lhe axons of which pioduce lhe neive nbeis
sweeping acioss lhe innei ielinal suiface lo be collecled al lhe oplic disk (and
which foim lhe giealei bulk of lhe neive nbeis of lhe oplic neive), aie
subslanlially fewei in numbei lhan lhe pholoieceplois. Theie is a conveigence
in lhe neuial palhways of lhe ielina as a whole. |Thal is, many pholoieceplois
leiminale on each bipolai cell (²: 1), and many bipolai cells, in luin, leiminale
on a single ganglion cell. The degiee of conveigence vaiies consideiably, being
giealei in lhe peiipheial pails of lhe ielina and minimal al lhe fovea (Iiguie
4.22). Thal is, lhe neuial chain fiompholoieceploi lo ganglion cell is 1 : 1 in lhe
foveal iegion.j The synaplic inleiconneclions belween pholoieceplois and
bipolai cells and belween bipolai cells and ganglion cells occui in lwo well-
denned iegions. The »¨¬»®²¿´ °´»¨·º±®³ ´¿§»® is lhe iegion of conlacl belween
pholoieceploi and bipolai cells, and lhe ·²¬»®²¿´ °´»¨·º±®³´¿§»® is lhe iegion of
conlacl belween bipolai and ganglion cells.
Laleial conneclions aie also found in bolh layeis. Ioi example, hoiizonlal
cells inleiconnecl iods and cones (denned below) al lhe level of lhe exleinal
plexifoimlayei, and amaciine cells piovide a second hoiizonlal nelwoik al lhe
level of lhe innei plexifoim layei. The ielina may lhus be consideied func-
lionally oiganized inlo lwo pails: an oulei sensoiy layei conlaining lhe
pholoelecliic sensois (pholoieceplois) and an innei layei iesponsible foi
oiganizing and ielaying elecliical impulses geneialed in lhe pholoieceploi
layei lo lhe biain.
Two lypes of pholoieceplois occui in lhe human ielina: ®±¼- (lhe agenls of
vision in dim lighl) and ½±²»- (lhe medialois of coloi vision in biighlei lighl).
Bolh iods and cones aie diffeienlialed inlo oulei and innei segmenls. The
innei segmenls aie lhe ma|oi siles of melabolism and conlain all lhe synaplic
ì ò é Ì Ø Û Û Ô Û Ý Ì Î Ñ Î Û Ì × Ò Ñ Ù Î ß Ó ïëç
leiminals. Oulei segmenls‰lypically cylindiical and lhin in iods and sloul and
conical in cones‰aie siles of visual excilalion. The nisl slage in lhe liansduc-
lion of lighl lo neuial messages is lhe absoiplion of pholons by pholopigmenls
localized in lhe oulei segmenls of lhe ielina`s pholoieceplois. The pholopig-
menl localized in lhe compacl membiane infolding of lhe iod`s exleinal
segmenl is ®¸±¼±°-·². ¡l is easily isolaled and has been exlensively sludied.
Cones in human beings conlain one of lhiee pholopigmenls and have pholo-
speclial absoiplion chaiacleiislics lhal diffei fiom one anolhei, and fiom lhe
iod pigmenl ihodopsin. Cone pigmenls have pioved veiy difncull lo isolale in
humans and olhei veilebiales, and hence lheii speclial chaiacleiislics have
usually had lo be measuied by indiiecl means (e.g., ieûeclion densilomeliy).
!ach cone pigmenl iesponds lo a iange of lighl wavelenglhs, bul wilh maximal
lighl absoiplion in lhe ied, gieen, oi blue iegions of wavelenglh, iespeclively.
Pholopigmenls aie embedded in lhe specialized membianes of lhe oulei
segmenls of lhe pholoieceplois, and lhey aie °¸±¬±´¿¾·´»; lhal is, evenls
inilialed by lighl absoiplion iesull evenlually in bieakdown oi bleaching``
of lhe pholopigmenl.
Ioi example, lhe pholopigmenl in iods is ihodopsin (Rh), and il is
compiised of lwo pails: a piolein called ±°-·² and ®»¬·²¿´, a lighl-sensilive
chiomophoie deiived fiom vilamin A. ¡n lhe absence of lighl, ielinal is in ils
11-cis foim and is bound lo opsin. Wilh absoiplion of a pholon, ielinal
sliaighlens oul lo assume ils all-lians foim and dissociales. This piocess
iniliales a cascade of inliamoleculai ieaclions lhal biings aboul a confoima-
lional change in ihodopsin (now called ¿½¬·ª¿¬»¼ ®¸±¼±°-·² θ ). Rh in luin
aclivales a G-piolein coupled signal liansduclion cascade which laigels closing
of Na channels on lhe exleinal segmenl membiane. An impoilanl second
messengei medialing lhis channel closing is cyclic guanosine 3,5-cyclic mono-
phosphale (GMP). Tuining off lhe Na cuiienl lhal ûows duiing lhe daik
hypeipolaiizes lhe cell membiane and ieduces lhe ielease of neuioliansmillei
lo downslieam neuions in lhe visual palhway. Rhodopsin kinase and aiieslin
inaclivale Rh ieselling lhe signal liansduclion palhway.
Delails of lhe phololiansduclion piocess aie beyond lhe scope of lhis
book, bul mosl physiology lexls covei lhis sub|ecl inlensively. Bolh inlia-
cellulai and exliacellulai polenlial iecoidings have been made fiom isolaled
pholoieceplois, as well as whole-cell vollage clamp iecoidings lhal piovide
quanlilalive desciiplions of some of lhe membianes cuiienls involved, e.g.,
Yagi and Macleish (1994).
ÛÔÛÝÌÎÑÐØÇÍ×ÑÔÑÙÇ ÑÚ ÌØÛ ÛÇÛ
When lhe ielina is slimulaled wilh a biief ûash of lighl, a chaiacleiislic
lempoial sequence of changes in polenlial can be iecoided belween an
exploiing elecliode‰placed eilhei on lhe innei suiface of lhe ielina oi on
lhe coinea‰and an indiffeienl elecliode placed elsewheie on lhe body
(usually lhe lemple, foiehead, oi eailobe). These polenlial changes aie
colleclively known as lhe »´»½¬®±®»¬·²±¹®¿³ (!RG), and lhey aie clinically
ïêð ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
iecoided wilh lhe aid of an Ag/AgCl elecliode embedded in a special conlacl
lens used as lhe exploiing elecliode. The saline-nlled conlacl lens is in good
conlacl wilh lhe coinea, which is veiy lhin and in inlimale conlacl wilh lhe
aqueous humoi and passive ûuid medium of lhe innei eye. The conlacl lens is
usually well loleialed by lhe sub|ecl and peimils long examinalions wilhoul
discomfoil. By consideiing lhe eye as a ûuid-nlled spheie and lhe ielina as a
lhin sheellike bioelecliic souice allached lo lhe posleiioi pole of lhe spheie
(Iiguie 4.22), we can easily visualize lhe volume-conducloi pioblem in
eleclioielinogiaphy.
Iiguie 4.23 shows a lypical veilebiale !RG wavefoim in iesponse lo a 2 s
lighl ûash. The foui mosl commonly idenlined componenls of lhe !RG
wavefoim (lhe a, b, c, and d waves) aie common lo mosl veilebiales, including
humans. The nisl pail of lhe iesponse lo a biief lighl ûash is lhe »¿®´§ó®»½»°¬±®
°±¬»²¬·¿´ (!RP) geneialed by lhe inilial lighl-induced changes in lhe pholo-
pigmenl molecules. ¡l appeais almosl inslanlaneously wilh lhe onsel of lhe
lighl slimulus. The second componenl, wilh a lalency of 1 lo 5 ms, is lhe ´¿¬»ó
®»½»°¬±® °±¬»²¬·¿´ (LRP), which has been found lo be maximal neai lhe
synaplic endings of lhe pholoieceplois and lheiefoie ieûecls lhe oulpuls of
lhe ieceplois. Noimally lhe !RP and LRP sum lo foim lhe leading edge of lhe
a wave. The b wave is geneialed by aclivily of lhe bipolai and ganglion cells of
lhe innei layeis of lhe ielina. This is besl seen in laboialoiy expeiimenls undei
condilions wheie lhe ielinal aileiy supplying lhe innei layeis of lhe ielina is
occluded, and lhe b wave is abolished. This expeiimenlal lechnique is useful
since in lhe absence of lhe b wave, lhe enliie lime couise of lhe eaily
pholoieceploi iesponse (!RP LRP) can be sludied. The !RP is lineai
wilh lighl inlensily; lhe LRP is alieady maikedly nonlineai, vaiying appioxi-
malely logaiilhmically wilh inlensily. The c wave is nol geneialed by lhe ielina
ilself, bul ialhei by lhe pigmenl epilhelial layei in which lhe lips of lhe exleinal
segmenls aie embedded. This is shown expeiimenlally by chemically ablaling
lhe pigmenl epilhelium oi using an isolaled ielina piepaialion. The d wave is
lhe off-iesponse of lhe ielina lo lhe lighl slimulus.
Ú·¹«®» ìòîí Ê»®¬»¾®¿¬» ÛÎÙ
ì ò é Ì Ø Û Û Ô Û Ý Ì Î Ñ Î Û Ì × Ò Ñ Ù Î ß Ó ïêï
ÍÐßÌ×ßÔ ÐÎÑÐÛÎÌ×ÛÍ ÑÚ ÌØÛ ÛÎÙ
¡l is possible lo iecoid !RGs fiom localized aieas of lhe ielina in addilion lo
lhe classical iesponse lhal we have desciibed in pievious seclions. |This
convenlional iesponse is usually eliciled fiom lhe daik-adapled eye via a
biief lighl ûash (ûash !RG)j. ¡n laboialoiy expeiimenls on fiog, lhe sumof lhe
!RGs pioduced by seveial ielinal iegions is equal lo lhe single !RGpioduced
when all lhese iegions aie slimulaled simullaneously.
Lineai supeiposilion of !RG iesponses has likewise been connimed in
humans. ¡n applying localized lighl slimuli lo poilions of lhe human ielina,
piecaulions should be laken lo pievenl lighl scalleied wilhin lhe eye fiom
slimulaling a much laigei aiea of ielina lhan is inlended. Thus ielalively high
sleady backgiound illuminalion is supplied lhal illuminales mosl of lhe ielina,
and a localized slimulus is supeiimposed. The backgiound illuminalion lighl
causes lhe ielina lo adapl and iendeis il much less sensilive lo lighl scalleied
fiom lhe slimulus iegion. ¡n geneial, ielalively high-backgiound and low-
slimulus inlensilies aie piefeiied, making lhese locally geneialed !RG
polenlials low in amplilude and deleclable wilh only aveiage iesponse calcu-
lalions involving laige numbeis of iesponses. Wilhoul lhese special piecau-
lions, lhe iesullanl !RG iepiesenls lhe oveiall ielinal iesponse lo lighl
slimulalion. Lillle is known aboul lhe aclual naluie of lhe lighl inpul lo a
pailiculai ielinal locus in lhe pholoieceplive layei.
Despile lhe analomical complexilies of lhe ielina, lhe pioblems of
oblaining good iecoids fiom unliained sub|ecls, and lhe need foi employing
aveiaging lechniques in oblaining spalially localized !RGs, lhe !RG has
polenlial impoilance in assessing funclional ielinal behavioi. ¡l seives as an
ob|eclive iecoid of ielinal funclion, is nol dependenl on lhe funclion of lhe
oplic neive oi lhe oplic palhways, and is minimally affecled by clouding of
lhe oplic palhway.
ÌØÛ ÛÔÛÝÌÎÑóÑÝËÔÑÙÎßÓ øÛÑÙ÷
¡n addilion lo lhe liansienl polenlial iecoided as lhe !RG, lheie is a sleady
coinealielinal polenlial. This sleady dipole may be used lo measuie eye
posilion by placing suiface elecliodes lo lhe lefl and iighl of lhe eye (e.g., on
lhe nose and lhe lemple). When lhe gaze is sliaighl ahead, lhe sleady dipole is
symmeliically placed belween lhe lwo elecliodes, and lhe !OGoulpul is zeio.
When lhe gaze is shifled lo lhe lefl, lhe posilive coinea becomes closei lo lhe
lefl elecliode, which becomes moie posilive. Theie is an almosl lineai
ielalionship belween hoiizonlal angle of gaze and !OG oulpul up lo appioxi-
malely 3Oè of aic. !lecliodes may also be placed above and below lhe eye lo
iecoid veilical eye movemenls.
The !OG, unlike olhei bipolenlials, iequiies a dc amplinei. The signal is
in lhe miciovoll iange, so iecessed Ag/AgCl elecliodes aie iequiied lo pievenl
diifl. ¡l is necessaiy lo abiade lhe skin lo shoil oul changes in lhe polenlial lhal
exisls belween lhe inside and lhe oulside of lhe skin. A noise is piesenl lhal is
ïêî ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
compounded of effecls fiom !!G, !MG, and lhe iecoiding equipmenl; il is
equivalenl lo appioximalely 1è of eye movemenl. Thus !OG dala suffei fiom
a lackof accuiacy al lhe exliemes. Specincally eye movemenls of less lhan 1è oi
2è aie difncull lo iecoid, wheieas laige eye movemenls (foi example, giealei
lhan 3Oè of aic) do nol pioduce bioelecliic ampliludes lhal aie sliiclly
piopoilional lo eye posilion. Ioi an analysis of lhe accuiacy and piecision
of eleclio-oculogiaphic iecoidings, consull Noilh (1965).
The !OGis fiequenlly lhe melhod of choice foi iecoiding eye movemenls
in sleep and dieam ieseaich, in iecoiding eye movemenls fiom infanls and
childien, and in evalualing ieading abilily and visual faligue. Ioi a piaclical
clinical !OG selup, see Niedeimeyei and Lopes Da Silva (1999).
ìòè ÌØÛ ÛÔÛÝÌÎÑÛÒÝÛÐØßÔÑÙÎßÓ
The backgiound elecliical aclivily of lhe biain in unaneslhelized animals was
desciibed qualilalively in lhe nineleenlh cenluiy, bul il was nisl analyzed in a
syslemalic mannei by lhe Geiman psychialiisl Hans Beigei, who inlioduced
lhe leim »´»½¬®±»²½»°¸¿´±¹®¿³ (!!G) lo denole lhe polenlial ûuclualions
iecoided fiomlhe biain. Convenlionally, lhe elecliical aclivily of lhe biain is
iecoided wilh lhiee lypes of elecliodes‰scalp, coilical, and deplh eleclio-
des. When elecliodes aie placed on lhe exposed suiface (coilex) of lhe biain,
lhe iecoiding is called an »´»½¬®±½±®¬·½±¹®¿³ (!CoG). Thin insulaled needle
elecliodes of vaiious designs may also be advanced inlo lhe neuial lissue of
lhe biain, in which case lhe iecoiding is iefeiied lo as a ¼»°¬¸ ®»½±®¼·²¹ò
(Theie is suipiisingly lillle damage lo lhe biain lissue when elecliodes of
appiopiiale size aie employed.) Whelhei oblained fiom lhe scalp, coilex, oi
deplhs of lhe biain, lhe iecoided ûuclualing polenlials iepiesenl a supeipo-
silion of lhe neld polenlials pioduced by a vaiiely of aclive neuional cuiienl
geneialois wilhin lhe volume-conducloi medium. \nlike lhe ielalively
simple bioelecliic souice consideied in Seclion 4.2 (lhe neive liunk wilh
ils enclosed bundles of ciiculai cylindiical neive axons), lhe souices genei-
aling lhese neld polenlials aie aggiegales of neuional elemenls wilh complex
inleiconneclions. The neuional elemenls menlioned pieviously aie lhe
dendiiles, cell bodies (somala), and axons of neive cells. Moieovei, lhe
aichilecluie of lhe neuional biain lissue is nol unifoim fiom one localion lo
anolhei in lhe biain. Theiefoie, piioi lo undeilaking any delailed sludy of
eleclioencephalogiaphy, we nisl discuss necessaiy backgiound infoimalion
iegaiding (1) lhe gioss analomy and funclion of lhe biain, (2) lhe ullia-
sliucluie of lhe ceiebial coilex, (3) lhe neld polenlials of single neuions
leading lo an inleipielalion of exliacellulai polenlials iecoided in lhe
ceiebial coilex, and (4) lypical clinical !!G wavefoims iecoided via scalp
elecliodes. We shall lhen focus on lhe geneial volume-conducloi pioblem in
eleclioencephalogiaphy and biieûy discuss abnoimal !!G wavefoims
(Sheiman and Walleispachei, 2OO6).
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïêí
×ÒÌÎÑÜËÝÌ×ÑÒ ÌÑ ÌØÛ ßÒßÌÑÓÇ ßÒÜ ÚËÒÝÌ×ÑÒ ÑÚ ÌØÛ ÞÎß×Ò
The cenlial neivous syslem (CNS) consisls of lhe spinal coid lying wilhin lhe
bony veilebial column and ils conlinualion, lhe biain, lying wilhin lhe skull
|Iiguie 4.24j. The biain is lhe gieally modined and enlaiged poilion of lhe
CNS, suiiounded by lhiee pioleclive membianes (lhe ³»²·²¹»-) and enclosed
wilhin lhe cianial cavily of lhe skull. The spinal coid is likewise suiiounded by
downwaid conlinualions of lhe meninges, and il is encased wilhin lhe piolec-
live bony veilebial column. Bolh biain and spinal coid aie balhed in a special
exliacellulai ûuid called ½»®»¾®¿´ -°·²¿´ A«·¼ (CSI).
Division of lhe biain inlo lhiee main pails‰½»®»¾®«³ô ¾®¿·²-¬»³, and
½»®»¾»´´«³‰piovides a useful basis foi lhe sludy of biain localizalion and
funclion (Iiguie 4.24). The biainslem (³»¼«´´¿ô °±²-ô ³·¼¾®¿·²ô ¼·»²½»°¸¿´±²)
is lhe oldesl pail of lhe biain. ¡l is aclually a shoil exlension of lhe spinal coidand
Ú·¹«®» ìòîì Analomical ielalionship of biainslem sliucluies |medulla oblon-
gala, pons, midbiain, and diencephalon (lhalamus and hypolhalamus)j lo lhe
ceiebium and ceiebellum. Geneial analomic diieclions of oiienlalion in lhe
neivous syslem aie supeiimposed on lhe diagiams. Heie lhe leims ®±-¬®¿´
(lowaid head), ½¿«¼¿´ (lowaid lail), ¼±®-¿´ (back), and ª»²¬®¿´ (fionl) aie
associaledwilhlhe biainslem; iemaining leims aie associaledwilh lhe ceiebium.
The leims ³»¼·¿´ and ´¿¬»®¿´ imply neainess and iemoleness, iespeclively, lo oi
fiom lhe cenlial midline axis of lhe biain. Symbols: T (lhalamus), HT (hypo-
lhalamus), MB (midbiain), SC (spinal coid), P piluilaiy gland). (Adapled fiom
1ohn H. Mailin, Ò»«®±¿²¿¬±³§æ Ì»¨¬ ¿²¼ ߬´¿-, 2nd ed., 1996, pp 1415, wilh
peimission of Applelon and Lange, a Simon and Schuslei Company.)
ïêì ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
seives lhiee ma|oi funclions: (1) a connecling link belween lhe ceiebial coilex,
spinal coid, and ceiebellum; (2) an inlegialive cenlei foi seveial visceial
funclions (e.g., conliol of blood piessuie and venlilalion); and (3) an inlegialion
cenlei foi vaiious moloi ieûexes. The ¼·»²½»°¸¿´±² is lhe mosl supeiioi poilion
of lhe biainslem; ils chief componenl and laigesl sliucluie is lhe ¬¸¿´¿³«-. The
lhalamus seives as a ma|oi ielay slalion and inlegialion cenlei foi all of lhe
geneial and special sensoiy syslems, sending infoimalion lo lheii iespeclive
coilical ieceplion aieas. ¡l seives as lhe galeway lo lhe ceiebium. Anolhei ma|oi
componenl of lhe diencephalon is lhe ¸§°±¬¸¿´¿³«-, which inlegiales funclions
of lhe aulonomic neivous syslem and along wilh lhe piluilaiy gland, iegulales
funclions of lhe lhyioid, adienal, and iepioduclive glands. The ½»®»¾»´´«³ is a
cooidinaloi in lhe volunlaiy (somalic) muscle syslem and acls in con|unclion
wilh lhe biainslem and ceiebial coilex lo mainlain balance and piovide haimo-
nious muscle movemenls. The laigei ½»®»¾®«³ occupies a special dominanl
posilion in lhe cenlial neivous syslem, and conscious funclions of lhe neivous
syslem aie localized wilhin lhis sliucluie.
Wilhin lhe CNS lheie aie ¿-½»²¼·²¹ (-»²-±®§) neive liacls lhal iun fiom
lhe spinal coid oi biain slem lo vaiious aieas of lhe biain, conveying
infoimalion iegaiding changes in lhe exleinal enviionmenl of lhe body lhal
aie iepoiled by vaiious peiipheial biological sensois. Theie aie a vaiiely of
such sensois, including lhe geneial sensois of lempeialuie, pain, nne louch,
piessuie, as well as lhe special senses of vision, audilion, equilibiium, lasle, and
olfaclion. Iiguie 4.25 shows lhe basic plan associaled wilh lhe geneial sense
palhways fiomlhe peiipheiy (e.g., skin, muscles) lo lhe coilex. Alhiee-neuion
chain is involved in conveying infoimalion lo lhe coilex wheie lhe °®·³¿®§
²»«®±² has ils cell body in a ganglion oulside lhe CNS and makes synaplic
conlacl wilh a secondaiy neuion whose cell body is localed in a nucleus wilhin
Ú·¹«®» ìòîë A simplined diagiam of lhe CNS showing a lypical geneial sense
palhway fiom lhe peiipheiy (neuion 1) lo lhe biain (neuion 3). Nole lhal lhe
axon of lhe secondaiy neuion (neuion 2) in lhe palhway decussales (ciosses) lo
lhe opposile side of lhe coid. Descending (moloi) palhways aie also ciossed
(see lexl).
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïêë
eilhei lhe spinal coid |e.g., lhe doisal hoin oi lhe biain slem (Iiguie 4.25)j.
Nole fiom Iiguie 4.25 lhal lhe axon of lhe -»½±²¼¿®§ ²»«®±² ciosses (decus-
sales) lo lhe olhei side of lhe coid and |oins a neive nbei liacl bound foi lhe
lhalamus. The ¬»®¬·¿®§ ²»«®±² in lhe palhway is localed in a lhalamic nucleus,
and ils axon liavels in lhe ¬¸¿´¿³±½±®¬·½¿´ ®¿¼·¿¬·±²- lo lhe °±-¬½»²¬®¿´ ¹§®«-ô
which is localed |usl posleiioi lo lhe ½»²¬®¿´ -«´½«- |Iiguie 4.24 (insel)j. Thus,
lhe poslcenlial gyius is lhe coilical pio|eclion aiea foi lhe geneial senses.
Neuial palhways foi lhe special senses, pailiculaily audilion and vision,
follow lhe same geneial giound plan; howevei, lheie aie nolable devialions
fiomlhe scheme depicled in Iiguie 4.25. \sually, moie lhan lhiee neuions aie
involved in lhe palhway and nol all of lhe secondaiy neuions`` decussale.
Mosl of lhe neuions cioss lo lhe opposile (conlialaleial) side of lhe body,
howevei a signincanl numbei ascend lo lhe lhalamus on lhe same (ipsilaleial)
side of lhe body. The audiloiy and visual palhways have lheii own special
lhalamic ielay cenleis‰lhe medial and laleial geniculale bodies, iespeclively,
as well as lheii own coilical pio|eclion aieas (Iiguie 4.24).
Likewise, wilhin lhe CNS lheie aie ¼»-½»²¼·²¹ (³±¬±®) neive liacls lhal
oiiginale in vaiious biain sliucluies such as lhe ceiebium and ceiebellum
(Iiguie 4.24) and leiminale ullimalely on moloi neuions in lhe venlial hoin of
lhe spinal coid (Iiguie 4.1O). These moloneuions, in luin, conliol lhe con-
liaclile aclivily of lhe skelelal musculaluie. Ioi example, lhe coilicospinal
liacl is a bundle of axons fiom lhe piimaiy moloi coilex |piecenlial gyius,
Iiguie 4.24 (insel)j, which pio|ecls diieclly lo moloi neuions in lhe spinal coid.
Since lhe ascending geneial sensoiy palhways aie ciossed, lhe descending
coilicospinal liacls each cioss lo lhe opposile side of lhe body piioi lo making
synaplic conlacl wilh lhe spinal moloi neuions.
Thus, lwo-way communicalion links exisl belween lhe biain and spinal
coid lhal allow highei cenleis in lhe biain lo conliol oi modify lhe behavioi of
lhe elemenlal spinal ieûex aic al a given spinal level. By means of lhese links,
lhe biain is nol only infoimed of a peiipheial evenl bul can also modify lhe
iesponse of lhe spinal ieûex lo lhal enviionmenlal slimulus. ¡nfoimalion is
liansmilled lo lhe biain by means of a fiequency-modulaled liain of neive
impulses lhal, upon ieaching specinc aieas of lhe biain, slimulales lhe aclivily
of iesidenl neuions. Similaily, lhe decision lo implemenl a moloi aclion in
iesponse lo lhe inilial slimulus is manifesled in lhe elecliical aclivily of coilical
neuions in specinc aieas of lhe biain |e.g., piecenlial gyius (piimaiy moloi
coilex); piemoloi coilex in fionlal lobej. The pallein of aclivily is specinc lo
lhe lype of moloi aclion lo be laken.
!lecliical aclivily in eilhei ascending oi descending neive nbei liacls may
be iepiesenled lo a nisl appioximalion by an aclion cuiienl dipole oiienled in
lhe diieclion of piopagalion (bioelecliic souice model). One should be awaie
lhal lhe piopeilies (e.g., size, bulk conduclivily) of lhe volume-conducloi
medium can change along lhe lenglh of a pailiculai nbei liacl belween lhe
spinal coid and lhe coilex, and lhe volume-conducloi model adopled should
be based on lhe pailiculai measuiemenl consideied. The volume-conducloi-
neld polenlial solulions can be used lo bolh nl and inleipiel body suiface
ïêê ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
polenlial measuiemenls oblained clinically. Recoiding neld polenlials non-
invasively fiom lhe ielalively small volume of aclive neive liunks, invaiiably
iequiies lhe use of cumulalive signal aveiaging lechniques. ¡n Iiguie 4.8, lhe
median neive was slimulaled and compound aclion polenlials weie iecoided
fiom lhe sub|ecl`s foieaim. Allhough nol shown in lhis nguie, sensoiy nbeis in
lhe median neive lhus aclivaled, iniliale aclivily in lhe geneial sense palhways
lo lhe biain. Aveiaged neld polenlial iecoidings can be laken al a vaiiely of
poinls along lhe ascending palhways |e.g., fiom spinal coid and biain slem
liacls laking nole of lhe ciossed naluie of lhe palhway, and nnally al lhe coilex
ilself (poslcenlial gyius)j. The neld polenlials associaled wilh long neive liacls
depends lo a laige exlenl on (a) whelhei lhe liacl is sliaighl oi benl and (b) lhe
iesislance (geomeliy and specinc conduclivily) of lhe suiiounding volume-
conducloi media.
This impoilanl sub|ecl is discussed lalei; howevei, foi lhe piesenl, lhese
diffeienl lypes of aveiaged neld polenlials aie called colleclively -±³¿¬±ó
-»²-±®§ »ª±µ»¼ °±¬»²¬·¿´-. The sub|ecl of neive liacls has been discussed
pieviously; howevei, lhe aclivily of bolh nuclei in lhe ascending palhway
and clusleis of cells in lhe coilex, depends nol only on lhe ensemble of neuions
lheie, bul also on lhe geomeliy of lhe ensemble and lhe diffeienl lypes of
synaplic conneclions involved.
Aveiaged sensoiy evokedpolenlials in iesponse lo biief audiloiy clicks``
oi ûashes of lighl aie also ioulinely iecoided as lhe audiloiy evoked iesponse
(A!R) and lhe visual evoked iesponse (\!R), iespeclively (1acobson, 1994;
Heckenlively and Aiden, 1991). \sing an elecliomagnelic slimulaling device
held ovei lhe piimaiy moloi coilex (|usl anleiioi lo lhe cenlial sulcus), il is
also possible lo induce cuiienls lhal aclivale lhe coilicospinal liacl, making
possible lhe iecoiding of aveiaged neld polenlials fiom lhe descending moloi
palhways (Yoik, 1987; Geddes, 1987; !sselle and Sluchly, 1992). The same
volume-conducloi piinciples aie applicable lo lhe analysis of lhese diffeienl
lypes of evoked polenlial iecoidings. The ceiebium is a paiied sliucluie, wilh
iighl and lefl ceiebial hemispheies, each ielaling lo lhe opposile side of lhe
body. Thal is, volunlaiy movemenls of lhe iighl hand aie willed`` by lhe lefl
ceiebial hemispheie. The suiface layei of lhe hemispheie is called lhe ½±®¬»¨;
il ieceives sensoiy infoimalion fiom skin, eyes, eais, and olhei ieceplois
localed geneially on lhe opposile side of lhe body. This infoimalion is
compaied wilh pievious expeiience and pioduces movemenls in iesponse
lo lhese slimuli.
!ach hemispheie consisls of seveial layeis. The oulei layei is a dense
colleclion of neive cells lhal appeai giay in coloi when examined in a fiesh
slale. ¡l is consequenlly called ¹®¿§ ³¿¬¬»®. This oulei layei, ioughly 1 cmlhick,
is called lhe ½»®»¾®¿´ ½±®¬»¨. ¡l has a highly convoluled suiface consisling of ¹§®·
(iidges) and -«´½· (valleys), lhe deepei sulci being leimed B--«®»-. The deepei
layeis of lhe hemispheie (benealh lhe coilex) consisl of myelinaled ¿¨±²- (oi
while mallei) and colleclions of cell bodies leimed ²«½´»·. Some of lhe
inlegialive funclions of lhe ceiebium can be localized wilhin ceilain iegions
of lhe coilex; olheis aie moie diffusely disliibuled.
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïêé
A ma|oi dividing landmaik of lhe ceiebial coilex is lhe laleial nssuie
(Iiguie 4.24), which iuns on lhe laleial (side) suiface of lhe biain fiom lhe
open end in fionl, posleiioily and doisally (backwaid and upwaid). The laleial
nssuie dennes a side lobe of coilex infeiioi lo (below) il lhal is called lhe
¬»³°±®¿´ ´±¾» |Iiguie 4.24 (insel)j. The supeiioi (uppei) pail of lhis lobe
conlains lhe °®·³¿®§ ¿«¼·¬±®§ ½±®¬»¨, which is lhe pail of lhe coilex lhal
ieceives audiloiy impulses via neuial palhways leading fiom lhe audiloiy
ieceplois in lhe innei eai.
The visual syslem is anolhei example of lhe pio|eclion of lhe senses onlo
lhe ceiebial coilex. The ±½½·°·¬¿´ ´±¾» al lhe back of lhe head is lhe piimaiy
visual coilex. Lighl ûashed inlo lhe eye evokes laige elecliical polenlials fiom
elecliodes placed ovei lhis aiea of lhe coilex.
Anolhei ma|oi landmaik of lhe ceiebial coilex is lhe cenlial sulcus
|Iiguie 4.24 (insel)j. Howevei, il is nol so piominenl and unvaiying an
analomical landmaik as lhe laleial nssuie. The cenlial sulcus iuns fiom
lhe medial suiface (suiface along lhe midline of lhe biain) ovei lhe convexily
of lhe hemispheie lo lhe laleial nssuie. ¡l also iepiesenls lhe posleiioi boidei
of lhe fionlal lobe. The gyius lying |usl anleiioi (foiwaid) lo lhe cenlial sulcus
is lhe °®»½»²¬®¿´ ¹§®«-, which funclions as lhe °®·³¿®§ ³±¬±® ½±®¬»¨. Iiom lhis
gyius, neive signals iun down lhiough lhe biainslem lo lhe spinal coid foi
conliol of skelelal muscles via neuial conliol of moloneuions in lhe venlial
hoin of lhe spinal coid (Iiguie 4.1O). Lesions (desliuclion) of pail of lhe
piecenlial gyius cause pailial paialysis on lhe opposile side of lhe body.
¡mmedialely posleiioi lo lhe cenlial sulcus |Iig. 24 (insel)j is lhe piimaiy
-±³¿¬±-»²-±®§ ½±®¬»¨, lhe °±-¬½»²¬®¿´ ¹§®«-. This iegion ieceives impulses fiom
all lhe geneial sense ieceplois fiom lhe skin (such as piessuie, louch, and pain
ieceplois). !ach lillle aiea along lhis gyius is ielaled lo a pailiculai pail of lhe
body (foi example, lhe legs on lhe medial end, lhe hand in lhe cenlei, and lhe
face on lhe end nexl lo lhe laleial nssuie). ¡f a iecoiding elecliode is placed
appiopiialely duiing a neuiosuigical pioceduie, a coilical iesponse can be
evoked by laclile slimuli deliveied lo lhe ½±²¬®¿´¿¬»®¿´ (opposile) hand. Like-
wise, if a slimulus is applied lhiough lhe same elecliode, lhe sub|ecl iepoils a
lingling sensalion in lhe conlialaleial hand. Highei-oidei sensoiy disciimina-
lion, such as lhe abilily lo iecognize a numbei diawn on lhe palm of lhe hand,
is oiganized solely in lhe paiielal lobe of which lhe poslcenlial gyius is a pail.
Desliuclion of lhe paiielal lobe iesulls in a loss of lhis disciiminalive abilily.
Ioi example, a sub|ecl may slill know lhal he oi she is being louched bul
cannol lell wheie oi whal is being diawn on lhe palm of lhe hand. The paiielal
lobe is also iesponsible foi a peison`s awaieness of lhe geneial posilion of lhe
body and ils limbs in space.
ËÔÌÎßÍÌÎËÝÌËÎÛ ÑÚ ÌØÛ ÝÛÎÛÞÎßÔ ÝÑÎÌÛÈ
The funclional pail of lhe ceiebium is lhe ceiebial coilex (baik, oulei
coveiing), a ielalively lhin layei of giay mallei (1.5 lo 4.O mm in lhickness)
coveiing lhe oulei suiface of lhe ceiebium, including ils inliicale convolulions.
ïêè ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
Because il is lhe mosl iecenl phylogenelic acquisilion of lhe biain, lhe ceiebial
coilex has undeigone a ielalively giealei developmenl lhan olhei pails of lhe
biain. The giealesl advance in ielalive giowlh has been lhe neocoilex, which is
piesenl on lhe supeiioi and laleial aspecls of lhe ceiebial hemispheies. The
dislinclly diffeienl lype of coilex localed on lhe medial suiface and base of lhe
biain is known as lhe °¿´»±½±®¬»¨. We shall use lhe leim ½±®¬»¨ in lhis chaplei
lo iefei specincally lo lhe neocoilex.
Coilical aichilecluies in veilebiales shaie seveial common fealuies:
(1) slialined layeis conlaining cell bodies and nbei bundles; (2) an ouleimosl
layei lhal lacks neuions (layei ¡); (3) al leasl one innei layei conlaining
neuions lhal give iise lo laige dendiiles, which iise veilically lo layei ¡ and
liavel in lhal layei foiming mulliple bianches (aiboiizalion). The human
coilex is geneially aiianged in six such coilical layeis. The neuions aie of lwo
main lypes: °§®¿³·¼¿´ and ²±²°§®¿³·¼¿´ (many sublypes have been idenli-
ned). Theie aie also a laige numbei of hoiizonlally oiienled layeis of neive
nbeis lhal exlend belween ad|acenl iegions of lhe coilex, as well as veilically
oiienled bundles lhal exlend fiom lhe coilex lo moie dislanl iegions of lhe
coilex oi downwaid lo lhe biainslem and spinal coid.
Iiguie 4.26 shows a schemalic diawing of a lypical coilical pyiamidal
cell. The bodies of lhis lype of cell aie commonly liiangulai in shape, wilh
lhe base down and lhe apex diiecled lowaid lhe coilical suiface. (Pyiamidal
Ú·¹«®» ìòîê !lecliogenesis of coilical neld polenlials foi a nel excilaloiy
inpul lo lhe apical dendiilic liee of a lypical pyiamidal cell. Ioi lhe case of a
nel inhibiloiy inpul, polaiily is ieveised and lhe apical iegion becomes a
souice ( ). Cuiienl ûow lo and fiom aclive ûuclualing synaplic knobs on lhe
dendiiles pioduces wavelike aclivily. (See lexl.)
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïêç
cell bodies vaiy gieally in size, fiom axial dimensions of 15 1O ³m up lo
12O 9O ³m oi moie foi lhe gianl pyiamids of lhe moloi coilex, which aie
called Þ»¬¦ ½»´´- aflei lheii discoveiei.) These cells usually consisl of lhe
following pails: (1) a long apical dendiile (up lo 2 mmin lenglh) lhal ascends
fiom lhe apex of lhe cell body lhiough lhe oveilaying cellulai layeis, and
which fiequenlly ieaches and bianches leiminally wilhin lhe ouleimosl
layei of lhe coilex; (2) dense dendiilic aiboiizalion occuiiing al lhe base
of lhe pyiamid-shaped cell (laigely hoiizonlally‰basilai dendiiles); and (3)
a single pyiamidal cell axon which can emeige fiom lhe innei suiface of lhe
coilex as pio|eclion nbeis lo olhei aieas of lhe coilex, oi lo olhei sliucluies
(e.g., lhe lhalamus, ceiebellum, oi spinal coid). Iiequenlly lhese axons send
iecuiienl collaleial (feedback) bianches back on lhe cellulai iegions fiom
which lhey spiang. Axons of some pyiamidal cells luin back lowaid lhe
coilical suiface (nevei leaving lhe giay mallei) lo end via lheii many
bianches on lhe dendiiles of olhei cells.
Nonpyiamidal cells of lhe neocoilex diffei iemaikably fiom pyiamidal
cells. Theii cell bodies aie small, and dendiiles spiing fiom lhem in all
diieclions lo iamify in lhe immediale vicinily of lhe cell. The axon may aiise
fiom a laige dendiile; il commonly divides iepealedly lo leiminale on lhe cell
bodies and dendiiles of immedialely ad|acenl cells. The axons of olhei non-
pyiamidal cells may luin upwaid lowaid lhe coilical suiface, oi lhey may leave
lhe moloi coilex (lhough lhis is nol common).
Ioi a delailed exposilion of lhe vaiious cells, layeis, cellulai inleiconnec-
lions, inpuls, and oulpuls of lhe neocoilex, see Kandel »¬ ¿´. (1991).
Þ×ÑÛÔÛÝÌÎ×Ý ÐÑÌÛÒÌ×ßÔÍ ÚÎÑÓ ÌØÛ ÞÎß×Ò
\nipolai iecoidings of lhe coilical suiface polenlial ielalive lo lhal of a
iemole iefeience polenlial may be viewed as a measuiemenl of lhe inlegialed
neld polenlial al a boundaiy of a laige volume conducloi lhal conlains an aiiay
of aclion cuiienl souices. \ndei noimal condilions, aclion polenlials con-
ducled by axons in lhe coilical medium conliibule veiy lillle lo lhe inlegialed
suiface polenlial, since lheie aie many axons in lhe coilex which iun in many
diieclions ielalive lo lhe suiface and which nie asynchionously. Consequenlly,
lheii nel spalial and lempoial inûuence on lhe neld polenlial al lhe suiface is
negligible. An exceplion occuis, of couise, in lhe case of a iesponse evoked by
lhe simullaneous (synchionous) slimulalion of a coilical inpul (e.g., diiecl
elecliical slimulalion of lhalamic nuclei oi lheii affeienl palhways, which
pio|ecl diieclly lo lhe coilex via lhalamocoilical axons‰lhe coilical inpul).
These synchionous iesponses aie called »ª±µ»¼ °±¬»²¬·¿´-ô and lhey aie of
ielalively laige amplilude. Synchionicily of lhe undeilying nbei and coilical
neuion aclivily is a ma|oi facloi inûuencing suiface polenlial magnilude.
\nipolai neld polenlials iecoided wilhin lhe coilical layeis have shown
lhal lhe coilical suiface polenlial is laigely due lo lhe nel effecl of local
poslsynaplic polenlials of coilical cells (Iiguie 4.26). These may be of eilhei
sign (excilaloiy oi inhibiloiy) and may occui diieclly undeinealh lhe elecliode
ïéð ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
oi al some dislance fiom il. A polenlial change iecoided al lhe suiface is a
measuie of lhe nel polenlial (cuiienl iesislance ·Î) diop belween lhe suiface
sile and lhe dislanl iefeience elecliode. ¡l is obvious, howevei, lhal if all lhe
cell bodies and dendiiles of coilical cells weie iandomly aiianged in lhe
coilical medium, lhe nel inûuence of synaplic cuiienls would be zeio. This
would iesull in a closed neld`` silualion lhal pioduces ielalively small fai-neld
polenlials (Loienle de No, 1947). Thus, any elecliical change iecoided al lhe
suiface musl be due lo lhe oideily and symmeliic aiiangemenl of some class of
cells wilhin lhe coilex.
Pyiamidal cells of lhe ceiebial coilex aie oiienled veilically, wilh lheii
long apical dendiiles iunning paiallel lo one anolhei. Polenlial changes in one
pail of lhe cell ielalive lo anolhei pail cieale open`` polenlial nelds in which
cuiienl may ûow and polenlial diffeiences can be measuied al lhe coilical
suiface. Iiguie 4.26 illusliales lhis concepl in diagiammalic fashion. Synaplic
inpuls lo lhe apical dendiilic liee cause depolaiizalion of lhe dendiilic
membiane. As a iesull, sublhieshold cuiienl ûows in a closed palh lhiough
lhe cyloplasmic coie of lhe dendiiles and cell body of lhe pyiamidal cell,
ieluining ullimalely lo lhe suiface synaplic siles via lhe exliacellulai balhing
medium. Iiom lhe indicaled diieclion of lhe lines of cuiienl ûow, lhe
exliacellulai medium aboul lhe soma behaves as a -±«®½» ( ), while lhe
uppei pail of lhe apical dendiilic liee behaves as a -·²µ ( ).
The inûuence of a pailiculai dendiilic °±-¬-§²¿°¬·½ °±¬»²¬·¿´ (PSP) on lhe
coilical suiface iecoiding depends on ils sign |excilaloiy ( ) oi inhibiloiy ( )j
and on ils localion ielalive lo lhe measuiemenl sile. The effecl of each PSP
may be iegaided as ciealing a iadially oiienled cuiienl dipole. Theiefoie,
conlinuing synaplic inpul cieales a seiies of polenlial dipoles and iesulling
cuiienl ûows lhal aie slaggeied bul oveilapped in space and lime. Suiface
polenlials of any foimcanbe geneialed by one populalion of piesynaplic nbeis
and lhe cells on which lhey leiminale, depending on lhe piopoilion lhal aie
inhibiloiy oi excilaloiy, lhe level of lhe poslsynaplic cells in lhe coilex, and so
foilh.
Nonpyiamidal cells in lhe neocoilex, on lhe olhei hand, aie unlikely lo
conliibule subslanlially lo suiface iecoids. Theii spalially iesliicled dendiilic
liees aie iadially aiianged aiound lheii cell bodies such lhal chaige diffeiences
belween lhe dendiiles and lhe cell body pioduce nelds of cuiienl ûowlhal sum
lo zeio when viewed fiom a ielalively gieal dislance on lhe coilical suiface
(closed-neld silualion).
Thus, lo summaiize, lhe apical dendiiles of pyiamidal cells conslilule a
meshwoik of similaily oiienled, densely packed unils in lhe oulei layeis of lhe
coilex. As mulliple synaplic endings on lhe dendiilic liee of each cell become
aclive, cuiienl can ûow in eilhei diieclion belween lhe dendiilic piocess
depending on whelhei lhe synapses aie excilaloiy oi inhibiloiy. The
souicesink ielalionship belween dendiile and cell is lhal of a conslanlly
shifling cuiienl dipole, wheie vaiialions in dipole oiienlalion and slienglh
pioduce wavelike ûuclualions in lhe suiface neld polenlial (Iiguie 4.26).
When lhe sum of dendiilic aclivily is negalive ielalive lo lhe cell, lhe cell
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïéï
is depolaiized and quile excilable. When il is posilive, lhe cell is hypei-
polaiized and less excilable.
ÎÛÍÌ×ÒÙ ÎØÇÌØÓÍ ÑÚ ÌØÛ ÞÎß×Ò
!lecliic iecoidings fiom lhe exposed suiface of lhe biain oi fiom lhe oulei
suiface of lhe head demonsliale conlinuous oscillaling elecliic aclivily wilhin
lhe biain. Bolh lhe inlensily and lhe palleins of lhis elecliic aclivily aie
deleimined lo a gieal exlenl by lhe oveiall excilalion of lhe biain iesulling
fiom funclions in lhe biainslem ieliculai aclivaling syslem (RAS). The
undulalions in lhe iecoided elecliic polenlials (Iiguie 4.27) aie called ¾®¿·²
©¿ª»-, and lhe enliie iecoid is called an »´»½¬®±»²½»°¸¿´±¹®¿³ (!!G).
Ú·¹«®» ìòîé (a) Diffeienl lypes of noimal !!G waves. (b) Replacemenl of
alpha ihylhm by an asynchionous dischaige when palienl opens eyes.
(c) Repiesenlalive abnoimal !!G wavefoims in diffeienl lypes of epilepsy.
(Iiom A. C. Guylon, ͬ®«½¬«®» ¿²¼ Ú«²½¬·±² ±º ¬¸» Ò»®ª±«- ͧ-¬»³, 2nd ed.,
Philadelphia: W.B. Saundeis, 1972; used wilh peimission.)
ïéî ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
The inlensilies of lhe biain waves on lhe suiface of lhe biain (iecoided
ielalive lo an indiffeienl elecliode such as lhe eailobe) may be as laige as 1O m\,
wheieas lhose iecoided fiomlhe scalphave a smallei amplilude of appioximalely
1OO ³\. The fiequencies of lhese biain waves iange fiomO.5 lo 1OO Hz, and lheii
chaiaclei is highly dependenl on lhe degiee of aclivily of lhe ceiebial coilex. Ioi
example, lhe waves change maikedly belween slales of wakefulness and sleep.
Much of lhe lime, lhe biain waves aie iiiegulai, and no geneial pallein can be
obseived. Yel al olhei limes, dislincl palleins do occui. Some of lhese aie
chaiacleiislic of specinc abnoimalilies of lhe biain, such as epilepsy (discussed
lalei). Olheis occui innoimal peisons andmay be classinedas belonging looneof
foui wave gioups (¿´°¸¿ô ¾»¬¿ô ¬¸»¬¿ô and ¼»´¬¿), which aie shown in Iiguie 4.27(a).
Alpha waves aie ihylhmic waves occuiiing al a fiequency belween 8 and
13 Hz. They aie found in !!Gs of almosl all noimal peisons when lhey aie
awake in a quiel, iesling slale of ceiebialion. These waves occui mosl inlensely
in lhe occipilal iegion bul can also be iecoided, al limes, fiom lhe paiielal and
fionlal iegions of lhe scalp. Theii vollage is appioximalely 2O lo 2OO ³\. When
lhe sub|ecl is asleep, lhe alpha waves disappeai complelely. When lhe awake
sub|ecl`s allenlion is diiecled lo some specinc lype of menlal aclivily, lhe alpha
waves aie ieplaced by asynchionous waves of highei fiequency bul lowei
amplilude. Iiguie 4.27(b) demonsliales lhe effecl on lhe alpha waves of simply
opening lhe eyes in biighl lighl and lhen closing lhem again. Nole lhal lhe
visual sensalions cause immediale cessalion of lhe alpha waves; lhese aie
ieplaced by low-vollage, asynchionous waves.
Ú·¹«®» ìòîé (ݱ²¬·²«»¼)
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïéí
ÛÈßÓÐÔÛ ìòë Design a syslem lhal would piovide nonvisual feedback lo a
sub|ecl who wished lo maximize lhe amplilude of his !!G alpha waves.
!xplain ils opeialion.
ßÒÍÉÛÎ Thiee elecliodes ovei lhe occipilal lobe delecl lhe 1OO ³\ !!G
and feed a diffeienlial amplinei wilh a gain of 1O,OOO. A band-pass nllei
cenleied al 1O Hz selecls lhe alpha waves, which aie demodulaled and nlleied
lo yield a dc vollage piopoilional lo amplilude. A vollage-lo-fiequency
conveilei incieases lhe fiequency of an acouslic lone, and lhe sub|ecl allempls
lo maximize lhe fiequency.
Bela waves noimally occui in lhe fiequency iange of 14 lo 3O Hz, and
somelimes‰pailiculaily duiing inlense menlal aclivily‰as high as 5O Hz.
These aie mosl fiequenlly iecoided fiomlhe paiielal and fionlal iegions of lhe
scalp. They can be divided inlo lwo ma|oi lypes: bela ¡ and bela ¡¡. The bela ¡
waves have a fiequency aboul lwice lhal of lhe alpha waves. They aie affecled
by menlal aclivily in much lhe same way as lhe alpha waves (lhey disappeai
and in lheii place appeais an asynchionous, low-vollage wave). The bela ¡¡
waves, on lhe olhei hand, appeai duiing inlense aclivalion of lhe cenlial
neivous syslem and duiing lension. Thus one lype of bela aclivily is eliciled by
menlal aclivily, wheieas lhe olhei is inhibiled by il.
Thela waves have fiequencies belween 4 and 7 Hz. These occui mainly in
lhe paiielal and lempoial iegions in childien, bul lhey also occui duiing
emolional sliess in some adulls, pailiculaily duiing peiiods of disappoinlmenl
and fiuslialion. Ioi example, lhey can oflen be bioughl aboul in lhe !!G of a
fiuslialed peison by allowing lhe peison lo en|oy some pleasanl expeiience
and lhen suddenly iemoving lhe elemenl of pleasuie. This causes appioxi-
malely 2O s of lhela waves.
Della waves include all lhe waves in lhe !!G below 3.5 Hz. Somelimes
lhese waves occui only once eveiy 2 oi 3 s. They occui in deep sleep, in infancy,
and in seiious oiganic biain disease. They can also be iecoided fiomlhe biains
of expeiimenlal animals lhal have had subcoilical lianseclions pioducing a
funclional sepaialion of lhe ceiebial coilex fiom lhe ieliculai aclivaling
syslem. Della waves can lhus occui solely wilhin lhe coilex, independenl of
aclivilies in lowei iegions of lhe biain.
Asingle coilical cell can give iise only lo small exliacellulai cuiienl, so laige
numbeis of neuions musl be synchionously aclive lo give iise lo lhe polenlials
iecoided fiomlhe ceiebial suiface. The individual waves of lhe !!G aie of long
duialion (foi example, 3O lo 5OO ms), and one mighl well ask how lhey aie
pioduced. They can be long-lasling depolaiizalions of lhe cell membianes (foi
example, of lhe apical dendiiles of pyiamidal cells) oi a summalion of a numbei
of shoilei iesponses. ¡n any evenl, a sufncienlly laige numbei of neuions musl
dischaige logelhei lo give iise lo lhese coilical polenlials. The leim -§²½¸®±²·ó
¦¿¬·±² is used lo desciibe lhe undeilying piocess lhal acls lo biing a gioup of
neuions inlo unined aclion. Synaplic inleiconneclions aie geneially lhoughl lo
biing aboul synchionizalion, allhough exliacellulai neld inleiaclion belween
ïéì ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
cells has beenpioposedas a possible mechanism. Rhylhmically niing neuions aie
veiy sensilive lo vollage giadienls in lheii suiiounding medium.
Besides lhe synchionizalioniequiiedfoi eachwave of iesling !!G, lhe seiies
of iepealed waves suggesls a ihylhmic and a liiggei oi pacemakei piocess lhal
iniliales such ihylhmic aclion. By means of knife culs belowlhe inlacl conneclive-
lissue coveiing (³»²·²¹»¿´ ´¿§»® ±® °·¿ ³¿¬¬»®) of lhe biain, one may piepaie
½¸®±²·½ ·-´¿²¼- of coilex‰wilh all neuional conneclions cul, bul wilh lhe blood
supply via suiface vessels inlacl. Only a low level of !!Gaclivily iemains in such
islands. Though lhe isolaled islands of coilex may nol show sponlaneous !!G
aclivily, lhey slill have lhe abilily lo iespond ihylhmically, which may be ieadily
demonslialed by lhe ihylhmic iesponses lhal aie eliciled by applying a single
elecliical slimulus. The infeience is lhal vaiious iegions of lhe coilex, lhough
capable of exhibiling ihylhmic aclivily, iequiie liiggei inpuls lo excile ihylhmic-
ily. The RAS, menlioned eailiei, appeais lo piovide lhis pacemakei funclion.
ÌØÛ ÝÔ×Ò×ÝßÔ ÛÛÙ
The syslem mosl oflen used lo place elecliodes foi moniloiing lhe clinical
!!G is lhe ¡nleinalional Iedeialion 1O2O syslem shown in Iiguie 4.28. This
syslem uses ceilain analomical landmaiks lo slandaidize placemenl of !!G
elecliodes. The iepiesenlalion of lhe !!G channels is iefeiied lo as a
³±²¬¿¹»ò ¡n lhe bipolai monlage, each channel measuies lhe diffeience
belween lwo ad|acenl elecliodes. ¡n lhe iefeienlial monlage, each channel
Ú·¹«®» ìòîè ̸» ïðPîð »´»½¬®±¼» -§-¬»³ This syslem is iecommended by lhe
¡nleinalional Iedeialion of !!G Socielies. |Iiom H. H. 1aspei, The len
lwenly elecliode syslem of lhe ¡nleinalional Iedeialion in !leclioencepha-
logiaphy and Clinical Neuiophysiology.`` ÛÛÙ Ö±«®²¿´, 1958, 1O (Appendix),
371375.j
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïéë
measuies lhe difffeience belween one elecliode and a iefeience elecliode,
such as on lhe eai. ¡n lhe aveiage iefeience monlage, each channel measuies
lhe diffeience belween one elecliode and lhe aveiage of all olhei elecliodes.
¡n lhe Laplacian monlage, each channel measuies lhe diffeience belween one
elecliode and a weighled aveiage of lhe suiiounding elecliodes. The diffei-
enlial amplinei iequiies a sepaiale giound elecliode plus diffeienlial inpuls lo
lhe elecliode conneclions. The advanlage of using a diffeienlial iecoiding
belween closely spaced elecliodes (belween successive paiis in lhe slandaid
syslem, foi example) is cancellalion of fai-neld aclivily common lo bolh
elecliodes; one lheieby oblains shaip localizalion of lhe iesponse. Allhough
lhe same elecliic evenls aie iecoided in each of lhe ways, lhey appeai in a
diffeienl foimal in each case. The polenlial changes lhal occui aie amplined by
high-gain, diffeienlial, capacilively coupled amplineis. The oulpul signals aie
iecoided and displayed.
¡n lhe iouline iecoiding of clinical !!Gs, lhe inpul elecliodes aie a
pioblem. They musl be small, lhey musl be easily afnxed lo lhe scalp wilh
minimal disluibance of lhe haii, lhey musl cause no discomfoil, and lhey musl
iemain in place foi exlended peiiods of lime. Technicians piepaie lhe suiface
of lhe scalp, degiease lhe iecoiding aiea by cleaning il wilh alcohol, apply a
conducling pasle, and glue nonpolaiizable Ag/AgCl elecliodes lo lhe scalp
wilh a glue (collodion) and hold lhem in place wilh iubbei sliaps, oi use a
iubbei cap lhal conlains all elecliodes.
The !!Gis usually iecoided wilh lhe sub|ecl awake bul iesling iecumbenl
on a bed wilh eyes closed. Wilh lhe palienl ielaxed in such a mannei, ailifacls
fiom elecliode-lead movemenl aie signincanlly ieduced, as aie conlaminaling
signals fiom lhe scalp. Muscle aclivily fiom lhe face, neck, eais, and so on is
peihaps lhe mosl sublle conlaminanl of !!G iecoids in lhe iecoiding of bolh
sponlaneous ongoing aclivily in lhe biain and aclivily evoked by a sensoiy
slimulus (»ª±µ»¼ ®»-°±²-»). Ioi example, lhe fiequency speclium of lhe neld
pioduced by mildly conliacled facial muscles conlains fiequency componenls
well wilhin lhe nominal !!G iange (O.5 lo 1OO Hz). Aflei lechnicians have
achieved iesling, quiescenl condilions in lhe noimal adull sub|ecl, lhe sub|ecl`s
scalp iecoidings show a dominanl alpha ihylhm in lhe paiielal-occipilal aieas,
wheieas in lhe fionlal aieas, lheie is a low-amplilude, highei-fiequency bela
ihylhm in addilion lo lhe alpha ihylhm. ¡n lhe noimal sub|ecl lheie is
symmeliy belween lhe iecoidings of lhe iighl and lefl hemispheies. Theie
can be a wide iange of !!G measuiemenl ailifacls.
¡n geneial lheie is a ielalionship belween lhe degiee of ceiebial aclivily
and lhe aveiage fiequency of lhe !!G ihylhm: The fiequency incieases
piogiessively wilh highei and highei degiees of aclivily. Ioi example, della
waves aie fiequenlly found in slupoi, suigical aneslhesia, and sleep; lhela
waves in infanls; alpha waves duiing ielaxed slales; and bela waves duiing
inlense menlal aclivily. Howevei, duiing peiiods of menlal aclivily, lhe waves
usually become asynchionous ialhei lhan synchionous, so lhal lhe magnilude
of lhe summed suiface polenlial iecoiding decieases despile incieased coilical
aclivily.
ïéê ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
ÍÔÛÛÐ ÐßÌÌÛÎÒÍ
When an individual in a ielaxed, inallenlive slale becomes diowsy and falls
asleep, lhe alpha ihylhm is ieplaced by slowei, laigei waves (Iiguie 4.29). ¡n
deep sleep, veiy laige, somewhal iiiegulai della waves aie obseived. ¡nlei-
speised wilh lhese waves‰duiing modeialely deep sleep‰aie buisls of alpha-
like aclivily called -´»»° -°·²¼´»-. The alpha ihylhm and lhe palleins of lhe
diowsy and sleeping sub|ecl aie -§²½¸®±²·¦»¼, in conliasl wilh lhe low-vollage
¼»-§²½¸®±²·¦»¼, iiiegulai aclivily seen in lhe sub|ecl who is in an aleil slale.
The high-amplilude, slowwaves seen in lhe !!Gof a sub|ecl who is asleep
aie somelimes ieplaced by iapid, low-vollage iiiegulai aclivily iesembling lhal
oblained in aleil sub|ecls. Howevei, lhe sleep of a sub|ecl wilh lhis iiiegulai
pallein is nol inleiiupled; in facl, lhe lhieshold foi aiousal by sensoiy slimuli is
elevaled. This condilion has lheiefoie come lo be called °¿®¿¼±¨·½¿´ -´»»°.
Duiing paiadoxical sleep, lhe sub|ecl exhibils iapid, ioving eye movemenls.
Ioi lhis ieason, il is also called ®¿°·¼ó»§»ó³±ª»³»²¬ sleep, oi R!M sleep.
Conveisely, -°·²¼´» oi synchionized sleep is fiequenlly called ²±²®¿°·¼ó»§»ó
³±ª»³»²¬ (NR!M), oi slow-wave sleep. Human sub|ecls aioused al a lime
when lheii !!G exhibils a paiadoxical (R!M) sleep pallein geneially iepoil
Ú·¹«®» ìòîç ̸» »´»½¬®±»²½»°¸¿´±¹®¿°¸·½ ½¸¿²¹»- ¬¸¿¬ ±½½«® ¿- ¿ ¸«³¿² -«¾¶»½¬
¹±»- ¬± -´»»° The calibialion maiks on lhe iighl iepiesenl 5O ³\. (Iiom H.
H. 1aspei, !lecliocephalogiaphy.`` ¡n Û°·´»°-§ ¿²¼ Ý»®»¾®¿´ Ô±½¿´·¦¿¬·±², W.
G. Penneld and T. C. !iickson (eds.). Spiingneld, ¡L: Chailes C. Thomas,
1941.)
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïéé
lhal lhey weie dieaming, wheieas individuals wakened fiom spindle sleep do
nol. This obseivalion and olhei evidence indicale lhal R!M sleep and
dieaming aie closely associaled. ¡l is inleiesling lhal duiing R!M sleep, lheie
is a maiked ieduclion in muscle lone, despile lhe iapid eye movemenls.
ÌØÛ ÊÑÔËÓÛóÝÑÒÜËÝÌÑÎ ÐÎÑÞÔÛÓ ×Ò
ÛÔÛÝÌÎÑÛÒÝÛÐØßÔÑÝÎßÐØÇ
Geomeliically speaking, lhe biain appioximales a spheie suiiounded by
concenliic shells lhal diffei in impedance and compiise lhe ³»²·²¹»- (connec-
live lissue coveiings of lhe biain), ceiebial spinal ûuid, skull, and scalp. This
model is inaccuiale lo lhe exlenl lhal lhe biain is nol ieally a liue spheie, and
ils coveiings aie iiiegulai in shape and lhickness. Such iiiegulaiilies aie
insignincanl foi lhe uppei half of lhe biain, bul complicalions aie inlioduced
by lhe maiked depailuie of lhe lowei pails of lhe biain fioma spheiical shape,
as well as by vaiialions in impedance pioduced by lhe openings (lo lhe spinal
column) lhiough lhe base of lhe shell. \aiious ceiebial sliucluies diffei
somewhal in specinc iesislivily. Resislivily also vaiies in ielalion lo lhe
piedominanl diieclion of lhe nbeis wilhin lhe while mallei. Thus lhe biain
is neilhei a homogeneous noi an isoliopic conducling medium.
¡n piaclice, neuiological geneialois do nol coiiespond piecisely lo simple,
one-dimensional dipoles. Any souice of aclivily laige enough lo manifesl ilself
in lhe !!G conslilules al leasl a small aiea of lhe coilex conlaining synchio-
nously aclive neuions. This souice may be iegaided as a lhiee-dimensional
sheel polaiized acioss ils lhickness. ¡f il is small enough, il may slill be
convenienlly iepiesenled as an equivalenl dipole pei unil volume. A laigei
aiea of lhe coilex may be cuived, oi even convoluled, and lhe equivalenl
dipole lhen becomes a complex vecloi sum of lhe whole. When lheie aie many
widely scalleied aclive-cuiienl geneialois, an innnile numbei of combinalions
may give iise lo lhe same pallein of suiface polenlials.
Deleimining lhe equivalenl dipole of ceiebial aclivily is lheiefoie of
piaclical value only when !!G souices aie highly focal.`` Ioilunalely, lhis
condilion occuis fiequenlly in lhe biain`s iesponse lo sensoiy slimulalion, as
well as in palhological condilions. Ioi example, Nunez (1981) consideis in
some deplh lhe sub|ecl of lhe calculalion of neld polenlials fiom equivalenl
cuiienl souices in inhomogeneous media. Pailiculaily in Chaplei of his book,
Nunez piovides an inlioduclion lo lhe equivalenl souice models lhal have
been used in lhe neld of lheoielical eleclioencephalogiaphy lo inleipiel scalp
polenlials. !xamples of lhese models include lhe simple dipole al lhe cenlei of
a spheiical conducling medium, lhe ®¿¼·¿´´§ ±®·»²¬»¼ dipole nol al lhe cenlei of
a spheie (lhe iadially oiienled eccenliic dipole), lhe fieely oiienled eccenliic
dipole in a spheie, lhe dipole in a lhiee-concenliic spheiical shell model, and a
dipole cuiienl souice below a mullilayeied planai conducling medium.
Consideiable inleiesl has aiisen in deleimining lhe localion of inlia-
ceiebial souices of lhe polenlials lhal aie measuied on lhe scalp. ¡n geneial,
nonuniqueness of lhis ·²ª»®-» pioblem is well known in lhal diffeienl
ïéè ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
connguialions of souices can lead lo lhe same suiface disliibulion. The usual
appioach laken lo oblaining an appioximale solulion lo lhe inveise pioblem is
as follows:
ïò Assume a model (such as lhe eccenliically localed dipole in a unifoim,
homogeneous spheiical conducling medium. Assume lhal lhe elecliic
neld is quasislalic).
îò Aflei oblaining a solulion lo lhe associaled boundaiy-value pioblem (lhe
foiwaid pioblem), pioduce model-geneialed polenlial values al measuie-
menl poinls on lhe coilical suiface.
íò Compaie lhese lheoielical polenlial values wilh pailiculai disciele-lime
values of !!G wavefoims measuied al lhe same suiface siles, and foim a
geneial leasl-squaies ieconsliuclion eiioi funclion wheiein lhe eiioi is
denned as lhe diffeience belween piedicled and measuied polenlial al
seveial selecled coilical measuiemenl siles.
ìò ¡leialively ad|usl lhe !!G dipolai souice paiameleis al each disciele-
lime inslanl lo oblain lhe besl nl lo sampled !!G wavefoims in a leasl-
squaies sense. The oplimal dipole localion is assumed lo be lhe dipole
localion oblained when lhe ieconsliuclion eiioi funclion is so minimized.
The inûuence of anisoliopy on vaiious !!G phenomena has been sludied
using models |Hendeison »¬ ¿´. (1975); Cufnn (1991); Haueisen »¬ ¿´. (2OO2)j.
These invesligalions, logelhei wilh vaiious ·² ª·ª± sludies, subslanlially agiee
lhal lhe piesence of lissue anisoliopy lends lo allenuale and smeai lhe pallein
of scalp-iecoided !!Gs. Howevei, lhis lype of amplilude-ielaled degiadalion
appaienlly does nol affecl lhe model`s abilily lo piedicl lhe locus of lhe !!G
equivalenl-dipole geneialoi (allhough lhe dipole momenl mighl be undei-
eslimaled). This is impoilanl in lhe sense lhal one of lhe ma|oi ob|eclives of
eleclioencephalogiaphy is deleiminalion of souice localion‰foi localized oi
focal aclivily‰because in case of evoked coilical polenlials and deep-biain
palhologies, lhis concepl of an equivalenl-dipole geneialoi is of clinical value.
ÌØÛ ßÞÒÑÎÓßÔ ÛÛÙ
One of lhe moie impoilanl clinical uses of lhe !!G is in lhe diagnosis of
diffeienl lypes of epilepsy and in lhe localion of lhe focus in lhe biain causing
lhe epilepsy. !pilepsy is chaiacleiized by unconliolled excessive aclivily by
eilhei a pail oi all of lhe CNS. A peison piedisposed lo epilepsy has allacks
when lhe basal level of excilabilily of all oi pail of lhe neivous syslem iises
above a ceilain ciilical lhieshold. Howevei, as long as lhe degiee of excilabilily
is held below lhis lhieshold, no allack occuis.
Theie aie lwo basic lypes of epilepsy, ¹»²»®¿´·¦»¼ »°·´»°-§ and °¿®¬·¿´
»°·´»°-§. Geneialized epilepsy involves lhe enliie biain al once, wheieas
pailial epilepsy involves a poilion of lhe biain‰somelimes only a minule
focal spol and al olhei limes a faii amounl of lhe biain. Geneialized epilepsy is
fuilhei divided inlo ¹®¿²¼ ³¿´ and °»¬·¬ ³¿´ epilepsy.
ì ò è Ì Ø Û Û Ô Û Ý Ì Î Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïéç
Giand mal epilepsy is chaiacleiized by exlieme dischaiges of neuions
oiiginaling in lhe biainslem poilion of lhe RAS. These dischaiges lhen spiead
lhioughoul lhe coilex, lo lhe deepei pails of lhe biain, and even lo lhe spinal
coid lo cause geneialized lonic convulsions of lhe enliie body. They aie
followedneai lhe end of lhe allackby alleinaling musculai conliaclions, called
½´±²·½ ½±²ª«´-·±²-. The giand mal seizuie lasls fioma fewseconds lo as long as
3 lo 4 min and is chaiacleiized by poslseizuie depiession of lhe enliie neivous
syslem. The sub|ecl may iemain in a slupoi foi 1 min lo as long as a day oi moie
aflei lhe allack is ovei.
The middle iecoiding in Iiguie 4.27(c) shows a lypical !!G duiing a
giand mal allack. This iesponse can be iecoided fiomalmosl any iegion of lhe
coilex. The iecoided polenlial is of a high magnilude, and lhe iesponse is
synchionous, wilh lhe same peiiodicily as noimal alpha waves. The same lype
of dischaige occuis on bolh sides of lhe biain al lhe same lime, indicaling lhal
lhe oiigin of lhe abnoimalily is in lhe lowei cenleis of lhe biain lhal conliol lhe
aclivily of lhe ceiebial coilex, nol in lhe coilex ilself. !lecliical iecoidings
fiom lhe lhalamus and ieliculai foimalion of expeiimenlal animals duiing an
induced giand mal allack indicale lypical high-vollage synchionous aclivily in
lhese aieas, similai lo lhal iecoided fiom lhe ceiebial coilex. !xpeiimenls on
animals have fuilhei shown lhal a giand mal allack is caused by inliinsic
hypeiexcilabilily of lhe neuions lhal make up lhe RAS sliucluies oi by some
abnoimalily of lhe local neuial palhways of lhis syslem.
Pelil mal epilepsy is closely allied lo giand mal epilepsy. ¡l occuis in lwo
foims, lhe ³§±½´±²·½ foim and lhe ¿¾-»²½» foim. ¡n lhe myoclonic foim, a
buisl of neuional dischaiges, lasling a fiaclion of a second, occuis lhioughoul
lhe neivous syslem. These dischaiges aie similai lo lhose lhal occui al lhe
beginning of a giand mal allack. The peison exhibils a single violenl musculai
|eik involving aims oi head. The enliie piocess slops immedialely, howevei,
and lhe allack is ovei befoie lhe sub|ecl loses consciousness oi slops whal he oi
she is doing. This lype of allack oflen becomes piogiessively moie seveie unlil
lhe sub|ecl expeiiences a giand mal allack. Thus lhe myoclonic foim of pelil
mal is similai lo a giand mal allack, excepl lhal some foim of inhibiloiy
inûuence piomplly slops il.
The absence lype of pelil mal epilepsy is chaiacleiized by 5 lo 2O s of
unconsciousness, duiing which lhe sub|ecl has seveial lwilchlike conliaclions
of lhe muscles, usually in lhe head iegion. Theie is a pionounced blinking of
lhe eyes, followed by a ieluin lo consciousness and conlinualion of pievious
aclivilies. This lype of epilepsy is also closely allied lo giand mal epilepsy. ¡n
iaie inslances, il can iniliale a giand mal allack.
Iiguie 4.27(c) shows a lypical -°·µ»ó¿²¼ó¼±³» pallein lhal is iecoided
duiing lhe absence lype of pelil mal epilepsy. The spike poilion of lhe iecoid is
almosl idenlical lo lhe spikes occuiiing in giand mal epilepsy, bul lhe dome
poilion is dislinclly diffeienl. The spike-and-dome pallein can be iecoided
ovei lhe enliie coilex, illuslialing again lhal lhe seizuie oiiginales in lhe RAS.
Pailial epilepsy can involve almosl any pail of lhe biain, eilhei localized
iegions of lhe ceiebial coilex oi deepei sliucluies of bolh lhe ceiebium and
ïèð ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
biainslem. Pailial epilepsy almosl always iesulls fiom some oiganic lesion of
lhe biain, such as a scai lhal pulls on lhe neuional lissue, a lumoi lhal
compiesses an aiea of lhe biain, oi a deslioyed iegion of lhe biain lissue.
Lesions such as lhese can cause local neuions lo nie veiy iapid dischaiges.
When lhe iale exceeds appioximalely 1OOO/s, synchionous waves begin
spieading ovei ad|acenl coilical iegions. These waves piesumably iesull
fiom lhe aclivily of localized ieveibeialing neuional ciicuils lhal giadually
ieciuil ad|acenl aieas of lhe coilex inlo lhe dischaige,`` oi niing, zone. The
piocess spieads lo ad|acenl aieas al iales as slow as a few millimeleis pei
minule lo as fasl as seveial cenlimeleis pei minule. When such a wave of
excilalion spieads ovei lhe moloi coilex, il causes a piogiessive maich`` of
musculai conliaclions lhioughoul lhe opposile side of lhe body, beginning
peihaps in lhe leg iegion and maiching piogiessively upwaid lo lhe head
iegion, oi al olhei limes maiching in lhe opposile diieclion. This is called
Ö¿½µ-±²·¿² »°·´»°-§ oi Ö¿½µ-±²·¿² ³¿®½¸.
Anolhei lype of pailial epilepsy is lhe so-called °-§½¸±³±¬±® -»·¦«®»,
which may cause (1) a shoil peiiod of amnesia, (2) an allack of abnoimal iage,
(3) sudden anxiely oi feai, (4) a momenl of incoheienl speech oi mumbling, oi
(5) a moloi acl of iubbing lhe face wilh lhe hand, allacking someone, and so
foilh. Somelimes lhe peison does nol iemembei his oi hei aclivilies duiing lhe
allack; al olhei limes lhe peison is complelely awaie of, bul unable lo conliol,
his oi hei behavioi. The bollom liacing of Iiguie 4.27(c) iepiesenls a lypical
!!Gduiing a psychomoloi seizuie showing a low-fiequency ieclangulai-wave
iesponse wilh a fiequency belween 2 and4 Hz wilh supeiimposed 14 Hz waves.
The !!G fiequenlly can be used lo locale lumois and also abnoimal
spiking waves oiiginaling in diseased biain lissue lhal mighl piedispose lo
epileplic allacks. Once such a focal poinl is found, suigical excision of lhe focus
oflen pievenls fuluie epileplic seizuies.
The !!G is also used lo moniloi lhe deplh of aneslhesia.
The !!G is also used as a biaincompulei inleiface lo enable disabled
peisons lo communicale wilh a compulei.
ìòç ÌØÛ ÓßÙÒÛÌÑÛÒÝÛÐØßÔÑÙÎßÓ
Aclive bioelecliic souices in lhe biain geneiale magnelic as well as elecliic
nelds. Howevei, lhe magnilude of lhe magnelic neld associaled wilh aclive
coilex is exliemely low. Ioi example, il is eslimaled lhal lhe magnelic neld of
lhe alpha wave is appioximalely O.1 pTal a dislance of 5 cmfiomlhe suiface of
lhe scalp. By way of compaiison, lhis biomagnelic neld associaled wilh lhe
magneloencephalogiam (M!G) is ioughly one hundied million limes weakei
lhan lhe magnelic neld of lhe eailh ( 5O ³T). Recenl lechnological advances
in lhe sludy of supeiconduclivily have made measuiemenl of lhese exliemely
low-slienglh magnelic nelds possible. Specincally, lhe supeiconducling quan-
lum inleifeience device (SÇ\¡D) magnelomelei, which is based on a
ì ò ç Ì Ø Û Ó ß Ù Ò Û Ì Ñ Û Ò Ý Û Ð Ø ß Ô Ñ Ù Î ß Ó ïèï
supeiconducling effecl al liquid helium lempeialuie, has sensilivily on lhe
oidei of O.O1 pT. Backgiound nelds such as lhe eailh`s magnelic neld and
uiban magnelic noise nelds ( 1O lo 1OO nT) can be iemoved foi all piaclical
puiposes by using a giadiomelei lechnique.
\sing lhe M!G offeis a numbei of advanlages: (1) The biain and ovei-
lying lissues can be chaiacleiized as a single medium having a conslanl
magnelic peimeabilily ³. Theiefoie, lhe magnelic neld (unlike lhe elecliic
neld) is nol inûuenced by lhe shell-like anisoliopic inhomogeneilies (menin-
ges, ûuid layeis, skull, muscle layei, and scalp) suiiounding lhe biain. (2) The
measuiemenl is indiiecl in lhal elecliodes aie nol necessaiy lo iecoid lhe
M!G. Thal is, lhe SÇ\¡D delecloi does nol need lo louch lhe scalp, because
lhe magnelic neld does nol disappeai in aii.
The magnelic vecloi polenlial ß has lhe same oiienlalion as lhe equiv-
alenl cuiienl dipole iepiesenling an aclive iegion of lhe biain. Ioi a deiivalion
of lhe vecloi polenlial in leims of lhe volume cuiienl densily Ö, see Plonsey
(1969). Because lhe magnelic neld lies peipendiculai lo lhe vecloi polenlial,
iadially oiienled cuiienl dipoles pioduce magnelic nelds lhal aie oiienled
langenlially lo lhe spheie iepiesenling lhe head. Similaily, langenlially oii-
enled biain dipoles pioduce iadially oiienled magnelic nelds.
The local lime dependence of biomagnelic nelds can be iecoided failhfully
wilh SÇ\¡D deleclion syslems, bul in oidei lo measuie lhe neld disliibulion
ovei lhe suiface of lhe scalp, measuiemenls musl be made al many localions.
This is a lime-consuming piocess. Supeiconducling quanlum inleifeience
device (SÇ\¡D) magnelomelei vendois have syslems wilh well ovei 1OO
channels (Wiksow, 1995). Advances in maleiial fabiicalion lechniques in lhe
neld of supeiconduclivily should yield smallei delecloi coils foi bellei spalial
iesolulion and, subsequenlly, moie piecise localizalion of inliaceiebial soui-
ces of aclivily.
ÐÎÑÞÔÛÓÍ
ìòï ɸ¿¬ ¿®» ¬¸» º±«® ³¿·² º¿½¬±®- ·²ª±´ª»¼ ·² ¬¸» ³±ª»³»²¬ ±º ·±²- ¿½®±-- ¬¸»
½»´´ ³»³¾®¿²» ·² ¬¸» -¬»¿¼§ó-¬¿¬» ½±²¼·¬·±²á
ìòî ß--«³» ¬¸¿¬ ´·º» ±² Ó¿®- ®»¯«·®»- ¿² ·²¬»®·±® ½»´´ °±¬»²¬·¿´ ±º ïðð ³Ê
¿²¼ ¬¸¿¬ ¬¸» »¨¬®¿½»´´«´¿® ½±²½»²¬®¿¬·±²- ±º ¬¸» ¬¸®»» ³¿¶±® -°»½·»- ¿®» ¿- ¹·ª»²
·² Û¨¿³°´» ìòïò ݸ±±-» ±²» species lhal has lhe peimeabilily coefncienl given,
and assume lhe olhei lwo peimeabililies aie zeio. Design lhe cell by calculal-
ing lhe inliacellulai concenlialion of lhe chosen species.
ìòí ß² »¨½·¬¿¾´» ½»´´ ·- ·³°¿´»¼ ¾§ ¿ ³·½®±°·°»¬¬»ô ¿²¼ ¿ -»½±²¼ »¨¬®¿½»´´«´¿®
»´»½¬®±¼» ·- °´¿½»¼ ½´±-» ¾§ ¿¬ ¬¸» ±«¬»®ó³»³¾®¿²» -«®º¿½»ò Þ®·»º °«´-»- ±º
½«®®»²¬ ¿®» ¬¸»² °¿--»¼ ¾»¬©»»² ¬¸»-» »´»½¬®±¼»-ô ©¸·½¸ ³¿§ ½¿«-» ·¬ ¬±
½±²¼«½¬ ¿² ¿½¬·±² °±¬»²¬·¿´ò Û¨°´¿·² ¸±© ¬¸» °±´¿®·¬§ ±º ¬¸» -¬·³«´¿¬·²¹ °¿·®
·²Œ«»²½»- ¬¸» ³»³¾®¿²» °±¬»²¬·¿´ô ¿²¼ -«¾-»¯«»²¬´§ ¬¸» ¿½¬·ª·¬§ô ±º ¬¸»
»¨½·¬¿¾´» ½»´´ò
ïèî ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
ìòì Û¨°´¿·² ¬¸» -«¾¬¸®»-¸±´¼ó³»³¾®¿²» °±¬»²¬·¿´ ½¸¿²¹»- ¬¸¿¬ ©±«´¼ ±½½«® ·²
¬¸» ·³³»¼·¿¬» ª·½·²·¬§ ±º »¿½¸ ±º ¬©± »¨¬®¿½»´´«´¿® -¬·³«´¿¬·²¹ »´»½¬®±¼»- °´¿½»¼
¿¬ ¬¸» ±«¬»®ó³»³¾®¿²» -«®º¿½» ±º ¿² »¨½·¬¿¾´» ½»´´ò øÍ»» Ú·¹«®» Ðìòïò÷ ß--«³»
¬¸¿¬ ³»³¾®¿²» °±¬»²¬·¿´ ·- ¼»¬»®³·²»¼ ¾§ ·³°¿´·²¹ ¬¸» ½»´´ ©·¬¸ ¿ ³·½®±°·°»¬¬»
¿¬ ª¿®·±«- °±·²¬- ·² ¬¸» ª·½·²·¬§ ±º ¬¸» -¬·³«´¿¬·²¹ »´»½¬®±¼»- ¿²¼ ®»½±®¼·²¹ ¬¸»
°±¬»²¬·¿´ ©·¬¸ ®»-°»½¬ ¬± ¿² ·²¼·ºº»®»²¬ »¨¬®¿½»´´«´¿® »´»½¬®±¼»ò
ìòë ׺ ¿ -¬·³«´«- ±º ¿¼»¯«¿¬» -¬®»²¹¬¸ ·- -«°°´·»¼ ¬± ¬¸» -¬·³«´¿¬·²¹ °¿·® ±º
Ю±¾´»³ ìòìô ¿² ¿½¬·±² °±¬»²¬·¿´ ·- ¹»²»®¿¬»¼ò Û¨°´¿·² ¾§ ³»¿²- ±º ¬¸» ½±²½»°¬
±º ‘‘´±½¿´ó½·®½«·¬•• ½«®®»²¬ Œ±©¸±©¬¸» ¿½¬·±²°±¬»²¬·¿´ ·- ¿¾´» ¬± °®±°¿¹¿¬» ·² ¿²
«²¿¬¬»²«¿¬»¼ º¿-¸·±² ¼±©² ¬¸» •¾»® ¿²¼ ¿©¿§ º®±³ ¬¸» -·¬» ±º -¬·³«´¿¬·±²ò
ìòê ׺ ¿² »´±²¹¿¬»¼ •¾»® ·- -¬·³«´¿¬»¼ ·² ¬¸» ³·¼¼´» ø¿- ±°°±-»¼ ¬± ¿¬ »·¬¸»®
»²¼÷ô ·- ¿² ¿½¬·±² °±¬»²¬·¿´ °®±°¿¹¿¬»¼ ·² ¾±¬¸ ¼·®»½¬·±²- ¿´±²¹ ¬¸» •¾»®á ׺ -±ô
©±«´¼ §±« »¨°»½¬ ¿²§ ¼·ºº»®»²½»- ·² ¬¸» ¿½¬·±²ó°±¬»²¬·¿´ ®»-°±²-» ³»¿-«®»¼ ¿¬
»¯«¿´ ¼·-¬¿²½»- ±² »·¬¸»® -·¼» ±º ¬¸» -¬·³«´¿¬·±² -·¬»á
ìòé Ü»•²» ¬¸» º±´´±©·²¹ ¬»®³-æ ø¿÷ ¿¾-±´«¬» ®»º®¿½¬±®§ °»®·±¼ô ø¾÷ ®»´¿¬·ª»
®»º®¿½¬±®§ °»®·±¼ô ø½÷ ½±³°±«²¼ ²»®ª»ó¿½¬·±² °±¬»²¬·¿´ô ø¼÷ -§²¿°-»ô ø»÷ ²»«®±ó
³§± ¶«²½¬·±²ô øº÷ ³±¬±® «²·¬ô ø¹÷ ®»Œ»¨ ¿®½ò
ìòè ß² »¨½·-»¼ô ¿½¬·ª» ²»®ª» ¬®«²µ -»®ª»- ¿- ¿ ¾·±»´»½¬®·½ -±«®½» ´±½¿¬»¼ ±² ¬¸»
¿¨·- ±º ¿ ½·®½«´¿® ½§´·²¼®·½¿´ ª±´«³» ½±²¼«½¬±®ò Ú·»´¼ °±¬»²¬·¿´- ¿®» ®»½±®¼»¼ ¿¬
ª¿®·±«- ®¿¼·¿´ ¼·-¬¿²½»- º®±³ ¬¸» ²»®ª» ¬®«²µ º®±³ ¿² ¿°°®±°®·¿¬» »´»½¬®±¼»
¿--»³¾´§ ½±²²»½¬»¼ ¬± ¿² ¿³°´·•»®ò ø¿÷ Ü»-½®·¾» ¬¸» ¾»¸¿ª·±® ±º ¬¸» •»´¼ °±¬»²¬·¿´
©·¬¸ ·²½®»¿-·²¹ ®¿¼·¿´ ¼·-¬¿²½» º®±³ ¬¸» ²»®ª» ø¿²¹´» ¿²¼ ¿¨·¿´ ¼·-¬¿²½» ¿®» •¨»¼÷ò
ø¾÷ Ü»-½®·¾» ¬¸» »ºº»½¬ ±º ·²½®»¿-·²¹ ¬¸» -°»½·•½ ®»-·-¬·ª·¬§ ® of lhe balhing medium
on lhe magnilude of lhe neldpolenlial, and explainhowlhis change in ® mighl be
accomplished expeiimenlally. (c) ¡n whal mannei would changing lhe iadius of
lhe suiiounding volume-conducloi affecl lhe magnilude and waveshape of lhe
exliacellulai neld polenlial? (d) When can a volume conducloi of nnile dimen-
sions be consideied an essenlially innnile`` volume conducloi?
ìòç ̸» »¨°»®·³»²¬¿´ -·¬«¿¬·±² °±-»¼ ·² Ю±¾´»³ ìòè ·- ®±«¹¸´§ ¿²¿´±¹±«- ¬±
¬¸» °®±¾´»³±º ®»½±®¼·²¹ »·¬¸»® -«®º¿½» ±® ·²¬®¿³«-½«´¿® °±¬»²¬·¿´- º®±³¬¸» ¿®³
±º ¿ ¸«³¿² -«¾¶»½¬ ©¸±-» «´²¿® ±® ³»¼·¿² ²»®ª» ¸¿- ¾»»² -¬·³«´¿¬»¼ ø-»» Ú·¹«®»
ìòèô º±® ·²-¬¿²½»÷ò Û¨°´¿·² ·² ¬»®³- ±º ½¸¿²¹»- ·² -°»½·•½ ®»-·-¬·ª·¬§ ¿²¼ ¹»±³»¬®§
©¸§ °±¬»²¬·¿´ ©¿ª»º±®³- ®»½±®¼»¼ ¿¬ ¬¸» ©®·-¬ ³¿§ ¼·ºº»® ½±²-·¼»®¿¾´§ º®±³
¬¸±-» ®»½±®¼»¼ ¿¬ ¬¸» ´»ª»´ ±º ¬¸» º±®»¿®³ ø-»» Ú·¹«®» ìòè÷ò
ìòïð Ü»•²» ¬¸» Ó ©¿ª» ¿²¼ ¬¸» Ø ®»Œ»¨ò
ìòïï ײ ³¿²§ º±®³- ±º °»®·°¸»®¿´ ²»«®±°¿¬¸·»-ô ¬¸» »¨½·¬¿¾·´·¬§ ±º -±³»
²»«®±²- ·- ½¸¿²¹»¼ô ¿²¼ ¬¸»·® ½±²¼«½¬·±² ª»´±½·¬·»- ¿®» ½±²-»¯«»²¬´§ ¿´¬»®»¼ò
Ú·¹«®» Ðìòï
Ð Î Ñ Þ Ô Û Ó Í ïèí
Ü»-½®·¾» ¬¸» »ºº»½¬ ¬¸¿¬ ¬¸·- ³·¹¸¬ ¸¿ª» ±² ¿² ÛÓÙ ®»½±®¼·²¹ ¿²¼ ±² ³«-½«´¿®
½±²¬®¿½¬·±²ò
ìòïî ß ³«-½´» ·- °¿®¿´§¦»¼ ·º ·¬- ²»«®¿´ ½±²²»½¬·±² ¬±ô ±® ©·¬¸·²ô ¬¸» ÝÒÍ ·-
·²¬»®®«°¬»¼ò ß ¼·-½±²²»½¬·±² ¿¬ ¬¸» ´»ª»´ ±º ¬¸» ³±¬±® ²»«®±² ·- ½¿´´»¼ ¿ ´±©»®
³±¬±²»«®±² ´»-·±². A disconneclion highei in lhe spinal coid oi biain is called
an «°°»® ³±¬±²»«®±² ´»-·±². ¡n bolh cases, lhe conliaclilily of lhe peiipheial
skelelal muscle is inilially pieseived, bul aflei a peiiod of disuse, lhe muscle
aliophies. (Aliophy, howevei, is much delayed in lhe case of an uppei
moloneuion lesion.) Considei Iiguie P4.2 lo iepiesenl schemalically a
quadiiplegic palienl wilh paialyzed exliemilies as shown. Suggesl a scheme
foi using lhe !MG fiom an auxiliaiy inlacl muscle (foi example, lhe lefl
liapezius muscle) lo aid in lhe conliol of slimulalion of lhe paialyzed limb.
(The moloi neive supply lo lhe liapezius muscle is assumed lo lie above lhe
sile of spinal-coid lesion and is lheiefoie undei volilional conliol. Diaw a
block diagiam of lhe suggesled conliol syslem. Label lhe analomical sliuc-
luies seiving as lhe planl (oi conliolled syslem), lhe conliollei, lhe feedback
palhway, lhe aclualoi, and so foilh. |Ø·²¬: The !MG signal is usually
amplined, ieclined, and low-pass nlleied befoie il is used lo modulale a
slimulaloi. Ioi fuilhei inleiesling discussions of lhe woik in lhis aiea, see
\odovnik »¬ ¿´. (1981).j
ìòïí ݱ²¼«½¬ ¿ -»¿®½¸ ±º ¬¸» ´·¬»®¿¬«®» ±² ¬¸» -«¾¶»½¬ ±º ¬¸» «-» ±º »´»½¬®±ó
³§±¹®¿°¸§ ·² ¬¸» -¬«¼§ ±º ø¿÷ ¬¸» º«²½¬·±² ±º ±½«´¿® ³«-½´»- ø¬¸» ÛÓÙ §·»´¼-
ª¿´«¿¾´» ·²º±®³¿¬·±² ®»¹¿®¼·²¹ ¬¸» -§²»®¹·-¬·½ ¿½¬·±² ±º ¬¸» ¼·ºº»®»²¬ ±½«´¿®
³«-½´»-ô ¿²¼ ·¬ ·- ±º ª¿´«» ·² ¬¸» ·²¬»®°®»¬¿¬·±² ±º °¿®¿´§¬·½ -¯«·²¬÷ ¿²¼ ø¾÷
³§¿-¬¸»²·¿ ¹®¿ª·- ¿²¼ ±¬¸»® ¼·-±®¼»®- ±º ²»«®±³«-½«´¿® ¬®¿²-³·--·±²ò
ìòïì Ü»•²» ¬¸» º±´´±©·²¹ ½¿®¼·¿½ ¿²¿¬±³·½¿´ ¬»®³-æ ø¿÷ ·²¬»®²±¼¿´ ¬®¿½¬-ô
ø¾÷ -«¾»²¼±½¿®¼·¿´ ´¿§»®ô ø½÷ ·²¬»®½¿´¿¬»¼ ¼·-µô ø¼÷ ¾«²¼´» ¾®¿²½¸»-ô ø»÷ ª»²¬®·½ó
«´¿® ¿½¬·ª¿¬·±²ò
ìòïë Ü®¿© ¿ ¬§°·½¿´ ´»¿¼ ×× »´»½¬®±½¿®¼·±¹®¿³ ¿²¼ ´¿¾»´ ¿´´ ©¿ª»- øÐô ÏÎÍô Ì÷
¿²¼ ·²¬»®ª¿´-ò Û¨°´¿·² ©¸¿¬ ·- ¸¿°°»²·²¹ »´»½¬®·½¿´´§ ©·¬¸·² ¬¸» ¸»¿®¬ ¼«®·²¹
»¿½¸ ©¿ª» ±® ·²¬»®ª¿´ò
Ú·¹«®» Ðìòî
ïèì ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
ìòïê ̸» »´»½¬®·½¿´ ¿½¬·ª·¬§ ±º ¬¸» Ø·- ¾«²¼´» ²±®³¿´´§ ·- ²±¬ °®»-»²¬ ·² ¬¸»
¬§°·½¿´ ÛÝÙ ®»½±®¼»¼ ¿¬ ¬¸» ¾±¼§ -«®º¿½» ¾»½¿«-» ±º ·¬- ®»´¿¬·ª»´§ -³¿´´ ¬·--«»
³¿--ò ر©»ª»®ô ½´·²·½¿´ ®»½±®¼·²¹- ±º Ø·- ¾«²¼´» ¿½¬·ª·¬§ ½±«´¼ ¾» ±º ½±²-·¼»®ó
¿¾´» ·³°±®¬¿²½» ·² ¬¸» ¿²¿´§-·- ±º ª¿®·±«- ¼·-±®¼»®- ±º ¬¸» ½±²¼«½¬·±² -§-¬»³ò
̸» Ø·- ¾«²¼´» -·¹²¿´ ½¿² ¾» »²¸¿²½»¼ º±® -«½¸ ¿²¿´§-»- ¾§ -«½½»--·ª»´§
¿ª»®¿¹·²¹ ¬¸» -«®º¿½» »´»½¬®±½¿®¼·±¹®¿³ô ±®‰¾»¬¬»® §»¬‰¾§ «-·²¹ ¿² ·²ª¿-·ª»
¬»½¸²·¯«» ©¸»®»·² ¿ -³¿´´ ¾·°±´¿® »´»½¬®±¼» ·- ·²¬®±¼«½»¼ ·²¬± ¬¸» ®·¹¸¬ ¿¬®·¿´
½¸¿³¾»® ª·¿ ½±²ª»²¬·±²¿´ ¬»½¸²·¯«»- ±º ½¿®¼·¿½ ½¿¬¸»¬»®·¦¿¬·±²ò ݱ²¼«½¬ ¿
-»¿®½¸ ±º ¬¸» ´·¬»®¿¬«®» ±² ¬¸» ¬±°·½- ±º ²±²·²ª¿-·ª» ¿²¼ ·²ª¿-·ª» ³»¬¸±¼- ±º
®»½±®¼·²¹ Ø·- ¾«²¼´» ¿½¬·ª·¬§ ¿- ©»´´ ¿- ±² ¬¸» «-» ±º ¬¸·- -·¹²¿´ ·² ¼·¿¹²±-·²¹
ª¿®·±«- ¼·-±®¼»®- ±º ¬¸» ½±²¼«½¬·±² -§-¬»³ò
ìòïé ɸ§ ·- ·¬ ²»½»--¿®§ º±® ¬¸» ª»²¬®·½«´¿® ¿½¬·±² °±¬»²¬·¿´ ¬± ¸¿ª» ¿ ®»´¿¬·ª»´§
´±²¹ ¿¾-±´«¬» ®»º®¿½¬±®§ °»®·±¼á
ìòïè Ü®¿© ¿²¼ ´¿¾»´ ¿ ¾´±½µ ¼·¿¹®¿³ ±º ¬¸» ®»¬·²¿ ½±²-·¼»®»¼ ¿- ¿ °¸±¬±ó
»´»½¬®·½ -»²-±®ò ɸ¿¬ ·- ¬¸» ±«¬°«¬ ¿¬ ¬¸» ¹¿²¹´·±² ½»´´ ´¿§»® ¿²¼ ¿¬ ¬¸»
°¸±¬±®»½»°¬·ª» ´¿§»®á
ìòïç Û¨°´¿·² ¬¸» ½±³°±²»²¬- ±º ¬¸» ÛÎÙ ·² ¬»®³- ±º ®»¬·²¿´ ½»´´ ¿½¬·ª·¬§ò
ìòîð Ü·-½«--ô ·² ¬»®³- ±º ª±´«³»ó½±²¼«½¬±® ¬¸»±®§ô ¬¸» °®±¼«½¬·±² ±º ¿² ÛÎÙ
-·¹²¿´ ¿¬ ¿ °±·²¬ ±² ¬¸» ½±®²»¿´ -«®º¿½» ±º ¬¸» »§» ©¸»² ¬¸» ®»¬·²¿´ ¾·±»´»½¬®·½
-±«®½» ·- ½±²-·¼»®»¼ ¿² ¿®®¿§ ±º ½«®®»²¬ ¼·°±´» -±«®½»- °»® «²·¬ ª±´«³»ò
ݱ²-·¼»® ¬¸» °±--·¾·´·¬§ ±º ø»¨°»®·³»²¬¿´´§÷ »¨½·¬·²¹ »¿½¸ ±º ¬¸» »´»³»²¬- ±º
®»¬·²¿´ ¼·°±´» ¿®®¿§ ·²¼·ª·¼«¿´´§ô ±²» ¿¬ ¿ ¬·³»ô ¾§ ¿°°´§·²¹ ¿ ´±½¿´·¦»¼ -°±¬ ±º
´·¹¸¬ -«°»®·³°±-»¼ ±² ¿ ¾¿½µ¹®±«²¼ ·´´«³·²¿¬·±² ¬¸¿¬ °¿®¬·¿´´§ ¿¼¿°¬- ¬¸»
®»¬·²¿ò ɸ¿¬ -°»½·¿´ ¬»½¸²·½¿´ ½±²-·¼»®¿¬·±²- ¿®» ·²ª±´ª»¼á
ìòîï Ü·-½«-- ¬¸» «-» ±º ¬¸» -¬»¿¼§ ½±®²»¿´›®»¬·²¿´ °±¬»²¬·¿´ ±º ¬¸» »§» ¬±
³»¿-«®» »§» ³±ª»³»²¬-ò ر© ¿½½«®¿¬» ·- ¬¸·- ¬»½¸²·¯«»á Ü·-½«-- ¿¬ ´»¿-¬ ¬©±
¿°°´·½¿¬·±²- ±º ¬¸·- ³»¬¸±¼ò
ìòîî Û¨°´¿·² ¬¸» º«²½¬·±²¿´ ®±´» °´¿§»¼ ¾§ ¬¸» º±´´±©·²¹ ÝÒÍ -¬®«½¬«®»-ò
¿ò The ascending palhways of lhe geneial sensoiy-neive nbeis and lhe
descending palhways of lhe moloi-neive nbeis
¾ò The ascending ieliculai foimalion (RAS)
½ò The pie- and poslcenlial gyii
¼ò The piimaiy audiloiy and visual coilices
»ò The specinc and nonspecinc lhalamic neuial nbeis lo lhe coilex
ìòîí λ´¿¬» ÛÛÙ󩿪» ¿½¬·ª·¬§ ®»½±®¼»¼ ¿¬ ¬¸» -«®º¿½» ±º ¬¸» ½±®¬»¨ ¬± ¬¸»
«²¼»®´§·²¹ ¿½¬·ª·¬§ ±º ½±®¬·½¿´ ²»«®±²-ò
ìòîì Ü·-½«-- ·² ¹»²»®¿´ ¬»®³- ¬¸» ¼»-·¹² ±º ¿ -°»½¬®«³ ¿²¿´§¦»® º±® ¿«¬±³¿¬·½
¿²¿´§-·- ±º ÛÛÙ ©¿ª»-ò
ìòîë ر© ³·¹¸¬ ª±´«³»ó½±²¼«½¬±® ¬¸»±®§ ¿·¼ ·² ¬¸» ¿²¿´§-·- ±º »ª±µ»¼
½±®¬·½¿´ °±¬»²¬·¿´- °®±¼«½»¼ ¾§ -°»½·•½ ®»°»¬·¬·ª» -¬·³«´· ø¿«¼·¬±®§ô ª·-«¿´ô »¬½ò÷á
ìòîê Ü»-·¹² ¬¸» -©·¬½¸»- ¿²¼ ®»-·-¬±® ²»¬©±®µ- ®»¯«·®»¼ô ¿²¼ -¸±© ¿´´ ½±²ó
²»½¬·±²- ¾»¬©»»² ¿²§ º±«® »´»½¬®±¼»- ±² ¬¸» -½¿´° øÚ·¹ò ìòîè÷ ¿²¼ ±²» ¼·ºº»®»²¬·¿´
¿³°´·•»®ô ¬± ®»½±®¼ ¬¸» ÛÛÙº±® »¿½¸ ±º ¬¸» ¬¸®»» lypes of elecliode conneclions
(monopolai, bipolai, and aveiage`` polenlial iecoidings). See lexl associaled
wilh Iiguie 4.28.
Ð Î Ñ Þ Ô Û Ó Í ïèë
ÎÛÚÛÎÛÒÝÛÍ
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ß«æ д»¿-»
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®»º»®»²½»å »´-»
¼»´»¬» ±®
½®»¿¬»
-»°¿®¿¬»
¾·¾´·±¹®¿°¸§
-»½¬·±²ò
ïèê ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
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Yoik, D. H., Review of descending moloi palhways involved wilh lianscianial slimulalion.``
Ò»«®±-«®¹»®§, 1987, 2O, 7O73.
ïèè ì Ì Ø Û Ñ Î × Ù × Ò Ñ Ú Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í
ë
Þ×ÑÐÑÌÛÒÌ×ßÔ ÛÔÛÝÌÎÑÜÛÍ
Ó·½¸¿»´ Îò Ò»«³¿²
¡n oidei lo measuie and iecoid polenlials and, hence, cuiienls in lhe body, il is
necessaiy lo piovide some inleiface belween lhe body and lhe eleclionic
measuiing appaialus. Biopolenlial elecliodes caiiy oul lhis inleiface funclion.
¡n any piaclical measuiemenl of polenlials, cuiienl ûows in lhe measuiing
ciicuil foi al leasl a fiaclion of lhe peiiod of lime ovei which lhe measuiemenl
is made. ¡deally lhis cuiienl should be veiy small. Howevei, in piaclical
silualions, il is nevei zeio. Biopolenlial elecliodes musl lheiefoie have lhe
capabilily of conducling a cuiienl acioss lhe inleiface belween lhe body and
lhe eleclionic measuiing ciicuil.
Oui nisl impiession is lhal lhis is a ialhei simple funclion lo achieve and
lhal biopolenlial elecliodes should be ielalively sliaighlfoiwaid. Bul when we
considei lhe pioblem in moie delail, we see lhal lhe elecliode aclually caiiies
oul a liansducing funclion, because in lhe body cuiienl is caiiied by ions,
wheieas in lhe elecliode and ils lead wiie il is caiiied by eleclions. Thus lhe
elecliode musl seive as a liansducei lo change an ionic cuiienl inlo an
eleclionic cuiienl. This gieally complicales elecliodes and places consliainls
on lheii opeialion. We shall biieûy examine lhe basic mechanisms involved in
lhe liansduclion piocess and shall look al how lhey affecl elecliode chaiaclei-
islics. We shall nexl examine lhe piincipal elecliical chaiacleiislics of bio-
polenlial elecliodes and discuss elecliical equivalenl ciicuils foi elecliodes
based on lhese chaiacleiislics. We shall lhen covei some of lhe diffeienl foims
lhal biopolenlial elecliodes lake in vaiious lypes of medical insliumenlalion
syslems. Iinally, we shall look al elecliodes used foi measuiing lhe !CG,
!!G, !MG, and inliacellulai polenlials.
ëòï ÌØÛ ÛÔÛÝÌÎÑÜÛŠÛÔÛÝÌÎÑÔÇÌÛ ×ÒÌÛÎÚßÝÛ
The passage of elecliic cuiienl fiom lhe body lo an elecliode can be undei-
slood by examining lhe elecliodeelecliolyle inleiface lhal is schemalically
illuslialed in Iiguie 5.1. The elecliolyle iepiesenls lhe body ûuid conlaining
ions. Anel cuiienl lhal ciosses lhe inleiface, passing fiom lhe elecliode lo lhe
elecliolyle, consisls of (1) eleclions moving in a diieclion opposile lo lhal of
ïèç
lhe cuiienl in lhe elecliode, (2) calions (denoled by Ý ) moving in lhe same
diieclion as lhe cuiienl, and (3) anions (denoled by ß ) moving in a diieclion
opposile lo lhal of lhe cuiienl in lhe elecliolyle.
Ioi chaige lo cioss lhe inleiface‰lheie aie no fiee eleclions in lhe
elecliolyle and no fiee calions oi anions in lhe elecliode‰somelhing musl
occui al lhe inleiface lhal liansfeis lhe chaige belween lhese caiiieis. Whal
aclually occui aie chemical ieaclions al lhe inleiface, which canbe iepiesenled
in geneial by lhe following ieaclions:
ÝàÝ
²
²e (5.1)
ß
³
àß ³e (5.2)
wheie ² is lhe valence of Ý and ³is lhe valence of ß. Nole lhal in (5.1) we aie
assuming lhal lhe elecliode is made up of some aloms of lhe same maleiial as
lhe calions and lhal lhis maleiial in lhe elecliode al lhe inleiface can become
oxidized lo foim a calion and one oi moie fiee eleclions. The calion is
dischaiged inlo lhe elecliolyle; lhe eleclion iemains as a chaige caiiiei in
lhe elecliode.
The ieaclion involving lhe anions is given in (5.2). ¡n lhis case an anion
coming lo lhe elecliodeelecliolyle inleiface can be oxidized lo a neulial
alom, giving off one oi moie fiee eleclions lo lhe elecliode.
Nole lhal bolh ieaclions aie oflen ieveisible and lhal ieduclion ieaclions
(going fiom iighl lo lefl in lhe equalions) can occui as well. As a mallei of facl,
when no cuiienl is ciossing lhe elecliodeelecliolyle inleiface, lhese ieaclions
oflen slill occui. Bul lhe iale of oxidalion ieaclions equals lhe iale of ieduclion
ieaclions, so lhe nel liansfei of chaige acioss lhe inleiface is zeio. When lhe
cuiienl ûow is fiom elecliode lo elecliolyle, as indicaled in Iiguie 5.1, lhe
oxidalion ieaclions dominale. When lhe cuiienl is in lhe opposile diieclion,
lhe ieduclion ieaclions dominale.
Ú·¹«®» ëòï Û´»½¬®±¼»Š»´»½¬®±´§¬»·²¬»®º¿½» The cuiienl ciosses il fiom lefl lo
iighl. The elecliode consisls of melallic aloms Ý. The elecliolyle is an aqueous
solulion conlaining calions of lhe elecliode melal Ý and anions ß .
ïçð ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
To fuilhei exploie lhe chaiacleiislics of lhe elecliodeelecliolyle inlei-
face, lel us considei whal happens when we place a piece of melal inlo a
solulion conlaining ions of lhal melal. These ions aie calions, and lhe
solulion, if il is lo mainlain neulialily of chaige, musl have an equal numbei
of anions. When lhe melal comes in conlacl wilh lhe solulion, lhe ieaclion
iepiesenled by (5.1) begins immedialely. ¡nilially, lhe ieaclion goes pie-
dominanlly eilhei lo lhe lefl oi lo lhe iighl, depending on lhe concenlialion
of calions in solulion and lhe equilibiium condilions foi lhal pailiculai
ieaclion. The local concenlialion of calions in lhe solulion al lhe inleiface
changes, which affecls lhe anion concenlialion al lhis poinl as well. The nel
iesull is lhal neulialily of chaige is nol mainlained in lhis iegion. Thus lhe
elecliolyle suiiounding lhe melal is al a diffeienl elecliic polenlial fiom lhe
iesl of lhe solulion. A polenlial diffeience known as lhe ¸¿´ºó½»´´ °±¬»²¬·¿´ is
deleimined by lhe melal involved, lhe concenlialion of ils ions in solulion,
and lhe lempeialuie, as well as olhei second-oidei faclois. Knowledge of
lhe half-cell polenlial is impoilanl foi undeislanding lhe behavioi of bio-
polenlial elecliodes.
The disliibulion of ions in lhe elecliolyle in lhe immediale vicinily of lhe
melalelecliolyle inleiface has been of gieal inleiesl lo elecliochemisls, and
seveial lheoiies have beendeveloped lo desciibe il. Geddes (1972) compaies lhe
chaiges and polenlial disliibulions foi foui of lhese lheoiies, wheieas Cobbold
(1974), ina discussionof lhe half-cell polenlial, consideis lhe Sleinmodel. Ralhei
lhan analyze lhese lheoiies heie, we shall accepl lheii geneial conclusion. Some
sepaialion of chaiges al lhe melalelecliolyle inleiface iesulls in an elecliic
double layei, wheiein one lype of chaige is dominanl on lhe suiface of lhe melal,
and lhe opposile chaige is disliibuled in excess in lhe immedialely ad|acenl
elecliolyle. This chaige disliibulion al lhe elecliodeelecliolyle inleiface can
affecl elecliode peifoimance, as we will see in Seclion 5.3.
¡l is nol possible lo measuie lhe half-cell polenlial of an elecliode
because‰unless we use a second elecliode‰we cannol piovide a conneclion
belween lhe elecliolyle and one leiminal of lhe polenlial-measuiing appaia-
lus. Because lhis second elecliode also has a half-cell polenlial, we meiely end
up measuiing lhe diffeience belween lhe half-cell polenlial of lhe melal and
lhal of lhe second elecliode. Theie would of couise be a veiy laige numbei of
combinalions of paiis of elecliodes, so labulalions of such diffeienlial half-cell
polenlials would be veiy exlensive. To avoid lhis pioblem, elecliochemisls
have adopled lhe slandaid convenlion lhal a pailiculai elecliode‰lhe hydio-
gen elecliode‰is denned as having a half-cell polenlial of zeio undei condi-
lions lhal aie achievable in lhe laboialoiy. We can lhen measuie lhe half-cell
polenlials of all olhei elecliode maleiials wilh iespecl lo lhis elecliode.
Table 5.1 lisls seveial common maleiials lhal aie used foi elecliodes and
gives lheii half-cell polenlials. Table 5.1 also gives lhe oxidalionieduclion
ieaclions lhal occui al lhe suifaces of lhese elecliodes and enable us lo aiiive
al lhe polenlials. The hydiogen elecliode is based on lhe ieaclion
H
2
à2Hà2H 2e (5.3)
ë ò ï Ì Ø Û Û Ô Û Ý Ì Î Ñ Ü Û Š Û Ô Û Ý Ì Î Ñ Ô Ç Ì Û × Ò Ì Û Î Ú ß Ý Û ïçï
wheie H
2
gas bubbled ovei a plalinum elecliode is lhe souice of hydiogen
molecules. The plalinum also seives as a calalysl foi lhe ieaclion on lhe lefl-
hand side of lhe equalion and as an acceploi of lhe geneialed eleclions.
ëòî ÐÑÔßÎ×ÆßÌ×ÑÒ
The half-cell polenlial of an elecliode is desciibed in Seclion 5.1 foi condilions
in which no elecliic cuiienl exisls belween lhe elecliode and lhe elecliolyle. ¡f,
on lhe olhei hand, lheie is a cuiienl, lhe obseived half-cell polenlial is oflen
alleied. The diffeience is due lo polaiizalion of lhe elecliode. The diffeience
belween lhe obseived half-cell polenlial and lhe equilibiiumzeio-cuiienl half-
cell polenlial is known as lhe ±ª»®°±¬»²¬·¿´ò Thiee basic mechanisms conliibule
lo lhis phenomenon, and lhe oveipolenlial can be sepaialed inlo lhiee
componenls: lhe ohmic, lhe concenlialion, and lhe aclivalion oveipolenlials.
The ±¸³·½ ±ª»®°±¬»²¬·¿´ is a diiecl iesull of lhe iesislance of lhe eleclio-
lyle. When a cuiienl passes belween lwo elecliodes immeised in an eleclio-
lyle, lheie is a vollage diop along lhe palh of lhe cuiienl in lhe elecliolyle as a
iesull of ils iesislance. This diop in vollage is piopoilional lo lhe cuiienl and
lhe iesislivily of lhe elecliolyle. The iesislance belween lhe elecliodes can
ilself vaiy as a funclion of lhe cuiienl. Thus lhe ohmic oveipolenlial does nol
Ì¿¾´» ëòï Ø¿´ºó½»´´ ᬻ²¬·¿´- º±® ݱ³³±² Û´»½¬®±¼»
Ó¿¬»®·¿´- ¿¬ îë èèÝ
The melal undeigoing lhe ieaclion shown has
lhe sign and polenlial
O
when iefeienced lo lhe
hydiogen elecliode
Ó»¬¿´ ¿²¼ λ¿½¬·±² ᬻ²¬·¿´
ð
øÊ÷
Al Al
3
3e 1.7O6
Zn Zn
2
2e O.763
Ci Ci
3
3e O.744
Ie Ie
2
2e O.4O9
Cd Cd
2
2e O.4O1
Ni Ni
2
2e O.23O
Pb Pb
2
2e O.126
H
2
2H 2e O.OOO by dennilion
Ag Cl AgCl e O.223
2Hg 2Cl Hg
2
Cl
2
2e O.268
Cu Cu
2
2e O.34O
Cu Cu e O.522
Ag Ag e O.799
Au Au
3
3e 1.42O
Au Au e 1.68O
SO\RC!: Dala fiom Ø¿²¼¾±±µ ±º ݸ»³·-¬®§ ¿²¼ и§-·½-ô 55lh ed., Cleve-
land, OH: CRC Piess, 19741975, wilh peimission.
ïçî ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
necessaiily have lo be lineaily ielaled lo lhe cuiienl. This is especially liue in
elecliolyles having low concenlialions of ions. This silualion, lhen, does nol
necessaiily follow Ohm`s law.
The ½±²½»²¬®¿¬·±² ±ª»®°±¬»²¬·¿´ iesulls fiom changes in lhe disliibulion of
ions in lhe elecliolyle in lhe vicinily of lhe elecliodeelecliolyle inleiface. Recall
lhal lhe equilibiium half-cell polenlial iesulls fiom lhe disliibulion of ionic
concenlialioninlhe vicinilyof lheelecliodeelecliolyle inleifacewhennocuiienl
ûows belween lhe elecliode and lhe elecliolyle. \ndei lhese condilions, ieaclions
(5.1) and (5.2) ieach equilibiium, so lhe iales of oxidalion and ieduclion al lhe
inleiface aie equal. When a cuiienl is eslablished, lhis equalily no longei exisls.
Thus il is ieasonable lo expecl lhe concenlialion of ions lo change. This change
iesulls in a diffeienl half-cell polenlial al lhe elecliode. The diffeience belween
lhis and lhe equilibiium half-cell polenlial is lhe concenlialion oveipolenlial.
The lhiid mechanism of polaiizalion iesulls in lhe ¿½¬·ª¿¬·±² ±ª»®°±¬»²¬·¿´ò
The chaige-liansfei piocesses involved in lhe oxidalionieduclion ieaclion
(5.1) aie nol enliiely ieveisible. ¡n oidei foi melal aloms lo be oxidized lo
melal ions lhal aie capable of going inlo solulion, lhe aloms musl oveicome an
eneigy baiiiei. This baiiiei, oi ¿½¬·ª¿¬·±² »²»®¹§ô goveins lhe kinelics of lhe
ieaclion. The ieveise ieaclion‰in which a calion is ieduced, lheieby plaling
oul an alom of lhe melal on lhe elecliode‰also involves an aclivalion eneigy,
bul il does nol necessaiily have lo be lhe same as lhal iequiied foi lhe
oxidalion ieaclion. When lheie is a cuiienl belween lhe elecliode and lhe
elecliolyle, eilhei oxidalion oi ieduclion piedominales, and hence lhe heighl
of lhe eneigy baiiiei depends on lhe diieclion of lhe cuiienl. This diffeience in
eneigy appeais as a diffeience in vollage belween lhe elecliode and lhe
elecliolyle, which is known as lhe ¿½¬·ª¿¬·±² ±ª»®°±¬»²¬·¿´ò
These lhiee mechanisms of polaiizalion aie addilive. Thus lhe nel ovei-
polenlial of an elecliode is given by
Ê
p
Û
O
Ê
i
Ê
c
Ê
a
(5.4)
wheie
Ê
p
lolal polenlial, oi polaiizalion polenlial, of lhe elecliode
Û
O
half-cell polenlial
Ê
i
ohmic oveipolenlial
Ê
c
concenlialion oveipolenlial
Ê
a
aclivalion oveipolenlial
When an ion-seleclive semipeimeable membiane sepaiales lwo aqueous ionic
solulions of diffeienl concenlialion, an elecliic polenlial exisls acioss lhis
membiane. ¡l can be shown (Plonsey and Baii, 2OO7) lhal lhis polenlial is given
by lhe Neinsl equalion
Û
ÎÌ
²Ú
ln
¿
1
¿
2
(5.5)
ë ò î Ð Ñ Ô ß Î × Æ ß Ì × Ñ Ò ïçí
wheie ¿
1
and ¿
2
aie lhe aclivilies of lhe ions on each side of lhe membiane.
|Olhei leims aie denned in (4.1) and lhe Appendix.j ¡n dilule solulions, ionic
aclivily is appioximalely equal lo ionic concenlialion. When inleimoleculai
effecls become signincanl, which happens al highei concenlialions, lhe aclivily
of lhe ions is less lhan lheii concenlialion.
The half-cell polenlials lisled in Table 5.1 aie known as lhe slandaid half-
cell polenlials because lhey apply lo slandaid condilions. When lhe elecliode
elecliolyle syslem no longei mainlains lhis slandaid condilion, half-cell
polenlials diffeienl fiom lhe slandaid half-cell polenlial aie obseived. The
diffeiences in polenlial aie deleimined piimaiily by lempeialuie and ionic
aclivily in lhe elecliolyle. ×±²·½ ¿½¬·ª·¬§ can be denned as lhe availabilily of an
ionic species in solulion lo enlei inlo a ieaclion.
The slandaid half-cell polenlial is deleimined al a slandaid lempeialuie;
lhe elecliode is placed in an elecliolyle conlaining calions of lhe elecliode
maleiial having unily aclivily. As lhe aclivily changes fiomunily (as a iesull of
changing concenlialion), lhe half-cell polenlial vaiies accoiding lo lhe Neinsl
equalion:
Û Û
O
ÎÌ
²Ú
ln ¿
½
² (5.6)
wheie
Û half-cell polenlial
Û
O
slandaid half-cell polenlial
² valence of elecliode maleiial
¿
½
² aclivily of calion Ý
²
!qualion (5.6) iepiesenls a specinc applicalion of lhe Neinsl equalion lo
lhe ieaclion of (5.1). The moie geneial foim of lhis equalion can be wiillen foi
a geneial oxidalionieduclion ieaclion as
¿ß ¾Þà¹Ý ¼Ü ²e (5.7)
wheie ² eleclions aie liansfeiied. The geneial Neinsl equalion foi lhis
silualion is
Û Û
O
ÎÌ
²Ú
ln
¿
¹
Ý
¿
¼
Ü
¿
¿
ß
¿
¾
Þ
(5.8)
wheie lhe ¿`s iepiesenl lhe aclivilies of lhe vaiious consliluenls of lhe
ieaclion.
An elecliodeelecliolyle inleiface is nol iequiied foi a polenlial diffei-
ence lo exisl. ¡f lwo elecliolylic solulions aie in conlacl and have diffeienl
concenlialions of ions wilh diffeienl ionic mobililies, a polenlial diffeience,
ïçì ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
known as a ´·¯«·¼ó¶«²½¬·±² °±¬»²¬·¿´ô exisls belween lhem. Ioi solulions of lhe
same composilion bul diffeienl aclivilies, ils magnilude is given by
Û

³ ³
³ ³
ÎÌ
²Ú
ln
¿
¿
(5.9)
wheie ³ and³ aie lhe mobililies of lhe posilive and negalive ions, and ¿ and
¿ aie lhe aclivilies of lhe lwo solulions. Though liquid-|unclion polenlials aie
geneially nol so high as elecliodeelecliolyle polenlials, lhey can easily be of
lhe oidei of lens of millivolls. Ioi example, lwo solulions of sodium chloiide,
al 25èC, wilh aclivilies lhal vaiy by a facloi of 1O, have a polenlial diffeience of
appioximalely 12 m\. Nole lhal you can geneiale polenlials of lhe oidei of
some biological polenlials by meiely ciealing diffeiences in concenlialion in
an elecliolyle. This is a facloi lo considei when you aie examining aclual
elecliode syslems used foi biopolenlial measuiemenls.
ÛÈßÓÐÔÛ ëòï An elecliode consisling of a piece of Zn wilh an allached
wiie and anolhei elecliode consisling of a piece of Ag coaled wilh a layei of
AgCl and an allached wiie aie placed in a 1 M ZnCl
2
solulion (aclivilies of
Zn
2
and Cl aie appioximalely unily) lo foim an elecliochemical cell lhal is
mainlained al a lempeialuie of 25 èC.
¿ò Whal chemical ieaclions mighl you expecl lo see al lhese elecliodes?
¾ò ¡f a veiy high inpul impedance vollmelei weie connecled belween lhese
elecliodes, whal would il iead?
½ò ¡f lhe lead wiies fiom lhe elecliodes weie shoiled logelhei, would a
cuiienl ûow? How would lhis affecl lhe ieaclions al lhe elecliodes?
¼ò How would you expecl lhe vollage belween lhe elecliodes lo diffei fiom
lhe equilibiium open-ciicuil vollage of lhe cell immedialely following
iemoval of lhe shoil ciicuil?
ßÒÍÉÛÎ
¿ò Zinc is much moie chemically aclive lhan Ag, so lhe aloms on ils suiface
oxidize lo Zn
2
ions accoiding lo lhe ieaclion: ZnàZn
2
2e , which
accoiding lo Table 5.1 has an Û
O
of O.763 \.
Al lhe Ag elecliode, Ag can be oxidized lo foim Ag ions accoiding
lo lhe ieaclion: Ag àAg 1e . These ions immedialely ieacl wilh lhe
Cl ions in solulion lo foim AgCl, Ag Cl àAgCl . Mosl of lhis
piecipilales oul of solulion due lo lhis sall`s low solubilily. This ieaclion
has an Û
O
of O.223 \ al 25 èC.
¾ò When no cuiienl is diawn fiom oi supplied lo eilhei elecliode, and lhe
concenlialion of ions is unifoimlhioughoul lhe solulion, lhe diffeience in
vollage belween lhe elecliodes is lhe diffeience belween lhe half-cell
polenlials:
Ê Û
O
Zn
Û
O
Ag
O 763\ O 233\ O 986\
ë ò î Ð Ñ Ô ß Î × Æ ß Ì × Ñ Ò ïçë
Because Zn oxidizes al a highei polenlial, lhe eleclions iemaining in il aie
al a highei eneigy lhan lhose in lhe Ag. Thus lhe Zn elecliode has a
negalive vollage wilh iespecl lo lhe Ag elecliode.
½ò Theie is a polenlial diffeience belween lhe lwo elecliodes, so lheie will be
a cuiienl when lhey aie shoiled logelhei. The ûowof eleclions is fiomlhe
Zn lo lhe Ag, because lhe Zn eleclions aie al a highei eneigy. Thus Zn is
consumed and yields eleclions, and AgCl absoibs eleclions and plales oul
melallic Ag.
¼ò Whenlhe elecliodes aie connecled, lheymusl be al lhe same polenlial al lhe
poinl of conneclion. Thus lhe O.986 \ half-cell polenlial diffeience musl be
opposed by polaiizalion oveipolenlials and ohmic losses in lhe elecliodes
and connecling wiies. When lhe conneclion is bioken and lhe cuiienl slops,
lhe ohmic oveipolenlial and elecliode losses become zeio, bul lhe concen-
lialion oveipolenlial iemains unlil lhe giadienl of lhe ionic concenlialion
al lhe elecliode suifaces ieluins lo ils equilibiium value foi zeio cuiienl.
Thus lhe diffeience in vollage belween lhe lwo elecliodes is less lhan O.986
\when lhe ciicuil is openedbul iises lo lhal value asymplolically wilh lime.
ëòí ÐÑÔßÎ×ÆßÞÔÛ ßÒÜ ÒÑÒÐÑÔßÎ×ÆßÞÔÛ ÛÔÛÝÌÎÑÜÛÍ
Theoielically, lwo lypes of elecliodes aie possible: lhose lhal aie peifeclly
polaiizable and lhose lhal aie peifeclly nonpolaiizable. This classincalion iefeis
lo whal happens lo an elecliode when a cuiienl passes belween il and lhe
elecliolyle. л®º»½¬´§ °±´¿®·¦¿¾´» »´»½¬®±¼»- aie lhose in which no aclual chaige
ciosses lhe elecliodeelecliolyle inleiface when a cuiienl is applied. Of couise,
lheie has lo be cuiienl acioss lhe inleiface, bul lhis cuiienl is a displacemenl
cuiienl, and lhe elecliode behaves as lhough il weie a capaciloi. л®º»½¬´§
²±²°±´¿®·¦¿¾´» »´»½¬®±¼»- aie lhose in which cuiienl passes fieely acioss lhe
elecliodeelecliolyle inleiface, iequiiing no eneigy lo make lhe liansilion. Thus,
foi peifeclly nonpolaiizable elecliodes lheie aie no oveipolenlials.
Neilhei of lhese lwo lypes of elecliodes can be fabiicaled; howevei, some
piaclical elecliodes can come close lo acquiiing lheii chaiacleiislics. !leclio-
des made of noble melals such as plalinum come closesl lo behaving as
peifeclly polaiizable elecliodes. Because lhe maleiials of lhese elecliodes
aie ielalively ineil, il is difncull foi lhem lo oxidize and dissolve. Thus cuiienl
passing belween lhe elecliode and lhe elecliolyle changes lhe concenlialion
piimaiily of ions al lhe inleiface, so a ma|oiily of lhe oveipolenlial seen fiom
lhis lype of elecliode is a iesull of Ê
c
, lhe concenlialion oveipolenlial. The
elecliical chaiacleiislics of such an elecliode show a sliong capacilive effecl.
ÌØÛ Í×ÔÊÛÎñÍ×ÔÊÛÎ ÝØÔÑÎ×ÜÛ ÛÔÛÝÌÎÑÜÛ
The silvei/silvei chloiide (Ag/AgCl) elecliode is a piaclical elecliode lhal
appioaches lhe chaiacleiislics of a peifeclly nonpolaiizable elecliode and can
ïçê ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
be easily fabiicaled in lhe laboialoiy. ¡l is a membei of a class of elecliodes
each of which consisls of a melal coaled wilh a layei of a slighlly soluble ionic
compound of lhal melal wilh a suilable anion. The whole sliucluie is immeised
in an elecliolyle conlaining lhe anion in ielalively high concenlialions.
The sliucluie is shown in Iiguie 5.2. A silvei melal base wilh allached
insulaled lead wiie is coaled wilh a layei of lhe ionic compound AgCl. (This
maleiial‰AgCl‰is only veiy slighlly soluble in walei, so il iemains slable.)
The elecliode is lhen immeised in an elecliolyle balh in which lhe piincipal
anion of lhe elecliolyle is Cl . Ioi besl iesulls, lhe elecliolyle solulion should
also be saluialed wilh AgCl so lhal lheie is lillle chance foi any of lhe suiface
nlm on lhe elecliode lo dissolve.
The behavioi of lhe Ag/AgCl elecliode is goveined by lwo chemical
ieaclions. The nisl involves lhe oxidalion of silvei aloms on lhe elecliode
suiface lo silvei ions in solulion al lhe inleiface.
AgàAg e (5.1O)
Ag Cl àAgCl (5.11)
The second ieaclion occuis immedialely aflei lhe foimalion of Ag ions.
These ions combine wilh Cl ions alieady in solulion lo foim lhe ionic
compound AgCl. As menlioned befoie, AgCl is only veiy slighlly soluble
in walei, so mosl of il piecipilales oul of solulion onlo lhe silvei elecliode and
conliibules lo lhe silvei chloiide deposil. Silvei chloiide`s iale of piecipilalion
and of ieluining lo solulion is a conslanl Õ
s
known as lhe -±´«¾·´·¬§ °®±¼«½¬ò
\ndei equilibiium condilions lhe ionic aclivilies of lhe Ag and Cl ions
musl be such lhal lheii pioducl is lhe solubilily pioducl.
¿
Ag
¿
Cl
Õ
s
(5.12)
¡n biological ûuids lhe concenlialion of Cl ions is ielalively high, which
gives il an aclivily |usl a lillle less lhan unily. The solubilily pioducl foi
AgCl, on lhe olhei hand, is of lhe oidei of 1O
1O
. This means lhal, when an
Ag/AgCl elecliode is in conlacl wilh biological ûuids, lhe aclivily of lhe Ag
Ú·¹«®» ëòî A silvei/silvei chloiide elecliode, shown in cioss seclion.
ë ò í Ð Ñ Ô ß Î × Æ ß Þ Ô Û ß Ò Ü Ò Ñ Ò Ð Ñ Ô ß Î × Æ ß Þ Ô Û Û Ô Û Ý Ì Î Ñ Ü Û Í ïçé
ion musl be veiy low and of lhe same oidei of magnilude as lhe solubilily
pioducl.
We can deleimine lhe half-cell polenlial foi lhe Ag/AgCl elecliode by
wiiling (5.6) foi lhe ieaclion of (5.1O).
Û Û
O
Ag
ÎÌ
²Ú
ln¿
Ag
(5.13)
By using (5.12), we can iewiile lhis as
Û Û
O
Ag
ÎÌ
²Ú
ln
Õ
s
¿
Cl
(5.14)
oi
Û Û
O
Ag
ÎÌ
²Ú
lnÕ
s
ÎÌ
²Ú
ln¿
Cl
(5.15)
The nisl and second leims on lhe iighl-hand side of (5.15) aie conslanls;
only lhe lhiid is deleimined by ionic aclivily. ¡n lhis case, il is lhe aclivily of
lhe Cl ion, which is ielalively laige and nol ielaled lo lhe oxidalion of Ag,
which is caused by lhe cuiienl lhiough lhe elecliode. The half-cell polenlial
of lhis elecliode is consequenlly quile slable when il is placed in an
elecliolyle conlaining Cl as lhe piincipal anion, piovided lhe aclivily of
lhe Cl iemains slable. Because lhis is lhe case in lhe body, we shall see in
lalei seclions of lhis chaplei lhal lhe Ag/AgCl elecliode is ielalively slable
in biological applicalions.
Theie aie seveial pioceduies lhal can be used lo fabiicale Ag/AgCl
elecliodes (1anz and ¡ves, 1968). Two of lhem aie of pailiculai impoilance
in biomedical elecliodes. One is lhe elecliolylic piocess foi foiming Ag/AgCl
elecliodes. An elecliochemical cell is made up in which lhe Ag elecliode on
which lhe AgCl layei is lo be deposiled seives as anode and anolhei piece of
Ag‰having a suiface aiea much giealei lhan lhal of lhe anode‰seives as
calhode. A 1.5 \ balleiy seives as lhe eneigy souice, and a seiies iesislance
limils lhe peak cuiienl, lheieby conliolling lhe maximal iale of ieaclion. A
milliammelei can be placed in lhe ciicuil lo obseive lhe cuiienl, which is
piopoilional lo lhe iale of ieaclion.
The ieaclions of (5.1O) and (5.11) begin lo occui as soon as lhe balleiy is
connecled, and lhe cuiienl |umps lo ils maximal value. As lhe lhickness of lhe
deposiled AgCl layei incieases, lhe iale of ieaclion decieases and lhe cuiienl
diops. This silualion conlinues, and lhe cuiienl appioaches zeio asymploli-
cally. Theoielically, lhe ieaclion is nol complele unlil lhe cuiienl diops lo zeio.
¡n piaclice lhis nevei occuis because of olhei piocesses going on lhal conducl a
cuiienl. Theiefoie lhe ieaclion can be slopped aflei a few minules, once lhe
cuiienl has ieached a ielalively slable low value‰of lhe oidei of 1O ³A foi
mosl biological elecliodes.
ïçè ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
ÛÈßÓÐÔÛ ëòî An AgCl suiface is giown on an Ag elecliode by lhe
elecliolylic piocess desciibed in lhe pievious paiagiaph. The cuiienl passing
lhiough lhe cell is measuied and iecoided duiing lhe giowlh of lhe AgCl
layei and is found lo be iepiesenled by lhe equalion
× 1OOmA»
¬ 1O s
(!5.1)
¿ò ¡f lhe ieaclion is allowed lo iun foi a long peiiod of lime, so lhal lhe
cuiienl al lhe end of lhis peiiod is essenlially zeio; how much chaige is
iemoved fiom lhe balleiy duiing lhis ieaclion?
¾ò How many giams of AgCl aie deposiled on lhe Ag elecliode`s suiface by
lhis ieaclion?
½ò The chloiide elecliode is now placed inlo a beakei conlaining 1 lilei of
O.9 molai NaCl solulion. How much AgCl will be dissolved?
ßÒÍÉÛÎ
¿ò The lolal chaige ciossing lhe elecliodeelecliolyle inleiface duiing lhe
ieaclion is
¯
O
· ¼¬ 1OOmA
O
»
¬ 1O
¼¬ 1 C (!5.2)
¾ò One molecule of AgCl is deposiled foi each eleclion. The numbei of
aloms deposiled is
Ò
1 C
1 6 1O
19
C/alom
6 25 1O
8
aloms (!5.3)
The numbei of moles can be found by dividing by Avogadio`s numbei.
Ò
6 25 1O
18
6 O3 1O
23
1 O36 1O
5
mol (!5.4)
The moleculai weighl of AgCl is 143.2, lheiefoie lhe mass of AgCl foimed is
142 3 1 O36 1O
5
1 47 1O
3
g (!5.5)
½ò Ioi AgCl lhe solubilily pioducl is Õ
s
1 56 1O
1O
al 25 èC. The aclivily
and concenlialion aie aboul lhe same al lhese low concenlialions. Thus
Ag Cl 1 56 1O
1O
(!5.6)
Since |Cl j in lhe NaCl solulion is O.9 mole/lilei, lhe dissolved Ag will be
Ag 1 73 1O
1O
mol lilei
¡n leims of mass lhis will be 1 73 1O
1O
142 3 2 46 1O
8
g.
ë ò í Ð Ñ Ô ß Î × Æ ß Þ Ô Û ß Ò Ü Ò Ñ Ò Ð Ñ Ô ß Î × Æ ß Þ Ô Û Û Ô Û Ý Ì Î Ñ Ü Û Í ïçç
The second piocess foi pioducing Ag/AgCl elecliodes useful in medical
insliumenlalion is a sinleiing piocess lhal foims pellel elecliodes, as shown
in Iiguie 5.3. The elecliode consisls of an Ag lead wiie suiiounded by a
sinleied Ag/AgCl cylindei. ¡l is foimed by placing lhe cleaned lead wiie in a
die lhal is lhen nlled wilh a mixluie of powdeied Ag and AgCl. The die is
compiessed in an aiboi piess lo foim lhe powdeied componenls inlo a
pellel, which is lhen iemoved fiom lhe die and baked al 4OO èC foi seveial
houis. These elecliodes lend lo have a giealei enduiance lhan lhe eleclio-
lylically deposiled AgCl elecliodes, and lhey aie besl applied when iepealed
usage is necessaiy. The elecliolylically deposiled AgCl has a lendency lo
ûake off undei mechanical sliess, leaving poilions of melallic Ag in conlacl
wilh lhe elecliolyle, which can cause lhe elecliode`s half-cell, polenlial lo be
unslable and noisy.
Silvei chloiide is nol a veiy good conducloi of an elecliic cuiienl. ¡f lhe
powdei lhal was compiessed lo make lhe sinleied elecliode consisled only of
nnely giound silvei chloiide, lhis would iesull in a high-iesislance elecliic
conneclion belween lhe elecliolylic solulion and lhe silvei wiie in lhe cenlei of
lhe sinleied elecliode. !lecliochemisls found lhal lhey could inciease lhe
conduclivily of lhe silvei chloiide pellel by including melallic silvei powdei
along wilh lhe silvei chloiide powdei. The amounl of melallic silvei is small
enough lo make highly unlikely any diiecl conneclion fiom lhe silvei wiie lo
lhe elecliode lhiough silvei pailicles. ¡nslead, lheie is always some silvei
chloiide belween lhe silvei pailicles, bul lhe piesence of lhe silvei pailicles
makes il easiei foi cuiienl lo pass lhiough lhe silvei chloiide.
A similai silualion occuis in lhe elecliolylically piepaied silvei/silvei
chloiide elecliode. Allhough lhe silvei chloiide layei is much lhinnei in
lhis case lhan il is foi lhe sinleied elecliode, il iemains a puie silvei chloiide
layei foi only a shoil lime aflei il is deposiled. Silvei chloiide is a silvei-halide
sall, and lhese maleiials aie pholosensilive. Lighl sliiking lhese salls can cause
lhe silvei ions lo be ieduced lo melallic silvei aloms. Thus, foi all piaclical
puiposes, lhe elecliolylically deposiled silvei chloiide layei conlains nne silvei
pailicles as well. !vidence of lheii piesence appeais when lhe layei is giown
Ú·¹«®» ëòí Í·²¬»®»¼ ß¹ñ߹ݴ »´»½¬®±¼»
îðð ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
and immedialely becomes daik giay because of lhe nne silvei pailicles (puie
silvei chloiide is ambei coloied).
¡n addilion lo ils nonpolaiizable behavioi, lhe Ag/AgCl elecliode exhibils
less elecliic noise lhan lhe equivalenl melallic Ag elecliodes. Geddes and
Bakei (1989) showed lhal elecliodes wilh lhe AgCl layei exhibiled fai less
noise lhan was obseived when lhe AgCl layei was iemoved. Also, a ma|oiily of
lhe noise foi lhe puiely melallic elecliodes was al low fiequencies. This would
piovide lhe mosl seiious inleifeience foi low-fiequency, low-vollage iecoid-
ings, such as lhe !!G.
A second kind of elecliode lhal has chaiacleiislics appioaching lhose of
lhe peifeclly nonpolaiizable elecliode is lhe ½¿´±³»´ »´»½¬®±¼»ò ¡l is used
piimaiily as a iefeience elecliode foi elecliochemical deleiminalions and is
fiequenlly applied as lhe iefeience elecliode when pH is measuied (see
Seclion 1O.2). The calomel elecliode is oflen consliucled as a glass lube
wilh a poious glass plug al ils base nlled wilh a pasle of meicuious chloiide
oi calomel (Hg
2
Cl
2
) mixed wilh a saluialed polassiumchloiide (KCl) solulion.
Like AgCl, lhe Hg
2
Cl
2
is only slighlly soluble in walei, so mosl of il ielains ils
solid foim. A layei of elemenlal meicuiy is placed on lop of lhe pasle layei
wilh an elecliic lead wiie wilhin il. This enliie assembly is lhen posilioned in
lhe cenlei of a laigei glass lube wilh a poious glass plug al ils base. The lube is
nlled wilh a saluialed KCl solulion so lhal lhe Hg
2
Cl
2
layei of lhe innei lube is
in conlacl wilh lhis elecliolyle lhiough lhe poious plug of lhe innei lube. We
have a half-cell made up of Hg in inlimale conlacl wilh an Hg
2
Cl
2
layei lhal is
in conlacl wilh lhe saluialed KCl elecliolyle. The poious plug al lhe bollom of
lhe elecliode assembly is used lo make conlacl belween lhe inleinal KCl
solulion and lhe solulion in which lhe elecliode is immeised. This is aclually a
liquidliquid |unclion lhal can iesull in a liquidliquid |unclion polenlial,
which will add lo lhe elecliode half-cell polenlial.
Silvei/silvei chloiide elecliodes can be fabiicaled in lhe same foim as lhe
calomel elecliode and used foi eleclioanalylical chemical measuiemenls. ¡n
lhis case, lhe meicuiy is ieplaced by silvei and AgCl ieplaces lhe Hg
2
Cl
2
in lhe
elecliode sliucluie.
\sing lhe same aigumenl as lhal used foi lhe Ag/AgCl elecliode, we can
show lhal lhe half-cell polenlial of lhis elecliode is dependenl on lhe Cl
aclivily in lhe saluialed KCl solulion. This is slable al a given lempeialuie,
because lhe solulion is saluialed and lheiefoie has a slable chloiide ion
aclivily. ¡n applicalion, lhe lip of lhis elecliode assembly lhal conlains lhe
poious plug is dipped inlo lhe elecliolylic solulion lhal il is lo conlacl. ¡n pH
measuiemenls, a pH elecliode is also dipped inlo lhe solulion, and lhe
polenlial diffeience belween lhe lwo elecliodes is measuied.
ÛÈßÓÐÔÛ ëòí To measuie lhe polenlial acioss lhe ieclal mucosa (innei
suiface of lhe ieclum), a lechnique has been developed wheieby an Ag/AgCl
iefeience elecliode is placed al some convenienl poinl on lhe skin suiface of
lhe body away fiom lhe anal oiince. Anolhei Ag/AgCl elecliode is placed
againsl lhe innei wall of lhe ieclum aboul 8 cm up fiom lhe anus. The
ë ò í Ð Ñ Ô ß Î × Æ ß Þ Ô Û ß Ò Ü Ò Ñ Ò Ð Ñ Ô ß Î × Æ ß Þ Ô Û Û Ô Û Ý Ì Î Ñ Ü Û Í îðï
polenlial diffeience belween lhese lwo elecliodes is measuied wilh a high-
inpul impedance vollmelei, and lhe iesull iecoided. The ieclal elecliode is
lhen iemoved and immedialely louched lo lhe skin suiiounding lhe anus, as
close lo il as possible. Anolhei polenlial diffeience is measuied and ie-
coided. The diffeience belween lhe lwo measuiemenls is lhen deleimined.
This is consideied lhe liue polenlial acioss lhe ieclal mucosa.
Al nisl glance, lhis appeais lo be a ialhei difncull way lo make a simple
measuiemenl. We may wondei why we couldn`l simply place one of lhe Ag/
AgCl elecliodes on lhe skin suiiounding lhe anus and lhe olhei in lhe ieclum
and meiely measuie lhe polenlial diffeience belween lhem. !xplain why lhe
biomedical engineei who developed lhis pioceduie consideied lhe simplei
appioach inadequale and chose lhe moie complicaled, lwo-measuiemenl
lechnique.
ßÒÍÉÛÎ Allhough lheoielically eveiy Ag/AgCl elecliode should have lhe
same half-cell polenlial, lheie aie usually diffeiences fiom one lo anolhei.
These diffeiences should be quile small, of lhe oidei of millivolls. Howevei,
occasions can aiise in which lhe diffeiences can be as high as lens‰oi in
exlieme cases, even hundieds‰of millivolls. When we aie measuiing lhe
polenlial diffeience belween lwo Ag/AgCl elecliodes, lhe diffeience belween
lhe half-cell polenlials of each elecliode enleis inlo lhe measuied value. When
bolh half-cell polenlials aie equal, lhe diffeiences cancel oul. Howevei if lhe
half-cell polenlials aie diffeienl, eiiois aie inlioduced inlo lhe measuiemenls.
The engineei who designed lhis measuiemenl knew lhal lhis was a possibilily
and lheiefoie used a single elecliode, inslead of lwo diffeienl Ag/AgCl
elecliodes, lo measuie lhe polenlial acioss lhe ieclal mucosa. Wilh lhis
lechnique, lhe half-cell polenlial when lhe elecliode is in lhe ieclum and
lhe half-cell polenlial when il is on lhe peiianal skin aie idenlical; lhey cancel
oul complelely.
ëòì ÛÔÛÝÌÎÑÜÛ ÞÛØßÊ×ÑÎ ßÒÜ Ý×ÎÝË×Ì ÓÑÜÛÔÍ
The elecliical chaiacleiislics of elecliodes have been lhe sub|ecl of much
sludy. Oflen lhe cuiienlvollage chaiacleiislics of lhe elecliodeelecliolyle
inleiface aie found lo be nonlineai, and, in luin, nonlineai elemenls aie
iequiied foi modeling elecliode behavioi. Specincally, lhe chaiacleiislics of an
elecliode aie sensilive lo lhe cuiienl passing lhiough lhe elecliode, and lhe
elecliode chaiacleiislics al ielalively high cuiienl densilies can be consideia-
bly diffeienl fiom lhose al low cuiienl densilies. The chaiacleiislics of
elecliodes aie also wavefoim dependenl. When sinusoidal cuiienls aie
used lo measuie lhe elecliode`s ciicuil behavioi, lhe chaiacleiislics aie also
fiequency dependenl.
The chaiacleiizalion of elecliodeelecliolyle inleifacial impedances has
been well ieviewed by Geddes (1972), Cobbold (1974), Ieiiis (1974), and
îðî ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
Schwan (1963). ¡l is only summaiized heie. Ioi sinusoidal inpuls, lhe leiminal
chaiacleiislics of an elecliode have bolh a iesislive and a ieaclive componenl.
Ovei all bul lhe lowesl fiequencies, lhis silualion can be modeled as a seiies
iesislance and capacilance. We should nol be suipiised lo see a capacilance
enleiing inlo lhis model, because lhe half-cell polenlial desciibed eailiei was
lhe iesull of lhe disliibulion of ionic chaige al lhe elecliodeelecliolyle
inleiface lhal had been consideied a double layei of chaige. This, of couise,
should behave as a capaciloi‰hence lhe capacilive ieaclance seen foi ieal
elecliodes.
The seiies iesislancecapacilance equivalenl ciicuil bieaks down al lhe
lowei fiequencies, wheie lhis model would suggesl an impedance going lo
innnily as lhe fiequency appioaches dc. To avoid lhis pioblem, we can conveil
lhis seiies ÎÝ ciicuil lo a paiallel ÎÝ ciicuil lhal has a puiely iesislive
impedance al veiy low fiequencies. ¡f we combine lhis ciicuil wilh a vollage
souice iepiesenling lhe half-cell polenlial and a seiies iesislance iepiesenling
lhe inleiface effecls and iesislance of lhe elecliolyle, we can aiiive al lhe
biopolenlial elecliode equivalenl ciicuil model shown in Iiguie 5.4.
¡n lhis ciicuil, Î
d
and Ý
d
iepiesenl lhe iesislive and ieaclive componenls
|usl discussed. These componenls aie slill fiequency and cuiienl-densily
dependenl. ¡n lhis connguialion il is also possible lo assign physical meaning
lo lhe componenls. Ý
d
iepiesenls lhe capacilance acioss lhe double layei of
chaige al lhe elecliodeelecliolyle inleiface. The paiallel iesislance Î
d
iepiesenls lhe leakage iesislance acioss lhis double layei. All lhe componenls
of lhis equivalenl ciicuil have values deleimined by lhe elecliode maleiial and
ils geomeliy, and‰lo a lessei exlenl‰by lhe maleiial of lhe elecliolyle and ils
concenlialion.
The equivalenl ciicuil of Iiguie 5.4 demonsliales lhal lhe elecliode
impedance is fiequency dependenl. Al high fiequencies, wheie 1 ªÝ Î
d
,
lhe impedance is conslanl al Î
s
. Al low fiequencies, wheie 1 ªÝ Î
d
, lhe
impedance is again conslanl bul ils value is laigei, being Î
s
Î
d
. Al fiequen-
cies belween lhese exliemes, lhe elecliode impedance is fiequency dependenl.
Ú·¹«®» ëòì !quivalenl ciicuil foi a biopolenlial elecliode in conlacl wilh an
elecliolyle Û
hc
is lhe half-cell polenlial, Î
d
and Ý
d
make up lhe impedance
associaled wilh lhe elecliodeelecliolyle inleiface and polaiizalion effecls,
and Î
s
is lhe seiies iesislance associaled wilh inleiface effecls and is due lo
iesislance in lhe elecliolyle.
ë ò ì Û Ô Û Ý Ì Î Ñ Ü Û Þ Û Ø ß Ê × Ñ Î ß Ò Ü Ý × Î Ý Ë × Ì Ó Ñ Ü Û Ô Í îðí
The impedance of Ag/AgCl elecliodes vaiies signincanlly fiom lhal of a
puie silvei elecliode al fiequencies undei 1OO Hz. Geddes »¬ ¿´ò (1969)
demonslialed lhis; lheii dala aie iepioduced in Iiguie 5.5.
A melallic silvei elecliode having a suiface aiea of O.25 cm
2
had lhe
impedance chaiacleiislic shown by cuive A. Al a fiequency of 1O Hz, lhe
magnilude of ils impedance was almosl lhiee limes lhe value al 3OO Hz. This
indicales a sliong capacilive componenl lo lhe equivalenl ciicuil. !lecliolyli-
cally deposiling 2.5 mA s of AgCl gieally ieduced lhe low-fiequency imped-
ance, as ieûecled in cuive B. Deposiling lhickei AgCl layeis had minimal
effecls unlil lhe chaige deposiled exceeded appioximalely 1OO mA s. The
cuives weie lhen seen lo shifl lo highei impedances in a paiallel fashion as lhe
amounl of AgCl deposiled incieased. Geddes and Bakei (1989) poinl oul lhal
deposiling an AgCl layei using a chaige of belween 1OO and 5OO mA s/cm
2
piovides lhe lowesl value of elecliode impedance. ¡f lhe cuiienl densily is
mainlained al giealei lhan 5 mA/cm
2
, we can ad|usl cuiienl and lime lo
piovide lhe mosl convenienl values foi deposiling lhe desiied layei.
The impedance decieases wilh fiequency foi diffeienl elecliode maleiials
as shown in Iiguie 5.6. Ioi 1 cm
2
al 1O Hz, a nickel- and caibon-loaded silicone
iubbei elecliode has an impedance of appioximalely 3O kÊ, wheieas Ag/AgCl
has an impedance of less lhan 1O Ê (Das and Webslei, 198O).
ÛÈßÓÐÔÛ ëòì We wanl lo develop an elecliical model foi a specinc
biopolenlial elecliode sludies in lhe laboialoiy. The elecliode is
Ú·¹«®» ëòë ¡mpedance as a funclion of fiequency foi Ag elecliodes coaled
wilh an elecliolylically deposiled AgCl layei. The elecliode aiea is O.25 cm
2
.
Numbeis allached lo cuives indicale numbei of mA s foi each deposil. (Iiom
L. A. Geddes, L. !. Bakei, andA. G. Mooie, Oplimumelecliolylic chloiiding
of silvei elecliodes.`` Ó»¼·½¿´ ¿²¼ Þ·±´±¹·½¿´ Û²¹·²»»®·²¹ô 1969, é, 4956.)
îðì ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
chaiacleiized by placing il in a physiological saline balh in lhe laboialoiy,
along wilh an Ag/AgCl elecliode having a much giealei suiface aiea and a
known half-cell polenlial of O.233 \. The dc vollage belween lhe lwo
elecliodes is measuied wilh a veiy-high-impedance vollmelei and found
lo be O.572 \ wilh lhe lesl elecliode negalive. The magnilude of lhe
impedance belween lhe lwo elecliodes is measuied as a funclion of fie-
quency al veiy low cuiienls; il is found lo be lhal given in Iiguie 5.6. Iiom
lhese dala, deleimine a ciicuil model foi lhe elecliode.
ßÒÍÉÛÎ The veiy laige suiface aiea of lhe Ag/AgCl iefeience elecliode
makes ils impedance veiy small compaied lo lhal of lhe lesl elecliode, so we
can neglecl il. We cannol, howevei, neglecl ils half-cell polenlial, which is
unaffecled by suiface aiea. The half-cell polenlial of lhe lesl elecliode is
Û
O
¨
O 223\ O 572\ O 349\.
Al fiequencies above aboul 2O kHz, lhe elecliode impedance is conslanl
because Ý
d
in Iiguie 5.4 is shoil-ciicuiled. Thus Î
s
5OOÊ. Al fiequencies
less lhan 5O Hz, lhe elecliode impedance is conslanl because Ý
d
is open-
ciicuiled. Thus Î
s
Î
d
3OkÊ. Thus Î
d
29 5 kÊ. The coinei fiequency is
1OO Hz. Thus Ý
d
1 2°ºÎ
d
1 2°1OO 295OO 5 3 1O
8
I.
ëòë ÌØÛ ÛÔÛÝÌÎÑÜÛŠÍÕ×Ò ×ÒÌÛÎÚßÝÛ ßÒÜ ÓÑÌ×ÑÒ ßÎÌ×ÚßÝÌ
¡n Seclion 5.1 we examined lhe elecliodeelecliolyle inleiface and saw how il
inûuenced lhe elecliical piopeilies lhal aie seen in piaclical elecliodes. When
biopolenlials aie iecoided fiom lhe suiface of lhe skin, we musl considei an
addilional inleiface‰lhe inleiface belween lhe elecliodeelecliolyle and lhe
skin‰in oidei lo undeisland lhe behavioi of lhe elecliodes. ¡n coupling an
elecliode lo lhe skin, we geneially use lianspaienl elecliolyle gel conlaining
Ú·¹«®» ëòê !xpeiimenlally deleimined magnilude of impedance as a func-
lion of fiequency foi elecliodes.
ë ò ë Ì Ø Û Û Ô Û Ý Ì Î Ñ Ü Û Š Í Õ × Ò × Ò Ì Û Î Ú ß Ý Û îðë
Cl as lhe piincipal anion lo mainlain good conlacl. Alleinalively, we may use
an elecliode cieam, which conlains Cl and has lhe consislency of hand lolion.
The inleiface belween lhis gel and lhe elecliode is an elecliodeelecliolyle
inleiface, as desciibed above. Howevei, lhe inleiface belween lhe elecliolyle
and lhe skin is diffeienl and iequiies some explanalion. Befoie we give lhis
explanalion, lel us biieûy ieview lhe sliucluie of lhe skin.
Iiguie 5.7 shows a cioss-seclional diagiam of lhe skin. The skin consisls of
lhiee piincipal layeis lhal suiiound lhe body lo piolecl il fiom ils enviionmenl
andlhal also seive as appiopiiale inleifaces. The ouleimosl layei, oi »°·¼»®³·-ô
plays lhe mosl impoilanl iole in lhe elecliodeskin inleiface. This layei, which
consisls of lhiee sublayeis, is conslanlly ienewing ilself. Cells divide and giowin
lhe deepesl layei, lhe -¬®¿¬«³¹»®³·²¿¬·ª«³ô and aie displaced oulwaid as lhey
giow by lhe newly foiming cells undeinealh lhem. As lhey pass lhiough lhe
-¬®¿¬«³ ¹®¿²«´±-«³ô lhey begin lo die and lose lheii nucleai maleiial. As lhey
conlinue lheii oulwaid |ouiney, lhey degeneiale fuilhei inlo layeis of ûal
keialinous maleiial lhal foims lhe -¬®¿¬«³ ½±®²»«³ô oi hoiny layei of dead
maleiial on lhe skin`s suiface. These layeis aie conslanlly being woin off and
ieplaced al lhe slialum gianulosum by new cells. The epideimis is lhus a
conslanlly changing layei of lhe skin, lhe oulei suiface of which consisls of dead
maleiial lhal has diffeienl elecliical chaiacleiislics fiom live lissue.
The deepei layeis of lhe skin conlain lhe vasculai and neivous componenls
of lhe skin as well as lhe sweal glands, sweal ducls, and haii follicles. These
layeis aie similai lo olhei lissues in lhe body and, wilh lhe exceplion of lhe
sweal glands, do nol beslow any unique elecliical chaiacleiislics on lhe skin.
To iepiesenl lhe elecliic conneclion belween an elecliode and lhe skin
lhiough lhe agency of elecliolyle gel, oui equivalenl ciicuil of Iiguie 5.4 musl
be expanded, as shown in Iiguie 5.8. The elecliodeelecliolyle inleiface
Ú·¹«®» ëòé (Copyiighl ý
1977 by The ¡nslilule of !lecliical and !leclionics !ngineeis. Repiinled, wilh
peimission, fiom ×ÛÛÛ Ì®¿²-ò Þ·±³»¼ò Û²¹òô Maich 1977, vol. BM!-24, no. 2,
pp. 134139.)
îðê ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
equivalenl ciicuil is shown ad|acenl lo lhe elecliodegel inleiface. The seiies
iesislance Î
s
is now lhe effeclive iesislance associaled wilh inleiface effecls of
lhe gel belween lhe elecliode and lhe skin. We can considei lhe epideimis, oi
al leasl lhe slialum coineum, as a membiane lhal is semipeimeable lo ions, so
if lheie is a diffeience in ionic concenlialion acioss lhis membiane, lheie is a
polenlial diffeience Û
se
, which is given by lhe Neinsl equalion. The epideimal
layei is also found lo have an elecliic impedance lhal behaves as a paiallel ÎÝ
ciicuil, as shown. Ioi 1 cm
2
, skin impedance ieduces fiom appioximalely
2OO kÊ al 1 Hz lo 2OO Ê al 1 MHz (Rosell »¬ ¿´òô 1988). The deimis and lhe
subculaneous layei undei il behave in geneial as puie iesislances. They
geneiale negligible dc polenlials.
Thus we see lhal‰if lhe effecl of lhe slialum coineum can be ieduced‰a
moie slable elecliode will iesull. We can minimize lhe effecl of lhe slialum
coineumby iemoving il, oi al leasl a pail of il, fiom undei lhe elecliode. Theie
aie many ways lo do lhis, ianging fiom vigoious iubbing wilh a pad soaked in
acelone lo abiading lhe slialum coineum wilh sandpapei lo puncluie il. ¡n all
cases, lhis piocess lends lo shoil oul Û
se
, Ý
e
, and Î
e
, as shown in Iiguie 5.8,
Ú·¹«®» ëòè A body-suiface elecliode is placed againsl skin, showing lhe lolal
elecliical equivalenl ciicuil oblained in lhis silualion. !ach ciicuil elemenl on
lhe iighl is al appioximalely lhe same level al which lhe physical piocess lhal il
iepiesenls would be in lhe lefl-hand diagiam.
ë ò ë Ì Ø Û Û Ô Û Ý Ì Î Ñ Ü Û Š Í Õ × Ò × Ò Ì Û Î Ú ß Ý Û îðé
lheieby impioving lhe slabilily of lhe signal, bul lhe slialum coineum can
iegeneiale in as shoil a lime as 24 h.
A facloi lhal is somelimes impoilanl in examinalion of, foi example, psycho-
genic elecliodeimal iesponses oi lhe galvanic skinieûex (GSR), is lheconliibulion
of lhe sweal glands and sweal ducls. The ûuid secieled by sweal glands conlains
Na , K , and Cl ions, lhe concenlialions of which diffei fiom lhose in lhe
exliacellulai ûuid. Thus lheie is a polenlial diffeience belween lhe lumen of lhe
sweal ducl and lhe deimis and subculaneous layeis. Theie also is a paiallel Î
p
Ý
p
combinalion in seiies wilh lhis polenlial lhal iepiesenls lhe wall of lhe sweal gland
and ducl, as shown by lhe bioken lines in Iiguie 5.8. These componenls aie oflen
neglecled when we considei biopolenlial elecliodes unless lhe elecliodes aie used
lo measuie lhe elecliodeimal iesponse oi GSR (Boucsein, 1992).
Whenapolaiizable elecliode is inconlacl wilhanelecliolyle, adouble layei of
chaige foims al lhe inleiface. ¡f lhe elecliode is moved wilh iespecl lo lhe
elecliolyle, lhis movemenl mechanically disluibs lhe disliibulion of chaige al
lhe inleiface and iesulls in a momenlaiy change of lhe half-cell polenlial unlil
equilibiiumcan be ieeslablished. ¡f a paii of elecliodes is in an elecliolyle and one
moves while lhe olhei iemains slalionaiy, a polenlial diffeience appeais belween
lhelwoelecliodes duiing lhis movemenl. This polenlial is knownas ³±¬·±²¿®¬·º¿½¬
and can be a seiious cause of inleifeience in lhe measuiemenl of biopolenlials.
Because molion ailifacl iesulls piimaiily fiom mechanical disluibances of
lhe disliibulion of chaige al lhe elecliodeelecliolyle inleiface, il is ieasonable
lo expecl lhal molion ailifacl is minimal foi nonpolaiizable elecliodes.
Obseivalion of lhe molion-ailifacl signals ieveals lhal a ma|oi componenl
of lhis noise is al low fiequencies. Seclion 6.6 and Iiguie 6.16 will show lhal
diffeienl biopolenlial signals occupy diffeienl poilions of lhe fiequency
speclium. Iiguie 6.16 shows lhal low-fiequency ailifacl does nol affecl signals
such as lhe !MG oi axon aclion polenlial (AAP) neaily so much as il does lhe
!CG, !!G, and !OG. ¡n lhe foimei case, nlleiing can be effeclively used lo
minimize lhe conliibulion of molion ailifacl on lhe oveiall signal. Bul in lhe
lallei case, such nlleiing also disloils lhe signal. Consequenlly, il is impoilanl
in lhese applicalions lo use a nonpolaiizable elecliode lo minimize molion
ailifacl slemming fiom lhe elecliodeelecliolyle inleiface.
This inleiface, howevei, is nol lhe only souice of molion ailifacl encounleied
when biopolenlial elecliodes aie applied lo lhe skin. The equivalenl ciicuil in
Iiguie 5.8 shows lhal, in addilionlolhe half-cell polenlial Û
hc
, lhe elecliolyle gel
skin polenlial Û
se
can also cause molion ailifacl if il vaiies wilh movemenl of lhe
elecliode. \aiialions of lhis polenlial indeed do iepiesenl a ma|oi souice of
molion ailifacl in Ag/AgCl skin elecliodes (Tamand Webslei, 1977). They have
shown lhal lhis ailifacl can be signincanlly ieduced when lhe slialumcoineumis
iemoved by mechanical abiasion wilh a nne abiasive papei. This melhod also
helps lo ieduce lhe epideimal componenl of lhe skin impedance. Tam and
Webslei (1977) also poinl oul, howevei, lhal iemoval of lhe body`s oulei
pioleclive baiiiei makes lhal iegion of skin moie susceplible lo iiiilalion
fiom lhe elecliolyle gel. Theiefoie, lhe choice of a gel maleiial is impoilanl.
Remembeiing lhe dynamic naluie of lhe epideimis, nole also lhal lhe slialum
coineum can iegeneiale ilself in as shoil a lime as 24 h, lheieby ienewing lhe
îðè ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
souice of molion ailifacl. This is a facloi lo be lakeninloaccounl if lhe elecliodes
aie lo be used foi chionic iecoiding. A polenlial belween lhe inside and oulside
of lhe skin can be measuied (Buibank and Webslei, 1978). Slielching lhe skin
changes lhis skin polenlial by 5 lo 1O m\, and lhis change appeais as molion
ailifacl. Ten O.5 mm skin puncluies lhiough lhe baiiiei layei shoil-ciicuils lhe
skin polenlial and ieduces lhe slielch ailifacl lo less lhan O.2 m\. De Talhouel
and Webslei (1996) piovide a model foi lhe oiiginof lhis skin polenlial and show
how il can be ieduced by sliipping layeis of lhe skin using Scolch lape.
ëòê ÞÑÜÇóÍËÎÚßÝÛ ÎÛÝÑÎÜ×ÒÙ ÛÔÛÝÌÎÑÜÛÍ
Ovei lhe yeais many diffeienl lypes of elecliodes foi iecoiding vaiious
polenlials on lhe body suiface have been developed. This seclion desciibes
lhe vaiious lypes of lhese elecliodes and gives an example of each. The ieadei
inleiesled in moie exlensive examples should consull Geddes (1972).
ÓÛÌßÔóÐÔßÌÛ ÛÔÛÝÌÎÑÜÛÍ
Hisloiically, one of lhe mosl fiequenlly used foims of biopolenlial sensing
elecliodes is lhe melal-plale elecliode. ¡n ils simplesl foim, il consisls of a
melallic conducloi in conlacl wilh lhe skin. An elecliolyle soaked pad oi gel is
used lo eslablish and mainlain lhe conlacl.
Iiguie 5.9 shows seveial foims of lhis elecliode. A limb elecliode foi use
wilh an elecliocaidiogiaph is shown in Iiguie 5.9(a). ¡l consisls of a ûal melal
plale lhal has been benl inlo a cylindiical segmenl. A leiminal is placed on ils
Ú·¹«®» ëòç Þ±¼§ó-«®º¿½» ¾·±°±¬»²¬·¿´ »´»½¬®±¼»- (a) Melal-plale elecliode
used foi applicalion lo limbs. (b) Melal-disk elecliode applied wilh suigical
lape. (c) Disposable foam-pad elecliodes oflen used wilh elecliocaidiogiaphic
moniloiing appaialus.
ë ò ê Þ Ñ Ü Ç ó Í Ë Î Ú ß Ý Û Î Û Ý Ñ Î Ü × Ò Ù Û Ô Û Ý Ì Î Ñ Ü Û Í îðç
oulside suiface neai one end; lhis leiminal is used lo allach lhe lead wiie lo lhe
elecliocaidiogiaph. The elecliode is liadilionally made of Geiman silvei
(a nickelsilvei alloy). Befoie il is allached lo lhe body wilh a iubbei sliap
oi lape, ils concave suiface is coveied wilh elecliolyle gel. Similaily aiianged
ûal melal disks aie also used as elecliodes. Allhough based upon pieceding
seclions of lhis chaplei, one would expecl lhal bellei elecliode designs could
be used wilh elecliocaidiogiaphs loday, lhese liadilional elecliodes aie slill
occasionally used.
A moie common vaiiely of melal-plale elecliode is lhe melal disk
illuslialed in Iiguie 5.9(b). This elecliode, which has a lead wiie soldeied
oi welded lo lhe back suiface, can be made of seveial diffeienl maleiials.
Somelimes a layei of insulaling maleiial, such as epoxy oi polyvinylchloiide,
piolecls lhe conneclion belween lead wiie and elecliode. This sliucluie can be
used as a chesl elecliode foi iecoiding lhe !CG oi in caidiac moniloiing foi
long-leim iecoidings. ¡n lhese applicalions lhe elecliode is oflen fabiicaled
fiom a disk of Ag lhal may have an elecliolylically deposiled layei of AgCl on
ils conlacling suiface. ¡l is coaled wilh elecliolyle gel and lhen piessed againsl
lhe palienl`s chesl wall. ¡l is mainlained in place by a sliip of suigical lape oi a
plaslic foam disk wilh a layei of adhesive lack on one suiface.
This slyle of elecliode is also populai foi suiface iecoidings of !MGoi !!G.
¡niecoiding !MGs, invesligalois use slainless sleel, plalinum, oi gold-plaleddisks
lo minimize lhe chance lhal lhe elecliode will enlei inlo chemical ieaclions wilh
peispiialion oi lhe gel. These maleiials pioduce polaiizable elecliodes, and
molion ailifacl can be a pioblem wilh aclive palienls. !lecliodes used in
moniloiing !MGs oi !!Gs aie geneially smallei in diamelei lhan lhose used
in iecoiding !CGs. Disk-shaped elecliodes such as lhese have also been fabii-
caled fiom melal foils (piimaiily silvei foil) and aie applied as single-use dispos-
able elecliodes. The lhin, ûexible foil allows lhe elecliode lo confoimlo lhe shape
of lhe body suiface. Also, because il is so lhin, lhe cosl can be kepl ielalively low.
!conomics necessaiily plays an impoilanl iole in deleimining whal
maleiials and appaialus aie used in hospilal adminislialion and palienl
caie. ¡n choosing suilable caidiac elecliodes foi palienl-moniloiing applica-
lions, physicians aie moie and moie luining lo piegelled, disposable elecliodes
wilh lhe adhesive alieady in place. These devices aie ieady lo be applied lo lhe
palienl and aie disposed aflei use. This minimizes lhe amounl of peisonnel
lime associaled wilh lhe use of lhese elecliodes.
A populai lype of elecliode of lhis vaiiely is illuslialed in Iiguie 5.9(c).
¡l consisls of a ielalively laige disk of plaslic foam maleiial wilh a silvei-
plaled disk on one side allached lo a silvei-plaled snap similai lo lhal used
on clolhing in lhe cenlei of lhe olhei side. A lead wiie wilh lhe female
poilion of lhe snap is lhen snapped onlo lhe elecliode and used lo connecl
lhe assembly lo lhe moniloiing appaialus. The silvei-plaled disk seives as
lhe elecliode and may be coaled wilh an AgCl layei. A layei of elecliolyle
gel coveis lhe disk. The elecliode side of lhe foam is coveied wilh an
adhesive maleiial lhal is compalible wilh lhe skin. A pioleclive covei oi
sliip of ielease papei is placed ovei lhis side of lhe elecliode and foam, and
îïð ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
lhe complele elecliode is packaged in a foil envelope so lhal lhe walei
componenl of lhe gel will nol evapoiale away. To apply lhe elecliode lo
lhe palienl, lhe clinician has only lo clean lhe aiea of skin on which lhe
elecliode is lo be placed, open lhe elecliode packel, snap lhe lead wiie on lo
lhe elecliode, iemove lhe ielease papei fiom lhe lack, and piess lhe
elecliode againsl lhe palienl`s skin. This pioceduie is quickly accomplished
and no special lechnique need be leained.
ÍËÝÌ×ÑÒ ÛÔÛÝÌÎÑÜÛÍ
A modincalion of lhe melal-plale elecliode lhal iequiies no sliaps oi adhe-
sives foi holding il in place is lhe suclion elecliode illuslialed in Iiguie 5.1O.
Such elecliodes aie fiequenlly used in elecliocaidiogiaphy as lhe piecoidial
(chesl) leads, because lhey can be placed al pailiculai localions and used lo
lake a iecoiding. They consisl of a hollow melallic cylindiical elecliode lhal
makes conlacl wilh lhe skin al ils base. An appiopiiale leiminal foi lhe lead
wiie is allached lo lhe melal cylindei, and a iubbei suclion bulb nls ovei ils
olhei base. !lecliolyle gel is placed ovei lhe conlacling suiface of lhe
elecliode, lhe bulb is squeezed, and lhe elecliode is lhen placed on lhe chesl
wall. The bulb is ieleased and applies suclion againsl lhe skin, holding lhe
elecliode assembly in place. This elecliode can be used only foi shoil peiiods
of lime; lhe suclion and lhe piessuie of lhe conlacl suiface againsl lhe skin can
cause iiiilalion. Allhough lhe elecliode ilself is quile laige, Iiguie 5.1O shows
lhal lhe aclual conlacling aiea is ielalively small. This elecliode lhus lends lo
have a highei souice impedance lhan lhe ielalively laige-suiface-aiea melal-
plale elecliodes used foi !CG limb elecliodes, as shown in Iiguie 5.9(a).
ÚÔÑßÌ×ÒÙ ÛÔÛÝÌÎÑÜÛÍ
¡n lhe pievious seclion, we noled lhal one souice of molion ailifacl in
biopolenlial elecliodes is lhe disluibance of lhe double layei of chaige al
Ú·¹«®» ëòïð A melallic suclion elecliode is oflen used as a piecoidial elec-
liode on clinical elecliocaidiogiaphs.
ë ò ê Þ Ñ Ü Ç ó Í Ë Î Ú ß Ý Û Î Û Ý Ñ Î Ü × Ò Ù Û Ô Û Ý Ì Î Ñ Ü Û Í îïï
lhe elecliodeelecliolyle inleiface. The use of nonpolaiizable elecliodes, such
as lhe Ag/AgCl elecliode, can gieally diminish lhis ailifacl. Bul il slill can be
piesenl, and effoils lo slabilize lhe inleiface mechanically can ieduce il
fuilhei. Ú´±¿¬·²¹ »´»½¬®±¼»- offei a suilable lechnique lo do so.
Iiguie 5.11 shows examples of lhese devices. Iiguie 5.11(a) depicls a
ûoaling elecliode known as a ¬±°ó¸¿¬ elecliode; ils inleinal sliucluie is
illuslialed in cioss seclion in Iiguie 5.11(b). The piincipal fealuie of lhe
elecliode is lhal lhe aclual elecliode elemenl oi melal disk is iecessed in a
cavily so lhal il does nol come in conlacl wilh lhe skin ilself. ¡nslead, lhe
elemenl is suiiounded by elecliolyle gel in lhe cavily. The cavily and hence lhe
gel does nol move wilh iespecl lo lhe melal disk, so il does nol pioduce any
mechanical disluibance of lhe double layei of chaige. ¡n piaclice, lhe elecliode
is nlled wilh elecliolyle gel and lhen allached lo lhe skin suiface by means of a
double-sided adhesive-lape iing, as shown in Iiguie 5.11. The elecliode
elemenl can be a disk made of a melal such as silvei coaled wilh AgCl.
Anolhei fiequenlly encounleied foim of lhe ûoaling elecliode uses a sinleied
Ag/AgCl pellel inslead of a melal disk. These elecliodes aie found lo be quile
slable and aie ieusable aflei appiopiiale cleaning belween uses.
A single-use, disposable modincalion of lhe ûoaling elecliode is shown in
cioss seclion in Iiguie 5.11(c). ¡ls sliucluie is basically lhe same as lhal of lhe
Ú·¹«®» ëòïï (a) Recessed
elecliode wilh lop-hal sliucluie. (b) Cioss-seclional view of lhe elecliode in
(a). (c) Cioss-seclional view of a disposable iecessed elecliode of lhe same
geneial sliucluie shown in Iiguie 5.9(c). The iecess in lhis elecliode is foimed
fiom an open foam disk, saluialed wilh elecliolyle gel, and placed ovei lhe
melal elecliode.
îïî ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
disposable melal-plale elecliode shown in Iiguie 5.9(c), bul il has one added
componenl‰a disk of lhin, open-cell foam saluialed wilh elecliolyle gel. The
foam is nimly afnxed lo lhe melal-disk elecliode, lheieby pioviding an
inleimediale elecliolyle-gel layei belween lhe elecliode and lhe skin. Because
lhe foam is nxed lo lhe melal disk, lhe gel conlained wilhin il al lhe disk
inleiface is mechanically slable. The olhei suiface of lhe foam lhal is placed
againsl lhe skin is able lo move wilh lhe skin, lheieby diminishing lhe molion
ailifacl lhal somelimes iesulls fiom diffeienlial movemenl belween lhe skin
and lhe elecliolyle gel.
Coosemans el al. (2OO6) have made elecliodes and anlenna oul of lexlile
maleiials inlegialed inlo lhe baby`s pa|amas lo measuie lhe !CG of childien
wilhanincieasediiskof sudden infanl dealhsyndiome(S¡DS). The lhieeknilled
and woven slainless sleel elecliodes (called Texliodes) yielded laigei molion
ailifacls lhan disposable Ag/AgCl elecliodes, bul lhey could measuie heail iale.
Kang el al. (2OO8) used bolh hand- and scieen-piinling lhick-nlm lech-
niques lo developfabiic aclive elecliodes lhal piovide lhe comfoil iequiied foi
clolhing. They used nonslielchable nonwoven (!volon 1OO) as lhe ûexible
fabiic subsliale and a silvei nlled polymei ink (Ciealive Maleiials CM¡ 112-15)
lo foim an elecliode layei and conduclive lines on lhe fabiics.
ÛÔÛÝÌÎÑÜÛ ÍÌßÒÜßÎÜÍ
Duiing denbiillalion, laige cuiienls may ûow lhiough lhe elecliodes, gieally
change lhe elecliode oveipolenlial, and make il difncull lo deleimine whelhei
lhe denbiillalion has been successful. ¡n geneial Ag/AgCl elecliodes aie
salisfacloiy, wheieas polaiizable elecliodes aie nol. Slandaids foi piegelled
disposable elecliodes (Anonymous, 2OO5) iequiie face-lo-face bench lesling lo
ensuie lhal lhe offsel vollage is less lhan 1OO m\, lhe noise is less lhan 15O ³\,
lhe 1O Hz impedance is less lhan 2 kÊ, lhe denbiillalion oveiload iecoveiy lo
foui 2 mCchaiges is less lhan 1OO m\, and lhe bias cuiienl loleiance lo 2OO nA
foi 8 h yields less lhan 1OO m\ offsel (McAdams, 2OO6). The denbiillalion
iecoveiy vollage veisus lime foi 12 elecliode maleiials shows lhal lhe oplimal
iecoveiy occuis foi 5OO mC/cm
2
of AgCl elecliodeposiled on Ag (Das and
Webslei, 198O). Addilional lesls on humans can assess molion ailifacl, adhe-
sive lack, and skin iiiilalion (Webslei, 1984a; ibid., 1984b).
ÚÔÛÈ×ÞÔÛ ÛÔÛÝÌÎÑÜÛÍ
The elecliodes desciibed so fai aie solid and eilhei aie ûal oi have a nxed
cuivaluie. The body suiface, on lhe olhei hand, is iiiegulaily shaped and can
change ils local cuivaluie wilh movemenl. Solid elecliodes cannol confoim lo
lhis change in body-suiface lopogiaphy, which can iesull in addilional molion
ailifacl. To avoid such pioblems, ûexible elecliodes have been developed,
examples of which aie shown in Iiguie 5.12.
One lype of ûexible elecliode is a woven, slielchable, nylon fabiic
impiegnaled wilh silvei pailicles. Lead wiie bonding is achieved by lhe use
of epoxy. Gel pads aie used foi shoil-leim moniloiing.
ë ò ê Þ Ñ Ü Ç ó Í Ë Î Ú ß Ý Û Î Û Ý Ñ Î Ü × Ò Ù Û Ô Û Ý Ì Î Ñ Ü Û Í îïí
Iiguie 5.12(a) shows anolhei lechnique employed lo piovide ûexible
elecliodes. A caibon-nlled silicone iubbei compound in lhe foim of a lhin
sliip oi disk is used as lhe aclive elemenl of an elecliode. The caibon pailicles
in lhe silicone make il an elecliic conducloi. Apin connecloi is pushed inlo lhe
lead connecloi hole, and lhe elecliode is used in lhe same way as a similai lype
of melal-plale elecliode.
Ilexible elecliodes aie especially impoilanl foi moniloiing piemaluie
infanls. !lecliodes foi delecling lhe !CG and iespiialion by lhe impedance
lechnique aie allached lo lhe chesl of piemaluie infanls, who usually weigh
less lhan 25OO g. Convenlional elecliodes aie nol appiopiiale; lhey cannol
confoim lo lhe shape of lhe infanl`s chesl and can cause seveie skin ulceialion
al piessuie poinls. They musl also be iemoved when chesl x iays aie laken of
lhe infanl, because lhey aie opaque and can obsliucl lhe view of signincanl
poilions of lhe lhoiacic cavily. Neuman (1973) developed ûexible, lhin-nlm
elecliodes foi use on newboin infanls lhal minimize lhese pioblems. The basic
elecliode consisls of a 13 ³m-lhick Mylai nlm on which an Ag and AgCl nlm
have been deposiled, as shown in Iiguie 5.12(b). The aclual sliucluie of lhe
elecliode is illuslialed in cioss seclion in Iiguie 5.12(c). The ûexible lead wiie
is allached lo lhe Mylai subsliale by means of a conducling adhesive, and a
silvei nlm appioximalely 1 ³m lhick is deposiled ovei lhis and lhe Mylai. An
Ú·¹«®» ëòïî Ú´»¨·¾´» ¾±¼§ó-«®º¿½» »´»½¬®±¼»- (a) Caibon-nlled silicone iub-
bei elecliode. (b) Ilexible lhin-nlm neonalal elecliode |aflei Neuman (1973)j.
(c) Cioss-seclional view of lhe lhin-nlm elecliode in (b). |Pails (b) and (c) aie
fiom ¡nleinalional Iedeialion foi Medical and Biological !ngineeiing. Ü·¹»-¬
±º ¬¸» ï𬸠×ÝÓÞÛô 1973.j
îïì ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
AgCl layei is lhen giown on lhe suiface of lhe silvei nlm via lhe elecliolylic
piocess.
¡n addilion lo lhe advanlage of being ûexible and confoiming lo lhe shape
of lhe newboin`s chesl, lhese elecliodes have a layei of silvei lhin enough lo be
essenlially x-iay lianspaienl, so lhey need nol be iemoved when chesl x iays of
lhe infanl aie laken. All lhal shows up on lhe x iays is lhe lead wiie.
Consequenlly, lhe infanl`s skin is also piolecled fiom lhe iiiilalion caused
by iemoving and ieapplying lhe adhesive lape lhal holds lhe elecliode in place.
This has been demonslialed lo ieduce lhe occuiience of skin iiiilalion
signincanlly in nuiseiies in which ûexible, lhin-nlm elecliodes have been used.
The ûexible elecliodes we have desciibed iequiie some lype of adhesive
lape lo hold lhem in place againsl lhe skin. New elecliolylic hydiogel maleiials
have been developed lhal aie in lhe foim of a lhin, ûexible slab of gelalinous
maleiial. This subslance has a slicky suiface lhal is similai lo lhe adhesive lack
on lhe lape used lo hold elecliodes in place. By viilue of lhe mobile ions lhal il
conlains, il is also elecliically conduclive. A piece of lhis maleiial lhe same size
as lhe ûexible elecliode can be secuied on lhe elecliode`s suiface and used lo
hold il in place againsl lhe skin. Because lhe elecliode and lhis inleiface
maleiial aie bolh ûexible, a good, mechanically secuie elecliic conlacl can be
made belween lhe elecliode and lhe skin. One diawback of lhis maleiial is ils
ielalively high elecliic iesislance, compaied lo lhal of lhe elecliolyle gel
ioulinely used wilh elecliodes. Hydiogels aie less effeclive al hydialing lhe
diy epideimal layei (1ossinel and McAdams, 199O). This is nol a seveie
pioblem anymoie, howevei, because lhe amplineis used wilh lhese elecliodes
now have inpul impedances of lhe oidei of 1O MÊ oi highei, which is much
giealei lhan lhe iesislance of lhe elecliolylic maleiial. Oflen lheie is less
molion ailifacl when lhese elecliodes aie used.
ëòé ×ÒÌÛÎÒßÔ ÛÔÛÝÌÎÑÜÛÍ
!lecliodes can also be used wilhin lhe body lo delecl biopolenlials. They can
lake lhe foim of °»®½«¬¿²»±«- »´»½¬®±¼»-ô in which lhe elecliode ilself oi lhe
lead wiie ciosses lhe skin, oi lhey may be enliiely ·²¬»®²¿´ »´»½¬®±¼»-ô in which
lhe conneclion is lo an implanled eleclionic ciicuil such as a iadiolelemeliy
liansmillei. These elecliodes diffei fiom body-suiface elecliodes in lhal lhey
do nol have lo conlend wilh lhe elecliolyleskin inleiface and ils associaled
limilalions, as desciibed in Seclion 5.5. ¡nslead, lhe elecliode behaves in lhe
way diclaled enliiely by lhe elecliodeelecliolyle inleiface. No elecliolyle gel
is iequiied lo mainlain lhis inleiface, because exliacellulai ûuid is piesenl.
Theie aie many diffeienl designs foi inleinal elecliodes. An invesligaloi
sludying a pailiculai bioelecliic phenomenon by using inleinal elecliodes
fiequenlly designs his oi hei elecliodes foi lhal specinc puipose. The following
paiagiaphs desciibe some of lhe moie common foims of lhese elecliodes and
give examples of lheii applicalion.
ë ò é × Ò Ì Û Î Ò ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í îïë
Iiguie 5.13 shows diffeienl lypes of peiculaneous needle and wiie eleclio-
des. The basic needle elecliode consisls of a solid needle, usually made of
slainless sleel, wilh a shaip poinl. The shank of lhe needle is insulaled wilh a
coaling such as an insulaling vainish; only lhe lip is lefl exposed. A lead wiie is
allached lo lhe olhei end of lhe needle, andlhe |oinl is encapsulaled in a plaslic
hub lo piolecl il. This elecliode, fiequenlly used in elecliomyogiaphy, is
shown in Iiguie 5.13(a). When il is placed in a pailiculai muscle, il oblains an
!MG fiom lhal muscle aculely and can lhen be iemoved.
A shielded peiculaneous elecliode can be fabiicaled in lhe foim shown in
Iiguie 5.13(b). ¡l consisls of a small-gage hypodeimic needle lhal has been
modined by iunning an insulaled nne wiie down lhe cenlei of ils lumen and
nlling lhe iemaindei of lhe lumen wilh an insulaling maleiial such as an epoxy
Ú·¹«®» ëòïí Ò»»¼´» ¿²¼ ©·®» »´»½¬®±¼»- º±® °»®½«¬¿²»±«- ³»¿-«®»³»²¬ ±º
¾·±°±¬»²¬·¿´- (a) ¡nsulaled needle elecliode. (b) Coaxial needle elecliode,
(c) Bipolai coaxial elecliode. (d) Iine-wiie elecliode connecled lohypodeimic
needle, befoie being inseiled. (e) Cioss-seclional view of skin and muscle,
showing nne-wiie elecliode in place. (f) Cioss-seclional view of skin and
muscle, showing coiled nne-wiie elecliode in place.
îïê ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
iesin. When lhe iesin has sel, lhe lip of lhe needle is nled lo ils oiiginal bevel,
exposing an oblique cioss seclion of lhe cenlial wiie, which seives as lhe aclive
elecliode. The needle ilself is connecled lo giound lhiough lhe shield of a
coaxial cable, lheieby exlending lhe coaxial sliucluie lo ils veiy lip.
Mulliple elecliodes in a single needle can be foimed as shown in Iiguie
5.13(c). Heie lwo wiies aie placed wilhin lhe lumen of lhe needle and can be
connecled diffeienlially so as lo be sensilive lo elecliical aclivily only in lhe
immediale vicinily of lhe elecliode lip.
The needle elecliodes |usl desciibed aie piincipally foi acule measuie-
menls, because lheii sliffness and size make lhem uncomfoilable foi long-
leim implanlalion. When chionic iecoidings aie iequiied, peiculaneous wiie
elecliodes aie moie suilable. Theie aie many diffeienl lypes of wiie eleclio-
des and schemes foi inlioducing lhemlhiough lhe skin. |The inleiesled ieadei
should iefei lo Geddes (1972) foi a moie delailed ieview.j The piinciple can
be illuslialed, howevei, wilh lhe help of Iiguie 5.13(d). A nne wiie‰oflen
made of slainless sleel ianging in diamelei fiom 25 lo 125 ³m‰is insulaled
wilh an insulaling vainish lo wilhin a few millimeleis of lhe lip. This non-
insulaled lip is benl back on ilself lo foim a 1-shaped sliucluie. The lip is
inlioduced inlo lhe lumen of lhe needle, as shown in Iiguie 5.13(d). The
needle is inseiled lhiough lhe skin inlo lhe muscle al lhe desiied localion, lo
lhe desiied deplh. ¡l is lhen slowly wilhdiawn, leaving lhe elecliode in place,
as shown in Iiguie 5.13(e). Nole lhal lhe benl-ovei poilion of wiie seives as a
baib holding lhe wiie in place in lhe muscle. To iemove lhe wiie, lhe
lechnician applies a mild unifoim foice lo sliaighlen oul lhe baib and pulls
il oul lhiough lhe wiie`s liack.
Caldwell and Reswick (1975) have desciibed a vaiialion on lhis basic
appioach. Realizing lhal wiie elecliodes chionically implanled in aclive
muscles undeigo a gieal amounl of ûexing as lhe muscle moves (which can
cause lhe wiie lo slip as il passes lhiough lhe skin and inciease lhe iiiilalionand
iisk of infeclion al lhis poinl, oi even cause lhe wiie lo bieak), lhey developed
lhe helical elecliode and lead wiie shown in Iiguie 5.13(f). ¡l, loo, is made fiom
a veiy nne insulaled wiie coiled inlo a lighl helix of appioximalely 15O ³m
diamelei lhal is placed in lhe lumen of lhe inseiling needle. The uninsulaled
baib pioliudes fiom lhe lip of lhe needle and is benl back along lhe needle
befoie inseilion. ¡l holds lhe wiie in place in lhe lissue when lhe needle is
iemoved fiom lhe muscle. Of couise, lhe exleinal end of lhe elecliode now
passes lhiough lhe needle and lhe needle musl be iemoved‰oi al leasl
piolecled‰befoie lhe elecliode is connecled lo lhe iecoiding appaialus.
Anolhei gioup of peiculaneous elecliodes aie lhose used foi moniloiing
felal heailbeals. ¡n lhis case il is desiiable lo gel lhe elecliocaidiogiam fiom
lhe felus duiing laboi by diiecl conneclion lo lhe piesenling pail (usually lhe
head) lhiough lhe uleiine ceivix (lhe moulh of lhe uleius). The felus lies in a
balh of amniolic ûuid lhal conlains ions and is conduclive, so suiface eleclio-
des geneially do nol piovide an adequale !CG as a iesull of lhe shoiling effecl
of lhe amniolic ûuid. Thus elecliodes used lo oblain lhe felal !CG musl
peneliale lhe skin of lhe felus.
ë ò é × Ò Ì Û Î Ò ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í îïé
An example of a suclion elecliode lhal does lhis is shown in Iiguie 5.14(a). A
shaip-poinled piobe in lhe cenlei of a suclion cup can be applied lo lhe felal
piesenlingpail, as showninIiguie5.14(b). Whensuclionis appliedlolhecupaflei
il has beenplacedagainsl lhefelal skin, lhesuifaceof lheskinis diawninlolhecup
andlhecenlial elecliodepieices lheslialumcoineum, conlaclinglhedeepei layeis
of lhe epideimis. Onlhe backof lhe suclionelecliode is a iefeience elecliode lhal
conlacls lhe ûuid, and lhe signal seen belween lhese lwo elecliodes is lhe vollage
diop acioss lhe iesislance of lhe slialum coineum. Thus, allhough lhe amniolic
ûuid essenlially places all lhe body suiface of lhe felus al a common polenlial, lhe
polenlials benealhlheslialumcoineumcanbediffeienl, andfelal !CGs lhal have
peak ampliludes of lhe oidei of 5O lo 7OO ³\ can be ieliably iecoided.
Anolhei inliadeimal elecliode lhal is widely applied foi delecling felal
!CG duiing laboi is lhe helical elecliode developed by Hon (1972). ¡l consisls
of a slainless sleel needle, shaped appioximalely like one luin of a helix,
mounled on a plaslic hub. |See Iiguie 5.14(c).j The back suiface of lhe hub
conlains an addilional slainless sleel iefeience elecliode. When laboi has
pioceeded fai enough, lhis elecliode can be allached lo lhe felal piesenling
pail by iolaling il so lhal lhe needle lwisls |usl benealh lhe suiface of lhe skin
as would a coiksciew shallowly penelialing a coik. This elecliode iemains
nimly allached, and because of lhe shoilness of lhe helical needle, il does nol
peneliale deep enough inlo lhe skin lo cause signincanl iisk lo lhe felus. ¡l
opeiales on lhe same basic piinciple as lhe suclion elecliode.
Oflen when implanlable wiieless liansmission is used, we wanl lo implanl
elecliodes wilhin lhe body and nol peneliale lhe skin wilh any wiies. ¡n lhis
case lhe iadio liansmillei is implanled in lhe body. A wide vaiiely of eleclio-
des can be used in lhis applicalion. Only a few examples aie given heie.
The simplesl elecliode foi lhis applicalion is shown in Iiguie 5.15(a).
¡nsulaled mullislianded slainless sleel oi plalinum wiie suilable foi
Ú·¹«®» ëòïì Û´»½¬®±¼»- º±® ¼»¬»½¬·²¹ º»¬¿´ »´»½¬®±½¿®¼·±¹®¿³ ¼«®·²¹ ´¿¾±®ô ¾§
³»¿²- ±º ·²¬®¿½«¬¿²»±«- ²»»¼´»- (a) Suclionelecliode. (b) Cioss-seclional view
of suclion elecliode in place, showing penelialion of piobe lhiough epideimis.
(c) Helical elecliode lhal is allached lo felal skin by coiksciew-lype aclion.
îïè ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
implanlalion has one end sliipped so lhal an eyelel can be foimed fiom lhe
sliands of wiie. This is besl done by individually laking each sliand and
foiming lhe eyelel eilhei by lwisling lhe wiies logelhei one by one al lhe poinl
al which lhe insulalion slops oi by spol-welding each sliand lo lhe wiie mass al
lhis poinl. The eyelel can lhen be suluied lo lhe poinl in lhe body al which
elecliic conlacl is lo be eslablished. Silvei should nol be used foi lhis lype of
elecliode due lo lhe loxicily of lhis melal and ils effecls on suiiounding lissue.
Iiguie 5.15(b) shows anolhei example of an implanlable elecliode foi
oblaining coilical-suiface polenlials fiom lhe biain. Ciilchneld »¬ ¿´ò (1971)
applied lhis elecliode foi lhe iadiolelemeliy of subduial !!Gs. The elecliode
consisls of a 2 mm-diamelei melallic spheie localed al lhe lip of lhe cylindiical
Teûon insulaloi lhiough which lhe elecliode lead wiie passes. The calvaiium is
exposed lhiough an incision in lhe scalp, and a buii hole is diilled. A small slil is
made in lhe exposed duia, and lhe silvei spheie is inlioduced lhiough lhis
opening so lhal il iesls on lhe suiface of lhe ceiebial coilex. The assembly is lhen
cemenled in place onlo lhe calvaiium by means of a denlal aciylic maleiial.
Deep coilical polenlials can be iecoided fiom mulliple poinls using lhe
lechnique desciibed by Delgado (1964), as shown in Iiguie 5.15(c). This kind
of elecliode consisls of a cluslei of nne insulaled wiies held logelhei by a
vainish bindei. !ach wiie has been cul liansveisely lo expose an uninsulaled
cioss seclion lhal seives as lhe aclive elecliode suiface. By slaggeiing lhe ends
of lhe wiies as shown, we can pioduce elecliodes localed al known diffeiences
in deplh in an aiiay. The olhei ends of lhe elecliodes can be allached lo
appiopiiale implanlable eleclionic devices oi lo a connecloi cemenled on lhe
skull lo allow conneclion lo an exleinal iecoiding appaialus.
Ú·¹«®» ëòïë ׳°´¿²¬¿¾´» »´»½¬®±¼»- º±® ¼»¬»½¬·²¹ ¾·±°±¬»²¬·¿´- (a) Wiie-loop
elecliode. (b) plalinum-spheie coilical-suiface polenlial elecliode. (c) Mulli-
elemenl deplh elecliode.
ë ò é × Ò Ì Û Î Ò ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í îïç
ëòè ÛÔÛÝÌÎÑÜÛ ßÎÎßÇÍ
Allhough implanlable elecliode aiiays can be fabiicaled one al a lime using
clusleis of nne insulaled wiies, lhis lechnique is bolh lime-consuming and
expensive. Iuilheimoie, when such clusleis aie made individually, each one
will be somewhal diffeienl fiomlhe olhei. Away lo minimize lhese pioblems is
lo ulilize miciofabiicalion lechnology lo fabiicale idenlical lwo- and lhiee-
dimensional elecliode aiiays. !xamples of some of lhe lypes of sliucluies lhal
aie possible aie shown in Iiguie 5.16. One-dimensional lineai aiiays of six paiis
of biopolenlial iecoiding elecliodes have been desciibed by Masliololaio »¬ ¿´ò
(1992). These piobes illuslialed in Iiguie 5.16(a) consisl of squaie Ag/AgCl
elecliodes 4O ³m on a side on lhin-nlm gold conduclois lhal have been
deposiled on eilhei ûexible polyimide subsliales oi moie iobusl molybdenum
subsliale coaled wilh an anodically giown oxide layei lo piovide lhe necessaiy
insulalion. The piobes weie lypically 1O mm long, O.5 mm wide, and 125 ³m
lhick. Lead wiies weie allached lo lhe bonding pads al lhe pioximal end of lhe
piobe. These elecliode aiiays weie designed lo be used foi measuiing lians-
muial polenlial disliibulions in lhe bealing myocaidium. Theii ûexibilily was
impoilanl lo minimize lissue damage as lhe muscle conliacls and ielaxes.
Two-dimensional elecliode aiiays foi mapping lhe elecliical polenlials acioss
a iegion of lhe suiface of an oigan such as lhe heail aie shown in Iiguie 5.16(b).
These elecliodes essenlially iepiesenl an exlension of lhe appioach used foi lhe
one-dimensional aiiays desciibed above. A pallein of minialuie elecliodes is
foimedona iigidoi ûexible suiface andconnecledbyconduclois lolheassocialed
insliumenlalion. This inleiconneclioncanbequilea pioblembecauselaige aiiays
iequiie many conneclions. Sock elecliodes consisling of individual silvei spheies
ioughly 1 mmin diamelei incoipoialed inlo a fabiic sock lhal nls snugly ovei lhe
heail have been used lo map epicaidial polenlials. !ach spheie is al lhe lip of an
insulaled wiie lhal connecls il lo lhe iecoiding appaialus. Needless lo say, an
aiiay of a laige numbei of elecliodes of lhis lype is difncull lo build and awkwaid
lo use due lo lhe laige numbei of wiies coming fiom lhe sock.
Ash »¬ ¿´ò (1992) have shown lhal lhis piocess can be simplined by using a
mullilayei ceiamic inlegialed ciicuil package as lhe elecliode aiiay. They have
used lhis sliucluie lo map epicaidial polenlials. These invesligalois have also
used lhin-nlmmiciofabiicalion lechnology lo foimaiiays of 144 minialuie Ag/
AgCl elecliodes on polyimide subsliales |Iiguie 5.16(b)j. The lhin gold nlms
seive as conduclois as well as lhe bases foi lhe Ag/AgCl elecliodes. The
inleiconneclions weie compleled by using a minialuie iibbon cable designed
foi suiface mounl micioeleclionic applicalions. Olsson »¬ ¿´ò (2OO5) have laken
lhis concepl a slep fuilhei by incoipoialing amplineis in lheii elecliode aiiay
piobes. These have been used foi exliacellulai iecoiding of neuial signals in
animal sludies.
Thiee-dimensional elecliode aiiays fabiicaled using silicon miciofabiica-
lion lechnology have been desciibed by Campbell »¬ ¿´ò (1991), Biannei »¬ ¿´ò
(2OO4), and olheis. Theii devices have lhe appeaiance of a lwo-dimensional
îîð ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
comb |Iiguie 5.16(c)j wilh each line being ioughly 1.5 mm long and suiiounded
wilh insulaling maleiial up lo lhe lip. The exposed lip seives as lhe elecliode, and
a wiie conneclion on lhe base of lhe sliucluie was needed lo make conlacl wilh
each line elecliode. Allhough lhis aiiay is a lhiee-dimensional sliucluie, il ieally
only measuies fioma lwo-dimensional aiiay of elecliodes because all of lhe lines
Ú·¹«®» ëòïê Û¨¿³°´»- ±º ³·½®±º¿¾®·½¿¬»¼ »´»½¬®±¼» ¿®®¿§- (a) one-dimen-
sional plunge elecliode aiiay |aflei Masliololaio »¬ ¿´ò (1992)j, (b) lwo-dimen-
sional aiiay, and (c) lhiee-dimensional aiiay |aflei Campbell »¬ ¿´ò (1991)j.
ë ò è Û Ô Û Ý Ì Î Ñ Ü Û ß Î Î ß Ç Í îîï
aie lhe same lenglh. A liuly lhiee-dimensional elecliode aiiay can be fabiicaled
by laking a sel of one-dimensional elecliode aiiay piobes such as seen in Iiguie
5.16(a) oi a micioelecliode piobe as seen in Iiguie 5.2O(b) and assembling lhem
in an aiiay of lines similai in appeaiance lo lhal of Iiguie 5.16(c).
These appioaches lo high-densily elecliode aiiays iequiie exlensive
miciofabiicalion facililies and lhe cosls lo consliucl lhe aiiays can be quile
high. Malkin and Pendley (2OOO) have demonslialed a ielalively inexpensive
way lo fabiicale elecliode aiiays foi caidiac !CG mapping in small iodenls
using iibbon cable. They pioduced aiiays of fiom 4 lo 4OO iegulaily spaced
elecliodes in lheii caidiac physiology laboialoiy wilhoul special equipmenl.
ëòç Ó×ÝÎÑÛÔÛÝÌÎÑÜÛÍ
¡n sludying lhe elecliophysiology of excilable cells, il is oflen impoilanl lo
measuie polenlial diffeiences acioss lhe cell membiane. To be able lo do lhis,
we musl have an elecliode wilhin lhe cell. Such elecliodes musl be small wilh
iespecl lo lhe cell dimensions lo avoid causing seiious cellulai in|uiy and
lheieby changing lhe cell`s behavioi. ¡n addilion lo being small, lhe elecliode
used foi measuiing inliacellulai polenlial musl also be sliong so lhal il can
peneliale lhe cell membiane and iemain mechanically slable.
!lecliodes lhal meel lhese iequiiemenls aie known as ³·½®±»´»½¬®±¼»-ò
They have lip diameleis ianging fiom appioximalely O.O5 lo 1O ³m. Micio-
elecliodes can be foimed fiom solid-melal needles, fiom melal conlained
wilhin oi on lhe suiface of a glass needle, oi fiom a glass miciopipelle having a
lumen nlled wilh an elecliolylic solulion. !xamples of each lype aie given in
lhe following paiagiaphs. Moie delailed desciiplions can be found in Geddes
(1972), Ieiiis (1974), and Cobbold (1974).
ÓÛÌßÔ Ó×ÝÎÑÛÔÛÝÌÎÑÜÛÍ
The melal micioelecliode is essenlially a nne needle of a sliong melal lhal is
insulaled wilh an appiopiiale insulaloi up lo ils lip, as shown in Iiguie 5.17.
Ú·¹«®» ëòïé The sliucluie of a melal micioelecliode foi inliacellulai
iecoidings.
îîî ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
The melal needle is piepaied in such a way as lo pioduce a veiy nne lip. This is
usually done by elecliolylic elching, using an elecliochemical cell in which lhe
melal needle is lhe anode. The elecliic cuiienl elches lhe needle as il is slowly
wilhdiawn fiom lhe elecliolyle solulion. \eiy nne lips can be foimed in lhis
way, bul a gieal deal of palience and piaclice aie iequiied lo gain lhe skill lo
make lhem. Suilable sliong melals foi lhese micioelecliodes aie slainless sleel,
plalinumiiidium alloy, and lungslen. The compound lungslen caibide is also
used because of ils gieal slienglh.
The elched melal needle is lhen suppoiledin a laigei melallic shafl lhal can
be insulaled. This shafl seives as a sluidy mechanical suppoil foi lhe micio-
elecliode and as a means of connecling il lo ils lead wiie. The micioelecliode
and suppoiling shafl aie usually insulaled by a nlm of some polymeiic maleiial
oi vainish. Only lhe exlieme lip of lhe elecliode iemains uninsulaled.
ÍËÐÐÑÎÌÛÜóÓÛÌßÔ Ó×ÝÎÑÛÔÛÝÌÎÑÜÛÍ
The piopeilies of lwo diffeienl maleiials aie used lo advanlage in suppoiled-
melal micioelecliodes. A sliong insulaling maleiial lhal can be diawn lo a nne
poinl makes up lhe basic suppoil, and a melal wilh good elecliical conduclivily
conslilules lhe conlacling poilion of lhe elecliode.
Iiguie 5.18 shows examples of suppoiled melal micioelecliodes. The
classic example of lhis foim is a glass lube diawn lo a miciopipelle sliucluie
wilh ils lumen nlled wilh an appiopiiale melal. Oflen lhis lype of micio-
elecliode, as shown in Iiguie 5.18(a), is piepaied by nisl nlling a glass lube
wilh a melal lhal has a melling poinl neai lhe soflening poinl of lhe glass. The
lube can lhen be healed lo lhe soflening poinl and pulled lo foim a naiiow
consliiclion. When il is biokenal lhe consliiclion, lwo miciopipelles nlledwilh
melal aie foimed. ¡n lhis lype of sliucluie, lhe glass nol only piovides lhe
mechanical suppoil bul also seives as lhe insulalion. The aclive lip is lhe only
melallic aiea exposed in cioss seclion wheie lhe pipelle was bioken away.
Ú·¹«®» ëòïè ͬ®«½¬«®»- ±º ¬©± -«°°±®¬»¼ ³»¬¿´ ³·½®±»´»½¬®±¼»- (a) Melal-
nlled glass miciopipelle. (b) Glass miciopipelle oi piobe, coaled wilh melal
nlm.
ë ò ç Ó × Ý Î Ñ Û Ô Û Ý Ì Î Ñ Ü Û Í îîí
Melals such as silvei-soldei alloy and plalinum and silvei alloys aie used. ¡n
some cases melals wilh low melling poinls, such as indium oi Wood`s melal,
aie used.
New suppoiled-melal elecliode sliucluies have been developed using
lechniques employed in lhe semiconducloi micioeleclionics indusliy. Iig-
uie 5.18(b) shows lhe cioss seclion of lhe lip of a deposiled-melal-nlm
micioelecliode. A solid glass iod oi glass lube is diawn lo foim lhe
miciopipelle. A melal nlm is deposiled unifoimly on lhis suiface lo a
lhickness of lhe oidei of lenlhs of a miciomelei. A polymeiic insulalion
is lhen coaled ovei lhis, leaving |usl lhe lip, wilh lhe melal nlm exposed.
Ó×ÝÎÑÐ×ÐÛÌÌÛ ÛÔÛÝÌÎÑÜÛÍ
Glass miciopipelle micioelecliodes aie fabiicaled fiom glass capillaiies. The
cenlial iegion of a piece of capillaiy lubing, as shown in Iiguie 5.19(a), is
healed wilh a buinei lo lhe soflening poinl. ¡l is lhen iapidly slielched lo
pioduce lhe consliiclion shown in Iiguie 5.19(b). Special devices, known as
³·½®±»´»½¬®±¼» °«´´»®-, lhal heal and slielch lhe glass capillaiy in a unifoim
iepioducible way lo fabiicale miciopipelles aie commeicially available. The
lwo halves of lhe slielched capillaiy sliucluie aie bioken apail al lhe con-
sliiclion lo pioduce a pipelle sliucluie lhal has a lip diamelei of lhe oidei
of 1 ³m. This pipelle is fabiicaled inlo lhe elecliode foim shown in
Iiguie 5.19(c). ¡l is nlled wilh an elecliolyle solulion lhal is fiequenlly 3Ó
KCl. A cap conlaining a melal elecliode is lhen sealed lo lhe pipelle, as
shown. The melal elecliode conlacls lhe elecliolyle wilhin lhe pipelle. The
Ú·¹«®» ëòïç
¬·±² (a) Seclion of nne-boie glass capillaiy. (b) Capillaiy naiiowed lhiough
healing and slielching. (c) Iinal sliucluie of glass-pipelle micioelecliode.
îîì ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
elecliode is fiequenlly a silvei wiie piepaied wilh an elecliolylic AgCl
suiface. Plalinum oi slainless sleel wiies aie also occasionally used.
Ó×ÝÎÑÛÔÛÝÌÎÑÜÛÍ ÞßÍÛÜ ÑÒ Ó×ÝÎÑÛÔÛÝÌÎÑÒ×Ý ÌÛÝØÒÑÔÑÙÇ
The lechnology used lo pioduce liansislois and inlegialed ciicuils can also be
used lo miciomachine small mechanical sliucluies. This lechnique has been
used by seveial invesligalois lo pioduce melal micioelecliodes. The sliucluie
shown in Iiguie 5.2O(a) uses lhe lechnology foi fabiicaling beam-lead liansis-
lois (Wise »¬ ¿´òô 199O). The basic sliucluie consisls of naiiow gold sliips
deposiled on a silicon subsliale lhe suiface of which has been nisl insulaled by
giowing an SiO
2
nlm. The gold sliips aie lhen fuilhei insulaled by deposiling
SiO
2
ovei lheii suiface. The silicon subsliale is nexl elched lo a lhin, naiiow
sliucluie lhal is |usl wide enough lo accommodale lhe gold sliips in lhe iegion
of lhe lip. The silicon subsliale is elched a millimelei oi lwo back fiom lhe lip
so lhal only lhe gold sliips and lheii SiO
2
insulalion iemain. The insulalion is
Ú·¹«®» ëòîð Ü·ºº»®»²¬ ¬§°»- ±º ³·½®±»´»½¬®±¼»- º¿¾®·½¿¬»¼ «-·²¹ ³·½®±»´»½¬®±²·½
¬»½¸²±´±¹§ (a) Beam-lead mulliple elecliode. (Based on Iiguie 7 in K. D.
Wise, 1. B. Angell, and A. Slaii, An inlegialed ciicuil appioach lo exliac-
ellulai micioelecliodes.`` Repiinled wilh peimission fiom ×ÛÛÛ Ì®¿²-ò
Þ·±³»¼ò Û²¹òô 197O, BM!-17, 238246. Copyiighl 197O by lhe ¡nslilule of
!lecliical and !leclionics !ngineeis.) (b) Mullielecliode silicon piobe aflei
Diake »¬ ¿´ò (c) Mulliple-chambei elecliode aflei Piohaska »¬ ¿´ò (d) Peiiph-
eial-neive elecliode based on lhe design of !dell.
ë ò ç Ó × Ý Î Ñ Û Ô Û Ý Ì Î Ñ Ü Û Í îîë
elched away fiom lhe veiy lip of lhe gold sliips lo expose lhe conlacling
suiface of lhe elecliodes. Allhough lhis lechnology cannol pioduce lips as
small as can be pioduced wilh lhe glass miciopipelle lechnique pieviously
desciibed, il is possible lo make mullielecliode aiiays and lo mainlain veiy
piecisely lhe geomeliy belween individual elecliodes in lhe aiiay. The high
iepioducibilily of micioeleclionic piocessing allows many elecliodes lo be
made lhal all have veiy similai geomeliic piopeilies. Thus lhe chaiacleiislics
vaiy lillle fiom one elecliode aiiay lo lhe nexl.
Seveial olhei designs foi sensing and slimulaling elecliodes have been
developed lhiough lhe use of micioeleclionic lechnology. An aiiay of mullisile
micioelecliodes can be giown on a lhin silicon piobe |Iiguie 5.2O(b)j lhal can
be placed in lhe coilex of lhe biain lo delecl local polenlials (Diake »¬ ¿´., 1988;
Kovacs »¬ ¿´ò, 1994). A similai design was ulilized by Piohaska »¬ ¿´ò (1986), bul
heie lhe aclual gold oi silvei/silvei chloiide elecliode was localed in a veiy
small chambei nlled wilh an elecliolylic solulion such as sodium chloiide and
was made fioman insulaling nlmwilh a small hole lo allowcommunicalionwilh
lhe neivous lissue in which il was placed |Iiguie 5.2O(c)j. A novel elecliode foi
sensing signals emilled fiom peiipheial neives has been developed (!dell,
1986). His elecliode consisled of an aiiay of channels elched lhiough a silicon
chip |Iiguie 5.2O(d)j. He used lhese elecliodes in animal sludies wheiein
peiipheial neives weie liansecled and each side of lhe cul neive was aligned
on opposile sides of lhe silicon chip so lhal lhe neive could iegeneiale and giow
lhiough lhe channels on lhe chip lo ieeslablish lhe conneclions. Gold melali-
zalion on lhe silicon suiface suiiounding each channel was used lo make
elecliic conlacl wilh lhe neive nbeis lhal passed lhiough lhe channels on lhe
silicon chip. These aie called -·»ª» »´»½¬®±¼»- (Alkin »¬ ¿´ò, 1994).
ÛÔÛÝÌÎ×ÝßÔ ÐÎÑÐÛÎÌ×ÛÍ ÑÚ Ó×ÝÎÑÛÔÛÝÌÎÑÜÛÍ
To undeisland lhe elecliical behavioi of micioelecliodes, we musl deiive an
elecliical equivalenl ciicuil fiom physical consideialions. This ciicuil diffeis
foi melal and miciopipelle elecliodes.
Iiguie 5.21 shows melal micioelecliodes. The micioelecliode conliibules
a seiies iesislance Î
s
lhal is due lo lhe iesislance of lhe melal ilself. A ma|oi
conliibuloi lo lhis iesislance is lhe melal in lhe shank and lip poilion of lhe
micioelecliode, because lhe ialio of lenglh lo cioss-seclional aiea is much
highei in lhis poilion lhan il is foi lhe shafl.
The melal is coaled wilh an insulaling maleiial ovei all bul ils mosl dislal
lip, soa capacilance is sel up belween lhe melal and lhe exliacellulai ûuid. This
is a disliibuled capacilance Ý
d
lhal we can iepiesenl in lumped foim by
sepaialing lhe shank and lip fiom lhe shafl. ¡n lhe shank iegion, we can
considei lhe micioelecliode lo be a coaxial cylindei capaciloi; lhe capacilance
pei unil lenglh (I/m) is given by
Ý
dl
Ô
2°»
i
»
O
lnÜ ¼
(5.16)
îîê ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
wheie
»
O
dielecliic conslanl of fiee space (Appendix A.1)
»
®
ielalive dielecliic conslanl of insulalion maleiial
Ü diamelei of cylindei consisling of elecliode plus insulalion
Ú·¹«®» ëòîï Û¯«·ª¿´»²¬ ½·®½«·¬ ±º ³»¬¿´ ³·½®±»´»½¬®±¼» (a) !lecliode wilh lip
placed wilhin a cell, showing oiigin of disliibuled capacilance. (b) !quivalenl
ciicuil foi lhe silualion in (a). (c) Simplined equivalenl ciicuil. (Iiom L. A.
Geddes, Û´»½¬®±¼»- ¿²¼ ¬¸» Ó»¿-«®»³»²¬ ±º Þ·±»´»½¬®·½ Ûª»²¬-ô Wiley-¡nlei-
science, 1972. \sed wilh peimission of 1ohn Wiley and Sons, New Yoik.)
ë ò ç Ó × Ý Î Ñ Û Ô Û Ý Ì Î Ñ Ü Û Í îîé
¼ diamelei of elecliode
Ô lenglh of shank
Of couise, lhis coaxial-cableappioximalionis nol a veiy goodappioximalion foi
lhe shank iegion, which is lapeied, bul il is ieasonable foi a iough calculalion.
Because insulalion lhicknesses aie usually on lhe oidei of 1 ³min lhe shank and
lip, il is impoilanl lo considei lhe sliucluie using lhe coaxial cylindei analog.
Howevei, when we considei lhe shafl poilionof lhe elecliode, if lhe lhickness of
lhe insulalion is slill appioximalely 1 ³m, lhe diamelei of lhe melal shafl can be
on lhe oidei of seveial millimeleis. Heie lhe ialio of diameleis would be
piaclically unily, so we can simplify lhe calculalion by unwiapping lhe ciicum-
feienlial suiface of lhe shafl and consideiing lhe syslem lo be a paiallel-plale
capaciloi of aiea equal lo lhe ciicumfeienlial suiface aiea and of lhickness equal
lo¬, lhe lhickness of lhe insulalion layei. The capacilance pei unil lenglh (I/m) is
given by
Ý
d2
Ô
»
i
»
O
°¼
¬
(5.17)
Nole lhal lhis capacilance comes fiom only lhal poilion of lhe elecliode shafl
lhal is submeiged in lhe exliacellulai ûuid. Oflen only lhe shank is submeiged,
so Ý
d2
is zeio.
The olhei signincanl conliibulions lo lhe equivalenl ciicuil fiomlhe melal
micioelecliode aie lhe componenls conliibuled by lhe melalelecliolyle
inleiface, Î
ma
, Ý
ma
, and Û
ma
. A similai sel of componenls, Ý
mb
, Î
mb
, and
Û
mb
, aie associaled wilh lhe iefeience elecliode. Because of lhe much laigei
suiface aiea of lhe iefeience elecliode compaied wilh lhe lip of lhe micio-
elecliode, lhe impedance due lo lhese componenls is much lowei. Of couise,
lhe half-cell polenlial due lo lhe iefeience elecliode is unaffecled by lhe
suiface aiea. The lip of lhe micioelecliode is wilhin a cell, so lheie is a seiies
iesislance Î
i
, associaled wilh lhe elecliolyle wilhin lhe cell membiane and
anolhei seiies iesislance Î
e
due lo lhe exliacellulai ûuid. The cell membiane
ilself can be modeled simply as a vaiiable polenlial Û
mp
, bul in moie delailed
analyses an equivalenl ciicuil of giealei complexily is iequiied. Some of lhe
disliibuled capacilance of lhe shank, Ý
d1
, is belween lhe micioelecliode and
lhe exliacellulai ûuid, as shown in lhe equivalenl ciicuil, wheieas lhe iemain-
dei of il is belween lhe micioelecliode and lhe inliacellulai ûuid.
Theie is also a capacilance associaled wilh lhe lead wiies, Ý
w
. The physical
basis foi lhis equivalenl ciicuil is shown in Iiguie 5.21(a); lhe aclual equivalenl
ciicuil is shown in Iiguie 5.21(b). Oflen il is acceplable lo simplify lhis
equivalenl ciicuil lo lhal shown in Iiguie 5.21(c), which neglecls lhe imped-
ance of lhe iefeience elecliode and lhe seiies-iesislance conliibulion fiom lhe
inliacellulai and exliacellulai ûuid and lumps all lhe disliibuled capacilance
logelhei. \ndei ciicumslances in which lhe inpul impedance of lhe amplinei
connecled lo lhis elecliode is nol sufncienlly laige, we see lhal lhis ciicuil can
behave as a high-pass nllei and signincanl wavefoim disloilion can iesull.
îîè ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
The effeclive impedance of melal micioelecliodes is fiequency dependenl
and can be of lhe oidei of 1O lo 1OO MÊ. We can, howevei, lowei lhis
impedance by incieasing lhe effeclive suiface aiea of lhe lip of lhe micio-
elecliode lhiough lhe applicalion of plalinum black, as we did in lhe case of
lhe hydiogen elecliode. ¡mpedance ieduclion of one oi lwo oideis of magni-
lude can be achieved in lhis way. Al lowei fiequencies, lhe impedance can be
ieduced by applying an Ag/AgCl suiface lo lhe elecliode lip. Caie musl be
laken in doing lhis, howevei, because of lhe mechanically fiagile naluie of lhis
nlmand ils lendency lo ûake off, and lhe fewsilvei ions lhal dissolve in lhe cell
mighl affecl ils behavioi.
The equivalenl ciicuil foi lhe miciopipelle elecliode is somewhal moie
complicaled lhan lhal of lhe melal micioelecliode. The physical silualion is
illuslialed in Iiguie 5.22(a), and lhe iesulling equivalenl ciicuil is shown in
Iiguie 5.22(b). The inleinal elecliode in lhe miciopipelle gives lhe melal
elecliolyle inleiface componenls Î
ma
, Ý
ma
, and Û
ma
. ¡n seiies wilh lhis is a
iesislive elemenl Î
l
coiiesponding lo lhe iesislance of lhe elecliolyle in lhe
shank and lip iegion of lhe micioelecliode. Connecled lo lhis is lhe disliibuled
capacilance Ý
d
coiiesponding lo lhe capacilance acioss lhe glass in lhis iegion.
The disliibuled capacilance due lo lhe shafl iegion has been neglecled,
because lhe glass wall of lhe elecliode is much lhickei in lhis iegion and
lhe capacilive conliibulion is quile small.
Theie aie lwo polenlials associaled wilh lhe lip of lhe miciopipelle
micioelecliode. The ´·¯«·¼ó¶«²½¬·±² °±¬»²¬·¿´ Û
|
coiiesponds lo lhe liquid
|unclion sel up belween lhe elecliolyle in lhe miciopipelle and lhe inlia-
cellulai ûuid. ¡n addilion, a polenlial known as lhe lip polenlial Û
l
aiises
because lhe lhin glass wall suiiounding lhe lip iegion of lhe miciopipelle
behaves like a glass membiane and has an associaled membiane polenlial.
The equivalenl ciicuil also includes iesislances coiiesponding lo lhe
inliacellulai Î
i
and exliacellulai Î
e
ûuids. These aie coupled lo lhe micio-
elecliode lhiough lhe disliibulive capacilance Ý
d
, as is lhe case foi lhe melal
micioelecliode. The equivalenl ciicuil foi lhe iefeience elecliode iemains
unchanged fiom lhal shown in Iiguie 5.21(b).
\nlike lhe melal micioelecliode, lhe miciopipelle`s ma|oi impedance
conliibulion is iesislive. This can be illuslialed by appioximaling lhe equiv-
alenl ciicuil lo give lhal shown in Iiguie 5.22(c). Heie lhe oveiall seiies
iesislance of lhe elecliode is lumped logelhei as Î
l
. This iesislance geneially
ianges in value fiom 1 lo 1OO MÊ. The lolal disliibuled capacilance is lumped
logelhei lo foim Ý
l
, which can be on lhe oidei of lens of picofaiads. All lhe
associaled dc polenlials aie lumped logelhei in lhe souice Û
m
, which is given
by
Û
m
Û
|
Û
l
Û
ma
Û
mb
(5.18)
Nole lhal lhe miciopipelle-lype micioelecliode behaves as a low-pass nllei.
The high seiies iesislance and disliibuled capacilance cause lhe elecliode
oulpul lo iespond slowly lo iapid changes in cell-membiane polenlial. To
ë ò ç Ó × Ý Î Ñ Û Ô Û Ý Ì Î Ñ Ü Û Í îîç
Ú·¹«®» ëòîî Û¯«·ª¿´»²¬ ½·®½«·¬ ±º ¹´¿-- ³·½®±°·°»¬¬» ³·½®±»´»½¬®±¼» (a) !lec-
liode wilh ils lip placed wilhin a cell, showing lhe oiigin of disliibuled
capacilance. (b) !quivalenl ciicuil foi lhe silualion in (a). (c) Simplined
equivalenl ciicuil. (Iiom L. A. Geddes, Û´»½¬®±¼»- ¿²¼ ¬¸» Ó»¿-«®»³»²¬ ±º
Þ·±»´»½¬®·½ Ûª»²¬-ô Wiley-¡nleiscience, 1972. \sed wilh peimission of 1ohn
Wiley and Sons, New Yoik.)
îíð ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
ieduce lhis pioblem, posilive-feedback, negalive-capacilance amplineis (see
Seclion 6.6) aie used lo ieduce lhe effeclive value of Ý
l
.
ëòïð ÛÔÛÝÌÎÑÜÛÍ ÚÑÎ ÛÔÛÝÌÎ×Ý ÍÌ×ÓËÔßÌ×ÑÒ ÑÚ Ì×ÍÍËÛ
!lecliodes used foi lhe elecliic slimulalion of lissue follow lhe same geneial
design as lhose used foi lhe iecoiding of bioelecliic polenlials. They diffei in
lhal cuiienls as laige as milliampeies cioss lhe elecliodeelecliolyle inleiface
in slimulaling elecliodes. !xamples of specinc elecliodes used in caidiac
pacemakeis, olhei funclional elecliic slimulalois, and caidiac denbiillalois
(wheie cuiienls aie even laigei) aie given in Chaplei 13. Olhei lypes of
slimulaling elecliodes aie of lhe same foim as lhe polenlial iecoiding eleclio-
des desciibed in lhis chaplei.
¡n consideiing slimulaling elecliodes, we musl beai in mind lhal lhe nel
cuiienl acioss lhe elecliodeelecliolyle inleiface is nol always zeio. When a
biphasic slimulaling pulse is used, lhe aveiage cuiienl ovei long peiiods of lime
should be zeio. Howevei, ovei lhe slimulus cycle, lheie aie peiiods of lime
duiing which lhe nel cuiienl acioss lhe elecliode is in one diieclion al one lime
and in lhe olhei diieclion al a diffeienl lime. Also, lhe magniludes of lhe cuiienls
in lhe lwo diieclions may be unequal. ¡n sludying lhe elecliical chaiacleiislics of
lhe elecliodeelecliolyle inleiface undei such ciicumslances, we may well
imagine lhal lhe equivalenl ciicuil changes as lhe slimulus piogiesses. Thus
lhe effeclive equivalenl ciicuil foi lhe elecliode is deleimined by lhe slimulus
paiameleis, piincipally lhe cuiienl and lhe duialion of lhe slimulus.
Reclangulai biphasic oi monophasic pulses aie fiequenlly used foi elecliic
slimulalion. Howevei, olhei waveshapes, such as decaying exponenlials,
liapezoids, oi sine waves, have also been used. Iiequenlly a slimulus is
used lhal is eilhei conslanl cuiienl oi conslanl vollage duiing lhe pulse.
The iesponse of a lypical elecliode lo lhis lype of slimulus is illuslialed in
Iiguie 5.23.
A conslanl-cuiienl slimulus pulse is applied lo lhe slimulaling elecliodes
in Iiguie 5.23(a), giving lhe vollage iesponse shown. Nole lhal lhe iesulling
vollage pulse is nol conslanl. This is undeislandable when we considei lhal
lheie is a sliong ieaclive componenl lo lhe elecliodeelecliolyle inleiface, oi
in olhei woids, polaiizalion occuis. The inilial iise in vollage coiiesponding lo
lhe leading edge of lhe cuiienl pulse is due lo lhe vollage diop acioss lhe
iesislive componenls of lhe elecliodeelecliolyle inleiface, bul we see lhal lhe
vollage conlinues lo iise wilh lhe conslanl cuiienl. This is due lo lhe eslablish-
menl of a change in lhe disliibulion of chaige concenlialion al lhe elecliode
elecliolyle inleiface‰in olhei woids, lo a change in polaiizalion iesulling
fiom lhe unidiieclional cuiienl. As slaled in lhe desciiplion of lhe simplined
elecliodeelecliolyle equivalenl ciicuil of Iiguie 5.4, lhis polaiizalion effecl
can be iepiesenled by a capaciloi. Again il is impoilanl lo iemembei lhal lhe
size of lhis capaciloi is deleimined by seveial faclois, one of which is lhe
ë ò ï ð Û Ô Û Ý Ì Î Ñ Ü Û Í Ú Ñ Î Û Ô Û Ý Ì Î × Ý Í Ì × Ó Ë Ô ß Ì × Ñ Ò Ñ Ú Ì × Í Í Ë Û îíï
cuiienl densily al lhe inleiface, so lhe equivalenl ciicuil foi slimulaling
elecliodes changes wilh lhe slimulus.
When lhe cuiienl falls back lo ils low value, lhe vollage acioss lhe
elecliodes diops, bul nol back lo ils inilial value. ¡nslead, aflei lhe inilial
sleep fall, lheie is a slowei decay coiiesponding lo lhe dissipalion of lhe
polaiizalion chaige al lhe inleiface.
Conslanl-vollage slimulalion of lhe elecliodes is shown in Iiguie 5.23(b).
¡n lhis case lhe cuiienl coiiesponding lo lhe iising edge of lhe vollage pulse is
seen lo |ump in a laige slep and, as lhe disliibulion of lhe polaiizalion chaige
Ú·¹«®» ëòîí Ý«®®»²¬ ¿²¼ ª±´¬¿¹» ©¿ª»º±®³- -»»² ©·¬¸ »´»½¬®±¼»- «-»¼ º±® »´»½ó
¬®·½ -¬·³«´¿¬·±² (a) Conslanl-cuiienl slimulalion. (b) Conslanl-vollage
slimulalion.
îíî ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
becomes eslablished, lo fall back lo a lowei sleady-slale value. When lhe
vollage pulse falls, lhe cuiienl is seen lo change diieclion and lhen slowly
ieluin lo ils inilial zeio value. This is a iesull of lhe dissipalion of lhe
polaiizalion chaige buill up al lhe elecliodeelecliolyle inleiface.
¡n choosing maleiials foi slimulaling elecliodes, we musl lake inlo con-
sideialionchemical ieaclions occuiiing al lhe elecliodeelecliolyle inleiface. ¡f
a slimulaling cuiienl causes lhe maleiial of lhe elecliode lo be oxidized, lhe
elecliode is consumed, which limils ils lifelime and also incieases lhe concen-
lialion of lhe ions of elecliode maleiial in lhe vicinily of lhe elecliode. This
could be loxic lo lhe lissue. When elecliodes such as lhe Ag/AgCl elecliode aie
used, lhe slimulaling cuiienl can iesull in eilhei lhe foimalion of addilional Cl
oi lhe ieduclion of whal is alieady foimed, lheieby gieally changing lhe
chaiacleiislics of lhe elecliode. Thus lhe besl slimulaling elecliodes aie
made fiom noble melals (oi al leasl slainless sleel), which undeigo only
minimal chemical ieaclions. ¡l is also possible in lhis case lhal lhe chemical
ieaclion involves walei in lhe vicinily of lhe elecliodes. Thus lhe local aclivily
of hydiogen oi hydioxyl ions in lhe vicinily of lhe elecliode can gieally change.
These changes in acidily oi alkalinily can pioduce lissue damage lhal limils lhe
oveiall effecliveness of lhe noble-melal elecliodes. Of couise, lhe polaiizalion
of lhese elecliodes is laige, and lhe wavefoims, such as lhose shown in Iiguie
5.23, aie less ieclangulai lhan lhey would be wilh nonpolaiizable elecliodes. ¡n
exlieme cases, elecliode vollage and cuiienl densily can iesull in lhe elec-
liolysis of walei lhal leads lo lhe evolulion of small bubbles of hydiogen oi
oxygen gas. Cleaily, lhis is a silualion lhal should be avoided.
Caibon-nlled silicone iubbei elecliodes aie used foi liansculaneous
slimulalion used in clinical pain managemenl (McAdams, 2OO6). Aizbaechei
(1982) desciibes a pill elecliode lhal can eilhei iecoid a laige P wave oi pace
lhe heail fiom lhe esophagus. Aslimulaling elecliode based upon lhe iiidium/
iiidium oxide syslem |Robblee »¬ ¿´ò (1983)j has been shown lo in|ecl chaige
inlo biologic lissue. This lype of elecliode has been found lo piovide maximal
cuiienl densily foi biphasic slimuli while minimizing chemical changes lhal
could lead lo lissue damage. The passage of chaige fiom lhe elecliode lo lissue
and in lhe ieveise diieclion iesulls in a chemical change in lhe iiidium oxide
chemical composilion as opposed lo in|ecling iiidium ions inlo solulion oi
ieducing lhem. Cogan (2OO8) has ieviewed iecenl lechniques foi elecliically
slimulaling and iecoiding neuial lissue and lhe undeilying elecliochemisliy
lhal can lead lo safei and moie efncienl inleifaces wilh lhe neivous syslem.
ëòïï ÐÎßÝÌ×ÝßÔ Ø×ÒÌÍ ×Ò ËÍ×ÒÙ ÛÔÛÝÌÎÑÜÛÍ
¡n using melal elecliodes foi measuiemenl and slimulalion, we should undei-
sland a few piaclical poinls nol menlioned elsewheie in lhis chaplei. The nisl
poinl is lhe impoilance of consliucling lhe elecliode and any pails of lhe lead
wiie lhal may be exposedlo lhe elecliolyle ¿´´ ±º ¬¸» -¿³» ³¿¬»®·¿´ò Iuilheimoie,
ë ò ï ï Ð Î ß Ý Ì × Ý ß Ô Ø × Ò Ì Í × Ò Ë Í × Ò Ù Û Ô Û Ý Ì Î Ñ Ü Û Í îíí
a lhiid maleiial such as soldei should nol be used lo connecl lhe elecliode lo ils
lead wiie unless il is ceilain lhal lhis maleiial will nol be in conlacl wilh lhe
elecliolyle. ¡l is fai bellei eilhei lo weld lhe lead wiie lo lhe elecliode oi al leasl
lo foim a mechanical bond lhiough ciimping oi peening. Dissimilai melals
should nol be usedinconlacl becauselheii half-cell polenlials aie diffeienl. Since
lhey aie elecliically connecledand in conlacl wilh lhe same elecliolyle, il is moie
lhan likely lhal an elecliochemical ieaclion will be sel up belween lhemlhal can
iesull in addilional polaiizalion and oflen in coiiosion of one of lhe melals. This
facloi also lends lo make half-cell polenlials less slable, lheieby conliibuling lo
incieased elecliic ailifacl fiom lhe elecliode.
When paiis of elecliodes aie used foi measuiing diffeienlial vollages, such
as in delecling suiface polenlials on lhe body oi inleinal polenlials wilhin il, il
is iecommended lo use lhe same maleiial foi each elecliode, because lhe half-
cell polenlials aie appioximalely equal. This means lhal lhe nel dc polenlial
seen al lhe inpul lo lhe amplinei connecled lo lhe elecliodes is ielalively small,
possibly even zeio. This minimizes possible saluialion effecls in lhe case of
high-gain diiecl-coupled amplineis.
!lecliodes placed on lhe skin`s suiface have a lendency lo come off.
Iiequenlly, lhis is due lo a loss of effecliveness of lhe adhesive lack holding lhe
elecliodes in place. Howevei, lhis is nol lhe only cause of lhis pioblem. Lead
wiies lo suiface elecliodes should be exliemely ûexible yel sliong. ¡f lhey aie,
only lension on lhe lead wiie can apply a foice lhal is likely lo sepaiale lhe
elecliode fiom lhe skin. ¡f lhe lead wiie iemains loose, il cannol apply any
foices lo lhe elecliode because of ils high ûexibilily. ¡l is helpful lo piovide
addilional ielief fiom sliain by laping lhe lead wiie lo lhe skin a few cm fiom
lhe elecliode wilh some slack oi even a loop in lhe wiie so lhal lension in lhe
wiie is nol liansfeiied lo lhe elecliode.
The poinl al which lhe lead wiie enleis lhe elecliode is a poinl of fiequenl
failuie. !ven lhough lhe insulalion appeais inlacl, lhe wiie wilhin may be
bioken as a iesull of seveie iepealed ûexing al lhis poinl. Well-designed
elecliodes minimize lhis pioblemby pioviding sliain ielief al lhis poinl, so lhal
lheie is a giadual liansilion belween lhe ûexible wiie and lhe solid maleiial of
lhe elecliode. \sing a lapeied iegion of insulalion lhal giadually incieases
fiom lhe diamelei of lhe wiie lo a shape lhal is closei lo lhal of lhe elecliode
oflen minimizes lhis pioblem and disliibules lhe ûexing foices ovei a giealei
poilion of lhe wiie.
Anolhei poinl lo considei is lhal lhe insulalion of lhe lead wiie and lhe
elecliode can also piesenl pioblems. !lecliodes aie oflen in a high-humidily
enviionmenl oi aie conlinually soaked in exliacellulai ûuid oi even in cleaning
solulion (if lhey aie of lhe ieusable lype). The insulalion of lhese elecliodes is
usually made of a polymeiic maleiial, so il can absoib walei. Some of lhese
maleiials can become moie conduclive when lhey absoib walei, and in lhe
case of implanlable elecliodes, lhis may iesull in a high-iesislance conneclion
belween lissue and lhe lead wiie as well as lhe conlacl al lhe elecliode ilself. ¡f
lhe lead wiie is made of a maleiial diffeienl fiom lhal of lhe elecliode, lhe
elecliolylic pioblems desciibed al lhe beginning of lhis seclion can iesull,
îíì ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
lheieby incieasing lhe obseived elecliic ailifacl and possibly leading lo a
weakening of lhe lead wiies due lo coiiosion. Thus il is impoilanl lo undei-
sland lhe insulalion maleiial used wilh lhe elecliode and lo make suie lhal
lheie is a layei of il lhick enough lo pievenl lhis pioblem fiom occuiiing.
When laige inleimillenl cuiienls in lhe fiequency iange aiound 5OO kHz
fiom an elecliosuigical unil ûow lhiough !CG elecliodes, lhe nonlineai
cuiienlvollage chaiacleiislics of lhe elecliodes can cause lhem lo acl as
ieclineis and yield laige inleimillenl dc vollage shifls. These cause laige low-
fiequency inleifeience in lhe !CGlhal cannol be iemoved by nlleiing (Millei
and Haiiison, 1974, p. 152).
One nnal poinl iegaiding elecliodes foi measuiing biopolenlials: ¡n
deiiving lhe equivalenl ciicuil foi elecliodes such as lhose shown in Iiguie
5.4, we sliessed lhal foi high-ndelily iecoidings of lhe measuied biopolenlial,
lhe inpul impedance of lhe amplinei lo which lhe elecliodes aie connecled
musl be much highei lhan lhe souice impedance iepiesenled by lhe elecliodes`
equivalenl ciicuil. ¡f lhis condilion is nol mel, nol only will lhe amplilude of lhe
iecoided signal be less lhan il should be, bul signincanl disloilion also will be
inlioduced inlo lhe wavefoim of lhe signal. This is demonslialed by Geddes
and Bakei (1989) foi elecliodes used lo iecoid elecliocaidiogiams. They show
how loweiing lhe inpul impedance of lhe amplinei causes lhe iecoided signal
lo lake on a moie and moie biphasic chaiaclei as well as a ieduced amplilude.
ÐÎÑÞÔÛÓÍ
ëòï ß -»¬ ±º ¾·±°±¬»²¬·¿´ »´»½¬®±¼»- ³¿¼» ±º -·´ª»® ·- ¿¬¬¿½¸»¼ ¬± ¬¸» ½¸»-¬ ±º ¿
°¿¬·»²¬ ¬± ¼»¬»½¬ ¬¸» »´»½¬®±½¿®¼·±¹®¿³ò ɸ»² ½«®®»²¬ °¿--»- ¬¸®±«¹¸ ¬¸» ¿²±¼»ô
·¬ ½¿«-»- -·´ª»® ¬± ¾» ±¨·¼·¦»¼ô °®±¼«½·²¹ -·´ª»® ·±²- ·² -±´«¬·±²ò ̸»®» ·- ¿ ïð ³ß
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ëòî Ü»-·¹² ¿ -§-¬»³ º±® »´»½¬®±´§¬·½¿´´§ º±®³·²¹ ß¹ñ߹ݴ »´»½¬®±¼»-ò Ù·ª» ¬¸»
½¸»³·½¿´ ®»¿½¬·±²- ¬¸¿¬ ±½½«® ¿¬ ¾±¬¸ elecliodes.
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-·¹²¿´á ر© ½¿² ¬¸·- ¼·-¬±®¬·±² ±º ¬¸» -·¹²¿´ ¾» ®»¼«½»¼á
ëòïð ß²«®-» ²±¬·½»¼ ¬¸¿¬ ±²» »´»½¬®±¼» ±º ¿ °¿·® ±º ß¹ñ߹ݴ ½¿®¼·¿½ »´»½¬®±¼»-
«-»¼ ±² ¿ ½¸®±²·½ ½¿®¼·¿½ ³±²·¬±® ©¿- ¼·®¬§ ¿²¼ ½´»¿²»¼ ·¬ ¾§ -½®¿°·²¹ ·¬ ©·¬¸
-¬»»´ ©±±´ øÞ®·´´±÷ «²¬·´ ·¬ ©¿- -¸·²§ ¿²¼ ¾®·¹¸¬ò ̸» ²«®-» ¬¸»² °´¿½»¼ ¬¸»
»´»½¬®±¼» ¾¿½µ ±² ¬¸» °¿¬·»²¬ò ر© ¼·¼ ¬¸·- °®±½»¼«®» ¿ºº»½¬ ¬¸» -·¹²¿´ ±¾-»®ª»¼
º®±³ ¬¸» »´»½¬®±¼» ¿²¼ »´»½¬®±¼» ·³°»¼¿²½»-á
ëòïï ß ³»¬¿´ ³·½®±»´»½¬®±¼» ¸¿- ¿ ¬·° ¬¸¿¬ ½¿² ¾» ³±¼»´»¼ ¿- ¾»·²¹ ½§´·²¼®·½¿´ò
̸» ³»¬¿´ ·¬-»´º ·- ï ³³ ·² ¼·¿³»¬»®ô ¿²¼ ¬¸» ¬·° ®»¹·±² ·- í ³³ ´±²¹ò ̸» ³»¬¿´
¸¿- ¿ ®»-·-¬·ª·¬§ ±º 1 2 1O
5
Ê ½³ ¿²¼ ·- ½±¿¬»¼ ±ª»® ·¬- ½·®½«³º»®»²½» ©·¬¸ ¿²
·²-«´¿¬·±² ³¿¬»®·¿´ ðòî ³³ ¬¸·½µò ̸» ·²-«´¿¬·±² ³¿¬»®·¿´ ¸¿- ¿ ®»´¿¬·ª» ¼·»´»½¬®·½
½±²-¬¿²¬ ±º ïòêéò Ѳ´§ ¬¸» ¾¿-» ±º ¬¸» ½§´·²¼»® ·- º®»» ±º ·²-«´¿¬·±²ò
¿ò Whal is lhe iesislance associaled wilh lhe lip of lhis micioeleclode?
¾ò Whal is lhe aiea of lhe suiface of lhe elecliode lhal conlacls lhe elecliolylic
solulion wilhin lhe cell? The iesislance associaled wilh lhe elecliode
elecliolyle inleiface of lhis maleiial is 1O
3
Ê foi 1 cm
2
. Whal is lhe
iesislance due lo lhis micioelecliode`s conlacl wilh lhe elecliolyle?
½ò Whal is lhe capacilance associaled wilh lhe lip of lhe micioelecliode when
lhe capacilances al lhe inleiface of lhe elecliodeelecliolylic solulion aie
neglecled?
¼ò Diaw an appioximale equivalenl ciicuil foi lhe lip poilion of lhis
micioelecliode.
»ò Al whal fiequencies do you expecl lo see disloilions when lhe elecliode is
connecled lo an amplinei having a puiely iesislive inpul impedance of 1O
MÊ? You may assume lhal lhe iefeience elecliode has an impedance low
enough so lhal il will nol enlei inlo lhe answei lo lhis queslion. ¡f lhe
amplinei`s inpul impedance is iaised lo 1OO MÊ, how does lhis affecl lhe
îíê ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
fiequency iesponse of lhe syslem? ¡s lhis diffeience signincanl foi mosl
inliacellulai biological applicalions?
ëòïî ß ³·½®±°·°»¬¬» »´»½¬®±¼» ¸¿- ¿ ´«³»²¿´ ¼·¿³»¬»® ±º í ³³ ¿¬ ·¬- ¬·°ò ߬ ¬¸·-
°±·²¬ô ¬¸» ¹´¿-- ©¿´´ ·- ±²´§ ðòë ³³ ¬¸·½µ ¿²¼ î ³³ ´±²¹ò ̸» ®»-·-¬¿²½» ±º ¬¸»
»´»½¬®±´§¬» ·² ¬¸» ¬·° ·- ìð ÓÊò ̸» ¹´¿-- ¸¿- ¿ ®»´¿¬·ª» ¼·»´»½¬®·½ ½±²-¬¿²¬ ±º ïòêíò
Û-¬·³¿¬» ¬¸» º®»¯«»²½§ ®»-°±²-» ±º ¬¸·- »´»½¬®±¼» ©¸»² ·¬ ·- ½±²²»½¬»¼ ¬± ¿²
·²•²·¬»ó·²°«¬ó·³°»¼¿²½» ¿³°´·•»®ò ر©½¿² ¬¸·- º®»¯«»²½§®»-°±²-» ¾» ·³°®±ª»¼á
ëòïí ß °¿·® ±º ¾·±°±¬»²¬·¿´ »´»½¬®±¼»- ¿®» «-»¼ ¬± ³±²·¬±® ¿ ¾·±»´»½¬®·½ -·¹²¿´
º®±³¬¸» ¾±¼§ò ̸» ³±²·¬±®·²¹ »´»½¬®±²·½ ½·®½«·¬ ¸¿- ¿ ´±©ó·²°«¬ ·³°»¼¿²½» ¬¸¿¬
·- ±º ¬¸» -¿³» ±®¼»® ±º ³¿¹²·¬«¼» ¿- ¬¸» -±«®½» ·³°»¼¿²½» ·² ¬¸» »´»½¬®±¼»-ò
¿ò Skelch an equivalenl ciicuil foi lhis silualion.
¾ò Desciibe qualilalively whal you expecl lhe geneial chaiacleiislics of lhe
fiequency iesponse of lhis syslem lo be. ¡l is nol necessaiy lo plol an
analylic Bode plol.
ëòïì ß °¿·® ±º ·¼»²¬·½¿´ -¬¿·²´»-- -¬»»´ »´»½¬®±¼»- ·- ¼»-·¹²»¼ ¬± ¾» «-»¼ ¬±
-¬·³«´¿¬» -µ»´»¬¿´ ³«-½´»-ò ̸» -¬·³«´«- ½±²-·-¬- ±º ¿ ®»½¬¿²¹«´¿® ½±²-¬¿²¬óª±´¬¿¹»
°«´-» ¿°°´·»¼ ¬± ¬¸» »´»½¬®±¼»-ò ̸» °«´-» ¸¿- ¿² ¿³°´·¬«¼» ±º ë Ê ©·¬¸ ¿ ¼«®¿¬·±²
±º ïð ³-ò Ü®¿©ô ±² ¬¸» ¾¿-·- ±º ¬¸» »¯«·ª¿´»²¬ ½·®½«·¬- ±º »¿½¸ ±º ¬¸» »´»½¬®±¼»-ô ¿²
»¯«·ª¿´»²¬ ½·®½«·¬ º±® ¬¸» ´±¿¼ -»»² ¾§ ¬¸» ½±²-¬¿²¬óª±´¬¿¹» °«´-» ¹»²»®¿¬±®ò
Í·³°´·º§ §±«® ½·®½«·¬ ¿- ³«½¸ ¿- °±--·¾´»ò ɸ¿¬ ·- ¬¸» ©¿ª»-¸¿°» ±º ¬¸» ½«®®»²¬
¿¬ ¬¸» ¹»²»®¿¬±® ¬»®³·²¿´-á λ³»³¾»® ¬¸¿¬ ¿ ½±²-¬¿²¬óª±´¬¿¹» ¹»²»®¿¬±® ¸¿- ¿
-±«®½» ·³°»¼¿²½» ±º ¦»®±ò Û¨°´¿·² ¿²¼ -µ»¬½¸ ¬¸» ®»-«´¬·²¹ ½«®®»²¬ ©¿ª»º±®³ò
ëòïë ß² »¨±¬·½ ²»© ¿²·³¿´ô ®»½»²¬´§ ¼·-½±ª»®»¼ô ¸¿- ¿² «²«-«¿´ »´»½¬®±´§¬»
³¿µ»«° ·² ¬¸¿¬ ·¬- ³¿¶±® ¿²·±² ·- Þ® ®¿¬¸»® ¬¸¿² Ý´ ò ͽ·»²¬·-¬- ©¿²¬ ¬±
³»¿-«®» ¬¸» ÛÛÙ ±º ¬¸·- ¿²·³¿´ô ©¸·½¸ ·- ´»-- ¬¸¿² îë ³Êò Û´»½¬®±¼»- ³¿¼» ±º
ß¹ñ߹ݴ -»»³ ¬± ¾» ²±·-§ò Ý¿² §±« -«¹¹»-¬ ¿ ¾»¬¬»® »´»½¬®±¼» -§-¬»³ ¿²¼
»¨°´¿·² ©¸§ ·¬ ·- ¾»¬¬»®á
ëòïê Ò»»¼´»ó¬§°» ÛÓÙ »´»½¬®±¼»- ¿®» °´¿½»¼ ¼·®»½¬´§ ·² ¿ ³«-½´»ò Ú·¹«®» Ðëòï
-¸±©- ¬¸»·® -·³°´·•»¼ »¯«·ª¿´»²¬ ½·®½«·¬ ¿²¼ ¿´-± ¬¸» »¯«·ª¿´»²¬ ½·®½«·¬ ±º ¬¸»
Ú·¹«®» Ðëòï
Ð Î Ñ Þ Ô Û Ó Í îíé
·²°«¬ -¬¿¹» ±º ¿² ¿³°´·•»®ò ̸» ª¿´«» ±º ¬¸» ½¿°¿½·¬±® Ý
2
in lhe amplinei may be
vaiied lo any desiied quanlily.
¿ò Assuming Ý
2
O and lhe amplinei gain is ß, wiile an equalion showing lhe
oulpul vollage of lhe amplinei as a funclion of »
s
(lhe signal) and fiequency.
¾ò Deleimine a value foi Ý
2
lhal gives elecliodeamplinei chaiacleiislics lhal
aie independenl of fiequency.
½ò Whal is lhe amplinei`s oulpul vollage in pail (b) when lhe signal is »
s
?
ëòïé Ú·¹«®» Ðëòî -¸±©- ¬¸» »¯«·ª¿´»²¬ ½·®½«·¬ ±º ¿ ¾·±°±¬»²¬·¿´ »´»½¬®±¼»ò ß
°¿·® ±º ¬¸»-» »´»½¬®±¼»- ¿®» ¬»-¬»¼ ·² ¿ ¾»¿µ»® ±º °¸§-·±´±¹·½¿´ -¿´·²» -±´«¬·±²ò
̸» ¬»-¬ ½±²-·-¬- ±º ³»¿-«®·²¹ ¬¸» ³¿¹²·¬«¼» ±º ¬¸» ·³°»¼¿²½» ¾»¬©»»² ¬¸»
»´»½¬®±¼»- ¿- ¿ º«²½¬·±² ±º º®»¯«»²½§ ª·¿ ´±©ó´»ª»´ -·²«-±·¼¿´ »¨½·¬¿¬·±² -± ¬¸¿¬
¬¸» ·³°»¼¿²½»- ¿®» ²±¬ ¿ºº»½¬»¼ ¾§ ¬¸» ½«®®»²¬ ½®±--·²¹ ¬¸» »´»½¬®±¼»›»´»½¬®±´§¬»
·²¬»®º¿½»ò ̸» ·³°»¼¿²½» ±º ¬¸» -¿´·²» -±´«¬·±² ·- -³¿´´ »²±«¹¸ ¬± ¾» ²»¹´»½¬»¼ò
͵»¬½¸ ¿ Þ±¼» °´±¬ ø´±¹ ±º ·³°»¼¿²½» ³¿¹²·¬«¼» ª»®-«- ´±¹ ±º º®»¯«»²½§÷ ±º ¬¸»
·³°»¼¿²½» ¾»¬©»»² ¬¸» »´»½¬®±¼»- ±ª»® ¿ º®»¯«»²½§ ®¿²¹» ±º ï ¬± ïððôððð ئò
ëòïè ß °¿·® ±º ¾·±°±¬»²¬·¿´ »´»½¬®±¼»- ¿®» ·³°´¿²¬»¼ ·² ¿² ¿²·³¿´ ¬± ³»¿-«®» ¬¸»
»´»½¬®±½¿®¼·±¹®¿³ º±® ¿ ®¿¼·±¬»´»³»¬®§ -§-¬»³ò Ѳ» ³«-¬ µ²±© ¬¸» »¯«·ª¿´»²¬
½·®½«·¬ º±® ¬¸»-» »´»½¬®±¼»- ·² ±®¼»® ¬± ¼»-·¹² ¬¸» ±°¬·³¿´ ·²°«¬ ½·®½«·¬ º±® ¬¸»
¬»´»³»¬®§ -§-¬»³ò Ó»¿-«®»³»²¬- ³¿¼» ±² ¬¸» °¿·® ±º »´»½¬®±¼»- ¸¿ª» -¸±©² ¬¸¿¬
¬¸» °±´¿®·¦¿¬·±² ½¿°¿½·¬¿²½» º±® ¬¸» °¿·® ·- îðð ²Ú ¿²¼ ¬¸¿¬ ¬¸» ¸¿´ºó½»´´ °±¬»²¬·¿´
º±® »¿½¸ »´»½¬®±¼» ·- îîí ³Êò ̸» ³¿¹²·¬«¼» ±º ¬¸» ·³°»¼¿²½» ¾»¬©»»² ¬¸» ¬©±
»´»½¬®±¼»- ©¿- ³»¿-«®»¼ ª·¿ -·²«-±·¼¿´ »¨½·¬¿¬·±² ¿¬ -»ª»®¿´ ¼·ºº»®»²¬ º®»¯«»²½·»-ò
̸» ®»-«´¬- ±º ¬¸·- ³»¿-«®»³»²¬ ¿®» ¹·ª»² ·² ¬¸» ¿½½±³°¿²§·²¹ ¬¿¾´»ò Ѳ ¬¸» ¾¿-·-
±º ¿´´ ±º ¬¸·- ·²º±®³¿¬·±²ô ¼®¿© ¿² »¯«·ª¿´»²¬ ½·®½«·¬ º±® ¬¸» »´»½¬®±¼» °¿·®ò ͬ¿¬»
©¸¿¬ »¿½¸ ½±³°±²»²¬ ·² §±«® ½·®½«·¬ ®»°®»-»²¬- °¸§-·½¿´´§ô ¿²¼ ¹·ª» ·¬- ª¿´«»ò
Ú®»¯«»²½§ ׳°»¼¿²½» øÓ¿¹²·¬«¼»÷ øÊ÷
5 Hz 2O,OOO
1O Hz 19,998
4O kHz 6O2
5O kHz 6OO
1OO kHz 6OO
Ú·¹«®» Ðëòî
îíè ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
ÎÛÚÛÎÛÒÝÛÍ
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Webslei, 1. G., Reducing molion ailifacls and inleifeience in biopolenlial iecoiding.`` ×ÛÛÛ
Ì®¿²-ò Þ·±³»¼ò Û²¹ò, 1984a, BM!-31, 823826.
Webslei, 1. G., Whal is impoilanl in biomedical elecliodes? `` Ю±½ò ß²²«ò ݱ²ºò Û²¹ò Ó»¼ò Þ·±´ò,
1984b, 26, 96.
Wise, K. D., K. Na|an, 1. 1i, 1. I. Helke, S. 1. Tanghe, A. Hoogeiweif, D. 1. Andeison, S. L. BeMenl,
M. Ghazzi, W. Baei, T. Hull, and Y. Yang. Miciomachined silicon miciopiobes foi CNS
iecoiding and slimulalion.`` Ю±½ò ß²²«ò ײ¬ò ݱ²ºò ×ÛÛÛÛ²¹ò Ó»¼ò Þ·±´ò ͱ½ò, 199O, 12, 2334
2335.
îìð ë Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Û Ô Û Ý Ì Î Ñ Ü Û Í
ê
Þ×ÑÐÑÌÛÒÌ×ßÔ ßÓÐÔ×Ú×ÛÎÍ
Ó·½¸¿»´ Îò Ò»«³¿²
Amplineis aie an impoilanl pail of modein insliumenlalion syslems foi
measuiing biopolenlials. Such measuiemenls involve vollages lhal oflen aie
al low levels, have high souice impedances, oi bolh. Amplineis aie iequiied lo
inciease signal slienglh while mainlaining high ndelily. Amplineis lhal have
been designed specincally foi lhis lype of piocessing of biopolenlials aie
known as ¾·±°±¬»²¬·¿´ ¿³°´·B»®-. ¡n lhis chaplei we examine some of lhe basic
fealuies of biopolenlial amplineis and also look al specialized syslems.
êòï ÞßÍ×Ý ÎÛÏË×ÎÛÓÛÒÌÍ
The essenlial funclion of a biopolenlial amplinei is lo lake a weak elecliic
signal of biological oiigin and inciease ils amplilude so lhal il can be fuilhei
piocessed, iecoided, oi displayed. \sually such amplineis aie in lhe foim of
vollage amplineis, because lhey aie capable of incieasing lhe vollage level of a
signal. Nonelheless, vollage amplineis also seive lo inciease powei levels, so
lhey can be consideied powei amplineis as well. ¡n some cases, biopolenlial
amplineis aie used lo isolale lhe load fiom lhe souice. ¡n lhis silualion, lhe
amplineis piovide only cuiienl gain, leaving lhe vollage levels essenlially
unchanged.
To be useful biologically, all biopolenlial amplineis musl meel ceilain
basic iequiiemenls. They musl have high inpul impedance, so lhal lhey
piovide minimal loading of lhe signal being measuied. The chaiacleiislics
of biopolenlial elecliodes can be affecled by lhe elecliic load lhey see, which,
combined wilh excessive loading, can iesull in disloilion of lhe signal. Loading
effecls aie minimized by making lhe amplinei inpul impedance as high as
possible, lheieby ieducing lhis disloilion. Modein biopolenlial amplineis have
inpul impedances of al leasl 1O MÊ.
The inpul ciicuil of a biopolenlial amplinei musl also piovide pioleclion
lo lhe oiganism being sludied. Any cuiienl oi polenlial appeaiing acioss lhe
amplinei inpul leiminals lhal is pioduced by lhe amplinei is capable of
affecling lhe biological polenlial being measuied. ¡n clinical syslems, elecliic
cuiienls fiom lhe inpul leiminals of a biopolenlial amplinei can iesull in
îìï
micioshocks oi macioshocks in lhe palienl being sludied‰a silualion lhal can
have giave consequences. To avoid lhese pioblems, lhe amplinei should have
isolalion and pioleclion ciicuiliy, so lhal lhe cuiienl lhiough lhe elecliode
ciicuil can be kepl al safe levels and any ailifacl geneialed by such cuiienl can
be minimized.
The oulpul ciicuil of a biopolenlial amplinei does nol piesenl so many
ciilical pioblems as lhe inpul ciicuil. ¡ls piincipal funclion is lo diive lhe
amplinei load, usually an indicaling oi iecoiding device, in such a way as lo
mainlain maximal ndelily and iange in lhis ieadoul. Theiefoie, lhe oulpul
impedance of lhe amplinei musl be low wilh iespecl lo lhe load impedance,
and lhe amplinei musl be capable of supplying lhe powei iequiied by lhe load.
Biopolenlial amplineis musl opeiale in lhal poilion of lhe fiequency
speclium in which lhe biopolenlials lhal lhey amplify exisl. Because of lhe low
level of such signals, il is impoilanl lo limil lhe bandwidlh of lhe amplinei so
lhal il is |usl gieal enough lo piocess lhe signal adequalely. ¡n lhis way, we can
oblain oplimal signal-lo-noise ialios (SNRs). Biopolenlial signals usually have
ampliludes of lhe oidei of a few millivolls oi less. Such signals musl be
amplined lo levels compalible wilh iecoiding and display devices. This means
lhal mosl biopolenlial amplineis musl have high gains‰of lhe oidei of 1OOO oi
giealei.
\eiy fiequenlly biopolenlial signals aie oblained fiom bipolai elecliodes.
These elecliodes aie oflen symmeliically localed, elecliically, wilh iespecl lo
giound. \ndei such ciicumslances, lhe mosl appiopiiale biopolenlial ampli-
nei is a diffeienlial one. Because such bipolai elecliodes fiequenlly have a
common-mode vollage wilh iespecl lo giound lhal is much laigei lhan lhe
signal amplilude, and because lhe symmeliy wilh iespecl lo giound can be
disloiled, such biopolenlial diffeienlial amplineis musl have high common-
mode-ie|eclion ialios lo minimize inleifeience due lo lhe common-mode
signal.
A nnal iequiiemenl foi biopolenlial amplineis lhal aie used bolh in
medical applicalions and in lhe laboialoiy is lhal lhey make quick calibialion
possible. ¡n iecoiding biopolenlials, lhe scienlisl and clinician need lo know
nol only lhe wavefoims of lhese signals bul also lheii ampliludes. To piovide
lhis infoimalion, lhe gain of lhe amplinei musl be well calibialed. Iiequenlly
biopolenlial amplineis have a slandaid signal souice lhal can be momenlaiily
connecled lo lhe inpul, aulomalically al lhe slail of a measuiemenl oi
manually al lhe push of a bullon, lo check lhe calibialion. Biopolenlial
amplineis lhal need lo have ad|uslable gains usually have a swilch by which
diffeienl, caiefully calibialed nxed gains can be selecled, ialhei lhan having a
conlinuous conliol (such as lhe volume conliol of an audio amplinei) foi
ad|usling lhe gain. Thus lhe gain is always known, and lheie is no chance of ils
being accidenlally vaiied by someone bumping lhe gain conliol.
Biopolenlial amplineis have addilional iequiiemenls lhal aie applicalion-
specinc and lhal can be asceilained fiom an examinalion of each applicalion.
To illusliale some of lhese, lel us nisl considei lhe elecliocaidiogiam (!CG),
lhe mosl fiequenlly used applicalion of biopolenlial amplineis.
îìî ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
êòî ÌØÛ ÛÔÛÝÌÎÑÝßÎÜ×ÑÙÎßÐØ
To leain moie aboul biopolenlial amplineis, we shall examine a lypical clinical
elecliocaidiogiaph. Iiisl, lel us ieview lhe !CG ilself.
ÌØÛ ÛÝÙ
As we leained in Seclion 4.6, lhe bealing heail geneiales an elecliic signal lhal
can be used as a diagnoslic lool foi examining some of lhe funclions of lhe
heail. This elecliic aclivily of lhe heail can be appioximalely iepiesenled as a
vecloi quanlily. Thus we need lo know lhe localion al which signals aie
delecled, as well as lhe lime dependence of lhe amplilude of lhe signals.
!lecliocaidiogiapheis have developed a simple model lo iepiesenl lhe elecliic
aclivily of lhe heail. ¡n lhis model, lhe heail consisls of an elecliic dipole
localed in lhe pailially conducling medium of lhe lhoiax. Iiguie 6.1 shows a
lypical example. Of couise in iealily lhe heail is a much moie complicaled
elecliophysiological enlily, and fai moie complex models aie needed lo
iepiesenl il.
This pailiculai neld and lhe dipole lhal pioduces il iepiesenl lhe elecliic
aclivily of lhe heail al a specinc inslanl. Al lhe nexl inslanl lhe dipole can
change ils magnilude and ils oiienlalion, lheieby causing a change in lhe
elecliic neld. Once we accepl lhis simplined model, we need nol diaw a neld
plol eveiy lime we wanl lo discuss lhe dipole neld of lhe heail. ¡nslead, we can
iepiesenl il by ils dipole momenl, a vecloi diiecled fiomlhe negalive chaige lo
lhe posilive chaige and having a magnilude piopoilional lo lhe amounl of
chaige (eilhei posilive oi negalive) mulliplied by lhe sepaialion of lhe lwo
chaiges. ¡n elecliocaidiogiaphy lhis dipole momenl, known as lhe ½¿®¼·¿½
ª»½¬±®, is iepiesenled by Ó, as shown in Iiguie 6.1. As we piogiess lhiough a
caidiac cycle, lhe magnilude and diieclion of Ó vaiy because lhe dipole neld
vaiies.
Ú·¹«®» êòï α«¹¸ -µ»¬½¸ ±º ¬¸» ¼·°±´» B»´¼ ±º ¬¸» ¸»¿®¬ ©¸»² ¬¸» Î ©¿ª» ·-
³¿¨·³¿´ The dipole consisls of lhe poinls of equal posiliveandnegalive chaige
sepaialed fiom one anolhei and denoled by lhe dipole momenl vecloi Ó.
ê ò î Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ð Ø îìí
The elecliic polenlials geneialed by lhe heail appeai lhioughoul lhe body
and on ils suiface. We deleimine polenlial diffeiences by placing elecliodes on
lhe suiface of lhe body and measuiing lhe vollage belween lhem, being caieful
lo diaw lillle cuiienl (ideally lheie should be no cuiienl al all, because cuiienl
disloils lhe elecliic neld lhal pioduces lhe polenlial diffeiences). ¡f lhe lwo
elecliodes aie localed on diffeienl equal-polenlial lines of lhe elecliic neld of
lhe heail, a nonzeio polenlial diffeience oi vollage is measuied. Diffeienl
paiis of elecliodes al diffeienl localions geneially yield diffeienl vollages
because of lhe spalial dependence of lhe elecliic neld of lhe heail. Thus il is
impoilanl lo have ceilain slandaid posilions foi clinical evalualion of lhe
!CG. The limbs make nne guideposls foi localing lhe !CG elecliodes. We
shall look al lhis in moie delail lalei.
¡n lhe simplined dipole model of lhe heail, il would be convenienl if we
could piedicl lhe vollage, oi al leasl ils wavefoim, in a pailiculai sel of
elecliodes al a pailiculai inslanl of lime when lhe caidiac vecloi is known.
We can do lhis if we denne a ´»¿¼ ª»½¬±® foi lhe paii of elecliodes. This vecloi is
a unil vecloi lhal dennes lhe diieclion a conslanl-magnilude caidiac vecloi
musl have lo geneiale maximal vollage in lhe pailiculai paii of elecliodes. A
paii of elecliodes, oi combinalion of seveial elecliodes lhiough a iesislive
nelwoik lhal gives an equivalenl paii, is iefeiied lo as a ´»¿¼.
Ioi a caidiac vecloi Ó, as shown in Iiguie 6.2, lhe vollage induced in a
lead iepiesenled by lhe lead vecloi ¿
1
is given by lhe componenl of Ó in lhe
diieclion of ¿
1
. ¡n vecloi algebia, lhis can be denoled by lhe dol pioducl
a1
Ó ¿
1
oi
a1
Ó cos « (6.1)
Wheie
a1
is lhe scalai vollage seen in lhe lead lhal has lhe vecloi ¿
1
. Lel us
considei anolhei lead, iepiesenled by lhe lead vecloi ¿
2
, as seen in Iiguie 6.2.
¡n lhis case, lhe vecloi is oiienled in space so as lo be peipendiculai lo lhe
Ú·¹«®» êòî Relalionships belween lhe lwo lead veclois ¿
1
and ¿
2
and lhe
caidiac vecloi Ó. The componenl of Óin lhe diieclion of ¿
1
is given by lhe dol
pioducl of lhese lwo veclois and denoled on lhe nguie by
a1
. Lead vecloi ¿
2
is
peipendiculai lo lhe caidiac vecloi, so no vollage componenl is seen in lhis
lead.
îìì ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
caidiac vecloi Ó. The componenl of Ó along lhe diieclion of ¿
2
is zeio, so no
vollage is seen in lhis lead as a iesull of lhe caidiac vecloi. ¡f we measuied lhe
!CG geneialed by Ó using one of lhe lwo leads shown in Iiguie 6.2 alone, we
could nol desciibe lhe caidiac vecloi uniquely. Howevei, by using lwo leads
wilh diffeienl lead veclois, bolh of which lie in lhe same plane as lhe caidiac
vecloi such as ¿
1
and ¿
2
, we can desciibe Ó.
¡n clinical elecliocaidiogiaphy, moie lhan one lead musl be iecoided lo
desciibe lhe heail`s elecliic aclivily fully. ¡n piaclice, seveial leads aie laken in
lhe º®±²¬¿´ °´¿²» (lhe plane of youi body lhal is paiallel lo lhe giound when you
aie lying on youi back) and lhe ¬®¿²-ª»®-» °´¿²» (lhe plane of youi body lhal is
paiallel lo lhe giound when you aie slanding eiecl).
Thiee basic leads make up ¬¸» º®±²¬¿´-°´¿²» !CG. These aie deiived fiom
lhe vaiious peimulalions of paiis of elecliodes when one elecliode is localed
on lhe iighl aim (RA in Iiguie 6.3), lhe lefl aim (LA), and lhe lefl leg (LL).
\eiy oflen an elecliode is also placed on lhe iighl leg (RL) and giounded oi
connecled lo special ciicuils, as shown in Iiguie 6.15. The iesulling lhiee leads
aie lead ¡, LA lo RA; lead ¡¡, LL lo RA; and lead ¡¡¡, LL lo LA. The lead
veclois lhal aie foimed can be appioximaled as an equilaleial liiangle, known
as Û·²¬¸±ª»²K- ¬®·¿²¹´», in lhe fionlal plane of lhe body, as shown in Iiguie 6.3.
Because lhe scalai signal on each lead of !inlhoven`s liiangle can be iepie-
senled as a vollage souice, we can wiile Kiichhoff`s vollage law foi lhe lhiee
leads.
¡ ¡¡ ¡¡¡ O (6.2)
The componenls of a pailiculai caidiac vecloi can be deleimined easily by
placing lhe vecloi wilhin lhe liiangle and deleimining ils pio|eclion along each
Ú·¹«®» êòí Caidiologisls use a slandaidnolalion suchlhal lhe diieclionof lhe
lead vecloi foi lead ¡ is Oè, lhal of lead ¡¡ is 6Oè, and lhal of lead ¡¡¡ is 12Oè. An
example of a caidiac vecloi al 3Oè wilh ils scalai componenls seen foi each lead
is shown.
ê ò î Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ð Ø îìë
side. The piocess can also be ieveised, which enables us lo deleimine lhe
caidiac vecloi when we know lhe componenls along lhe lhiee lead veclois, oi
al leasl lwo of lhem. ¡l is lhis lallei pioblem lhal usually conceins lhe
elecliocaidiogiaphei.
Thiee addilional leads in lhe fionlal plane‰as well as a gioup of leads in
lhe liansveise plane‰aie ioulinely used in laking clinical !CGs. These leads
aie based on signals oblained fiom moie lhan one paii of elecliodes. They aie
oflen iefeiied lo as «²·°±´¿® ´»¿¼-, because lhey consisl of lhe polenlial
appeaiing on one elecliode laken wilh iespecl lo an equivalenl iefeience
elecliode, which is lhe aveiage of lhe signals seen al lwo oi moie elecliodes.
One such equivalenl iefeience elecliode is lhe É·´-±² ½»²¬®¿´ ¬»®³·²¿´,
shown in Iiguie 6.4. Heie lhe lhiee limb elecliodes |usl desciibed aie
connecled lhiough equal-valued iesislois lo a common node. The vollage
al lhis node, which is lhe Wilson cenlial leiminal, is lhe aveiage of lhe vollages
al each elecliode. ¡n piaclice, lhe values of lhe iesislois should be al leasl 5 MÊ
so lhal lhe loading of any pailiculai lead will be minimal. Thus, a moie
piaclical appioachis lo use buffeis (vollage followeis, see Seclion 3.3) belween
each elecliode and lhe equal-valued iesislois. The signal belween LA and lhe
cenlial poinl is known as \L, lhal al RA as \R, and lhal al lhe lefl fool as \I.
Nole lhal foi each of lhese leads, one of lhe iesislances Î shunls lhe ciicuil
Ú·¹«®» êòì ݱ²²»½¬·±² ±º »´»½¬®±¼»- ¬± ¬¸» ¾±¼§ ¬± ±¾¬¿·² É·´-±²K- ½»²¬®¿´
¬»®³·²¿´
îìê ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
belween lhe cenlial leiminal and lhe limb elecliode. This lends lo ieduce lhe
amplilude of lhe signal obseived, and we can modify lhese leads lo ¿«¹³»²¬»¼
´»¿¼- by iemoving lhe conneclion belween lhe limb being measuied and lhe
cenlial leiminal. This does nol affecl lhe diieclion of lhe lead vecloi bul iesulls
in a 5O inciease in amplilude of lhe signal.
The augmenled leads‰known as a\L, a\R, and a\I‰aie illuslialed
in Iiguie 6.5, which also illusliales lheii lead veclois, along wilh lhose of leads
¡, ¡¡, and ¡¡¡. Nole lhal when lhe negalive diieclion foi a\R is consideied wilh
Ú·¹«®» êòë (a), (b), (c) Conneclions of elecliodes foi lhe lhiee augmenled
limb leads. (d) \ecloi diagiam showing slandaid and augmenled lead-vecloi
diieclions in lhe fionlal plane.
ê ò î Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ð Ø îìé
lhe olhei nve, all six veclois aie equally spaced, by 3Oè. ¡l is lhus possible foi
lhe caidiologisl looking al an !CG consisling of lhese six leads lo eslimale lhe
posilion of lhe caidiac vecloi by seeing which of lhe six leads has lhe giealesl
signal amplilude al lhal poinl in lhe caidiac cycle.
ÛÈßÓÐÔÛ êòï Show lhal lhe vollage in lead a\R is 5O giealei lhan lhal
in lead \R al lhe same inslanl.
ßÒÍÉÛÎ Consideiing lhe conneclions foi a\R and \R, we can diaw lhe
equivalenl ciicuils of Iiguie !6.1(a) and (b). The vollages belween each limb
and giound aie
a
,
b
, and
c
. When no cuiienl is diawn by lhe vollage
measuiemenl ciicuil, lhe negalive leiminal foi a\R (lhe modined Wilson`s
cenlial leiminal) is al a vollage of
©
wilh iespecl lo giound, which can be
deleimined as follows:
·
1
b c

w
·
1
Î
c
b c

Î
c
b c
2
(!6 1
Because no cuiienl is diawn, lhe posilive a\R leiminal (lhe iighl aim) is
al a vollage
a
wilh iespecl lo giound. Then a\R is
a\R
a
b c
2
2
a b c
2
(!6 2
We can deleimine \R fiom Iiguie !6.1(b). To nnd lhe Wilson`s cenlial
leiminal vollage
w
, we simplify lhe ciicuil by laking lhe The´ venin equivalenl
ciicuil of lhe lwo iighl-hand bianches. This gives lhe ciicuil shown in Iiguie
!6.1(c) wheie
w
comes fiom (!6.1). Now
w
is
w
a
w
3Î 2
Î
2
w
a
2
w
3
(!6 3
Ú·¹«®» Ûêòï (a) a\R, (b) \R, and (c) simplined ciicuil of (a).
îìè ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
w
a
2
b c
2
3
a b c
3
(!6 4
Thus
\R
a w
2
a b c
3
(!6 5
which shows lhal
a\R
3
2
\R
When physicians look al lhe !CG in lhe liansveise plane, lhey use
°®»½±®¼·¿´ (chesl) leads. They place an elecliode al vaiious analomically
denned posilions on lhe chesl wall, as shown in Iiguie 6.6. The polenlial
belween lhis elecliode and Wilson`s cenlial leiminal is lhe elecliocaidiogiam
foi lhal pailiculai lead. Iiguie 6.6 also shows lhe lead-vecloi posilions.
Physicians can oblain !CGs fiom lhe posleiioi side of lhe heail by means
of an elecliode placed in lhe esophagus. This sliucluie passes diieclly behind
lhe heail, and lhe polenlial belween lhe esophageal elecliode and Wilson`s
cenlial leiminal gives a posleiioi lead.
ÍÐÛÝ×Ú×Ý ÎÛÏË×ÎÛÓÛÒÌÍ ÑÚ ÌØÛ ÛÔÛÝÌÎÑÝßÎÜ×ÑÙÎßÐØ
Because lhe elecliocaidiogiaph is widely used as a diagnoslic lool and lheie
aie seveial manufacluieis of lhis insliumenl, slandaidizalion is necessaiy.
Slandaid iequiiemenls foi elecliocaidiogiaphs have been developed ovei lhe
yeais (Bailey »¬ ¿´ò 199O; Anonymous, 1991). Table 6.1 gives a summaiy of
peifoimance iequiiemenls fiom lhe mosl iecenl of lhese (Anonymous, 1991).
These iecommendalions aie a pail of a volunlaiy slandaid. The Iood and
Ú·¹«®» êòê (a) Posilions of piecoidial leads on lhe chesl wall. (b) Diieclions
of piecoidial lead veclois in lhe liansveise plane.
ê ò î Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ð Ø îìç
Diug Adminislialion is planning lo develop mandaloiy slandaids foi fie-
quenlly employed insliumenls such as lhe elecliocaidiogiaph.
ÚËÒÝÌ×ÑÒßÔ ÞÔÑÝÕÍ ÑÚ ÌØÛ ÛÔÛÝÌÎÑÝßÎÜ×ÑÙÎßÐØ
Iiguie 6.7 shows a block diagiam of a lypical clinical elecliocaidiogiaph. To
undeisland lhe oveiall opeialion of lhe syslem, lel us considei each block
sepaialely.
ïò Ю±¬»½¬·±² ½·®½«·¬æ This ciicuil includes pioleclion devices so lhal lhe
high vollages lhal may appeai acioss lhe inpul lo lhe elecliocaidiogiaph
undei ceilain condilions do nol damage il.
îò Ô»¿¼ -»´»½¬±®æ !ach elecliode connecled lo lhe palienl is allached lo lhe
lead selecloi of lhe elecliocaidiogiaph. The funclion of lhis block is lo
deleimine which elecliodes aie necessaiy foi a pailiculai lead and lo
connecl lhem lo lhe iemaindei of lhe ciicuil. ¡l is lhis pail of lhe
elecliocaidiogiaph in which lhe conneclions foi lhe cenlial leiminal
aie made. This block can be conliolled by lhe opeialoi oi by lhe
Ú·¹«®» êòé Þ´±½µ ¼·¿¹®¿³ ±º ¿² »´»½¬®±½¿®¼·±¹®¿°¸
îëð ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
miciocompulei of lhe elecliocaidiogiaph when il is opeialed in aulomalic
mode. ¡l selecls one oi moie leads lo be iecoided. ¡n aulomalic mode,
each of lhe 12 slandaid leads is iecoided foi a shoil duialion such as 1O s.
íò Ý¿´·¾®¿¬·±² -·¹²¿´æ A 1 m\ calibialion signal is momenlaiily inlioduced
inlo lhe elecliocaidiogiaph foi each channel lhal is iecoided.
ìò Ю»¿³°´·B»®æ The inpul pieamplinei slage caiiies oul lhe inilial ampli-
ncalion of lhe !CG. This slage should have veiy high inpul impedance
and a high common-mode-ie|eclion ialio (CMRR). A lypical pie-
amplinei slage is lhe diffeienlial amplinei lhal consisls of lhiee opeia-
lional amplineis (op amps), shown in Iiguie 3.5. A gain-conliol swilch is
oflen included as a pail of lhis slage.
ëò ×-±´¿¬·±² ½·®½«·¬æ The ciicuiliy of lhis block conlains a baiiiei lo lhe
passage of cuiienl fiom lhe powei line (5O oi 6O Hz). Ioi example, if lhe
palienl came in conlacl wilh a 12O \ line, lhis baiiiei would pievenl
dangeious cuiienls fiomûowing fiom lhe palienl lhiough lhe amplinei lo
lhe giound of lhe iecoidei oi miciocompulei.
êò Ü®·ª»²ó®·¹¸¬ó´»¹½·®½«·¬æ This ciicuil piovides aiefeiencepoinl onlhepalienl
lhal noimally is al giound polenlial. This conneclionis made lo an elecliode
on lhe palienl`s iighl leg. Delails on lhis ciicuil aie given in Seclion 6.5.
éò Ü®·ª»® ¿³°´·B»®æ Ciicuiliy in lhis block amplines lhe !CG lo a level al
which il can appiopiialely iecoid lhe signal on lhe iecoidei. ¡ls inpul
should be ac coupled so lhal offsel vollages amplined by lhe pieamplinei
aie nol seen al ils inpul. These dc vollages, when amplined by lhis slage,
mighl cause il lo saluiale. This slage also caiiies oul lhe bandpass nlleiing
of lhe elecliocaidiogiaph lo give lhe fiequency chaiacleiislics desciibed
in Table 6.1. Also il oflen has a zeio-offsel conliol lhal is used lo posilion
lhe signal on lhe iecoidei. This conliol ad|usls lhe dc level of lhe oulpul
signal.
èò Ó»³±®§ -§-¬»³æ Many modein elecliocaidiogiaphs sloie elecliocai-
diogiams inmemoiy as well as piinling lhemoul ona iecoidei. Thesignal
is nisl digilized by an analog-lo-digilal conveilei (ADC), and lhen
samples fiom each lead aie sloied in memoiy. Palienl infoimalion
enleied via lhe keyboaid is also sloied. The miciocompulei conliols
lhis sloiage aclivily.
çò Ó·½®±½±³°«¬»®æ The miciocompulei conliols lhe oveiall opeialion of
lhe elecliocaidiogiaph. The opeialoi can selecl seveial modes of opeia-
lion by invoking a pailiculai piogiam. Ioi example, she oi he can ask lhe
miciocompulei lo geneiale lhe slandaid 12-lead elecliocaidiogiam by
selecling lhiee simullaneous 1O s segmenls of lhe six fionlal plane
leads followed by lhiee 1O s segmenls of lhe six liansveise plane leads.
The miciocompulei in some machines can also peifoim a pieliminaiy
analysis of lhe elecliocaidiogiam lo deleimine lhe heail iale, iecognize
some lypes of aiihylhmia, calculale lhe axes of vaiious fealuies of lhe
elecliocaidiogiam, and deleimine inleivals belween lhese fealuies. A
keyboaid and an alphanumeiic display enable lhe opeialoi lo communi-
cale wilh lhe miciocompulei.
ê ò î Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ð Ø îëï
Ì¿¾´» êòï Í«³³¿®§ ±º л®º±®³¿²½» λ¯«·®»³»²¬- º±®
Û´»½¬®±½¿®¼·±¹®¿°¸- øß²±²§³±«-ô ïççï÷
Í»½¬·±² λ¯«·®»³»²¬ Ü»-½®·°¬·±² Ó·²ñ³¿¨ ˲·¬- Ó·²ñÓ¿¨ Ê¿´«»
3.2.1 Opeialing condilions:
Line vollage Range \ ims 1O4 lo 1127
Iiequency Range Hz 6O 1
Tempeialuie Range èC 25 1O
Relalive humidily Range 5O 2O
Almospheiic piessuie Range Pa 7 1O
4
lo
1O 6 1O
4
3.2.2 Lead dennilion (numbei
of leads):
NA NA Table 3
Single-channel Min NA 7
Thiee-channel Min NA 12
3.2.3 ¡npul Dynamic Range:
Range of lineai opeialions
of inpul signal
Min m\ 5
Slew iale change Max m\/s 32O
DC offsel vollage iange Min m\ 3OO
Allowed vaiialion of
amplilude wilh dc offsel
Max 5
3.2.4 Gain conliol, accuiacy, and
slabilily:
Gain seleclions Min mm/m\ 2O, 1O, 5
Gain eiioi Max 5
Manual oveiiide of aulomalic
gain conliol
NA NA NA
Gain change iale/min Max /min O 33
Tolal gain change/h Max 3
3.2.5 Time base seleclion and
accuiacy:
Time base seleclions Min mm/s 25, 5O
Time base eiioi Max 5
3.2.6 Oulpul display:
Geneial NA NA pei 3.2.3
Widlh of display Min mm 4O
Tiace visibilily (wiiling iales) Max mm/s 16OO
Tiace widlh (peimanenl
iecoid only)
Max mm 1
Depailuie fiom lime axis
alignmenl
Max mm O.5
Max ms 1O
Pieiuled papei division Min div/cm 1O
!iioi of iulings Max 2
Time maikei eiioi Max 2
3.2.7 Accuiacy of inpul signal
iepioduclion:
Oveiall eiioi foi signals Max 5
\p lo 5 m\ and 125 m\/s Max ³\ 4O
îëî ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
Ì¿¾´» êòï øݱ²¬·²«»¼÷
Í»½¬·±² λ¯«·®»³»²¬ Ü»-½®·°¬·±² Ó·²ñ³¿¨ ˲·¬- Ó·²ñÓ¿¨ Ê¿´«»
\ppei cul-off fiequency
(3 dB)
Min Hz 15O
Response lo 2O ms, 1.5 m\
liiangulai inpul
Min mm 13.5
Response aflei 3 m\, 1OO ms
impulse
Max m\ O.1
Max m\/s O.3O
!iioi in lead weighling faclois Max 5
Hysleiesis aflei 15 mm
deûeclion fiom baseline
Max mm O.5
3.2.8 Slandaidizing vollage:
Nominal value NA m\ 1.O
Rise lime Max ms 1
Decay lime Min s 1OO
Amplilude eiioi Max 5
3.2.9 ¡npul impedance al 1O Hz
(each lead)
Min megohms 2.5
3.2.1O DC cuiienl (any inpul lead) Max ³A O.1
DC cuiienl (any palienl
elecliode)
Max ³A 1.O
3.2.11 Common-Mode Re|eclion:
Allowable noise wilh 2O \, 6O Hz
and 3OO m\ dc and 51 kÊ
Max mm 1O
¡mbalance Max m\ 1
3.2.12 Syslem noise: 3O
RT¡, °ó° Max ³\ 3O
Mullichannel ciosslalk Max 2
3.2.13 Baseline conliol and slabilily:
Reluin lime aflei iesel Max s 3
Reluin lime aflei lead swilch Max s 1
Baseline slabilily:
Baseline diifl iale RT¡ Max ³\/s 1O
Tolal baseline diifl RT¡ (2 min
peiiod)
Max ³\ 5OO
3.2.14 Oveiload pioleclion:
No damage fiom diffeienlial
vollage, 6O Hz, 1 \p-p, 1O s
applicalion
Min \ 1
No damage fiom simulaled
denbiillaloi dischaiges:
Ѫ»®ª±´¬¿¹» N/A \ 5OOO
Û²»®¹§ N/A 1 36O
Recoveiy lime Max s 8
!neigy ieduclion by
denbiillaloi shunling
Max 1O
Tiansfei of chaige lhiough
denbiillaloi chassis
Max ³C 1OO
øݱ²¬·²«»¼)
ê ò î Ì Ø Û Û Ô Û Ý Ì Î Ñ Ý ß Î Ü × Ñ Ù Î ß Ð Ø îëí
ïðò λ½±®¼»®P°®·²¬»®æ This block piovides a haid copy of lhe iecoided
!CG signal. ¡l also piinls oul palienl idenlincalion, clinical infoimalion
enleied by lhe opeialoi, and lhe iesulls of lhe aulomalic analysis of lhe
elecliocaidiogiam. Allhough analog oscillogiaph-lype iecoideis weie
employed foi lhis funclion in lhe pasl, modein elecliocaidiogiaphs
make use of lheimal oi eleclioslalic iecoiding lechniques in which lhe
only moving pail is lhe papei being lianspoiled undei lhe piinl head
(\eimaiien, 2OO6). Digilized elecliocaidiogiams can also be sloied in
peimanenl memoiy such as ûash memoiy oi oplically based disk media
such as CDs oi D\Ds.
êòí ÐÎÑÞÔÛÓÍ ÚÎÛÏËÛÒÌÔÇ ÛÒÝÑËÒÌÛÎÛÜ
Theie aie many faclois lhal musl be laken inlo consideialion in lhe design and
applicalion of lhe elecliocaidiogiaph as well as olhei biopolenlial amplineis.
These faclois aie impoilanl nol only lo lhe biomedical engineei, bul also lo lhe
individual who opeiales lhe insliumenl and lhe physician who inleipiels lhe
iecoided infoimalion. ¡n lhe following paiagiaphs, we shall desciibe a few of
lhe moie common pioblems encounleied and shall indicale some of lheii
causes.
ÚÎÛÏËÛÒÝÇ Ü×ÍÌÑÎÌ×ÑÒ
The elecliocaidiogiaph does nol always meel lhe fiequency-iesponse slan-
daids we have desciibed. When lhis happens, fiequency disloilion is seen in
lhe !CG.
Ì¿¾´» êòï øݱ²¬·²«»¼÷
Í»½¬·±² λ¯«·®»³»²¬ Ü»-½®·°¬·±² Ó·²ñ³¿¨ ˲·¬- Ó·²ñÓ¿¨ Ê¿´«»
!CG display in piesence
of pacemakei pulses:
ß³°´·¬«¼» Range m\ 2 lo 25O
Ы´-» ¼«®¿¬·±² Range ms O.1 lo 2.O
η-» ¬·³» Max ³s 1OO
Ú®»¯«»²½§ Max pulses/min 1OO
3.2.15 Risk cuiienl (isolaled palienl
conneclion)
Max ³A 1O
As pei applicable documenl 2.11
3.2.16 Auxiliaiy oulpul (if piovided):
No damage fiom shoil ciicuil iisk Max ³A 1O
Cuiienl (isolaled palienl
conneclion)
As pei applicable documenl 2.1.1
îëì ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
Ø·¹¸óº®»¯«»²½§ ¼·-¬±®¬·±² iounds off lhe shaip coineis of lhe wavefoims
and diminishes lhe amplilude of lhe ÇRS complex.
An insliumenl lhal has a fiequency iesponse of 1 lo 15O Hz shows ´±©-
º®»¯«»²½§ ¼·-¬±®¬·±². The baseline is no longei hoiizonlal, especially immedi-
alely following any evenl in lhe liacing. Monophasic waves in lhe !CGappeai
lo be moie biphasic.
ÍßÌËÎßÌ×ÑÒ ÑÎ ÝËÌÑÚÚ Ü×ÍÌÑÎÌ×ÑÒ
High offsel vollages al lhe elecliodes oi impiopeily ad|usled amplineis in lhe
elecliocaidiogiaph can pioduce saluialion oi culoff disloilion lhal can gieally
modify lhe appeaiance of lhe !CG. The combinalion of inpul-signal ampli-
lude and offsel vollage diives lhe amplinei inlo saluialion duiing a poilion of
lhe ÇRS complex (Seclion 3.2). The peaks of lhe ÇRS complex aie cul off
because lhe oulpul of lhe amplinei cannol exceed lhe saluialion vollage.
¡n a similai occuiience, lhe lowei poilions of lhe !CG aie cul off. This
can iesull fiom negalive saluialion of lhe amplinei. ¡n lhis case only a poilion
of lhe S wave may be cul off. ¡n exlieme cases of lhis lype of disloilion even
lhe P and T waves may be below lhe culoff level such lhal only lhe R wave
appeais.
ÙÎÑËÒÜ ÔÑÑÐÍ
Palienls who aie having lheii !CGs laken on eilhei a clinical elecliocaidio-
giaph oi conlinuously on a caidiac moniloi aie oflen connecled lo olhei pieces
of elecliic appaialus. !ach elecliic device has ils own giound conneclion eilhei
lhiough lhe powei line oi, in some cases, lhiougha heavy giound wiie allached
lo some giound poinl in lhe ioom.
A ¹®±«²¼ ´±±° can exisl when lwo machines aie connecled lo lhe palienl.
Bolh lhe elecliocaidiogiaph and a second machine have a giound elecliode
allached lo lhe palienl. The elecliocaidiogiaph is giounded lhiough lhe powei
line al a pailiculai sockel. The second machine is also giounded lhiough lhe
powei line, bul il is pluggedinloanenliielydiffeienl oullel acioss lheioom, which
has adiffeienl giound. ¡f onegioundis al aslighllyhighei polenlial lhanlheolhei
giound, a cuiienl fiom one giound ûows lhiough lhe palienl lo lhe giound
elecliodeof lheelecliocaidiogiaphandalongils leadwiielolheolhei giound. ¡n
addilion lo lhis cuiienl`s piesenling a safely pioblem, il can elevale lhe palienl`s
body polenlial lo some vollage above lhe lowesl giound lo which lhe insliumen-
lalion is allached. This pioduces common-mode vollages on lhe elecliocaidio-
giaph lhal, if il has a pooi CMRR, can inciease lhe amounl of inleifeience seen.
ÑÐÛÒ ÔÛßÜ É×ÎÛÍ
Iiequenlly one of lhe wiies connecling a biopolenlial elecliode lo lhe eleclio-
caidiogiaph becomes disconnecled fiom ils elecliode oi bieaks as a iesull of
excessively iough handling, in which case lhe elecliode is no longei connecled
ê ò í Ð Î Ñ Þ Ô Û Ó Í Ú Î Û Ï Ë Û Ò Ì Ô Ç Û Ò Ý Ñ Ë Ò Ì Û Î Û Ü îëë
lo lhe elecliocaidiogiaph. Relalively high polenlials can oflen be induced in
lhe open wiie as a iesull of elecliic nelds emanaling fiom lhe powei lines oi
olhei souices in lhe vicinily of lhe machine. This causes a wide, peak-lo-peak
deûeclion of lhe liace on lhe iecoidei al lhe powei-line fiequency, as well as,
of couise, signal loss. Such a silualion also aiises when an elecliode is nol
making good conlacl wilh lhe palienl. A ciicuil foi delecling pooi elecliode
conlacl is desciibed in Seclion 6.9.
ßÎÌ×ÚßÝÌ ÚÎÑÓ ÔßÎÙÛ ÛÔÛÝÌÎ×Ý ÌÎßÒÍ×ÛÒÌÍ
¡n some silualions in which a palienl is having an !CG laken, caidiac
denbiillalion may be iequiied (Seclion 13.2). ¡n such a case, a high-vollage
high-cuiienl elecliic pulse is applied lo lhe chesl of lhe palienl so lhal
liansienl polenlials can be obseived acioss lhe elecliodes. These polenlials
can be seveial oideis of magnilude highei lhan lhe noimal polenlials
encounleied in lhe !CG. Olhei elecliic souices can cause similai liansienls.
When lhis silualion occuis, il can cause an abiupl deûeclion in lhe !CG, as
shown in Iiguie 6.8. This is due lo lhe saluialion of lhe amplineis in lhe
elecliocaidiogiaph caused by lhe ielalively high-amplilude pulse oi slep al
ils inpul. This pulse is sufncienlly laige lo cause lhe buildup of chaige on
coupling capacilances in lhe amplinei, iesulling in ils iemaining saluialed foi
a nnile peiiod of lime following lhe pulse and lhen slowly diifling back lo lhe
oiiginal baseline wilh a lime conslanl deleimined by lhe low coinei fie-
quency of lhe amplinei. An example of lhe slowly iecoveiing wavefoim is
shown in Iiguie 6.8 al a ieduced amplilude and lime scale lo demonsliale lhe
liansienl.
Tiansienls of lhe lype |usl desciibed can be geneialed by means olhei
lhan denbiillalion. Seiious ailifacl caused by molion of lhe elecliodes can
pioduce vaiialions in polenlial giealei lhan !CG polenlials. Anolhei souice
of ailifacl is lhe palienl`s encounleiing a buill-up slalic elecliic chaige
lhal can be pailially dischaiged lhiough lhe body. Oldei elecliocaidiogiaphs
exhibil a similai liansienl when lhey aie swilched manually fiom one lead
Ú·¹«®» êòè !ffecl of a vollage liansienl on an !CG iecoided on an eleclio-
caidiogiaph in which lhe liansienl causes lhe amplinei lo saluiale and a nnile
peiiod of lime is iequiied foi lhe chaige lo bleed off enough lo biing lhe !CG
back inlo lhe amplinei`s aclive iegion of opeialion. This is followed by a nisl-
oidei iecoveiy of lhe syslem.
îëê ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
lo anolhei, because lheie aie diffeienl offsel polenlials al each elecliode.
This is usually nol seen on newei machines lhal swilch leads aulomalically,
because vollages due lo excess chaige aie dischaiged duiing lhe swilching
piocess.
This pioblem is gieally allevialed by ieducing lhe souice of lhe ailifacl.
Because we do nol have lime lo disconnecl an elecliocaidiogiaph when
a palienl is being denbiillaled, we can include eleclionic pioleclion
ciicuiliy, such as lhal desciibed in Seclion 6.4, in lhe machine ilself. ¡n
lhis way, we can limil lhe maximal inpul vollage acioss lhe !CG amplinei
so as lo minimize lhe saluialion and chaige buildup effecls due lo lhe
high-vollage inpul signals. This iesulls in a moie iapid ieluin lo noimal
opeialion following lhe liansienl. Such ciicuiliy is also impoilanl in pio-
lecling lhe elecliocaidiogiaph fiom any damage lhal mighl be caused by
lhese pulses.
Ailifacl caused by slalic elecliic chaige on peisonnel can be lessened
noliceably by ieducing lhe buildup of slalic chaige lhiough lhe use of
conduclive clolhing, shoes, and ûooiing, as well as by having peisonnel louch
lhe bed befoie louching lhe palienl. Molion ailifacl fiomlhe elecliodes can be
decieased by using lhe lechniques desciibed in Chaplei 5.
ÛÈßÓÐÔÛ êòî An elecliocaidiogiaph has a bioad fiequency iesponse so
lhal ils amplinei has a nisl-oidei lime conslanl of 16 s. The elecliocaidio-
giaph amplinei has a bioad dynamic iange of inpul vollages, bul any inpul
vollage giealei lhan 2 m\ will be oul lhe iange of ils display and cul off.
While iecoiding lhe !CG of a palienl, a liansienl occuis lhal has an
amplilude of 1O m\, and lhis causes lhe !CG lo fall oul of lhe iange of
lhe insliumenl`s display. ¡f lhe !CG R wave has an amplilude of 1 m\, how
long will il lake foi lhe enliie signal lo be visible on lhe display?
ßÒÍÉÛÎ Ioi lhe enliie amplilude iange of lhe !CG lo be visible on lhe
display, ils baseline musl be al a vollage of 2 m\ 1 m\ 1 m\. The
iecoveiy vollage al lhe amplinei will follow nisl-oidei exponenlial decay
as given by
1Om\
16 s
(!6.6)
This vollage musl diop lo 1 m\foi lhe enliie !CGwavefoimlo be visible,
so
1 m\ 1Om\»
¬ 16 s
O 1 »
¬ 16 s
(!6.7)
Solving foi ¬, we nnd
ln O 1
¬
16 s
2 3O3 (!6.8)
and
¬ 36 8 s
ê ò í Ð Î Ñ Þ Ô Û Ó Í Ú Î Û Ï Ë Û Ò Ì Ô Ç Û Ò Ý Ñ Ë Ò Ì Û Î Û Ü îëé
×ÒÌÛÎÚÛÎÛÒÝÛ ÚÎÑÓ ÛÔÛÝÌÎ×Ý ÜÛÊ×ÝÛÍ
A ma|oi souice of inleifeience when one is iecoiding oi moniloiing lhe !CG
is lhe elecliic-powei syslem. Besides pioviding powei lo lhe elecliocaidio-
giaph ilself, powei lines aie connecled lo olhei pieces of equipmenl and
appliances in lhe lypical hospilal ioom oi physician`s ofnce. Theie aie also
powei lines in lhe walls, ûooi, and ceiling iunning pasl lhe ioom lo olhei
poinls in lhe building. These powei lines can affecl lhe iecoiding of lhe !CG
and inlioduce inleifeience al lhe line fiequency in lhe iecoided liace, as
illuslialed in Iiguie 6.9(a). Such inleifeience appeais on lhe iecoidings as a
iesull of lwo mechanisms, each opeialing singly oi, in some cases, bolh
opeialing logelhei.
Û´»½¬®·½óB»´¼ coupling belween lhe powei lines and lhe elecliocaidiogiaph
and/oi lhe palienl is a iesull of lhe elecliic nelds suiiounding main powei lines
and lhe powei coids connecling diffeienl pieces of appaialus lo elecliic
oullels. These nelds can be piesenl even when lhe appaialus is nol luined
on, because cuiienl is nol necessaiy lo eslablish lhe elecliic neld. These nelds
couple inlo lhe palienl, lhe lead wiies, and lhe elecliocaidiogiaph ilself. ¡l is
almosl as lhough small capacilois |oined lhese enlilies lo lhe powei lines, as
shown by lhe ciude model in Iiguie 6.1O.
The cuiienl lhiough lhe capacilance Ý
3
coupling lhe ungiounded side of
lhe powei line and lhe elecliocaidiogiaph ilself ûows lo giound and does nol
cause inleifeience. Ý
1
iepiesenls lhe capacilance belween lhe powei line
and one of lhe leads. Cuiienl ·
d1
does nol ûow inlo lhe elecliocaidiogiaph
because of ils high inpul impedance, bul ialhei lhiough lhe skinelecliode
impedances Æ
1
and Æ
G
and lhe sub|ecl being measuied lo giound. Similaily,
·
d2
ûows lhiough Æ
2
and Æ
G
and lhe sub|ecl lo giound. Body impedance,
which is aboul 5OO Ê, can be neglecled when compaied wilh lhe olhei
Ú·¹«®» êòç (a) A 6O Hz powei-line inleifeience. (b) !lecliomyogiaphic
inleifeience on lhe !CG. Seveie 6O Hz inleifeience is also shown on lhe
bollom liacing in Iiguie 4.13.
îëè ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
impedances shown. The vollage amplined is lhal appeaiing belween inpuls A
and B,
A B
.
A B
·
d1
Æ
1
·
d2
Æ
2
(6.3)
Huhla and Webslei (1973) suggesl lhal if lhe lwo leads iun neai each olhei,
·
d1
·
d2
. ¡n lhis case,
A B
·
d1
Æ
1
Æ
2
(6.4)
\alues measuied foi 9 mcables showlhal ·
d
6 nA, allhough lhis value will be
dependenl on lhe ioom and lhe localion of olhei equipmenl and powei lines.
Skinelecliode impedances may diffei by as much as 2O kÊ. Hence
A B
6 nA 2OkÊ 12O³\ (6.5)
which would be an ob|eclionable level of inleifeience. This can be minimized
by shielding lhe leads and giounding each shield al lhe elecliocaidiogiaph.
This is done, in facl, in mosl modein elecliocaidiogiaphs. Loweiing skin
elecliode impedances is also helpful.
Iiguie 6.11 shows lhal cuiienl also ûows fiom lhe powei line diieclly inlo
lhe body. This displacemenl cuiienl ·
db
ûows lhiough lhe giound impedance
Ú·¹«®» êòïð A mechanism of elecliic-neld pickup of an elecliocaidiogiaph
iesulling fiom lhe powei line. Coupling capacilance belween lhe hol side of
lhe powei line and lead wiies causes cuiienl lo ûow lhiough skinelecliode
impedances on ils way lo giound.
ê ò í Ð Î Ñ Þ Ô Û Ó Í Ú Î Û Ï Ë Û Ò Ì Ô Ç Û Ò Ý Ñ Ë Ò Ì Û Î Û Ü îëç
Æ
G
lo giound. The iesulling vollage diop causes a common-mode vollage
cm
lo appeai lhioughoul lhe body.
cm
·
db
Æ
G
(6.6)
Subsliluling lypical values yields
cm
O 2 ³A 5O kÊ 1O m\ (6.7)
¡n pooi elecliical enviionmenls in which ·
db
1 ³A,
cm
can be giealei lhan
5O m\. Ioi a peifecl amplinei, lhis would cause no pioblem, because a
diffeienlial amplinei ie|ecls common-mode vollages (Seclion 3.4). Howevei,
ieal amplineis have nnile inpul impedances Æ
in
. Thus
cm
is decieased because
of lhe allenualoi aclion of lhe skinelecliode impedances and Æ
in
. Thal is,
A B cm
Æ
in
Æ
in
Æ
1
Æ
in
Æ
in
Æ
2
(6.8)
Ú·¹«®» êòïï Cuiienl ûows fiom lhe powei line lhiough lhe body and giound
impedance, lhus ciealing a common-mode vollage eveiywheie on lhe body.
Æ
in
is nol only iesislive bul, as a iesull of RI bypass capacilois al lhe amplinei
inpul, has a ieaclive componenl as well.
îêð ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
Because Æ
1
and Æ
2
aie much less lhan Æ
in
,
A B cm
Æ
2
Æ
1
Æ
in
(6.9)
Subsliluling lypical values yields
A B
1Om\ 2O kÊ 5 MÊ 4O³\ !6.1O
which would be noliceable on an !CG and would be veiy ob|eclionable on an
!!G. This inleifeience can be minimized by loweiing skinelecliode imped-
ance and iaising amplinei inpul impedance.
Thus we see lhal lhe diffeience belween lhe skinelecliode impedances is
an impoilanl consideialion in lhe design of biopolenlial amplineis. Some
common-mode vollage is always piesenl, so lhe inpul imbalance and Æ
in
aie
ciilical faclois deleimining lhe common-mode ie|eclion, no mallei how good
lhe diffeienlial amplinei ilself is.
ÛÈßÓÐÔÛ êòí A clinical slaff membei has allached a palienl lo an eleclio-
encephalogiaph (!!G machine) foi a sleep sludy lhal conlinuously displays
lhal palienl`s !!G on a compulei scieen and sloies il in memoiy. This slaff
membei accidenlly used lwo diffeienl lypes of elecliodes foi lhe !!G lead,
and each elecliode had a diffeienl souice impedance. One had a ielalively
low impedance of 15OO Ê al !!G fiequencies, while lhe olhei had a highei
impedance of 47OO Ê. A giound elecliode having an impedance of 25OO Ê
was also used. The inpul impedance of each diffeienlial inpul of lhe !!G
machine lo giound was 1O MÊ, and lhe insliumenl had a CMRR of 8O dB.
The powei-line displacemenl cuiienl lo lhe palienl was measuied al 4OO nA.
The amplilude of lhe palienl`s !!G was 12 ³\.
¿ò How much common-mode vollage will be seen on lhis palienl and will il
signincanlly inleifeie wilh lhe !!G signal?
¾ò How much powei-line inleifeience will be seen on lhe palienl`s !!G?
ßÒÍÉÛÎ The common-mode vollage will be deleimined by lhe displace-
menl cuiienl lhiough lhe giound elecliode impedance Æ
G
|see (6.6)j.
¿ò
cm
4OO 1O
9
A 25OO Ê 1O
3
\ (!6.9)
The !!G machine`s CMRR is 8O dB, which means lhal ils diffeienlial
gain is 1O
4
limes giealei lhan ils common-mode gain. Thus even lhough
lhe signal-lo-common-mode-noise ialio is 12/1OOO al lhe !!G machine`s
inpul, il will be 12O/1 al ils ieadoul. This should be sufncienlly high lo
allow clinical inleipielalion of lhe !!G signal.
ê ò í Ð Î Ñ Þ Ô Û Ó Í Ú Î Û Ï Ë Û Ò Ì Ô Ç Û Ò Ý Ñ Ë Ò Ì Û Î Û Ü îêï
¾ò Since lhe common-mode inleifeience is low, any powei-line inleifeience
seen will be lhe iesull of lhe unbalanced impedances of lhe !!G eleclio-
des. This will iesull in a diffeienlial signal as deleimined by 6.17.
a b
1O
3
4 7OO Ê 1 5OOÊ
1O
6
Ê
3 2 1O
6
\ 3 2³\ (!6.1O)
This is small compaied lo lhe 1OO ³\ amplilude of lhe !!G signal and
would be noliceable bul loleiable inleifeience.
The olhei souice of inleifeience fiom powei lines is magnelic induclion.
Cuiienl in powei lines eslablishes a ³¿¹²»¬·½ B»´¼ in lhe vicinily of lhe line.
Magnelic nelds can also somelimes oiiginale fiom liansfoimeis and ballasls in
ûuoiescenl lighls oi elecliic appliances and olhei appaialus. ¡f such magnelic
nelds pass lhiough lhe effeclive single-luin coil pioduced by lhe elecliocaidio-
giaph, lead wiies, and lhe palienl, as shown in Iiguie 6.12, a vollage is induced
in lhis loop. This vollage is piopoilional lo lhe magnelic-neld slienglh and lhe
aiea of lhe effeclive single-luin coil. ¡l can be ieduced (1) by ieducing lhe
magnelic neld lhiough lhe use of magnelic shielding, (2) by keeping lhe
elecliocaidiogiaph and leads away fiom polenlial magnelic-neld iegions
(bolh of which aie ialhei difncull lo achieve in piaclice), oi (3) by ieducing
lhe effeclive aiea of lhe single-luin coil.
Ú·¹«®» êòïî Ó¿¹²»¬·½óB»´¼ °·½µ«° ¾§ ¬¸» »´»½¬®±½¿®¼·±¹®¿°¸ (a) Lead wiies
foi lead ¡ make a closed loop (shaded aiea) when palienl and elecliocaidio-
giaph aie consideied in lhe ciicuil. The change in magnelic neld passing
lhiough lhis aiea induces a cuiienl in lhe loop. (b) This effecl can be
minimized by lwisling lhe lead wiies logelhei and keeping lhem close lo
lhe body in oidei lo sublend a much smallei aiea.
îêî ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
This lasl appioach can be achieved easily by lwisling lhe lead wiies logelhei
ovei as much as possible of lhe dislance belween lhe elecliocaidiogiaph and
lhe palienl.
ÑÌØÛÎ ÍÑËÎÝÛÍ ÑÚ ÛÔÛÝÌÎ×Ý ×ÒÌÛÎÚÛÎÛÒÝÛ
!lecliic inleifeience fiom souices olhei lhan lhe powei lines can also affecl
lhe elecliocaidiogiaph. Û´»½¬®±³¿¹²»¬·½ ·²¬»®º»®»²½» fiom neaiby high-powei
iadio, lelevision, oi iadai facililies can be picked up and ieclined by lhe
°P² |unclions of lhe liansislois in lhe elecliocaidiogiaph and somelimes even
by lhe elecliodeelecliolyle inleiface on lhe palienl. Lowei powei eleclio-
magnelic inleifeience can aiise fiom local souices such as wiieless devices
including mobile lelephones and wiieless compuling nelwoiks. The lead wiies
and lhe palienl seive as an anlenna in eilhei case. Once lhe signal is delecled,
lhe demodulaled signal appeais as inleifeience on lhe elecliocaidiogiam. ¡l
was lhoughl lhal such inleifeience fiom mobile lelephones could inleifeie
wilh palienl moniloiing equipmenl in hospilals, bul a sludy al lhe Mayo Clinic
has shown lhis nol lo be a pioblem al lheii inslilulion (Tii »¬ ¿´òô 2OO7).
!lecliomagnelic inleifeience can also be geneialed by high-fiequency
geneialois in lhe hospilal ilself. !lecliosuigical and dialheimy (Seclion 13.9)
equipmenl is a fiequenl offendei. Giobslein and Galzke (1977) show bolh lhe
piopei use of elecliosuigical equipmenl and lhe design of an !CG amplinei
iequiied lo minimize inleifeience. !lecliomagnelic iadialion can be genei-
aled fiom x-iay machines oi swilches and ielays on heavy-duly elecliic
equipmenl in lhe hospilal as well. !ven aicing in a ûuoiescenl lighl lhal is
ûickeiing and in need of ieplacemenl can pioduce seiious inleifeience.
!lecliomagnelic inleifeience can usually be minimized by shunling lhe
inpul leiminals lo lhe elecliocaidiogiaph amplinei wilh a small capaciloi of
appioximalely 2OO pI. The ieaclance of lhis capaciloi is quile high ovei lhe
fiequency iange of lhe !CG, so il does nol appieciably lowei lhe inpul
impedance of lhe elecliocaidiogiaph. Howevei, wilh loday`s modein high-
inpul-impedance machines, il is impoilanl lo make suie lhal lhis is ieally lhe
case. Al iadiofiequencies, ils ieaclance is low enough lo cause effeclive
shoiling of lhe elecliomagnelic inleifeience picked up by lhe lead wiies
and lo keep il fiom ieaching lhe liansislois in lhe amplinei.
Theie is also a souice of elecliic inleifeience localed wilhin lhe body ilself
lhal can have an effecl on !CGs. Theie is always some skelelal muscle localed
belween lhe elecliodes making up a lead of lhe elecliocaidiogiaph. Any lime
lhis muscle is conliacling, il geneiales ils own elecliomyogiaphic signal lhal
can be picked up by lhe lead along wilh lhe !CGand can iesull in inleifeience
on lhe !CG, as shown in Iiguie 6.9(b). When we look only al lhe !CGand nol
al lhe palienl, il is somelimes difncull lodeleimine whelhei inleifeience of lhis
lype is muscle inleifeience oi lhe iesull of elecliomagnelic iadialion. How-
evei, while lhe !CG is being laken, we can easily sepaiale lhe lwo souices,
because lhe !MG inleifeience is associaled wilh lhe palienl`s muscle conliac-
lions lhal can be obseived when we look al lhe palienl.
ê ò í Ð Î Ñ Þ Ô Û Ó Í Ú Î Û Ï Ë Û Ò Ì Ô Ç Û Ò Ý Ñ Ë Ò Ì Û Î Û Ü îêí
êòì ÌÎßÒÍ×ÛÒÌ ÐÎÑÌÛÝÌ×ÑÒ
The isolalion ciicuils desciibed in Seclion 14.9 aie piimaiily foi lhe pioleclion
of lhe palienl in lhal lhey eliminale lhe hazaid of elecliic shock iesulling fiom
inleiaclion among lhe palienl, lhe elecliocaidiogiaph, and olhei elecliic
devices in lhe palienl`s enviionmenl. Theie aie also limes when olhei equip-
menl allached lo lhe palienl can piesenl a iisk lo lhe machine. Ioi example, in
lhe opeialing suile, palienls undeigoing suigeiy usually have lheii !CGs
conlinuously moniloied duiing lhe pioceduie. ¡f lhe suigical pioceduie
involves lhe use of an elecliosuigical unil (Seclion 13.9), il can inlioduce
onlo lhe palienl ielalively high vollages lhal can enlei lhe elecliocaidiogiaph
oi caidiac moniloi lhiough lhe palienl`s elecliodes. ¡f lhe giound conneclion
lo lhe elecliosuigical unil is faully oi if highei-lhan-noimal iesislance is
piesenl, lhe palienl`s vollage wilh iespecl lo giound can become quile high
duiing coagulalion oi culling. These high polenlials enlei lhe elecliocaidio-
giaph oi caidiac moniloi and can be laige enough lo damage lhe eleclionic
ciicuiliy. They can also cause seveie liansienls, of lhe lype shown in Iiguie 6.8.
¡deally, caidiac monilois and elecliocaidiogiaphs should be designed so
lhal lhey aie unaffecled by such liansienls. \nfoilunalely, lhis cannol be
achieved complelely. Howevei, il is possible lo ieduce lhe effecls of lhese
elecliic liansienls and lo piolecl lhe equipmenl fiom seiious damage. Iiguie
6.13 shows lhe basic aiiangemenl of such pioleclive ciicuils. Two-leiminal
vollage-limiling devices aie connecled belween each palienl elecliode and
elecliic giound.
Iiguie 6.14(a) shows lhe lypical cuiienlvollage chaiacleiislic of such a
device. Al vollages less lhan Ê
b
, lhe bieakdown vollage, lhe device allows veiy
lillle cuiienl lo ûow and ideally appeais as an open ciicuil. Once lhe vollage
acioss lhe device allempls lo exceed Ê
b
, lhe chaiacleiislics of lhe device
shaiply change, and cuiienl passes lhiough lhe device lo such an exlenl
lhal lhe vollage cannol exceed Ê
b
as a iesull of lhe vollage diop acioss lhe
Ú·¹«®» êòïí A vollage-pioleclion scheme al lhe inpul of an elecliocaidio-
giaph lo piolecl lhe machine fiom high-vollage liansienls. Ciicuil elemenls
connecled acioss limb leads on lefl-hand side aie vollage-limiling devices.
îêì ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
seiies iesislois Î (in Iiguie 6.13). \ndei lhese condilions, lhe device
appeais lo behave as a shoil ciicuil in seiies wilh a conslanl-vollage souice
of magnilude Ê
b
.
¡n piaclice, lheie aie seveial ways lo achieve a chaiacleiislic appioaching
lhis idealized chaiacleiislic. Iiguie 6.14 indicales lhiee of lhese. п®¿´´»´ -·´·½±²
¼·±¼»-, as shown in Iiguie 6.14(b), give a chaiacleiislic wilh a bieakdown
vollage of appioximalely 6OO m\. The diodes aie connecled such lhal lhe
leiminal vollage on one has a polaiily opposile lhal on lhe olhei. Thus, when
lhe vollage ieaches appioximalely 6OO m\, one of lhe diodes is foiwaid-
biased. And even lhough lhe olhei is ieveise-biased, ils bias vollage is limiled
lo lhe foiwaid vollage diop. When lhe vollage acioss lhe nelwoik is ieveised,
lhe ioles of lhe lwo diodes aie ieveised, again limiling lhe vollage acioss lhe
nelwoik lo appioximalely 6OO m\. The liansilion fiom nonconducling slale lo
conducling slale, howevei, is nol so shaip as shown in lhe chaiacleiislic cuive,
and signal disloilion can begin lo appeai fiom lhese diodes al vollages of
appioximalely 3OO m\. Allhough lhe !CG ilself does nol appioach such a
vollage, il is possible undei exlieme condilions foi dc-offsel polenlials of lhal
oidei of magnilude lo iesull fiomfaully elecliodes. The main advanlage of lhis
ciicuil is ils low bieakdown vollage; lhe maximal liansienls al lhe amplinei
inpul aie only appioximalely 6OO m\ peak amplilude.
Because lhe bieakdown vollage of lhis ciicuil is loo small, il is usually
incieased simply by connecling lwo oi lhiee diodes in seiies inslead of using
single diodes in each bianch. This has lhe advanlage of nol only incieasing lhe
bieakdown vollage by mulliplying lhe inilial 6OO m\ by lhe numbei of diodes
in seiies bul also incieasing lhe iesislance of lhe ciicuil, bolh in lhe conducling
and lhe nonconducling slale.
When we wanl highei bieakdown vollages, we can use lhe ciicuil of
Iiguie 6.14(c). This ciicuil consisls of lwo silicon diodes, usually ¦»²»® ¼·±¼»-,
connecled back lo back. When a vollage is connecled acioss lhis ciicuil, one of
Ú·¹«®» êòïì ʱ´¬¿¹»ó´·³·¬·²¹¼»ª·½»- (a) Cuiienlvollage chaiacleiislics of a
vollage-limiling device. (b) Paiallel silicon-diode vollage-limiling ciicuil.
(c) Back-lo-back silicon zenei-diode vollage-limiling ciicuil. (d) Gas-dischaige
lube (neon lighl) vollage-limiling ciicuil elemenl.
ê ò ì Ì Î ß Ò Í × Û Ò Ì Ð Î Ñ Ì Û Ý Ì × Ñ Ò îêë
lhe diodes is biased in lhe foiwaid diieclion and lhe olhei in lhe ieveise
diieclion. The bieakdown vollage in lhe foiwaid diieclion is appioximalely
6OO m\, bul lhal in lhe ieveise diieclion is much highei. ¡l geneially coveis lhe
iange of 2 lo 2O \. Thus lhis ciicuil does nol conducl unlil ils leiminal vollage
exceeds lhe ieveise bieakdown of lhe diode by appioximalely 6OO m\. Again,
when lhe polaiily of lhe ciicuil leiminal vollage is ieveised, lhe ioles of lhe lwo
diodes aie inleichanged.
A device lhal gives an even highei bieakdown vollage is lhe ¹¿-ó¼·-½¸¿®¹»
¬«¾» illuslialed in Iiguie 6.14(d). This device appeais as an open ciicuil unlil
il ieaches ils bieakdown vollage. ¡l lhen swilches lo lhe conducling slale
and mainlains a vollage lhal is usually seveial volls less lhan lhe bieakdown
vollage. Bieakdown vollages ianging fiom 5O lo 9O \ aie lypical foi lhis
device. This bieakdown vollage is consideied high foi lhe inpul lo mosl
elecliocaidiogiaphic amplineis. Thus il is impoilanl lo include a ciicuil
elemenl such as a iesisloi belween lhe gas-dischaige lube and lhe amplinei
inpul lo limil lhe amplinei`s inpul cuiienl.
Designeis of biopolenlial amplineis oflen use minialuie neon lamps as
vollage limileis. They aie essenlially gas dischaige lubes and aie veiy in-
expensive and have a symmeliic chaiacleiislic, iequiiing only a single device
pei elecliode paii. Theii iesislance in lhe nonconducling slale is neaily innnile,
so lheie is no loading effecl on lhe elecliodes‰a fealuie lhal is mosl desiiable
when lhe biopolenlial amplinei has veiy high inpul impedance.
êòë ÝÑÓÓÑÒóÓÑÜÛ ßÒÜ ÑÌØÛÎ
×ÒÌÛÎÚÛÎÛÒÝÛóÎÛÜËÝÌ×ÑÒ Ý×ÎÝË×ÌÍ
As we noled eailiei, common-mode vollages can be iesponsible foi much of
lhe inleifeience in biopolenlial amplineis. Allhough having an amplinei wilh
a high CMRR minimizes lhe effecls of common-mode vollages, a bellei
appioach lo lhis pioblem is lo discovei lhe souice of lhe vollage and liy lo
eliminale il. ¡n lhis seclion, we shall look al some of lhe souices of lhis and
olhei lypes of inleifeience lo discovei ways in which lhey can be minimized.
ÛÔÛÝÌÎ×Ýó ßÒÜ ÓßÙÒÛÌ×ÝóÚ×ÛÔÜ ×ÒÌÛÎÚÛÎÛÒÝÛ
As we saw in Seclion 6.3, elecliic inleifeience can be inlioduced in syslems of
biopolenlial measuiemenl lhiough capacilive coupling and magnelic induc-
lion. We can minimize lhese inleifeiing signals by liying lo eliminale lhe
souices of lhe signals via shielding lechniques. !leclioslalic shielding is
accomplished by placing a giounded conducling plane belween lhe souice
of lhe elecliic neld and lhe measuiemenl syslem. The measuiemenl of veiy-
low-level biopolenlials, such as lhe !!G, has liadilionally been caiiied oul in a
shielded enclosuie conlaining eilhei conlinuous solid-melal panels oi al leasl
giounded coppei scieening lo minimize inleifeience. Today, high-qualily
îêê ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
diffeienlial insliumenlalion amplineis wilh high CMRRs make such shielding
unnecessaiy.
This lype of shielding is ineffeclive foi magnelic nelds unless lhe melal
panels have a high peimeabilily (such as sheel sleel oi mumelal, a high
peimeabilily alloy). ¡n olhei woids, lhe panels musl be good magnelic
conduclois as well as good elecliic conduclois. Such iooms aie available lo
piovide magnelic shielding, bul a much less expensive way of achieving a
ieduclion of magnelically induced signals is lo ieduce lhe effeclive suiface aiea
belween lhe diffeienlial inpuls lo lhe biopolenlial amplinei, in lhe case of
diffeienlial signals, and belween lhe inpuls and giound, in lhe case of common-
mode signals. Somelhing as simple as a lwisled paii of lead wiies, as illuslialed
in Iiguie 6.12(b), may gieally impiove lhe silualion.
ÜÎ×ÊÛÒóÎ×ÙØÌóÔÛÙ ÍÇÍÌÛÓ
¡n mosl modein elecliocaidiogiaphic syslems, lhe palienl is nol giounded al
all. ¡nslead, lhe iighl-leg elecliode is connecled(as shown in Iiguie 6.15) lo lhe
oulpul of an auxiliaiy op amp. The common-mode vollage on lhe body is
sensed by lhe lwo aveiaging iesislois Î
a
, inveiled, amplined, and fed back
lo lhe iighl leg. This negalive feedback diives lhe common-mode vollage lo a
Ú·¹«®» êòïë Ü®·ª»²ó®·¹¸¬ó´»¹ ½·®½«·¬ º±® ³·²·³·¦·²¹ ½±³³±²ó³±¼» ·²¬»®ó
º»®»²½» The ciicuil deiives common-mode vollage fiom a paii of aveiaging
iesislois connecled lo
3
and
4
in Iiguie 3.5. The iighl leg is nol giounded bul
is connecled lo oulpul of lhe auxiliaiy op amp.
ê ò ë × Ò Ì Û Î Ú Û Î Û Ò Ý Û ó Î Û Ü Ë Ý Ì × Ñ Ò Ý × Î Ý Ë × Ì Í îêé
low value. The body`s displacemenl cuiienl ûows nol lo giound bul ialhei
lo lhe op-amp oulpul ciicuil. This ieduces lhe inleifeience as fai as lhe
!CG amplinei is conceined and effeclively giounds lhe palienl (Winlei
and Webslei, 1983).
The ciicuil can also piovide some elecliic safely. ¡f an abnoimally high
vollage should appeai belween lhe palienl and giound as a iesull of elecliic
leakage oi olhei cause, lhe auxiliaiy op amp in Iiguie 6.15 saluiales. This
effeclively ungiounds lhe palienl, because lhe amplinei can no longei diive lhe
iighl leg. Now lhe paiallel iesislances Î
f
and Î
o
aie belween lhe palienl and
giound. They can be seveial megohms in value‰laige enough lo limil lhe
cuiienl. These iesislances do nol piolecl lhe palienl, howevei, because 12O \
on lhe palienl would bieak down lhe op-amp liansislois of lhe !CG amplinei,
and laige cuiienls would ûow lo giound.
ÛÈßÓÐÔÛ êòì Deleimine lhe common-mode vollage
cm
on lhe palienl in
lhe diiven-iighl-leg ciicuil of Iiguie 6.15 when a displacemenl cuiienl ·
d
ûows lo lhe palienl fiom lhe powei lines. Choose appiopiiale values foi lhe
iesislances in lhe ciicuil so lhal lhe common-mode vollage is minimal and
lheie is only a high-iesislance palh lo giound when lhe auxiliaiy op amp
saluiales. Whal is
cm
foi lhis ciicuil when ·
d
O 2³ß?
ßÒÍÉÛÎ The equivalenl ciicuil foi lhe ciicuil of Iiguie 6.15 is shown in
Iiguie !6.2. Nole lhal because lhe common-mode gain of lhe inpul slage is
1 (Seclion 3.4) and because lhe inpul slage as shown has a veiy high inpul
impedance,
cm
al lhe inpul is isolaled fiom lhe oulpul ciicuil. Î
RL
iepiesenls
lhe iesislance of lhe iighl-leg elecliode. Summing lhe cuiienls al lhe negalive
inpul of lhe op amp, we gel
2
cm
Î
a
o
Î
f
O (!6.11)
Ú·¹«®» Ûêòî !quivalenl ciicuil of diiven-iighl-leg syslem of Iiguie 6.15.
îêè ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
This gives
o

f
Î
a
cm
(!6.12)
bul
cm
Î
RL
·
d o
(!6.13)
Thus, subsliluling (!6.2) inlo (!6.3) yields
cm
Î
RL
·
d
1 2Î
f
Î
a
(!6.14)
The effeclive iesislance belween lhe iighl leg and giound is lhe iesislance of
lhe iighl-leg elecliode divided by 1 plus lhe gain of lhe auxiliaiy op-amp
ciicuil. When lhe amplinei saluiales, as would occui duiing a laige liansienl
cm
, ils oulpul appeais as lhe saluialion vollage
s
. The iighl leg is now
connecled lo giound lhiough lhis souice and lhe paiallel iesislances Î
f
and Î
o
.
To limil lhe cuiienl, Î
f
and Î
o
should be laige. \alues as high as 5 MÊ aie
used.
When lhe amplinei is nol saluialed, we would like
cm
lo be as small as
possible oi, in olhei woids, lo be an effeclive low-iesislance palh lo giound.
This can be achieved by making Î
f
laige and Î
a
ielalively small. Î
f
can be
equal lo Î
o
, bul Î
a
can be much smallei.
A lypical value of Î
a
would be 25 kÊ. A woisl-case elecliode iesislance
Î
RL
would be 1OO kÊ. The effeclive iesislance belween lhe iighl leg and
giound would lhen be
1OOkÊ
1
2 5 MÊ
25kÊ
249 Ê
Ioi lhe O.2 ³A displacemenl cuiienl, lhe common-mode vollage is
cm
249Ê O 2 ³A 5O³\
êòê ßÓÐÔ×Ú×ÛÎÍ ÚÑÎ ÑÌØÛÎ Þ×ÑÐÑÌÛÒÌ×ßÔ Í×ÙÒßÔÍ
\p lo lhis poinl we have sliessed biopolenlial amplineis foi lhe !CG. Amplineis
foi use wilh olhei biopolenlials aie essenlially lhe same. Howevei, olhei signals
do pul diffeienl consliainls on some aspecls of lhe amplinei. The fiequency
conlenl of diffeienl biopolenlials coveis diffeienl poilions of lhe speclium. Some
biopolenlials have highei ampliludes lhan olheis. Bolh lhese facls place gain and
ê ò ê ß Ó Ð Ô × Ú × Û Î Í Ú Ñ Î Ñ Ì Ø Û Î Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í × Ù Ò ß Ô Í îêç
fiequency-iesponse consliainls on lhe amplineis used. Iiguie 6.16 shows lhe
ianges of ampliludes and fiequencies coveied by seveial of lhe common bio-
polenlial signals. Depending on lhe signal, fiequencies iange fiom dc lo aboul
1O kHz. Ampliludes can iange fiomlens of miciovolls lo appioximalely 1OO m\.
The amplinei foi a pailiculai biopolenlial musl be designed lo handle lhal
polenlial and lo piovide an appiopiiale signal al ils oulpul.
The elecliodes used lo oblain lhe biopolenlial place ceilain consliainls on
lhe amplinei inpul slage. To achieve lhe mosl effeclive signal liansfei, lhe
amplinei musl be malched lo lhe elecliodes. Also, lhe amplinei inpul ciicuil
musl nol piomole lhe geneialion of ailifacl by lhe elecliode, as could occui
wilh excessive bias cuiienl. Lel us look al a few iequiiemenls placed on
diffeienl lypes of biopolenlial amplineis by lhe measuiemenl being made.
ÛÔÛÝÌÎÑÓÇÑÙÎßÐØÇ ßÓÐÔ×Ú×ÛÎ
Iiguie 6.16 shows lhal elecliomyogiaphic signals iange in fiequency fiom
25 Hz lo seveial kiloheilz. Signal ampliludes iange fiom 1OO ³\ lo 9O m\,
depending on lhe lype of signal and elecliodes used. Thus elecliomyogiaphy
(!MG) amplineis musl have a widei fiequency iesponse lhan !CGamplineis,
bul lhey do nol have lo covei so low a fiequency iange as lhe !CGs. This is
desiiable because molion ailifacl conlains moslly low fiequencies lhal can be
Ú·¹«®» êòïê \ollage and fiequency ianges of some common biopolenlial
signals; dc polenlials include inliacellulai vollages as well as vollages meas-
uied fiom seveial poinls on lhe body. !OG is lhe eleclio-oculogiam, !!G is
lhe eleclioencephalogiam, !CG is lhe elecliocaidiogiam, !MG is lhe eleclio-
myogiam, and AAP is lhe axon aclion polenlial. |Iiom 1. M. R. Delgado,
!lecliodes foi !xliacellulai Recoiding and Slimulalion.`` ¡n W. L. Nasluk
(ed.), и§-·½¿´ Ì»½¸²·¯«»- ·² Þ·±´±¹·½¿´ λ-»¿®½¸. New Yoik: Academic Piess,
1964.j
îéð ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
nlleied moie effeclively in !MG amplineis lhan in !CG amplineis wilhoul
affecling lhe signal.
¡f skin-suiface elecliodes aie used lo delecl lhe !MG, lhe levels of signals
aie geneially low, having peakampliludes of lhe oidei of O.1 lo 1 m\. !lecliode
impedance is ielalively low, ianging fiom aboul 2OO lo 5OOO Ê, depending on
lhe lype of elecliode, lhe elecliodeelecliolyle inleiface, and lhe fiequency al
which lhe impedance is deleimined. Thus lhe amplinei musl have somewhal
highei gain lhan lhe !CG amplinei foi lhe same oulpul-signal iange, and ils
inpul chaiacleiislics should be almosl lhe same as lhose of lhe !CG amplinei.
When inliamusculai needle elecliodes aie used, lhe !MG signals can be an
oidei of magnilude sliongei, lhus iequiiing an oidei of magnilude less gain.
Iuilheimoie, lhe suiface aiea of lhe !MG needle elecliode is much less lhan
lhal of lhe suiface elecliode, so ils souice impedance is highei. Theiefoie, a
highei amplinei inpul impedance is desiiable foi qualily signal iepioduclion.
ßÓÐÔ×Ú×ÛÎÍ ÚÑÎ ËÍÛ É×ÌØ ÙÔßÍÍ Ó×ÝÎÑÐ×ÐÛÌÌÛ
×ÒÌÎßÝÛÔÔËÔßÎ ÛÔÛÝÌÎÑÜÛÍ
¡nliacellulai elecliodes oi micioelecliodes lhal can measuie lhe polenlial
acioss lhe cell membiane geneially delecl polenlials on lhe oidei of 5O lo
1OO m\. Theii small size and small effeclive suiface-conlacl aiea give lhem a
veiy high souice impedance, and lheii geomeliy iesulls in a ielalively laige
shunling capacilance. These fealuies place on lhe amplinei lhe consliainl of
iequiiing an exliemely high inpul impedance. Iuilheimoie, lhe high shunling
capacilance of lhe elecliode ilself affecls lhe fiequency-iesponse chaiaclei-
islics of lhe syslem. Oflen posilive-feedback schemes aie used in lhe bio-
polenlial amplinei lo piovide an effeclive negalive capacilance lhal can
compensale foi lhe high shunl capacilance of lhe souice.
The fiequency iesponse of micioelecliode amplineis musl be quile wide.
¡nliacellulai elecliodes aie oflen used lo measuie lhe dc polenlial diffeience
acioss a cell membiane, so lhe amplinei musl be capable of iesponding lo dc
signals. When excilable cell-membiane polenlials aie lo be measuied, such as
in muscle cells and neive cells, iise limes can conlain fiequencies of lhe oidei
of 1O kHz, and lhe amplineis musl be capable of passing lhese, loo. The facl
lhal lhe polenlials aie ielalively high means lhal lhe vollage gain of lhe
amplinei does nol have lo be as high as in pievious examples.
A pieamplinei ciicuil lhal is especially useful wilh micioelecliodes is lhe
negalive-inpul-capacilance amplinei shown in Iiguie 6.17. The basic ciicuil
consisls of a low-gain, veiy-high-inpul-impedance, noninveiling amplinei wilh
a capaciloi Ý
f
pioviding posilive feedback lo lhe inpul. ¡f we look al lhe
equivalenl ciicuil foi lhis amplinei |Iiguie 6.17(b)j, we can ielale lhe inpul
vollage and cuiienl:
i
1
Ý
f
·
i
¼¬ ß
v i
(6.11)
ê ò ê ß Ó Ð Ô × Ú × Û Î Í Ú Ñ Î Ñ Ì Ø Û Î Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í × Ù Ò ß Ô Í îéï
wheie ß
v
is lhe amplinei gain, piovided lhe op amp ilself diaws no cuiienl.
This equalion can be ieaiianged as follows:
i
1
1 ß
v
Ý
f
·
i
¼¬ (6.12)
Thus lhe equivalenl capacilance al lhe amplinei inpul is 1 ß
v
Ý
f
. ¡f ß
v
is
giealei lhan unily, lhis equivalenl capacilance is negalive. The amplinei is
connecled lo lhe micioelecliode, wilh ils high souice iesislance Î
s
. The shunl
capacilance fiom lhe elecliode and cable is Ý
s
. The lolal ciicuil capacilance is
Ý Ý
s
1 ß
v
Ý
f
(6.13)
which is zeio when
Ý
s
ß
v
1 Ý
f
(6.14)
This condilion can be mel by ad|usling eilhei lhe amplinei gain ß
v
oi lhe
feedback capacilance Ý
f
.
¡n piaclical negalive-inpul-capacilance amplineis, lhe idealized condilion
of (6.14) cannol be mel, because lhe gain of any amplinei has some fiequency
dependence. Theie aie lhus fiequencies wheie lhe inpul capacilance of lhe
amplinei does nol cancel lhe souice capacilance, and lhe ciicuil does nol have
an ideal liansienl iesponse. The amplinei employs posilive feedback and does
nol have an ideal fiequency iesponse, so il is possible foi lhe condilions of
oscillalion lo be mel al some fiequency, and lhe amplinei will lhen become
unslable. Thus il is impoilanl lhal lhe amplinei be caiefully ad|usled lo meel
Ú·¹«®» êòïé (a) Basic aiiangemenl foi negalive-inpul-capacilance amplinei.
Basic amplinei is on lhe iighl-hand side; equivalenl souice wilh lumped seiies
iesislance Î
s
and shunl capacilance Ý
s
is on lhe lefl. (b) !quivalenl ciicuil of
basic negalive-inpul-capacilance amplinei.
îéî ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
lhe condilion of (6.14) as closely as possible wilhoul becoming unslable.
Anolhei consequence of lhe posilive feedback is lhal lhe amplinei lends lo
be noisy. This is nol a seiious pioblem, howevei, because lhe vollages fiom
micioelecliodes aie usually ielalively high. A noninveiling amplinei wilh
ad|uslable gain giealei lhan one can be used lo diive a shield aiound lhe wiie
leading lo lhe inpul. Then lhe sliay capacilance belween lhe wiie and lhe
shield can seive as Ý
f
and lhe shield minimizes inleifeience.
ÛÔÛÝÌÎÑÛÒÝÛÐØßÔÑÙÎßÐØ ßÓÐÔ×Ú×ÛÎÍ
Iiguie 6.16 shows lhal lhe eleclioencephalogiaph (!!G) iequiies an amplinei
wilh a fiequency iesponse of fiom O.1 lo 1OO Hz. When suiface elecliodes aie
used, as in clinical eleclioencephalogiaphy, ampliludes of signals iange fiom
25 lo 1OO ³\. Thus amplineis wilh ielalively high gain aie iequiied. These
elecliodes aie smallei lhan lhose used foi lhe !CG, so lhey have somewhal
highei souice impedances, and a high inpul impedance is essenlial in lhe !!G
amplinei. Because lhe signal levels aie so small, common-mode vollages can
have moie seiious effecls. Theiefoie, moie sliingenl effoils musl be made lo
ieduce common-mode inleifeience, as well as lo use amplineis wilh highei
CMRRs and low noise.
ÛÈßÓÐÔÛ êòë A small iuial hospilal would like lo puichase an eleclio-
encephalogiaph bul cannol affoid lo build a shielded ioom in which lo
measuie palienls` !!Gs. A clinical engineei has deleimined lhal lheie can
be common-mode noise on lheii palienls wilh ampliludes as laige as 1OO m\.
Whal musl lhe minimum CMRR of lheii eleclioencephalogiaph be so lhal
an !!G signal of 25 ³\ amplilude has no moie lhan 1 common-mode
noise?
ßÒÍÉÛÎ The SNR al lhe amplinei inpul can be as low as
SNR
25 1O
6
\
1O
1
\
2 5 1O
4
(!6.15)
The SNRal lhe oulpul oi display of lhe eleclioencephalogiaphmusl be al leasl
SNR 1
1
1OO (!6.16)
The CMRR lhen musl be lhe ialio of lhe oulpul SNR lo lhal al lhe inpul
CMRR
1OO
2 5 1O
4
4 1O
5
(!6.17)
oi 2O log
1O
4 1O
5
dB 112dB
This is wilhin lhe iange of CMRR available in high-qualily diffeienlial
amplineis. (Palla´ s-Aieny and Webslei, 199O).
ê ò ê ß Ó Ð Ô × Ú × Û Î Í Ú Ñ Î Ñ Ì Ø Û Î Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í × Ù Ò ß Ô Í îéí
êòé ÛÈßÓÐÔÛ ÑÚ ß Þ×ÑÐÑÌÛÒÌ×ßÔ ÐÎÛßÓÐÔ×Ú×ÛÎ
As we have seen, biopolenlial amplineis can be used foi a vaiiely of signals. The
gain and fiequency iesponse aie lwo impoilanl vaiiables lhal ielale lhe amplinei
lo lhe pailiculai signal. An impoilanl facloi common lo all amplineis is lhe nisl
slage, oi pieamplinei. This slage musl have low noise, because ils oulpul musl be
amplinedlhiough lhe iemaining slages of lhe amplinei, andany noise is amplined
along wilh lhe signal. ¡l musl also be coupled diieclly lo lhe elecliodes (no seiies
capacilois) lo piovide oplimal low-fiequency iesponse as well as lo minimize
chaiging effecls on coupling capacilois fiom inpul bias cuiienl. Of couise, eveiy
allempl should be made lo minimize lhis cuiienl. !ven wilhoul coupling
capacilois il can polaiize lhe elecliodes, iesulling in polaiizalion oveipolenlials
lhal pioduce a laige dc offsel vollage al lhe amplineis` inpul. This is why
pieamplineis oflen have ielalively low vollage gains. The offsel polenlial is
coupled diieclly lo lhe inpul, so il could saluiale high-gain pieamplineis, culling
oul lhe signal allogelhei. To eliminale lhe saluialing effecls of lhis dc polenlial,
lhe pieamplinei can be capaciloi-coupled lo lhe iemaining amplinei slages. A
nnal consideialion is lhal lhe pieamplinei musl have a veiy highinpul impedance,
because il iepiesenls lhe load on lhe elecliodes (Thakoi, 1988).
Oflen, foi safely ieasons, lhe pieamplinei eilhei is elecliically isolaled
fiom lhe iemaining amplinei slages (and hence fiom lhe powei lines) (Seclion
14.9) oi is localed neai lhe signal souice lominimize inleifeience pickupon lhe
high-impedance lead wiies. ¡n lhe lallei case, we can use a balleiy-poweied
pieamplinei wilh low powei consumplion oi a powei supply lhal is elecliically
isolaled wilh lhis ciicuil.
Iiguie 6.18 shows lhe ciicuil of an !CG amplinei. The insliumenlalion
amplinei of Iiguie 3.5 is used lo piovide veiy high inpul impedance. High
common-mode ie|eclion is achieved by ad|usling lhe polenliomelei lo aboul
47 kÊ. !lecliodes maypioduce anoffsel polenlial of uploO.3\. Thus, lopievenl
saluialion, lhe dc-coupled slages have a gain of only 25. Coupling capacilois aie
nol placedal lhe inpul because lhis would block lhe op-amp bias cuiienl. Adding
iesislois lo supply lhe bias cuiienl would lowei lhe Æ
in
. Coupling capacilois
placedaflei lhe nisl op amps would have lobe impiaclically laige. Theiefoie, lhe
single 1 ³Icoupling capaciloi andlhe 3.3 MÊiesisloi foima high-pass nllei. The
iesulling 3.3 s lime conslanl passes all fiequencies above O.O5 Hz. The oulpul
slage is a noninveiling amplinei lhal has a gain of 32 (Seclion 3.3).
A second 3.3 MÊ iesisloi is added lo balance bias-cuiienl souice imped-
ances. The 15O kÊ and O.O1 ³I low-pass nllei allenuales fiequencies above
1O6 Hz. Swilch Í
1
may be momenlaiily closed lo deciease lhe dischaige lime
conslanl when lhe oulpul saluiales. This is iequiied aflei denbiillalion oi lead
swilching lo chaige lhe 1 ³I capaciloi iapidly lo lhe new value and ieluin lhe
oulpul lo lhe lineai iegion. We do ²±¬ dischaige lhe capaciloi vollage lo zeio.
Ralhei, we wanl lhe iighl end lo be al O \when lhe lefl end is al lhe dc vollage
deleimined by lhe elecliode offsel vollage. Swilch closuie may be aulomalic,
via a ciicuil lhal delecls when lhe oulpul is in saluialion, oi il may be manual.
îéì ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
Allhough any geneial-puipose op amp such as lhe 741, 3O1, and 358 is
salisfacloiy in lhis ciicuil, an op amp such as lhe 411, which has lowei bias
cuiienl, may be piefeiied.
Spinelli »¬ ¿´. (2OO4) developed an !CG amplinei based on slandaid low-
powei op amps anda single 5 \powei supply. ¡l accepls inpul offsel vollages up
lo 5OOm\, yields a CMRR of 1O2 dB al 5O Hz, and piovides a iesel behavioi
foi iecoveiing fiomoveiloads oi ailifacls. Dobiev »¬ ¿´. (2OO8) desciibe a ciicuil
lhal measuies lhe !CG using lwo elecliodes inslead of lhe usual lhiee.
êòè ÑÌØÛÎ Þ×ÑÐÑÌÛÒÌ×ßÔ Í×ÙÒßÔ ÐÎÑÝÛÍÍÑÎÍ
ÝßÎÜ×ÑÌßÝØÑÓÛÌÛÎÍ
A caidiolachomelei is a device foi deleimining heail iale. The signal mosl
fiequenlly used is lhe !CG. Howevei, soflwaie foi deiiving heail iale fiom
signals such as lhe aileiial piessuie wavefoim, pulse oximelei pulse waves, oi
heail sounds has also been developed.
Ú·¹«®» êòïè This !CGamplinei has a gain of 25 in lhe dc-coupled slages. The
high-pass nllei feeds a noninveiling-amplinei slage lhal has a gain of 32. The
lolal gain is 25 32 8OO. When ³A 776 op amps weie used, lhe ciicuil was
found lo have a CMRR of 86 dB al 1OO Hz and a noise level of 4O m\ peak lo
peak al lhe oulpul. The fiequency iesponse was O.O5 lo 1O6 Hz foi 3 dB and
was ûal ovei 4 lo 4O Hz. A single op-amp chip, lhe LM 324, lhal conlains foui
individual op amps could also be used in lhis ciicuil ieducing lhe lolal pails
counl.
ê ò è Ñ Ì Ø Û Î Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í Ñ Î Í îéë
The beal-lo-beal caidiolachomelei deleimines lhe iecipiocal of lhe lime
inleival belweenheailbeals foi each beal and piesenls il as lhe heail iale foi lhal
pailiculai inleival. Any slighl vaiiabilily in lhe inleival belween beals shows up
as a vaiialion in lhe inslanlaneous heail iale deleimined by lhis melhod.
Iiguie 6.19 shows lhe liming diagiam beal-lo-beal caidiolachomelei. ¡n
soflwaie, lhe !CG inilially passes lhiough a bandpass nllei, which passes ÇRS
complexes while ieducing ailifacl and mosl of lhe P and T waves. ¡n one
example, a lhieshold delecloi liiggeis lhe pulse Ð
1
.
A 1 kHz clock signal enleis a counling iegislei whenevei Ð
3
is high.
Because Ð
3
is highduiing lhe inleival belween ÇRS complexes, lhe 1 ms pulses
coming fiom lhe clock (Ð
4
) accumulale in iegislei 1 duiing lhis peiiod. ¡f lhe
iegislei is inilially al zeio, lhe numbei of pulses in lhe iegislei by lhe lime lhe
nexl ÇRS complex aiiives equals lhe numbei of milliseconds in lhe inleival
belween lhis ÇRS complex and lhe pievious one. Once lhe gale piohibils
addilional clock pulses fiom enleiing iegislei 1, pulse Ð
1
enables lhe signal in
lhis iegislei lo be sloied in a second iegislei, which seives as a memoiy.
Soflwaie calculales
o
using
o
µ
Ì
R
(6.15)
Ú·¹«®» êòïç Ì·³·²¹ ¼·¿¹®¿³ º±® ¾»¿¬ó¬±ó¾»¿¬ ½¿®¼·±¬¿½¸±³»¬»®
îéê ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
wheie µ is a conslanl and Ì
R
is lhe inleival belween ÇRS complexes. We see
lhal
o
is piopoilional lo lhe iecipiocal of lhe beal-lo-beal lime inleival of lhe
oiiginal !CG; in olhei woids, il is piopoilional lo lhe heail iale. Nole lhal lhis
vollage shifls wilh each heail beal and lhal ils amplilude is calculaled fiom lhe
duialion of lhe pievious beal-lo-beal inleival.
Alaim ciicuils can also be used wilh lhis lype of caidiolachomelei. These
compaie lhe signal in iegislei 1 lo deleimine whelhei an inleival of longei lhan
a piesel value has occuiied (lhis could happen if lhe heail iale weie loo low).
Soflwaie can moniloi lhe signal in iegislei 2 lo deleimine whelhei il is less
lhan a piesel value, a silualion lhal would occui if lhe heail iale weie loo high.
¡n eilhei case, lhe soflwaie can lhen be used lo aclivale appiopiiale alaims.
ÛÔÛÝÌÎÑÓÇÑÙÎßÓ ×ÒÌÛÙÎßÌÑÎÍ
¡l is fiequenlly of inleiesl lo quanlify lhe amounl of !MGaclivily measuied by
a pailiculai syslemof elecliodes. Such quanlincalion oflenassumes lhe foimof
laking lhe absolule value of lhe !MG and inlegialing il.
The iaw !MG, amplined appiopiialely
1
, is fed lo soflwaie, which in one
example lakes lhe absolule value. As indicaled in lhe wavefoim of Iiguie 6.2O,
only posilive-going signals
2
iesull following lhis. The negalive-going poilions
of lhe signal have been inveiled, making lhem posilive. Soflwaie lhen inle-
giales lhe signal. Once lhe inlegialoi oulpul has exceeded a piesel lhieshold
level
l
, a compaialoi lhen ieiniliales inlegialion of lhe !MG unlil lhe cycle
iepeals ilself.
Ú·¹«®» êòîð ̸» ª¿®·±«- ©¿ª»º±®³- º±® ¬¸» ÛÓÙ ·²¬»¹®¿¬±®
ê ò è Ñ Ì Ø Û Î Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í Ñ Î Í îéé
We can view lhe oulpul fiom lhe inlegialoi in lwo ways. The aclual
vollage oulpul fiomlhe inlegialoi can be iecoided on a convenlional iecoidei
oi compulei lo give lhe aclual inlegial al any inslanl. The lolal inlegial
necessaiy lo iesel lhe inlegialoi is known, so al any inslanl lhe inlegial equals
lhe numbei of limes lhe inlegialoi has beeniesel, mulliplied by lhis calibialion
conslanl, plus whalevei is iecoided as being in lhe inlegialoi al lhal lime.
Anolhei way lo view lhe oulpul of lhe inlegialoi is lo counl lhe numbei of
iesel pulses Ð
l
. We lhen deleimine lhe appioximale inlegial by deleimining
lhe numbei of iesels ovei a specinc lime inleival and calculaling lolal aclivily.
ÛÊÑÕÛÜ ÐÑÌÛÒÌ×ßÔÍ ßÒÜ Í×ÙÒßÔ ßÊÛÎßÙÛÎÍ
Ofleninneuiophysiology weaieinleiesledinlooking al lhe neuiological iesponse
lo a pailiculai slimulus. This iesponse is elecliic in naluie, and il fiequenlly
iepiesenls a veiy weak signal wilh a veiy pooi signal-lo-noise ialio (SNR). When
lhe slimulus is iepealed, lhe same oi a veiy similai iesponse is iepealedly eliciled.
This is lhe basis foi biopolenlial signal piocessois lhal can oblain an enhanced
iesponse by means of iepealed applicalion of lhe slimulus (Childeis, 1988).
Iiguie 6.21 shows how signal aveiaging woiks. The iesponse lo each
slimulus is iecoided. The lime al which each slimulus occuis is consideied lhe
Ú·¹«®» êòîï Signal-aveiaging lechnique foi impioving lhe SNRin signals lhal
aie iepelilive oi iespond lo a known slimulus.
îéè ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
iefeience lime, and lhe values foi each iesponse al lhis iefeience lime aie
summed lo gel lhe lolal iesponse al lhe iefeience lime. This piocess is
iepealed foi lhe values of lhe iesponses sampled immedialely aflei lhe
iefeience lime, and lhe sum is deleimined foi lhis poinl in lime aflei
lhe slimulus. The piocess is lhen iepealed foi each sample poinl aflei lhe
iefeience lime so lhal a wavefoim lhal is lhe sum of lhe individual iesponses
can be displayed, as shown al lhe bollom of Iiguie 6.22. The only limils on lhe
numbei of samples lhal can be summed aie lhe available memoiy foi sloiing
lhe iesponses and lhe lime iequiied lo collecl lhe dala. Piaclical signal
aveiaging algoiilhms can piocess moie lhan 1OOO iepealed iesponses lo exliacl
lhe weak iesponse wavefoim fiom lhe noise.
The noise on lhe individual iesponses is iandom wilh iespecl lo lhe
slimulus. This means lhal if a laige enough sample is laken, some posilive-
going noise pulses al a pailiculai inslanl aflei lhe slimulus pailially cancel
some negalive-going noise spikes al lhe same inslanl. Thus lhe nel sum of lhe
noise al any inslanl following lhe slimulus incieases as ², wheie ² is lhe
numbei of iesponses. The evoked iesponse, on lhe olhei hand, follows
lhe same lime couise aflei each slimulus. Thus lheie is no cancellalion in
lhis signal as lhe individual iesponses aie summed. ¡nslead, lhe amplilude of
lhe evoked iesponse incieases in diiecl piopoilion lo ². By iepelilive
summing, one is lhus able lo enhance lhe SNR by lhe facloi ² ² ².
This lechnique is fiequenlly used wilh lhe !!G and !RG. As slaled
eailiei in lhis chaplei, !!Gs oblained fiom suiface elecliodes aie veiy weak
andconsequenlly canhave a high noise componenl. When a iepelilive slimulus
Ú·¹«®» êòîî ̧°·½¿´ º»¬¿´ ÛÝÙ ±¾¬¿·²»¼ º®±³ ¬¸» ³¿¬»®²¿´ ¿¾¼±³»² I iepie-
senls felal ÇRS complexes; M iepiesenls maleinal ÇRS complexes. Maleinal
!CG and felal !CG (iecoided diieclly fiom lhe felus) aie included foi
compaiison. (Iiom 1. I. Roux, M. R. Neuman, and R. C. Goodlin, Moniloi-
ing of inliapailum phenomena.`` ¡n ÝÎÝÝ®·¬·½¿´ λª·»©- ·² Þ·±»²¹·²»»®·²¹, 2,
1anuaiy 1975, pp. 119158 Copyiighl CRC Piess. \sed by peimission of CRC
Piess, ¡nc.)
ê ò è Ñ Ì Ø Û Î Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í Ñ Î Í îéç
(such as elecliic shock, ûashing lighl, oi iepealing sound) is applied lo lhe lesl
sub|ecl, il is difncull lo asceilain lhe iesponse in a diieclly iecoided !!G.
Howevei, if we apply lhis signal summing oi aveiaging lechnique, il is possible
lo oblain lhe evoked iesponse.
ÛÈßÓÐÔÛ êòê The eleclioielinogiam (!RG) fiom a palienl had a ie-
sponse lo a ûash of lighl lhal was buiied in lhe noise such lhal lhe SNR was
1:1. A compulei can be used lo aveiage lhis iesponse ovei many ûashes lo
exliacl il fiom lhe noise. How many iesponses lo ûashes need lo be aveiaged
lo impiove lhe SNR lo 1O:1 (2O dB) and 1OO:1 (4O dB)?
ßÒÍÉÛÎ The SNR is impioved by a facloi of ² so lo gel a 1O-fold
impiovemenl we need
1O ²
² 1O
2
1OOsamples aveiaged
(!6.18)
Ioi a 1OO-fold impiovemenl we need
1OO ²
1OO
2
² 1O OOOsamples aveiaged
(!6.19)
Signal aveiaging is usually peifoimed on a compulei. The basic scheme
involves digilizing lhe signal and lhen localing lhe slimulus. The iesponse is
sloied in memoiy. Aflei lhe second applicalion of lhe slimulus, lhe signal is
digilized and sloied, and lhe slimulus is localed. The nisl sample of lhe
iesponse aflei lhe slimulus is added lo lhe nisl sample of lhe iesponse lo
lhe nisl slimulus, and lhe sum iemains in memoiy. The second samples laken
of each iesponse aie added, and so on. The summed signal can be displayed on
an oscilloscope, a chail iecoidei oi piinlei. The opeialoi of lhe syslem can
look al lhe sum aflei each applicalion of lhe slimulus lo deleimine how many
slimuli aie necessaiy lo exliacl lhe signal fiom lhe noise adequalely.
This lechnique can be used wilhoul applying lhe exleinal slimulus. One
example of ils use is lhe iecoiding of lhe !CGof a felus. Allhough il is possible
lo iecoid lhe felal R waves fiom elecliodes placed on lhe abdomen of lhe
molhei, ailifacls geneialed by lhe !CG of lhe molhei and olhei biopolenlials,
as well as by elecliode noise, obscuie lhe nnei delails of lhe felal !CG. A
signal-aveiaging lechnique similai lo lhal we have desciibed can be applied by
using lhe felal R wave in lhe same capacily as lhe slimulus. ¡n lhis case lhe
compulei locales lhe R wave and aveiages seveial hundied milliseconds of lhe
signal piioi lo il and seveial hundied milliseconds of lhe signal following il, in
oidei lo iecovei lhe complele P-ÇRS-T connguialion of lhe felal !CG. Such
aveiaging lechniques do nol always woik, howevei, because lhe vaiious
inleivals of lhe felal !CG, as well as lhe wavefoims lhemselves, may change
slighlly fiom one beal lo lhe nexl. The sum is an aveiage of all lhe iecoided
îèð ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
!CG connguialions and mighl piovide a wavefoim lhal does nol indicale lhe
single-beal !CG of lhe felal heail.
ÚÛÌßÔ ÛÝÙ
As we have said, physicians can deleimine lhe !CG of a felus fiom a paii of
biopolenlial-sensing elecliodes placed on lhe abdomen of lhe molhei. Oflen il
is necessaiy lo liy seveial diffeienl placemenls lo gel lhe besl signal. Once lhe
besl placemenl is deleimined, we oblain a iecoiding such as lhal shown in lhe
lop liace of Iiguie 6.22. Ioi compaiison, Iiguie 6.22 also shows a diiecl !CG
of lhe same felus and a diiecl !CGof lhe same molhei. The felal !CGsignal is
usually quile weak; il geneially has an amplilude of aiound 5O ³\ oi less. This
makes il exliemely difncull lo iecoid lhe heailbeal of lhe felus by using
elecliodes allached lo lhe abdomen of lhe molhei duiing laboi, when lhe
molhei is ieslless and molion ailifacl as well as !MG inleifeie. Theie is also
consideiable inleifeience fiom lhe !CG of lhe molhei (Neuman, 2OO6).
Nole lhal lhe ÇRS complexes of lhe molhei aie much sliongei lhan lhose
of lhe felus, which makes il difncull lo deleimine lhe felal heail iale eleclioni-
cally fiom iecoidings of lhis lype. This infoimalion can be oblained manually,
howevei, by measuiing lhe felal RR inleival on lhe chail and conveiling il lo
heail iale.
Seveial melhods have been devised foi impioving lhe qualily of felal
!CGs oblained by allaching elecliodes lo lhe molhei`s abdomen. ¡n addilion
lo lhe signal-aveiaging lechnique, physicians have applied vaiious foims of
anlicoincidence deleclois lo eliminale lhe maleinal ÇRS complexes (Offnel
and Moisand, 1966). This melhod, as shown in lhe block diagiam of
Iiguie 6.23, uses al leasl lhiee elecliodes: one on lhe molhei`s chesl, one
al lhe uppei pail oi fundus of lhe uleius, and one ovei lhe lowei pail of lhe
uleius. The !CG of lhe molhei is oblained fiom lhe lop lwo elecliodes, and
lhe felal-plus-maleinal signal is oblained fiom lhe bollom lwo. The cenlei
Abdominal
electrodes
Chest
electrodes
Amplifier
Amplifier
Amplifier
Recorder
Analog
switch
Threshold
detector
F + M F + M
M M
F
Ú·¹«®» êòîí Block diagiam of a scheme foi isolaling felal !CG fiom an
abdominal signal lhal conlains bolh felal and maleinal !CGs. (Iiom 1. I.
Roux, M. R. Neuman, and R. C. Goodlin, Moniloiing of inliapailum
phenomena.`` ¡n ÝÎÝ Ý®·¬·½¿´ λª·»©- ·² Þ·±»²¹·²»»®·²¹, 2, 1anuaiy 1975,
pp. 119158 Copyiighl CRC Piess. \sed by peimission of CRC Piess, ¡nc.)
ê ò è Ñ Ì Ø Û Î Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô Í × Ù Ò ß Ô Ð Î Ñ Ý Û Í Í Ñ Î Í îèï
elecliode is common lo bolh. A lhieshold delecloi deleimines lhe molhei`s
ÇRS complexes and uses lhis infoimalion lo luin off an analog swilch belween
lhe elecliodes iecoiding lhe felal !CG and lhe iecoiding appaialus. Theie-
foie, whenevei a maleinal ÇRS complex is delecled, lhe signal fiom lhe
abdominal leads is lempoiaiily blocked unlil lhe end of lhe ÇRS complex,
lheieby eliminaling il fiom lhe abdominal iecoiding. Nole lhal lhis lechnique
also eliminales any felal ÇRS complexes lhal occui simullaneously wilh
lhe maleinal ones. Modein syslems incoipoiale compuling ciicuils lo iecog-
nize lhe absence of lhis felal signal and lo compensale foi il when deleimining
lhe felal heail iale. One musl always be caulious in using such a syslemsince il
can anlicipale a felal beal duiing a maleinal ÇRS complex, bul, in facl, lhe
beal did nol occui duiing lhe maleinal ÇRS.
ÌØÛ ÊÛÝÌÑÎÝßÎÜ×ÑÙÎßÐØ
¡n Seclion6.2 we lookedal lhe basis of lhe !CGand denned lhe caidiac vecloi.
The ensuing desciiplion of lhe elecliocaidiogiaph showed how a pailiculai
componenl of lhe caidiac vecloi could be iecoided. Such scalai !CGs aie lhe
lype lhal aie usually laken. Howevei, we can oblain moie infoimalion fiom a
ª»½¬±®½¿®¼·±¹®¿³ (\CG). A \CG shows a lhiee-dimensional‰oi al leasl a
lwo-dimensional‰picluie of lhe oiienlalion and magnilude of lhe caidiac
vecloi lhioughoul lhe caidiac cycle. ¡l is difncull foi piaclical machines lo
display lhe \CG in lhiee dimensions, bul il is ielalively simple lo display il in
lwo dimensions‰oi, in olhei woids, ils componenl in a pailiculai plane of lhe
body.
Special lead syslems have been developed lhal can piovide lhe ¨, §, and ¦
componenls of lhe !CG. Any lwo of lhese can be fed inlo a vecloicaidiogiaph
lo aiiive al lhe \CGfoi lhe plane denned by lhe axes. The signal fiomlhe lead
foi one axis is connecled lo inpul 1, and lhal foi lhe olhei enleis inpul 2. These
signals aie lhen plolled one veisus lhe olhei on lhe ieadoul scieen and/oi lhey
aie piinled. Ioi each heailbeal, a vecloi loop iepiesenling lhe locus of lhe lip
of lhe caidiac vecloi when ils lail is al lhe oiigin is deleimined.
Because of lhe complexilies of oblaining lhe vecloicaidiogiam and lhe
difncully lhal aiises in inleipieling lhe palleins, lhis lechnique is geneially
limiled lo special sludies al leiliaiy-medical-caie facililies oi lo use as a
ieseaich lool. The scalai 12-lead elecliocaidiogiam is employed foi iouline
clinical sludies.
êòç ÝßÎÜ×ßÝ ÓÑÒ×ÌÑÎÍ
Theie aie seveial clinical silualions in which conlinuous obseivalion of lhe
!CG and heail iale is impoilanl lo lhe caie of lhe palienl. Conlinuous
obseivalion of lhe !CG duiing lhe adminislialion of aneslhesia helps doclois
moniloi lhe palienl`s condilion while he oi she is undeigoing medical
îèî ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
pioceduies and duiing iecoveiy fiom aneslhesia. Conslanl moniloiing of lhe
!CG and heail iale of lhe myocaidial-infaiclion palienl duiing lhe dangei
peiiod of seveial days following lhe inilial incidenl has made possible lhe eaily
deleclion of life-lhiealening caidiac aiihylhmias. Conlinuous moniloiing of
lhe felal heail iale duiing laboi may help in lhe eaily deleclion of
complicalions.
These and olhei clinical applicalions of conlinuous moniloiing of lhe !CG
and heail iale aie made possible by ½¿®¼·¿½ ³±²·¬±®-. Iiguie 6.24 shows lhe
basic caidiac moniloi in block-diagiam foim. ¡ls fionl-end ciicuiliy is similai
lo lhal of lhe elecliocaidiogiaph. A paii of elecliodes, usually localed on lhe
anleiioi pail of lhe chesl, pick up lhe !CG and aie connecled by lead wiies lo
lhe inpul ciicuil of lhe moniloi. The inpul ciicuil conlains ciicuiliy, as
desciibed in Seclion 6.4, lo piolecl lhe moniloi fiom high-vollage liansienls
lhal can occui duiing denbiillalion pioceduies.
The nexl slage of lhe moniloi is a slandaid biopolenlial amplinei designed
lo amplify lhe !CG. Allhough il is besl lo have lhe fiequency-iesponse
chaiacleiislics desciibed in Seclion 6.2, caidiac monilois oflen have a slighlly
naiiowei fiequency iesponse lhan would be acceplable foi a diagnoslic
elecliocaidiogiaph. The ieason foi lhis is lhal much of lhe molion-ailifacl
signal seen duiing movemenl of lhe palienl is al veiy low fiequencies. By
nlleiing oul some of lhese low fiequencies, we can oblain a vasl impiovemenl
in SNR and iecoiding slabilily wilhoul seiiously affecling lhe infoimalion lhal
peilains lo caidiac ihylhm in lhe !CG. Iiequency iesponse should be fiom
O.67 lo 4O Hz (Anonymous, 1992). Caidiac monilois should nol liiggei on
pacemakei spikes, which conlinue even when lhe heail has slopped. To avoid
double counling, caidiac monilois should nol liiggei on lall T waves (Anony-
mous, 199O).
Palienl isolalion ciicuiliy (Seclion 6.2) is usually found in lhe ciicuil
following an !CG pieamplinei. This is followed by an addilional amplinei
lo iaise lhe signal lo levels appiopiiale foi fuilhei piocessing.
¡n mosl modein caidiac monilois, lhe amplined !CG signal is digilized by
an ADC, and lhe iemaining piocessing is caiiied oul by a compulei. The
Patient Electrodes Preamplifier Isolation Amplifier
Analog to
digital
converter
Display
screen
RAM
Communication
port
Bus
Program
PROM
Chart
recorder
Storage
medium
Keyboard
Alarm
indicator
Microcomputer
CPU
Ú·¹«®» êòîì The caidiac moniloi displays a conlinuous elecliocaidiogiam
and heail iale and also idenlines alaim condilions.
ê ò ç Ý ß Î Ü × ß Ý Ó Ñ Ò × Ì Ñ Î Í îèí
digilal signal is piocessed by a miciocompulei in lhe moniloi. This syslem
block can peifoim many funclions depending on lhe piogiam lhal conliols il.
The digilal signal can be nlleied and displayed on a compulei scieen, lhe heail
iale deleimined by caidiolachomelei soflwaie, alaim condilions idenlined
and alaims sounded, dala sloied in lempoiaiy oi peimanenl memoiy, an !CG
ihylhmsliip piinled foi ieviewand chailing, and communicalion of lhe dala lo
olhei syslems wilhin oi oulside of lhe hospilal.
Oflen a physician wanls lo have a peimanenl iecoid of lhe !CG being
moniloied. Ioi lhis ieason, many caidiac monilois have a small chail iecoidei
oi giaphic piinlei buill inlolhemlhal can be swilched onby lhe opeialoi oi lhe
compulei lo iecoid a pailiculaily inleiesling !CG as il appeais on lhe scieen.
¡l is oflen desiiable lo have a iecoid of lhe evenls in lhe !CG lhal lead up
lo a seiious aiihylhmia. Such a iecoid can be made if lhe digilal signal is fed
nisl lo a memoiy loop, which delays lhe !CG signal by aboul 15 s. The oulpul
fiom lhe memoiy loop can lhen be fed lo lhe piinlei oi chail iecoidei wheie
lhe haid copy is pioduced. Thus, when lhe opeialoi of lhe moniloi sees an
inleiesling !CG wavefoim oi lhe moniloi ilself delecls a clinically signincanl
aiihylhmia, lhe infoimalion can be oblained fiom lhe memoiy loop lo give a
iecoid of lhe evenls lhal led up lo lhal pailiculai pallein.
The heail iale is deleimined fiom lhe !CG using a compulei algoiilhm
lhal peifoims lhe funclion of a caidiolachomelei. The oulpul is displayed on a
iale display so lhal lhe opeialoi can immedialely lell lhe palienl`s heail iale.
Alaim ciicuiliy lo wain of high and low heail iale is also associaled wilh lhis
algoiilhm. The alaim syslem can also pioduce a haid copy of lhe evenls lhal
led up lo lhe alaim foi analysis by clinicians. This can be a valuable aid lo
clinicians in selecling appiopiiale lheiapy foi lhe alaim-pioducing evenl.
Mosl hospilals also ulilize caidiac monilois in an oiganized syslem called
an ·²¬»²-·ª»ó½¿®» «²·¬. ¡n such unils, lheie aie individual monilois al each
palienl`s bedside lhal display lhe !CG in ieal lime as well as lhe heail iale and
any alaim condilions lhal have iecenlly occuiied. These individual monilois
aie connecled lo a cenlial unil localed al lhe nuising slalion lhal shows lhe
!CGs foi all palienls being moniloied, along wilh a heail-iale display and
alaim indicaloi foi each palienl. A piinlei al lhe cenlial slalion can be
aclivaled eilhei locally oi by iemole conliol fiom lhe individual monilois
al lhe palienl`s bedside.
Compulei algoiilhms lhal can iecognize caidiac aiihylhmias and iecoid
lhe fiequency of lheii occuiience aie also included in caidiac monilois. The
machines can also piepaie haid-copy chails showing liends in lhe palienl`s
moniloied paiameleis and can keep iecoids of vaiious lheiapeulic measuies
laken by lhe clinical slaff. The compulei can also be a big help in lhe inlensive-
caie unil by caiiying oul many obseivalional and chailing funclions, lheieby
fieeing lhe clinical slaff lo caie foi lhe palienl (Nazeian, 2OO6).
The availabilily of miciocompuleis and high-capacily eleclionic memoiy
has made il possible lo moniloi ambulaloiy palienls wilh deleclion of caidiac
aiihylhmias. These monilois consisl of an !CGamplinei lhal piovides a signal
lo an ADC, wheie il is digilized and sloied in memoiy foi lalei download and
îèì ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
analysis. Such devices can collecl dala fiom ambulaloiy palienls, and lhese
dala aie analyzed lalei by a compulei (1uigen, 1976).
Miciocompuleis in caidiac monilois peifoim lwo basic funclions, dala
managemenl anddala analysis. ¡n lhe foimei case, lhe miciocompulei conliols
lhe vaiious componenls of lhe syslem and diiecls lhe lianspoil of dala fiom
one block lo anolhei along lhe bus. Caiiying oul lhe second funclion involves
lhe aclual analysis of lhe elecliocaidiogiam. ¡l includes nlleiing and ailifacl
ieduclion, idenlincalion of lhe vaiious componenls of lhe elecliocaidiogiam,
deleiminalion of lhe heail iale, and idenlincalion of aiihylhmias. Moie lhan
one miciocompulei can be used in a moniloi syslem lo caiiy oul lhese
funclions. The miciocompulei is undei lhe soflwaie conliol. This makes il
possible lo updale lhe moniloi by ieplacing lhe soflwaie ialhei lhan modifying
any haidwaie of lhe insliumenl.
The miciocompulei can lempoiaiily sloie lhe dala, and an alleinalive
medium such as a sepaiale haid diive is used lo aichive selecled incidenls oi
lhe enliie moniloied dala. Theie is also a slaff inleiface lo lhe syslem lhal
consisls of a keyboaid and a display moniloi.
Compuleiized caidiac monilois can be inlegialed inlo olhei hospilal
infoimalion syslems. Iiequenlly lhese monilois also have a nelwoik connec-
lion lhal enables lhemloinleiacl wilh olhei infoimalion syslems oi lo liansmil
dala lo physicians` ofnces localed away fiom lhe inlensive-caie unil.
Ambulaloiy caidiac monilois aie oflen used in lhe diagnosis and lieal-
menl of heail disease. The mosl fiequenlly applied ambulaloiy moniloi‰lhe
Hollei moniloi‰includes a minialuie digilal iecoidei wilh eleclionic memoiy
lhal lhe palienl weais. These devices consisl of a balleiy-poweied !CG
amplinei and iecoidei lhal aie connecled lo elecliodes placed on lhe palienl`s
chesl. The insliumenl is sufncienlly small lo allow lhe palienl lo weai il like a
necklace, and lhe iecoidei memoiy can hold fiom 24 lo 48 h of conlinuous
!CG iecoiding. Some iecoideis can collecl dala fiom lhiee leads simulla-
neously so lhal vecloicaidiogiams can be sloied. Special compuleiized play-
back unils iapidly analyze lhe dala nles foi caidiac aiihylhmias and display
lhese poilions of lhe elecliocaidiogiam on a compulei scieen oi geneiale a
haid-copy piinloul of lhem. The playback unils also summaiize lhe lolal
iecoiding in a iepoil lhal indicales vaiiables such as heail iale, vaiiabilily in
heail iale, lype and numbei of aiihylhmias, and amounl of ailifacl.
Hollei monilois aie used by physicians lo delecl caidiac aiihylhmias lhal
occui infiequenlly in palienls and aie usually nol delecled duiing ofnce oi
hospilal examinalions. Micioeleclionics has made il possible lo make lhese
moniloiiecoideis so small lhal lhey can be suigically implanled undei lhe
skin of palienls oi incoipoialed inlo olhei implanled devices such as pace-
makeis. The Medlionic Coip. (2OO8) Reveal ¡nseilable Loop Recoidei has a
mass of only 17 g and can sloie up lo 42 min of !CG. ¡l can moniloi a palienl
foi up lo 14 monlhs wilh buill-in elecliodes. The iecoidei can eilhei be
aclivaled by lhe palienl when lhey expeiience lhe symploms oi be pio-
giammed lo iecognize and iecoid signincanl evenls. By being implanlable,
lhe pioblems of palienl compliance oi elecliode delachmenl aie avoided.
ê ò ç Ý ß Î Ü × ß Ý Ó Ñ Ò × Ì Ñ Î Í îèë
Iaiwell »¬ ¿´. (2OO6) have shown how lhis lechnology can impacl clinical
evalualion of palienls wilh fainling spells lhal could be lhe iesull of infiequenl
life-lhiealening caidiac aiihylhmias.
¡n silualions in which caidiac monilois aie used lo obseive a palienl`s
!CGovei a long peiiod of lime, ailifacl and failuie of lhe moniloi can occui as
a iesull of a pooi elecliodepalienl inleiface. The longei lhe elecliodes iemain
on lhe palienl, lhe moie oflen lhis occuis. ¡n inlensive-caie unils, elecliodes
aie ioulinely changed‰somelimes once a shifl, somelimes once a day‰lo
ensuie againsl lhis lype of bieakdown. Mosl caidiac monilois also have alaim
ciicuils lhal indicale when elecliodes fall off lhe palienl oi lhe elecliode
palienl conneclion degeneiales.
Iiguie 6.25 is a block diagiam of a lypical lead fall-off alaim. A 5O kHz
high-impedance souice is connecled acioss lhe elecliodes. Peak ampliludes of
lhe cuiienl can be as gieal as 1OO lo 2OO ³A wilhoul any iisk lo lhe palienl,
because lhe micioshock hazaid lo excilable lissue decieases as lhe fiequency
incieases above 1 kHz (Iiguie 14.3). The cuiienl passes lhiough lhe body
belween lhe elecliodes, and, as long as lheie is good elecliode conlacl, lhe
vollage diop is ielalively small. ¡f lhe elecliode conneclions become pooi, as
can happen when lhe elecliolyle gel begins lo diy, oi if one of lhe elecliodes
falls off oi lhe wiie bieaks, lhe impedance belween lhe elecliodes incieases
consideiably. This causes lhe vollage pioduced by lhe 5O kHz souice lo iise.
The high-fiequency signal is sepaialed fiom lhe !CG by lhe nlleiing scheme,
as shown. The !CG passes lhiough a low-pass nllei wilh appioximalely a 15O
Hz coinei fiequency, and is piocessed in lhe usual way. Abandpass nllei wilh a
5O kHz cenlei fiequency passes lhe vollage iesulling fiomlhe cuiienl souice lo
a lhieshold delecloi. This delecloi sels off an alaimwhen lhe vollage exceeds a
ceilain lhieshold, which would coiiespond lo pooi elecliode conlacl. When an
elecliode falls off lhe palienl, lhe inleielecliode impedance should inciease lo
50-kHz
current
source
Low-pass
filter
150 Hz
Electrode 1
Electrode 2
ECG
amplifier
50-kHz
bandpass
filter
Threshold
detector
etc.
Alarm
Ú·¹«®» êòîë Block diagiam of a syslem used wilh caidiac monilois lo delecl
incieased elecliode impedance, lead wiie failuie, oi elecliode falloff.
îèê ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
innnily, iesulling in lhe possibilily of 5O kHz vollages high enough lo cause
some damage lo lhe eleclionic devices. Ioi lhis ieason, a high-vollage
pioleclion ciicuil, such as lhal desciibed in Seclion 6.4, is fiequenlly connecled
acioss lhe inpul leiminals lo lhe moniloi. ¡n lhe case shown in Iiguie 6.25,
back-lo-back zenei diodes aie used.
êòïð Þ×ÑÌÛÔÛÓÛÌÎÇ
Biopolenlial and olhei signals aie oflen piocessed by iadiolelemeliy, a
lechnique lhal piovides a wiieless link belween lhe palienl and lhe ma|oiily
of lhe signal-piocessing componenls. By using a minialuie iadio liansmillei
allached lo lhe palienl lo bioadcasl lhe infoimalion ovei a limiled iange,
clinicians canmoniloi a palienl oi sludy a ieseaich animal while lhe sub|ecl has
full mobilily. This lechnique also piovides lhe besl melhod of isolaling lhe
palienl fiom lhe iecoiding equipmenl and powei lines. Ioi a single-channel
syslem of biopolenlial iadiolelemeliy, a minialuie balleiy-opeialed iadio
liansmillei is connecled lo lhe elecliodes on lhe palienl. This liansmillei
bioadcasls lhe biopolenlial ovei a limiled iange lo a iemolely localed ieceivei,
which delecls lhe iadio signals and iecoveis lhe signal foi fuilhei piocessing. ¡n
lhis silualion lheie is obviously negligible conneclion oi sliay capacilance
belween lhe elecliode ciicuil connecled lo lhe iadio liansmillei and lhe iesl of
lhe insliumenlalion syslem. The ieceiving syslem can even be localed in a
ioomsepaiale fiomlhe palienl`s. Hence lhe palienl is complelely isolaled, and
lhe only iisk of elecliic shock lhal lhe palienl iuns is due lo lhe balleiy-
poweied liansmillei ilself. Thus, if lhe liansmillei powei supply is kepl al a
low vollage, lheie is negligible iisk lo lhe palienl.
Many lypes of iadiolelemeliy syslems aie used in biomedical insliu-
menlalion (Ziaie, 2OO6). The basic connguialion of lhe syslem, howevei, is
pielly much lhe same foi all. A pieamplinei amplines lhe !CG signal lo a
level al which il can modulale lhe liansmillei. Pulse-code modulalion in lhe
iange of 1OO lo 5OO MHz is lhe dominanl melhod. The enliie liansmillei is
poweied by a small balleiy pack. ¡l is caiiied by lhe palienl and usually
allached by means of a special hainess. \lliaminialuie iadio liansmilleis
can be allached by suigical lape diieclly lo lhe palienl`s skin. ¡n ieseaich
wilh expeiimenlal animals, expeiimenleis can suigically implanl lhe liny
liansmilleis wilhin lhe bodies of lhe animals so lhal no exleinal conneclions
oi wiies aie iequiied. Sluail Mackay of Boslon \niveisily pioneeied lhis
lechnique many yeais ago (Mackay, 197O), and many applicalions fiom
wildlife biology lo clinical medicine followed. Today, lhe lechnique is
ioulinely found in hospilal inlensive-caie and slep-down unils foi caidiac
moniloiing (Budingei, 2OO3).
¡n lhe ieceiving syslem, a pickup anlenna ieceives lhe modulaled signal.
The signal is lhen demodulaled lo iecovei lhe oiiginal infoimalion fiom lhe
caiiiei. The signal can be fuilhei amplined lo piovide a usable oulpul. The
ê ò ï ð Þ × Ñ Ì Û Ô Û Ó Û Ì Î Ç îèé
ieceivei syslem is geneially poweied diieclly fiomlhe powei line, because il is
in a peimanenl localion and is nol allached lo lhe palienl in any way.
The bandwidlh of lhe syslem is deleimined by lhe iale al which il is
sampled. Theoielically, lhe iale of sampling should be al leasl lwice lhal of lhe
highesl-fiequency componenl lo be liansmilled, bul in piaclical ciicuils lhe
iale of sampling is usually al leasl nve limes lhal of lhe highesl-fiequency
componenl.
¡l is impoilanl lo nole lhal, allhough iadiolelemeliy syslems piovide ideal
isolalion wilh no palienl giound iequiied, lhey aie nol complelely immune lo
pioblems of elecliic noise. Because coupling is achieved by a iadialed eleclio-
magnelic signal, olhei elecliomagnelic signals al similai fiequencies can
inleifeie and cause ailifacls. ¡n exlieme cases, lhese olhei signals can even
biing aboul complele loss of signal.
¡n addilion, lhe ielalive oiienlalion belween liansmilling and ieceiving
anlennas is impoilanl. Theie can be oiienlalions in which none of lhe
signals iadialed fiom lhe liansmilling anlenna aie picked up by lhe
ieceiving anlenna. ¡n such cases, lheie is no liansmission of signals. ¡n
high-qualily iadiolelemeliy syslems, il is lheiefoie impoilanl lo have a
means of indicaling when signal inleifeience oi signal diopoul is occuiiing.
Such a signal makes il possible lo lake sleps lo ieclify lhis pioblem and
infoims lhe clinical slaff lhal lhe infoimalion being ieceived is noise and
should be disiegaided.
The advenl of wiieless compulei communicalion syslems has affecled
biolelemeliy as well. Telemeliy syslems capable of lwo-way communicalion
ulilize lhe slandaidized wiieless compulei conneclion piolocols such as
WiIi, Blueloolh and ZigBee. Complele liansceivei (liansmillei and ie-
ceivei) syslems foi lhese piolocols aie available on a single inlegialed ciicuil
chip, so veiy small wiieless devices can now be iealized. These can be
incoipoialed inlo wiieless sensing nelwoiks lhal can eilhei be implanled in
lhe body oi incoipoialed inlo clolhing. Allhough syslems such as Blueloolh
and ZigBe aie limiled lo shoil iange, exleinal lianspondeis can exlend
coveiage.
ÐÎÑÞÔÛÓÍ
êòï Whal posilion of lhe caidiac vecloi al lhe peak of lhe R wave of an
elecliocaidiogiam gives lhe giealesl sum of vollages foi leads ¡, ¡¡, and ¡¡¡?
êòî Whal posilion of lhe caidiac vecloi duiing lhe R wave gives idenlical
signals in leads ¡¡ and ¡¡¡? Whal does lhe !CG seen in lead ¡ look like foi lhis
oiienlalion of lhe vecloi?
êòí An !CG has a scalai magnilude of 1 m\ on lead ¡¡ and a scalai
magnilude of O.5 m\ on lead ¡¡¡. Ý¿´½«´¿¬» lhe scalai magnilude on lead ¡.
êòì Design a syslem lhal has as inpuls lhe -½¿´¿® vollages of lead ¡¡ and lead
¡¡¡ and as oulpul lhe -½¿´¿® vollage of lhe caidiac vecloi Ó.
îèè ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
êòë Design lhe lead conneclions foi lhe \I and a\I leads. Ioi each, choose
minimal iesisloi values lhal meel lhe iequiiemenls foi inpul impedance given
in Table 6.1.
êòê A sludenl designs a new lead syslem by inveiling !indhoven`s liiangle.
She places one elecliode on each hip and one on lhe neck. Ioi lhis newsyslem,
design a iesisloi nelwoik (show lhe ciicuil and give iesisloi values) lo yield
convenlional lead a\I (show polaiily). !xplain lhe ieason foi each iesisloi.
êòé Design an elecliocaidiogiaph wilh an inpul-swilching syslem such lhal
we can iecoid lhe six fionlal-plane leads by means of changing lhe swilch.
êòè Discuss lhe faclois lhal enlei inlo choosing a iesislance value foi lhe lhiee
iesislois used lo eslablish lhe Wilson cenlial leiminal. Desciibe lhe advanlages
and disadvanlages of having lhis iesislance eilhei veiy laige oi veiy small.
êòç The cenlial leiminal iequiiemenls foi an elecliocaidiogiaph lhal meels
lhe iecommendalions of Table 6.1 sels lhe minimal value of lhe iesislances al
1.7 MÊ. Show lhal lhis value is a iesull of lhe specincalion given in Table 6.1.
êòïð Asludenl allempls lo measuie his own !CGon an oscilloscope having a
diffeienlial inpul. Ioi Iiguie 6.11, Æ
in
1 MÊ, Æ
1
2OkÊ, Æ
2
1O kÊ,
Æ
G
3O kÊ, and ·
db
O 5 ³A. Calculale lhe powei-line inleifeience lhe
sludenl obseives.
êòïï Design a diiven-iighl-leg ciicuil, and show all iesisloi values. Ioi 1 ³A
of 6O Hz cuiienl ûowing lhiough lhe body, lhe common-mode vollage should
be ieduced lo 2 m\. The ciicuil should supply no moie lhan 5 ³A when lhe
amplinei is saluialed al 13\.
êòïî Anengineei sees no puipose foi Î 2 in Iiguie 6.5(a) and ieplaces il wilh
a wiie in oidei lo simplify lhe ciicuil. Whal is lhe iesull?
êòïí An !CG lead is oiienled such lhal ils elecliodes aie placed on lhe body
in posilions lhal pick up an elecliomyogiam fiom lhe chesl muscles as well as
lhe elecliocaidiogiam. Design a ciicuil lhal sepaiales lhese lwo signals as well
as possible, and discuss lhe limilalions of such a ciicuil.
êòïì A caidiac moniloi is found lo have 1 m\ p-p of 6O Hz inleifeience.
Desciibe a pioceduie lhal you could use lo deleimine whelhei lhis is due lo an
elecliic neld oi a magnelic neld pickup.
êòïë Assume zeio skinelecliode impedance, and design (give componenl
values foi) simple B´¬»®- lhal will allenuale incoming 1 MHz iadiofiequency
inleifeience lo O.OO1 of ils foimei value. Skelch lhe placemenl of lhese nlleis
(show all conneclions) lo pievenl inleifeience fiom enleiing an !CG ampli-
nei. Then calculale lhe 6O Hz inleifeience lhal lhey cause foi common-mode
vollage of 1O m\ and skinelecliode impedances of 5O kÊ and 4O kÊ.
êòïê You design an !CGmachine using I!Ts such lhal lhe Æ
in
of Iiguie 6.11
exceeds 1OO MÊ. Because of iadiofiequency (RI) inleifeience, you wish lo
add equal shunl capacilois al lhe lwo Æ
in
localions. Ioi
cm
1Om\,
Æ
2
1OOkÊ, and Æ
1
8O kÊ, calculale lhe maximal capacilance so
6O Hz
A B
1O³\. Calculale lhe iesull using (6.19).
êòïé Silicon diodes having a foiwaid iesislance of 2 Ê aie lo be used as
vollage-limiling devices in lhe pioleclion ciicuil of an elecliocaidiogiaph.
They aie connecled as shown in Iiguie 6.14(b). The pioleclion ciicuil is shown
ê ò ï ð Ð Î Ñ Þ Ô Û Ó Í îèç
in Iiguie 6.13. ¡f vollage liansienls as high as 5OO \ can appeai al lhe eleclio-
caidiogiaph inpul duiing denbiillalion, whal is lhe minimal value of Î lhal lhe
designei can choose solhal lhe vollage al lhe pieamplinei inpul does nol exceed
8OO m\? Assume lhal lhe silicon diodes have a bieakdown vollage of 6OO m\.
êòïè Ioi Iiguie 6.15, assume ×
d
5OOnA and RL skin impedance is 1OO kÊ
Design (give componenl values foi) a ¼®·ª»²ó®·¹¸¬ó´»¹ ciicuil lo achieve
cm
1O³\.
êòïç Ioi Iiguie 6.17, assume Ý
s
1OpI andÝ
f
2OpI. Design lhe amplinei
ciicuil lo ieplace lhe liiangle conlaining ß
v
. \se an op amp and passive
componenls lo achieve an ideal negalive-inpul capacilance amplinei. Showlhe
ciicuil diagiam and conneclions lo olhei componenls lhal appeai in Iiguie
6.17.
êòîð Design a lechnique foi aulomalically calibialing an elecliocaidiogiaph
al lhe beginning of each iecoiding. The calibialion can consisl of a 1 m\
slandaidizing pulse.
êòîï A sludenl decides lo iemove lhe swilch acioss lhe 3.3 MÊ iesisloi in
Iiguie 6.18 and place il acioss lhe l ³I capaciloi lo dischaige lhe capaciloi
aflei denbiillalion.`` Skelch whal lhe lypical oulpul looks like befoie, duiing,
and aflei denbiillalion and swilch closuie, and explain why il looks lhal way.
êòîî Redesign Iiguie 6.18 by placing a capaciloi in seiies wilh lhe 1O kÊ
iesisloi belween lhe lwoinveiling inpuls. !liminale lhe lasl op amp, and ad|usl
olhei componenls lo keep lhe same gain, coinei fiequencies, and abilily lo use
a swilch lo ieluin lhe oulpul lo lhe lineai iegion.
êòîí Design a biopolenlial pieamplinei lhal is balleiy-poweied and isolaled
in such a way lhal lheie is less lhan O.5 pI coupling capacilance belween lhe
inpul and oulpul leiminals. The amplinei should have a nominal gain of 1O and
an inpul impedance giealei lhan 1O MÊ diffeienlially and giealei lhan 1O GÊ
wilh iespecl lo giound. The oulpul impedance should be less lhan 1OO Ê and
single ended.
êòîì Design a ciicuil lhal uses one op amp plus olhei passive componenls
lhal will delecl ÇRS complexes of lhe !CG even when lhe amplilude of lhe T
wave exceeds lhal of lhe ÇRS complex and piovides oulpul signals suilable foi
counling lhese complexes on a counlei.
êòîë Design an aulomalic iesel ciicuil foi an elecliocaidiogiaph.
êòîê Design an aiihylhmia-deleclion syslem foi delecling and counling lhe
P\Cs shown in Iiguie 4.18. Nole lhal P\Cs occui eailiei lhan expecled, bul
lhe following beal occuis al lhe noimal lime, because il is geneialed by lhe SA
node. Show a block diagiam, and desciibe lhe opeialion of lhe syslem.
êòîé ¡n an evoked-iesponse expeiimenl in which lhe !!G is sludied aflei a
palienl is given lhe slimulus of a ûashing lighl, lhe expeiimenlei nnds lhal lhe
iesponse has appioximalely lhe same amplilude as lhe iandom noise of lhe
signal. ¡f a signal aveiagei is used, how many samples musl be aveiaged lo gel
an SNR of 1O:1? ¡f we wanled an SNRof 1OO:1, would il be piaclical lo use lhis
lechnique?
êòîè A physician wishes lo oblain lwo simullaneous !CGs in lhe fionlal
plane fiom leads lhal have lead veclois al iighl angles. The signal will be used
îçð ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
lo geneiale a \CG. Desciibe how you would go aboul oblaining lhese lwo
signals, and suggesl a lesl lo deleimine whelhei lhe leads aie liuly oilhogonal.
êòîç The !CG shown in Iiguie P6.1 is disloiled as a iesull of an insliumen-
lalion pioblem. Discuss possible causes of lhis disloilion, and suggesl means of
coiiecling lhe pioblem.
êòíð Iiguie P6.2 shows !CGs fiom simullaneous leads ¡ and ¡¡. Skelch lhe
vecloi loop foi lhis ÇRS complex in lhe fionlal plane.
ÎÛÚÛÎÛÒÝÛÍ
Anonymous, Ambulaloiy !CG monilois.`` Ø»¿´¬¸ Ü»ª·½»-, 1989, 18, 295321.
Anonymous, Diagnoslic elecliocaidiogiaphic devices`` ANS¡/AAM¡ !C111991. Ailinglon,
\A: Associalion foi lhe Advancemenl of Medical ¡nsliumenlalion, 1991.
Anonymous, Caidiac monilois, heail iale meleis and alaims.`` ANS¡/AAM¡ !C131992.
Ailinglon, \A: Associalion foi lhe Advancemenl of Medical ¡nsliumenlalion, 1992.
Ú·¹«®» Ðêòî
Ú·¹«®» Ðêòï
ê ò ï ð Î Û Ú Û Î Û Ò Ý Û Í îçï
Bailey, 1. 1., A. S. Beison, A. Gaison, 1i., L. G. Hoian, P. W. MacIailane, D. W. Moilaia, and C.
Zywielz, Recommendalions foi slandaidizalion and specincalions in aulomaled eleclio-
caidiogiaphy: Bandwidlh and digilal signal piocessing.`` Ý·®½«´¿¬·±², 199O, 81(2), 73O739.
Budingei, T. I., Biomoniloiing wilh wiieless communicalions,`` ß²²«ò λªò Þ·±³»¼ò Û²¹ò, 2OO3,
5, 383412.
Childeis, D. G., !voked polenlials.`` ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»- ¿²¼
ײ-¬®«³»²¬¿¬·±². New Yoik: Wiley, 1988, pp. 12451254.
Dobiev D. P., T. Neycheva, and N. Mudiov, Boolsliapped lwo-elecliode biosignal amplinei.``
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Huhla, 1. C., and 1. G. Webslei, 6O-Hz inleifeience in elecliocaidiogiaphy.`` ×ÛÛÛ Ì®¿²-ò
Þ·±³»¼ò Û²¹ò, 1973, BM!-2O, 911O1.
1uigen, R. K., Soflwaie (and haidwaie) foi lhe medics.`` ×ÛÛÛ Í°»½¬®«³, Apiil 1976, 13(4),
4O43.
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Medlionic Coip., Reveal ¡nseilable Loop Recoidei, 2OO8. hllp://www.medlionic.com/physician/
ieveal/index.hlml.
Nazeian, H., !lecliocaidiogiaphy, compuleis in.`` ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º
Ó»¼·½¿´ Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed. New Yoik: Wiley, 2OO6, \ol. 3, pp. 3453.
Neuman, M. R., Neonalal moniloiing`` ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»-
¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed., New Yoik: Wiley, 2OO6, \ol. 5, pp. 1132.
Palla´ s-Aieny, R., and 1. G. Webslei, Composile insliumenlalion amplinei foi biopolenlials.``
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Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±². New Yoik: Wiley, 1988, pp. 1OO21O17.
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hospilal enviionmenl.`` Ó¿§± Ý´·²ò Ю±½ò, 2OO7, 82, 282285.
\eimaiien, H., Recoideis, giaphic.`` ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»- ¿²¼
ײ-¬®«³»²¬¿¬·±², 2nd ed. New Yoik: Wiley, 2OO6, \ol. 6, pp. 4862.
Winlei, B. B., and 1. G. Webslei, Diiven-iighl-leg ciicuil design.`` ×ÛÛÛ Ì®¿²-ò Þ·±³»¼ò Û²¹ò,
1983, BM!-3O, 6266.
Ziaie, B., Biolelemeliy.`` ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»- ¿²¼
ײ-¬®«³»²¬¿¬·±², 2nd ed. New Yoik: Wiley, 2OO6, \ol. 1, pp. 417429.
îçî ê Þ × Ñ Ð Ñ Ì Û Ò Ì × ß Ô ß Ó Ð Ô × Ú × Û Î Í
é
ÞÔÑÑÜ ÐÎÛÍÍËÎÛ ßÒÜ ÍÑËÒÜ
α¾»®¬ ßò л«®¿
Deleimining an individualŽs blood piessuie is a slandaidclinical measuiemenl,
suigical pioceduie. Blood-piessuie values in lhe vaiious chambeis of lhe heail
and in lhe peiipheial vasculai syslem help lhe physician deleimine lhe
funclional inlegiily of lhe caidiovasculai syslem. Anumbei of diiecl (invasive)
and indiiecl (noninvasive) lechniques aie being used lo measuie blood
piessuie in lhe human. The accuiacy of each should be eslablished, as well
as ils suilabilily foi a pailiculai clinical silualion.
Iluclualions in piessuie iecoided ovei lhe fiequency iange of heaiing aie
called -±«²¼-. The souices of heail sounds aie lhe vibialions sel up by lhe
acceleialions and deceleialions of blood.
The funclion of lhe blood ciiculalion is lo lianspoil oxygen and olhei
nuliienls lo lhe lissues of lhe body and lo caiiy melabolic wasle pioducls away
fiom lhe cells. ¡n Seclion 4.6 we poinled oul lhal lhe heail seives as a foui-
chambeied pump foi lhe ciiculaloiy syslem. This is illuslialed in Iiguie 4.12.
The heail is divided inlo lwo pumping syslems, lhe iighl side of lhe heail and
lhe lefl side of lhe heail. The pulmonaiy ciiculalion and lhe syslemic ciicula-
lion sepaiale lhese lwo pumps and lheii associaled valves. !ach pump has a
Iiguie 7.15 is a diagiam lhal shows how lhe elecliic and mechanical evenls aie
ielaled duiing lhe caidiac cycle. The foui heail sounds aie also indicaled in lhis
diagiam.
Iiguie 7.1 is a schemalic diagiam of lhe ciiculaloiy syslem. The lefl
venliicle e|ecls blood lhiough lhe aoilic valve inlo lhe aoila, and lhe blood
is lhen disliibuled lhiough lhe bianching nelwoik of aileiies, aileiioles, and
aie undei local, neuial, and endociine conliol. The exchange of lhe nuliienl
maleiial lakes place al lhe capillaiy level. The blood lhen ieluins lo lhe
lhe iighl venliicle. The blood is pumped fiom lhe iighl venliicle inlo lhe
lhe pulmonaiy aileiies, aileiioles, capillaiies, and veins lo lhe lefl aliium.
Al lhe pulmonaiy capillaiies, O
2
diffuses fiom lhe lung alveoli lo lhe blood,
îçí
and CO
2
lefl venliicle. When lhe lefl venliicle conliacls in iesponse lo lhe elecliic
slimulalion of lhe myocaidium (discussed in delail in Seclion 4.6), blood is
pumped lhiough lhe aoilic valve inlo lhe aoila.
The piessuies geneialed by lhe iighl and lefl sides of lhe heail diffei
somewhal in shape and in amplilude (see Iiguie 7.2). As we noled in Seclion
4.6, caidiac conliaclion is caused by elecliic slimulalion of lhe caidiac muscle.
An elecliic impulse is geneialed by specialized cells localed in lhe sino-aliial
node of lhe iighl aliium. This elecliic impulse quickly spieads ovei bolh aliia.
Ú·¹«®» éòï The lefl venliicle e|ecls blood inlo lhe syslemic ciiculaloiy sys-
lem. The iighl venliicle e|ecls blood inlo lhe pulmonaiy ciiculaloiy syslem.
îçì é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
Al lhe |unclion of lhe aliia and venliicles, lhe elecliic impulse is conducled
aflei a shoil delay al lhe aliiovenliiculai node. Conduclion quickly spieads
ovei lhe inleiioi of bolh venliicles by means of a specialized conduclion
syslem, lhe His bundle, and lhe Puikin|e syslem. Conduclion lhen piopagales
lhioughoul bolh venliicles. This impulse causes mechanical conliaclion of
bolh venliicles. Mechanical conliaclion of lhe venliiculai muscle geneiales
venliiculai piessuies lhal foice blood lhiough lhe pulmonaiy and aoilic valves
inlo lhe pulmonaiy ciiculalion and lhe syslemic ciiculalion, causing piessuies
in each. Seclion 7.9 desciibes lhe coiielalion of lhe foui heail sounds wilh lhe
aie associaled wilh lhe movemenl of blood duiing lhe caidiac cycle. Muimuis
aie vibialions caused by lhe luibulence in lhe blood moving iapidly lhiough
lhe heail.
éòï Ü×ÎÛÝÌ ÓÛßÍËÎÛÓÛÒÌÍ
Blood-piessuie sensoi syslems can be divided inlo lwo geneial calegoiies
accoiding lo lhe localion of lhe sensoi elemenl. The mosl common clinical
melhod foi diieclly measuiing piessuie is lo couple lhe vasculai piessuie lo an
Ú·¹«®» éòî ̧°·½¿´ ª¿´«»- ±º ½·®½«´¿¬±®§ °®»--«®»- SP is lhe syslolic piessuie,
DP is lhe diaslolic piessuie, and MP is lhe mean piessuie. The wedge piessuie
é ò ï Ü × Î Û Ý Ì Ó Û ß Í Ë Î Û Ó Û Ò Ì Í îçë
calegoiy, lhe liquid coupling is eliminaled by incoipoialing lhe sensoi inlo lhe
lip of a calhelei lhal is placed in lhe vasculai syslem. This device is known as an
·²¬®¿ª¿-½«´¿® °®»--«®» -»²-±®.
A numbei of diffeienl kinds of sensoi elemenls may be used; lhey include
sliain gage, lineai-vaiiable diffeienlial liansfoimei, vaiiable induclance, vaii-
able capacilance, oploeleclionic, piezoelecliic, and semiconducloi devices
piopeilies of commeicial piessuie sensois. This seclion desciibes lhe piinci-
ples of opeialion of an exliavasculai and an inliavasculai syslem. Ioi a
desciiplion of olhei sensois, see Chaplei 2.
ÛÈÌÎßÊßÍÝËÔßÎ ÍÛÒÍÑÎÍ
The exliavasculai sensoi syslem is made up of a calhelei connecled lo a lhiee-
way slopcock and lhen lo lhe piessuie sensoi (Iiguie 7.3). The calheleiŠsensoi
solulion eveiy few minules lo pievenl blood fiom clolling al lhe lip.
The physician inseils lhe calhelei eilhei by means of a suigical cul-down,
which exposes lhe aileiy oi vein, oi by means of peiculaneous inseilion, which
Ú·¹«®» éòí Û¨¬®¿ª¿-½«´¿® °®»--«®»ó-»²-±® -§-¬»³
solulion (hepaiinized saline) lhiough a disposable piessuie sensoi wilh an
blood samples and zeio lhe piessuie sensoi.
îçê é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
involves lhe use of a special needle oi guide-wiie lechnique. Blood piessuie is
which lhe displacemenl of lhe diaphiagm is liansmilled lo a syslem composed
of a moving aimaluie and an unbonded sliain gage. Iiguie 2.5 shows a modein
disposable blood-piessuie sensoi.
×ÒÌÎßÊßÍÝËÔßÎ ÍÛÒÍÑÎÍ
Calhelei-lip sensois have lhe advanlage lhal lhe hydiaulic conneclion via lhe
calhelei, belween lhe souice of piessuie and lhe sensoi elemenl, is elimi-
naled. The fiequency iesponse of lhe calheleiŠsensoi syslem is limiled by
lhe hydiaulic piopeilies of lhe syslem. Deleclion of piessuies al lhe lip of
lhe calhelei wilhoul lhe use of a liquid-coupling syslem can lhus enable lhe
physician lo oblain a high fiequency iesponse and eliminale lhe lime delay
encounleied when lhe piessuie pulse is liansmilled in a calheleiŠsensoi
syslem.
A numbei of basic lypes of sensois aie being used commeicially foi lhe
deleclion of piessuie in lhe calhelei lip. These include vaiious lypes of sliain-
lype aie available in lhe I 5 calhelei |1.67 mm oulei diamelei (OD)j size. ¡n lhe
Iiench scale (I), used lo denole lhe diamelei of calheleis, each unil is appioxi-
malely equal lo O.33 mm. Smallei-sized calheleis may become available as lhe
lechnology impioves and lhe pioblems of lempeialuie and elecliic diifl, fiagilily,
and nondesliuclive sleiilizalion aie solvedmoie salisfacloiily. Adisadvanlage of
lhe calhelei-lip piessuie sensoi is lhal il is moie expensive lhan olheis and may
bieak aflei only a few uses, fuilhei incieasing ils cosl pei use.
devices aie inheienlly safei elecliically, bul unfoilunalely lhey lack a conve-
nienl way lo measuie ielalive piessuie wilhoul an addilional lumen eilhei
connecled lo a second piessuie sensoi oi venled lo lhe almospheie.
·² ª·ª± measuiemenls inside lhe human
connecled lo a lighl-emilling diode (L!D) souice and lhe olhei lo a pholo-
delecloi (Hansen, 1983). The piessuie-sensoi lip consisls of a lhin melal
souice and lhe pholodelecloi. Iiguie 7.4(b) shows lhe oulpul signal veisus
«
A
, which is equal lo lhe
Ò
A
(Seclion 2.14). The coupling belween L!D
souice and delecloi is a funclion of lhe oveilap of lhe lwo acceplance angles
é ò ï Ü × Î Û Ý Ì Ó Û ß Í Ë Î Û Ó Û Ò Ì Í îçé
on lhe piessuie-sensoi membiane. The opeialing poilion of lhe cuive is lhe
lefl slope iegion wheie lhe chaiacleiislic is sleepesl.
modulales lhe lighl liansveising a channel belween souice and delecloi.
suie measuiemenls in lhe newboin. Iiguie 7.5 shows a schemalic of lhe device,
which is applied lo lhe anleiioi fonlanel. Piessuie is applied wilh lhe sensoi
occuis, equal piessuie exisls on bolh sides of lhe membiane, which consisls of
sofl lissue belween lhe scalp suiface and lhe duia. Moniloiing of lhe piobe
piessuie deleimines lhe duia piessuie. Piessuie bends lhe membiane, which
Aii piessuie fiom a pneumalic seivo syslem conliols lhe aii piessuie
wilhin lhe piessuie sensoi, which is ad|usled such lhal diaphiagm‰and lhus
Ú·¹«®» éòì
îçè é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
lhe fonlanel lissue‰
fonlanel oi inliacianial piessuie aie equal.
Similai piessuie-unloading lechniques aie used in lhin, complianl sensois
lhal measuie inleiface piessuies belween lhe skin and suppoil sliucluies such
as seal cushions (Webslei, 1991).
Silicon fusion bonding is used lo fabiicale micio silicon piessuie-sensoi
chips (Howe »¬ ¿´., 199O). A wedge-shaped cavily is elched in a silicon wafei lo
foim a diaphiagm. Piezoiesislive sliain gages aie implanled and a melal
conneclion is made in oidei lo cieale a sensoi foi a calhelei lip miciopiessuie
sensoi.
Ü×ÍÐÑÍßÞÔÛ ÐÎÛÍÍËÎÛ ÍÛÒÍÑÎÍ
Tiadilionally, physiological piessuie sensois have been ieusable devices, bul
mosl modein hospilals have adopled inexpensive, disposable piessuie sensois
in oidei lo lowei lhe iisk of palienl cioss-conlaminalion and ieduce lhe
amounl of handling of piessuie sensois by hospilal peisonnel. Because ieus-
able piessuie sensois aie sub|ecl lo lhe abuses of iepiocessing and iepealed
usei handling, lhey lend lo be less ieliable lhan disposable sensois.
By miciomachining silicon, a piessuie diaphiagm is elched and piezo-
iesislive sliain gages aie diffused inlo lhe diaphiagm foi measuiing ils
displacemenl. This piocess iesulls in a small, inlegialed, sensilive, and iela-
lively inexpensive piessuie sensoi. This silicon chip is incoipoialed inlo a
disposable piessuie-moniloiing lubing syslem. The disposable piessuie sensoi
iemove offsel vollages and sel lhe same sensilivily foi similai disposable
lempeialuie compensalion. The iesislance of lhe biidge elemenls is usually
high in oidei lo ieduce self-healing, which may cause eiioneous iesulls. This
iesulls in high oulpul impedance foi lhe device. Thus, a high-inpul impedance
moniloi musl be used wilh disposable piessuie sensois.
Piessuie sensois can moniloi blood piessuie in poslsuigical palienls as
pail of a closed-loop feedback syslem. Such a syslem in|ecls conliolled
amounls of lhe diug niliopiusside lo slabilize lhe blood piessuie (Yu, 2OO6).
Ú·¹«®» éòë Iibei-oplic piessuie sensoi foi inliacianial piessuie measuie-
menls in lhe newboin. The sensoi membiane is placed in conlacl wilh lhe
anleiioi fonlanel of lhe newboin.
é ò ï Ü × Î Û Ý Ì Ó Û ß Í Ë Î Û Ó Û Ò Ì Í îçç
éòî ØßÎÓÑÒ×Ý ßÒßÔÇÍ×Í ÑÚ ÞÔÑÑÜóÐÎÛÍÍËÎÛ ÉßÊÛÚÑÎÓÍ
The basic sine-wave componenls of any complex lime-vaiying peiiodic wave-
funclions of lhe piopei fiequency lhal, when added, iepioduce lhe oiiginal
complex wavefoim. ¡l has been shown lhal ieseaicheis can apply lechniques of
Iouiiei analysis whenlhey wanl lochaiacleiize lhe oscillaloiy componenls of lhe
ciiculaloiy and iespiialoiy syslems, because lwo basic poslulales foi Iouiiei
analysis‰peiiodicily and lineaiily‰ »¬ ¿´., 197O).
Caidiovasculai physiologisls and some clinicians have been employing
melhod was eslablished in lhe 195Os. !aily Iouiiei analysis used bandpass
need foi special haidwaie. The advanlage of lhe lechnique is lhal il allows foi a
quanlilalive iepiesenlalion of a physiological wavefoim; lhus il is quile easy lo
compaie coiiesponding haimonic componenls of pulses.
OŽRouike (1971) poinls oul lhal lhe physician who luins lo a slandaid
medical lexlbook foi assislance in inleipieling lhe aileiial pulse is likely lo be
confused, misled, and disappoinled. He fuilhei indicales lhal in iecenl yeais,
analysis of lhe fiequency componenls of lhe pulse appeais lo have yielded
moie infoimalion on aileiial piopeilies lhan any olhei appioach. He pioposes
lhal lhe aileiial pulse be iepiesenled in leims of ils fiequency componenls.
The blood-piessuie pulse can be divided inlo ils fundamenlal componenl
Ú·¹«®» éòê ̸» B®-¬ -·¨ ¸¿®³±²·½- ±º ¬¸» ¾´±±¼ó°®»--«®» ©¿ª»º±®³ The lable
gives ielalive values foi ampliludes. (Iiom T. A. Hansen, ••piessuie measuie-
menl in lhe human oiganism.ŽŽ ß½¬¿ и§-·±´±¹·½¿ ͽ¿²¼·²¿ª·½¿, 1949, 19,
Suppl. 68, 1Š227. \sed wilh peimission.)
íðð é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
and lhe iesullanl sum. When we compaie lhe oiiginal wavefoim and lhe
Nole lhal lhe amplilude of lhe sixlh haimonic is appioximalely 12 of lhe
fundamenlal. We can achieve moie failhful iepioduclion of lhe oiiginal wave-
foim by adding highei haimonic componenls.
éòí ÜÇÒßÓ×Ý ÐÎÑÐÛÎÌ×ÛÍ ÑÚ ÐÎÛÍÍËÎÛóÓÛßÍËÎÛÓÛÒÌ
ÍÇÍÌÛÓÍ
An undeislanding of lhe dynamic piopeilies of a piessuie-measuiemenl syslem
is impoilanl if we wish lo pieseive lhe dynamic accuiacy of lhe measuied
piessuie. !iiois in measuiemenl of dynamic piessuie can have seiious conse-
quences in lhe clinical silualion. Ioi inslance, an undeidamped syslem can lead
lo oveieslimalion of piessuie giadienls acioss slenolic (naiiowed) heail valves.
eilhei disliibuled- oi lumped-paiamelei models. Disliibuled-paiamelei models
aie desciibed in lhe lileialuie (Iiy, 196O), which gives an accuiale desciiplion
of lhe dynamic behavioi of lhe calhelei-sensoi syslem. Howevei, disliibuled-
paiamelei models aie nol noimally employed, because lhe single-degiee-of-
fieedom (lumped-paiamelei) model is easiei lo woik wilh, and lhe accuiacy of
lhe iesulls oblained by using lhese models is acceplable foi lhe clinical silualion.
ßÒßÔÑÙÑËÍ ÛÔÛÝÌÎ×Ý ÍÇÍÌÛÓÍ
The modeling appioach laken heie develops a lumped-paiamelei model foi
lhe calhelei and sensoi sepaialely and shows how, wilh appiopiiale appioxi-
malions, il ieduces lo lhe lumped-paiamelei model foi a second-oidei syslem.
Iiguie 7.7 shows lhe physical model of a calheleiŠsensoi syslem. An inciease
lhe calhelei lip, lhiough lhe calhelei, and inlo lhe sensoi. This liquid shifl
A liquid calhelei has ineilial, fiiclional, and elaslic piopeilies iepiesenled
by ineilance, iesislance, and compliance, iespeclively. Similaily, lhe sensoi has
lhese same piopeilies, in addilion lo lhe compliance of lhe diaphiagm. Iiguie
7.7(b) shows an elecliic analog of lhe piessuie-measuiing syslem, wheiein lhe
analogous elemenls foi hydiaulic ineilance, iesislance, and compliance aie
elecliic induclance, iesislance, and capacilance, iespeclively.
Iiguie 7.8(a). The compliance of lhe sensoi diaphiagmis much laigei lhan lhal
bubble-fiee and lhe calhelei maleiial is ielalively noncomplianl. The iesisl-
ance and ineilance of lhe liquid in lhe sensoi can be neglecled compaied lo
é ò í Ü Ç Ò ß Ó × Ý Ð Î Ñ Ð Û Î Ì × Û Í Ñ Ú Ð Î Û Í Í Ë Î Û ó Ó Û ß Í Ë Î Û Ó Û Ò Ì íðï
lhose of lhe liquid in lhe calhelei. Lel us now deiive equalions ielaling lhe
iesislance and induclance lo lhe piopeilies of lhe syslem.
The liquid iesislance Î
c
of lhe calhelei is due lo fiiclion belween sheaiing
Î
c
ÜÐ
Ú
Pa s/m
3
(7.1)
oi
Î
c
ÜÐ
«ß
wheie
° piessuie diffeience acioss lhe segmenl in Pa pascal N/m
2
Ú
3
/s
« aveiage velocily, m/s
ß cioss-seclion aiea, m
2
PoiseuilleŽs equalion enables us lo calculale Î
c
when we aie given lhe values of
calhelei lenglh Ô, inmeleis; iadius ®, inmeleis; and liquid viscosily ¸, inpascal-
Î
c
8¸Ô
°®
4
(7.2)
Ú·¹«®» éòé (a) Physical model of a calheleiŠsensoi syslem. (b) Analogous
elecliic syslem foi lhis calheleiŠsensoi syslem. !ach segmenl of lhe calhelei
has ils own iesislance Î
c
, ineilance Ô
c
, and compliance Ý
c
. ¡n addilion, lhe
sensoi has iesislance Î
s
, ineilance, Ô
s
, and compliance Ý
s
. The compliance of
lhe diaphiagm is Ý
d
.
íðî é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
The liquid ineilance Ô
c
of lhe calhelei is due piimaiily lo lhe mass of lhe
liquid. ¡l can be iepiesenled by lhe equalion
Ô
c
ÜÐ
¼Ú/¼¬
Pa s
2
/m
3
(7.3)
oi
Ô
c
ÜÐ
¿ß
wheie ¿ acceleialion m/s
2
.
This equalion ieduces fuilhei lo
Ô
c
³
ß
2
Ú·¹«®» éòè
phiagmis laigei lhan compliance of calhelei oi sensoi cavily foi a bubble-fiee,
noncomplianl calhelei. The iesislance and ineilance of lhe calhelei aie laigei
lhan lhose of lhe sensoi, because lhe calhelei has longei lenglh and smallei
diamelei. (b) Analogous ciicuil foi calheleiŠsensoi syslemwilha bubble in lhe
calhelei. Calhelei piopeilies pioximal lo lhe bubble aie ineilance Ô
c
and
iesislance Î
c
. Calhelei piopeilies dislal lo lhe bubble aie Ô
cd
and Î
lf
. Com-
pliance of lhe diaphiagm is Ý
d
; compliance of lhe bubble is Ý
b
analogous ciicuil foi calheleiŠsensoi syslem wilh a bubble in lhe calhelei,
assuming lhal Ô
cd
and Î
cd
aie negligible wilh iespecl lo Î
c
and Ô
c
.
é ò í Ü Ç Ò ß Ó × Ý Ð Î Ñ Ð Û Î Ì × Û Í Ñ Ú Ð Î Û Í Í Ë Î Û ó Ó Û ß Í Ë Î Û Ó Û Ò Ì íðí
oi
Ô
c
®Ô
°®
2
(7.4)
wheie ³ mass of liquid (kg) and ® densily of liquid (kg/m
3
).
!qualions (7.2) and (7.4) showlhal we can neglecl lhe iesislive and ineilial
componenls of lhe sensoi wilh iespecl lo lhose of lhe liquid calhelei. The
‰one based on kinelic-eneigy consideialions‰in which he
calhelei.
The compliance Ý
d
of lhe sensoi diaphiagm is given by lhe equalion
Ý
d
ÜÊ
ÜÐ
1
Û
d
wheie Û
d
is lhe volume modulus of elaslicily of lhe sensoi diaphiagm.
i
, analogous lo
applied piessuie, and lhe oulpul vollage
o
, analogous lo piessuie al lhe
diaphiagm, by using KiichhoffŽs vollage law. Thus,
i
¬
Ô
c
Ý
d
¼
2
o
¬
¼¬
2
Î
c
Ý
d
¼
o
¬
¼¬
o
¬ (7.5)
\sing lhe geneial foim of a second-oidei syslem equalion deiived in Seclion
1.1O, we can show lhal lhe naluial undamped fiequency ª
n
is 1 Ô
c
Ý
d
1 2
and
lhal lhe damping ialio ¦ is Î
c
2 Ý
d
Ô
c
1 2
. Ioi lhe hydiaulic syslem undei
sludy, by subsliluling (7.2) and (7.4) inlo lhe expiessions foi ª
n
and ¦, we can
show lhal
º
n
®
2
1
°®Ô
ÜÐ
ÜÊ
1 2
(7.6)
and
¦

®
3
Ô ÜÊ ÜÐ
°®
1 2
(7.7)
Table 7.1 lisls a numbei of useful ielalionships and peilinenl conslanls.
We can sludy lhe liansienl iesponse and lhe fiequency iesponse of lhe
calheleiŠsensoi syslem by means of lhe analogous elecliic ciicuil. ¡n addilion,
we can sludy lhe effecls of changes in lhe hydiaulic syslem by adding
appiopiiale elemenls lo lhe ciicuil. Ioi example, an aii bubble in lhe liquid
makes lhe syslem moie complianl. Thus ils effecl on lhe syslem is lhe same as
íðì é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
lhal caused by connecling an addilional capaciloi in paiallel lo lhal iepiesenl-
ing lhe diaphiagm compliance. !xample 7.1 illusliales how lhe analogous
ciicuil is used.
ÛÈßÓÐÔÛ éòï A 5 mm-long aii bubble has foimed in lhe iigid-walled
calhelei connecled lo a Slalham P23Dd sensoi. The calhelei is 1 m long, 6
èC. (The isolheimal compiession
of aii ÜÊ ÜÐ is 1 ml/cm of walei piessuie pei lilei of volume.) Plol lhe
fiequency-iesponse cuive of lhe syslem wilh and wilhoul lhe bubble. (¡nlei-
nal iadius of lhe calhelei is O.46 mm; volume modulus of elaslicily of lhe
diaphiagm is O 49 1O
15
N/m
5
.)
ßÒÍÉÛÎ The analogous ciicuil foi lhe hydiaulic syslem wilh and wilhoul
lhe bubble is shown in Iiguie 7.8(b) and (c). We can calculale lhe values of lhe
naluial fiequency º
n
and lhe damping ialio ¦ wilhoul lhe bubble by using (7.6)
and (7.7). Thal is,
º
n
®
2
1
°Ô
ÜÐ
®ÜÊ
1 2
O O46 1O
2
2
1
° 1
O 49 1O
15
1 1O
3
1 2
91Hz
¦

®
3
Ô
°®
ÜÊ
ÜÐ
1 2
4 O OO1
O O46 1O
2
3
1
°
1
1 1O
3
O 49 1O
15
1 2
O O33
The fiequency iesponse foi lhe calheleiŠsensoi syslem is shown in
Iiguie 7.9.
The nexl slep is lo calculale lhe newvalues of ¦ and º
n
, foi lhe case in which
a bubble is piesenl. Because lhe lwo capacilois aie in paiallel, lhe lolal
capacilance foi lhe ciicuil is equal lo lhe sum of lhese lwo. Thal is,
Ý
l
Ý
d
Ý
b
(7.8)
Ì¿¾´» éòï Ó»½¸¿²·½¿´ ݸ¿®¿½¬»®·-¬·½- ±º Ú´«·¼-
п®¿³»¬»® Í«¾-¬¿²½» Ì»³°»®¿¬«®» Ê¿´«»
¸ Walei 2O èC O.OO1 Pa s
¸ Walei 37 èC O.OOO7 Pa s
¸ Aii 2O èC O.OOOO18 Pa s
® Aii 2O èC 1 21 kg/m
3
ÜÊ ÜÐ Walei 2O èC O 53 1O
15
m
5
/N pei ml volume
¸ Blood All 4 ¸ foi walei
é ò í Ü Ç Ò ß Ó × Ý Ð Î Ñ Ð Û Î Ì × Û Í Ñ Ú Ð Î Û Í Í Ë Î Û ó Ó Û ß Í Ë Î Û Ó Û Ò Ì íðë
oi
Ý
l
ÜÊ
ÜÐ
d
ÜÊ
ÜÐ
b
The value of ÜÊ ÜÐ
d
1 Û
d
2 O4 1O
15
m
5
/N. The volume of lhe
bubble is
°®
2
´ 3 33 1O
9
m
3
3 33 1O
6
lilei
One cenlimelei of walei piessuie is 98.5 N/m
2
. Thus
ÜÊ ÜÐ
b
3 33 1O
9
1 1 1O
3
m
3
/1
98 5 N/m
2
3 38 1O
14
m
5
/N
Consequenlly, Ý
l
3 38 1O
14
m
5
º
n
and ¦
by iefeiiing lo (7.6) and (7.7) and assuming lhal lhe only paiamelei lhal
changes is lhe value of ÜÊ ÜÐ. Thus
º
n bubble
º
n no bubble
ÜÐÜÊ
lolal
ÜÐ ÜÊ
no bubble
1 2
Ú·¹«®» éòç Iiequency-iesponse cuives foi calheleiŠsensoi syslem wilh and
wilhoul bubbles. Naluial fiequency decieases fiom 91 lo 22 Hz and damping
ialio incieases fiom O.O33 lo O.137 wilh lhe bubble piesenl.
íðê é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
oi
º
n bubble
92
2 O4 1O
15
3 38 1O
14
1 2
22Hz
and
¦
bubble
¦
no bubble
ÜÊ ÜÐ
lolal
ÜÊ ÜÐ
no bubble
1 2
O 137
The fiequency iesponse foi lhe syslem wilh lhe bubble piesenl is shown in
Iiguie 7.9. Nole lhal lhe bubble loweis º
n
and incieases ¦. This loweiing of º
n
may cause disloilion pioblems wilh lhe highei haimonics of lhe blood-
piessuie wavefoim.
ÛÈßÓÐÔÛ éòî By changing only lhe iadius of lhe calhelei, iedesign lhe
(no-bubble) calhelei of Iiguie 7.9 lo achieve lhe damping ialio ¦ 1.
Calculale lhe iesulling naluial fiequency º
n
.
ßÒÍÉÛÎ Iiom !q. (7.7), ®
3
®
3
O
¦ ¦
O
.
®
3
1 O O O33 O 46mm
3
O OO32 ® O 147mm
Iiom !q. (7.6), º
n
º
nO
® ®
O
,
º
n
91 O 147 O 5 29Hz
ÛÈßÓÐÔÛ éòí
modulus of elaslicily. Theiefoie, a lheoielical uppei limil of high-fiequency
º
n
foi a sensoi lhal has a O.5O ml liquid chambei and lhal is connecled lo lhe
piessuie souice by means of a =2O ® O 29 mm 5O mm-long sleel needle.
ßÒÍÉÛÎ A sleel needle is used foi lhe calhelei, so lhe volume modulus of
elaslicily of lhe calhelei is assumed lo be zeio. We do nol considei lhe volume
modulus of elaslicily of lhe diaphiagm because we wanl lhe lheoielical uppei
limil of fiequency iesponse. Thus ÜÊ ÜÐ foi lhis example is lhal of walei,
O 53 1O
15
m
5
/N pei millililei volume. The lolal volume of lhe walei is equal
lo lhe volume of lhe liquid chambei of lhe sensoi plus lhe volume of lhe
cylindiical needle.
Ê
l
O 5 ° O O29
2
5 ml O 513ml
ÜÊ
ÜÐ
walei
O 53 1O
15
O 513 O 272 1O
15
m
5
/N
º
n
O O29 1O
2
2
1
° O O5 1OOO O 27 1O
15
1 2
7OOHz
é ò í Ü Ç Ò ß Ó × Ý Ð Î Ñ Ð Û Î Ì × Û Í Ñ Ú Ð Î Û Í Í Ë Î Û ó Ó Û ß Í Ë Î Û Ó Û Ò Ì íðé
éòì ÓÛßÍËÎÛÓÛÒÌ ÑÚ ÍÇÍÌÛÓ ÎÛÍÐÑÒÍÛ
The iesponse chaiacleiislics of a calheleiŠsensoi syslemcan be deleimined by
lwo melhods. The simplesl and mosl sliaighlfoiwaid lechnique involves
measuiing lhe liansienl slep iesponse foi lhe syslem. A polenlially moie
accuiale melhod‰bul a moie complicaled one because il iequiies special
equipmenl‰involves measuiing lhe fiequency iesponse of lhe syslem.
ÌÎßÒÍ×ÛÒÌ ÍÌÛÐ ÎÛÍÐÑÒÍÛ
The basis of lhe liansienl-iesponse melhod is lo apply a sudden slep inpul lo
lhe piessuie calhelei and iecoid lhe iesullanl damped oscillalions of lhe
syslem. This is also called lhe °±° lechnique, foi ieasons lhal will become
evidenl in lhe following discussion. The liansienl iesponse can be found by lhe
melhod shown in Iiguie 7.1O.
The calhelei, oi needle, is sealed in a lube by a sciew adaploi lhal
compiesses a iubbei washei againsl lhe inseil. Ilushing of lhe syslem is
accomplished by passing excess liquid oul of lhe lhiee-way slopcock. The
lesl is peifoimed by secuiing a iubbei membiane ovei lhe lube by means of an
O-iing. Suigical-glove maleiial is an excellenl choice foi lhe membiane. The
lechnician piessuiizes lhe syslem by squeezing lhe sphygmomanomelei bulb,
puncluies lhe balloon wilh a buining malch oi hol soldeiing iion, and obseives
lhe iesponse. The iesponse should be obseived on a iecoidei iunning al a
speed lhal makes il possible lodislinguish lhe individual oscillalions. Howevei,
if lhe fiequency bandwidlh of lhe iecoidei is inadequale, lhe lechnician can
use a sloiage oscilloscope oi dala acquisilion syslem.
Iiguie 7.11 shows an example of lhe liansienl iesponse. ¡n lhis case lhe
iesponse iepiesenls a second-oidei syslem. The lechnician can measuie lhe
Ú·¹«®» éòïð Tiansienl-iesponse lechnique foi lesling a piessuie-sensoiŠ
calhelei-sensoi syslem.
íðè é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
amplilude ialio of successive posilive peaks and deleimine lhe logaiilhmic
deciemenl Ô. !qualion (1.38) yields lhe damping ialio ¦. The obseivei can
measuie Ì, lhe lime belween successive posilive peaks, and deleimine lhe
undamped naluial fiequency fiom ª
n
2° Ì 1 ¦
2
1 2
.
Í×ÒËÍÑ×ÜßÔ ÚÎÛÏËÛÒÝÇ ÎÛÍÐÑÒÍÛ
As we noled befoie, lhe sinusoidal fiequency-iesponse melhod is moie
complex because il iequiies moie specialized equipmenl. Iiguie 7.12 is a
Ú·¹«®» éòïï Ю»--«®»ó-»²-±® ¬®¿²-·»²¬ ®»-°±²-» Negalive-slep inpul pies-
suie is iecoided on lhe lop channel; lhe bollom channel is sensoi iesponse
foi a Slalham P23Gb sensoi connecled lo a 31 cm needle (O.495 mm ¡D).
(Iiom ¡. T. Gabe, ••Piessuie measuiemenl in expeiimenlal physiology,ŽŽ ¡n D.
H. Beigel (ed.), ¡, \ol. ¡, New Yoik: Academic Piess, 1972.)
Ú·¹«®» éòïî ß -·²«-±·¼¿´ °®»--«®»ó¹»²»®¿¬±® ¬»-¬ -§-¬»³ A low-fiequency
sine geneialoi diives an undeiwalei-speakei syslem lhal is coupled lo lhe
calhelei of lhe piessuie sensoi undei lesl. An ••idealŽŽ piessuie sensoi, wilh a
fiequency iesponse fiom O lo 1OO Hz, is connecled diieclly lo lhe lesl chambei
housing and monilois inpul piessuie.
é ò ì Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Í Ç Í Ì Û Ó Î Û Í Ð Ñ Ò Í Û íðç
schemalic diagiam of a sinusoidal piessuie-geneialoi lesl syslem. A pump
pioduces sinusoidal piessuies lhal aie noimally moniloied al lhe piessuie
souice by a piessuie sensoi wilh known chaiacleiislics. This is used because
lhe ampliludes of lhe souice-piessuie wavefoims aie nol noimally conslanl foi
all fiequencies. The souice piessuie is coupled lo lhe calhelei sensoi undei lesl
by means of bubble-fiee saline. The aii is iemoved by boiling lhe liquid.
mining lhe amplilude and phase of lhe oulpul as a funclion of fiequency
wilhoul lhe consliainl of lhe second-oidei syslem model iequiied in lhe
liansienl-iesponse case. ¡n some cases, iesonance al moie lhan one fiequency
may be piesenl.
éòë ÛÚÚÛÝÌÍ ÑÚ ÍÇÍÌÛÓ ÐßÎßÓÛÌÛÎÍ ÑÒ ÎÛÍÐÑÒÍÛ
We have shown in oui discussion of lhe model of lhe calheleiŠsensoi syslem
lhal lhe values of lhe damping ialio ¦ and naluial fiequency ª
n
aie funclions
of lhe vaiious syslem paiameleis. This seclion iepoils on expeiimenlal
using slep liansienl-iesponse and sinusoidal piessuie-geneialion lechniques
similai lo lhose desciibed above, lhese invesligalois deleimined lhe effecls on
lhe peifoimance of lhe calheleiŠsensoi syslem of de-aeialing walei and of
using vaiious calhelei maleiials and conneclois. They found lhal even minule
aii bubbles, which inciease lhe compliance of lhe calhelei manomelei syslem,
diaslically decieased lhe damped naluial fiequency ª
d
2° Ì. Ioi a P!-19O
calhelei of lenglhs 1O lo 1OO cm, lhe damped naluial fiequency decieased by
appioximalely 5O lo 6O foi an unboiled-walei case compaied lo a boiled-
walei case. Lenglh of lhe calhelei was shown lo be inveisely ielaled lo lhe
diameleis lesled (O.58 lo 2.69 mm). The lheoielical lineai ielalionshipbelween
lhe damped naluial fiequency and 1 calhelei lenglh
1 2
seemed lo hold
wilhin expeiimenlal eiiois. A lineai ielalionship was found lo exisl belween
lhe innei diamelei of lhe calhelei and lhe damped naluial fiequency foi bolh
¡n compaiing lhe effecl of calhelei maleiial on fiequency iesponse,
polyelhylene, il has a slighlly highei fiequency iesponse al any given lenglh. As
expecled, lhe incieased compliance of silicone iubbei lubing caused a maiked
deciease in fiequency iesponse. The aulhois concluded lhal silicone iubbei is a
pooi maleiial foi deleimining paiameleis olhei lhan mean piessuie.
They examined lhe effecl of conneclois on lhe syslem iesponse by
inseiling‰in seiies wilh lhe calhelei‰vaiious connecling needles lhal added
lillle lo lhe oveiall lenglh of lhe syslem. They found lhal lhe damped naluial
fiequency was lineaily ielaled lo lhe needle boie foi needles of lhe same
lenglh. The connecloi seives as a simple seiies hydiaulic dampei lhal
íïð é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
decieases lhe fiequency iesponse. They suggesled lhal lhe fewesl possible
walei seal. ¡nfuilhei lesls, lhey found lhal coils and bends in lhe calhelei cause
changes in lhe iesonanl fiequency. Howevei, lhe magnilude of lhese changes
compliance.
éòê ÞßÒÜÉ×ÜÌØ ÎÛÏË×ÎÛÓÛÒÌÍ ÚÑÎ ÓÛßÍËÎ×ÒÙ
ÞÔÑÑÜ ÐÎÛÍÍËÎÛ
When we know lhe iepiesenlalive haimonic componenls of lhe blood-piessuie
wavefoim‰oi, foi lhal mallei, any peiiodic wavefoim‰we can specify lhe
bandwidlhiequiiemenls foi lhe insliumenlalion syslem. As wilh all biomedical
measuiemenls, bandwidlh iequiiemenls aie a funclion of lhe invesligalion.
Ioi example, if lhe mean blood piessuie is lhe only paiamelei of inleiesl,
il is of lillle value lo liy lo achieve a wide bandwidlh syslem. ¡l is geneially
accepled lhal haimonics of lhe blood-piessuie wavefoimhighei lhan lhe lenlh
may be ignoied. As an example, lhe bandwidlh iequiiemenls foi a heail iale of
12O bpm (oi 2 Hz) would be 2O Hz.
Ioi a peifecl iepioduclion of lhe oiiginal wavefoim, lheie should be no
disloilion in lhe amplilude oi phase chaiacleiislics. The waveshape can be
pieseived, howevei, even if lhe phase chaiacleiislics aie nol ideal. This is lhe
case if lhe ielalive ampliludes of lhe fiequency componenls aie pieseived bul
lheii phases aie displaced in piopoilion lo lheii fiequency. Then lhe synlhe-
sized wavefoim gives lhe oiiginal waveshape, excepl lhal il is delayed in lime,
depending on lhe phase shifl.
Measuiemenls of lhe deiivalive of lhe piessuie signal inciease lhe band-
widlh iequiiemenls, because lhe diffeienlialion of a sinusoidal haimonic
incieases lhe amplilude of lhal componenl by a facloi piopoilional lo ils
fiequency. As wilh lhe oiiginal blood-piessuie wavefoim, a Iouiiei analysis of
lhe deiivalive signal can eslimale lhe bandwidlh iequiiemenls foi lhe deiiva-
live of lhe blood piessuie. The amplilude-veisus-fiequency chaiacleiislics of
any calheleiŠmanomelei syslem used foi lhe measuiemenl of venliiculai
5 , up lo lhe 2Olh haimonic (Geish »¬ ¿´., 1971).
éòé ÌÇÐ×ÝßÔ ÐÎÛÍÍËÎÛóÉßÊÛÚÑÎÓ Ü×ÍÌÑÎÌ×ÑÒ
Accuiale measuiemenls of blood piessuie aie impoilanl in bolh clinical and
physiological ieseaich. This seclion gives examples of lypical lypes of disloi-
lion of blood-piessuie wavefoim lhal aie due lo an inadequale fiequency
iesponse of lhe calhelei-sensoi syslem.
é ò é Ì Ç Ð × Ý ß Ô Ð Î Û Í Í Ë Î Û ó É ß Ê Û Ú Ñ Î Ó Ü × Í Ì Ñ Î Ì × Ñ Ò íïï
Theie may be seiious consequences when an undeidamped syslem leads
lo oveieslimalion of lhe piessuie giadienls acioss a slenolic (naiiowed)
heail valve. Iiguie 7.13 shows examples of disloilion of piessuie wavefoim.
The aclual blood-piessuie wavefoim |Iiguie 7.13(a)j was iecoided wilh a
high-qualily piessuie sensoi wilh a bandwidlh fiom dc lo 1OO Hz. Nole lhal
in lhe undeidamped case, lhe amplilude of lhe highei-fiequency compo-
ed, wheieas foi lhe oveidamped case
lhese highei-fiequency componenls aie allenualed. The aclual peak pies-
suie |Iiguie 7.13(a)j is appioximalely 13O mm Hg (17.3 kPa). The undei-
damped iesponse |Iiguie 7.13(b)j has a peak piessuie of aboul 165 mm Hg
(22 kPa), which may lead lo a seiious clinical eiioi if lhis peak piessuie is
used lo assess lhe seveiily of aoilic-valve slenosis. The minimal piessuie is
in eiioi, loo; il is 15 mmHg 2 kPa and lhe aclual value is 5 mm Hg
(O.7 kPa). Theie is also a lime delay of appioximalely 3O ms in lhe undei-
damped case.
appioximalely 15O ms andan allenualed amplilude of 12O mmHg (16 kPa); lhe
aclual value is 13O mm Hg (17.3 kPa). This lype of iesponse can occui in lhe
piesence of a laige aii bubble oi a blood clol al lhe lip of lhe calhelei.
An undeidamped calheleiŠsensoi syslem can be liansfoimed lo an ovei-
damped syslem by pinching lhe calhelei. This pioceduie incieases lhe damp-
ing ialio ¦ and has lillle effecl on lhe naluial fiequency. (See Pioblem 7.6.)
Anolhei example of disloilion in blood-piessuie measuiemenls is known
as ½¿¬¸»¬»® ©¸·°. Iiguie 7.14 shows lhese low-fiequency oscillalions lhal
appeai in lhe blood-piessuie iecoiding. This may occui when an aoilic
aboul by lhe acceleialing blood. This lype of disloilion can be minimized by
Ú·¹«®» éòïí Ю»--«®»ó©¿ª»º±®³ ¼·-¬±®¬·±² (a) Recoiding of an undisloiled
lefl-venliiculai piessuie wavefoim via a piessuie sensoi wilh bandwidlh dc lo
1OO Hz. (b) \ndeidamped iesponse, wheie peak value is incieased. A lime
delay is also evidenl in lhis iecoiding. (c) Oveidamped iesponse lhal shows a
íïî é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
lhe use of sliff calheleis oi by caieful placemenl of calheleis in iegions of low
éòè ÍÇÍÌÛÓÍ ÚÑÎ ÓÛßÍËÎ×ÒÙ ÊÛÒÑËÍ ÐÎÛÍÍËÎÛ
Measuiemenls of venous piessuie aie an impoilanl aid lo lhe physician foi
deleimining lhe funclion of lhe capillaiy bed and lhe iighl side of lhe heail.
lhe value of lhe capillaiy piessuie. The inlialhoiacic venous piessuie delei-
cenlial venous piessuie is measuied in a cenlial vein oi in lhe iighl aliium. ¡l
wheieas lhe exlialhoiacic venous piessuie is 2 lo 5 cm H
2
O (O.2 lo O.5 kPa)
above almospheiic. The iefeience level foi venous piessuie is al lhe iighl
aliium.
Cenlial venous piessuie is an impoilanl indicaloi of myocaidial peifoim-
ance. ¡l is noimally moniloied on suigical and medical palienls lo assess piopei
lheiapy in cases of heail dysfunclion, shock, hypovolemic oi hypeivolemic
slales, oi ciiculaloiy failuie. ¡l is used as a guide lo deleimine lhe amounl of
liquid a palienl should ieceive.
Physicians usually measuie sleady slale oi mean venous piessuie by
making a peiculaneous venous puncluie wilh a laige-boie needle, inseiling
a calhelei lhiough lhe needle inlo lhe vein, and advancing il lo lhe desiied
posilion. The needle is lhen iemoved. A plaslic lube is allached lo lhe
Ú·¹«®» éòïì Ü·-¬±®¬·±² ¼«®·²¹ ¬¸» ®»½±®¼·²¹ ±º ¿®¬»®·¿´ °®»--«®» The bollom
liace is lhe iesponse when lhe piessuie calhelei is benl and whipped by
é ò è Í Ç Í Ì Û Ó Í Ú Ñ Î Ó Û ß Í Ë Î × Ò Ù Ê Û Ò Ñ Ë Í Ð Î Û Í Í Ë Î Û íïí
inliavenous calhelei by means of a slopcock, which enables clinicians lo
of venous piessuie can be made by connecling lo lhe venous calhelei a high-
sensilivily piessuie sensoi wilh a lowei dynamic iange lhan lhal necessaiy foi
aileiial measuiemenls.
Pioblems in mainlaining a sleady baseline occui when lhe palienl changes
posilion. !iiois may aiise in lhe measuiemenls if lhe calhelei is misplaced oi if
il becomes blocked by a clol oi is impacled againsl a vein wall. ¡l is noimal
piaclice lo accepl venous-piessuie values only when iespiialoiy swings aie
evidenl. Noimal cenlial venous piessuies iange widely fiom O lo 12cm
H
2
O O lo 1 2 kPa , wilh a mean piessuie of 5 cmH
2
O O 5 kPa .
!sophageal manomeliy uses a similai low-piessuie calhelei syslem
(\elanovich, 2OO6). A hydiaulic capillaiy infusion syslem infuses O.6 ml/
éòç ØÛßÎÌ ÍÑËÒÜÍ
The auscullalion of lhe heail gives lhe clinician valuable infoimalion aboul lhe
funclional inlegiily of lhe heail. Moie infoimalion becomes available when
clinicians compaie lhe lempoial ielalionships belween lhe heail sounds and
lhe mechanical and elecliic evenls of lhe caidiac cycle. This lallei appioach is
known as °¸±²±½¿®¼·±¹®¿°¸§.
Theie is a wide diveisily of opinion conceining lhe lheoiies lhal allempl lo
explain lhe oiigin of heail sounds and muimuis. Moie lhan 4O diffeienl
197O). Heail sounds aie vibialions oi sounds due lo lhe acceleialion oi
deceleialion of blood, wheieas muimuis aie vibialions oi sounds due lo blood
luibulence.
ÓÛÝØßÒ×ÍÓ ßÒÜ ÑÎ×Ù×Ò
Iiguie 7.15 shows how lhe foui heail sounds aie ielaled lo lhe elecliic and
lhe movemenl of blood duiing venliiculai syslole (Rushmei, 197O). As lhe
venliicles conliacl, blood shifls lowaid lhe aliia, closing lhe aliiovenliiculai
oiiginales fiom oscillalions of blood belween lhe descending iool of lhe aoila
and venliicle and fiom vibialions due lo blood luibulence al lhe aoilic and
nous closuie of lhe liicuspid and milial valves. The second heail soundis a low-
aoila and pulmonaiy aileiy and wilh lhe closuie of lhe semilunai valves (lhe
valves silualed belween lhe venliicles and lhe aoila oi lhe pulmonaiy liunk).
íïì é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
This second heail sound is coincidenl wilh lhe complelion of lhe T wave of lhe
!CG.
The lhiid heail sound is alliibuled lo lhe sudden leiminalion of lhe iapid-
lhe venliiculai muscle walls, which aie ielaxed. This low-amplilude, low-
fiequency vibialion is audible in childien and in some adulls.
The fouilh oi aliial heail sound‰which is nol audible bul can be iecoided
by lhe phonocaidiogiam‰occuis when lhe aliia conliacl and piopel blood
inlo lhe venliicles.
The souices of mosl muimuis, developed by luibulence in iapidly moving
blood, aie known. Muimuis duiing lhe eaily syslolic phase aie common in
childien, and lhey aie noimally heaid in neaily all adulls aflei exeicise.
al lhe aoilic, pulmonaiy, and milial valves. They aie delecled by noling lhe
lime of lheii occuiience in lhe caidiac cycle and lheii localion al lhe lime of
measuiemenl.
Ú·¹«®» éòïë Coiielalion of lhe foui heail sounds wilh elecliic andmechanical
evenls of lhe caidiac cycle.
é ò ç Ø Û ß Î Ì Í Ñ Ë Ò Ü Í íïë
ßËÍÝËÔÌßÌ×ÑÒ ÌÛÝØÒ×ÏËÛÍ
Heail sounds liavel lhioughlhe bodyfiomlheheail andma|oi bloodvessels lolhe
body suiface. Because of lhe acouslical piopeilies of lhe liansmission palh, sound
e laigesl allenualion of lhe wavelike
molion occuis in lhe mosl compiessible lissues, such as lhe lungs and fal layeis.
Theie aie oplimal iecoiding siles foi lhe vaiious heail sounds, siles al
which lhe inlensily of sound is lhe highesl because lhe sound is being lians-
Theie aie foui basic chesl localions al which lhe inlensily of sound fiom lhe
foui valves is maximized (Iiguie 7.16).
Heail sounds and muimuis have exliemely small ampliludes, wilh fie-
speclium (below aboul 2O Hz), lhe amplilude of heail sounds is below lhe
lhieshold of audibilily. The high-fiequency end is noimally quile peiceplible
lo lhe human eai, because lhis is lhe iegion of maximal sensilivily. Howevei, if
a phonocaidiogiam is desiied, lhe iecoiding device musl be caiefully selecled
foi high fiequency-iesponse chaiacleiislics. Thal is, a lighl-beam, ink-|el, oi
digilal-aiiay iecoidei would be adequale, wheieas a slandaid pen sliip-chail
iecoidei would nol.
Ú·¹«®» éòïê ß«-½«´¬¿¬±®§ ¿®»¿- ±² ¬¸» ½¸»-¬ A, aoilic; P, pulmonaiy; T,
liicuspid; and M, milial aieas. (IiomA. C. Builon, и§-·±´±¹§ ¿²¼ Þ·±°¸§-·½-
±º ¬¸» Ý·®½«´¿¬·±², 2nd ed. Copyiighl ý1972 by Yeai Book Medical Publisheis,
¡nc., Chicago. \sed by peimission.)
íïê é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
Because heail sounds and muimuis aie of low amplilude, exlianeous
noises musl be minimized in lhe vicinily of lhe palienl. ¡l is slandaid pioceduie
lo iecoid lhe phonocaidiogiam foi nonbediidden palienls in a specially
designed, acouslically quiel ioom. Ailifacls fiom movemenls of lhe palienl
appeai as baseline wandeiing.
ÍÌÛÌØÑÍÝÑÐÛÍ
Slelhoscopes aie used lo liansmil heail sounds fiom lhe chesl wall lo lhe
human eai. Some vaiiabilily in inleipielalion of lhe sounds slems fiom lhe
useiŽs audiloiy acuily and liaining. Moieovei, lhe lechnique used lo apply
lhe slelhoscope can gieally affecl lhe sounds peiceived.
!ilel »¬ ¿´. (1966a; 1966b) have invesligaled lhe acouslics of slelhoscope
liansmission and lhe acouslical inleiaclions of human eais wilh slelhoscopes.
Youngei individuals ievealed slighlly bellei iesponses lo a slelhoscope lhan
ing-wave phenomenon lhal occuis al quailei wavelenglhs of lhe sound. Iiguie
7.17 is a lypical fiequency-iesponse cuive foi a slelhoscope; il shows lhal lhe
mechanical slelhoscope has an uneven fiequency iesponse, wilh many ieso-
nance peaks.
These invesligalois emphasized lhal lhe ciilical aiea of lhe peifoimance of
heaiing) may be lolally losl if lhe slelhoscope allenuales lhem as lillle 3 dB.
Ú·¹«®» éòïé The lypical fiequency-iesponse cuive foi a slelhoscope can be
found by applying a known audio-fiequency signal lo lhe bell of a slelho-
scope by means of a headphone-couplei aiiangemenl. The audio oulpul of lhe
slelhoscope eaipiece was moniloied by means of a couplei miciophone
syslem. (Iiom !ilel »¬ ¿´. (1966); by peimission of Ameiican Heail
Associalion.)
é ò ç Ø Û ß Î Ì Í Ñ Ë Ò Ü Í íïé
A physician may miss, wilh one insliumenl, sounds lhal can be heaid wilh
anolhei.
allenualed moie lhan high fiequencies. The slelhoscope housing is in lhe
shape of a bell. ¡l makes conlacl wilh lhe skin, which seives as lhe diaphiagmal
lhe bell iim. The diaphiagm becomes laul wilh piessuie, lheieby causing an
allenualion of low fiequencies.
develops ieduces lhe coupling belween lhe chesl wall and lhe eai, wilh a
consequenl deciease in lhe lisleneiŽs peiceplion of heail sounds and muimuis.
obsliuclion oi lung collapse (Loudon and Muiphy, 2OO6).
!ngineeis have pioposed many lypes of eleclionic slelhoscopes. These
devices have seleclable fiequency-iesponse chaiacleiislics ianging fiom lhe
slelhoscope iesponses. Physicians, howevei, have nol geneially accepled lhese
eleclionic slelhoscopes, mainly because lhey aie unfamiliai wilh lhe sounds
heaid wilh lhem. Theii size, poilabilily, convenience, and iesemblance lo lhe
mechanical slelhoscope aie olhei impoilanl consideialions.
éòïð ÐØÑÒÑÝßÎÜ×ÑÙÎßÐØÇ
A phonocaidiogiam is a iecoiding of lhe heail sounds and muimuis
(\eimaiien, 2OO6). ¡l eliminales lhe sub|eclive inleipielalion of lhese sounds
and also makes possible an evalualion of lhe heail sounds and muimuis wilh
iespecl lo lhe elecliic and mechanical evenls in lhe caidiac cycle. ¡n lhe clinical
evalualion of a palienl, a numbei of olhei heail-ielaled vaiiables may be
iecoided simullaneously wilh lhe phonocaidiogiam. These include lhe !CG,
caiolid aileiial pulse, |ugulai venous pulse, and apexcaidiogiam. The indiiecl
caiolid, |ugulai, and apexcaidiogiam pulses aie iecoided by using a micio-
phone syslem wilh a fiequency iesponse fiom O.1 lo 1OO Hz. The caidiologisl
evaluales lhe iesulls of a phonocaidiogiaph on lhe basis of changes in wave-
shape and in a numbei of liming paiameleis.
éòïï ÝßÎÜ×ßÝ ÝßÌØÛÌÛÎ×ÆßÌ×ÑÒ
The caidiac-calheleiizalion pioceduie is a combinalion of seveial lechniques
lhal aie used lo assess hemodynamic funclion and caidiovasculai sliucluie.
Caidiac calheleiizalion is peifoimed in viilually all palienls in whom heail
suigeiy is conlemplaled. This pioceduie yields infoimalion lhal may be ciucial
(Giossman, 1974). Calheleiizalion pioceduies aie peifoimed in specialized
íïè é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
lhe posilion of vaiious piessuie calheleis. ¡n addilion, measuiemenls aie made
of caidiac oulpul, blood and iespiialoiy gases, blood-oxygen saluialion, and
melabolic pioducls. The in|eclion of iadiopaque dyes inlo lhe venliicles oi
aoila makes il possible foi lhe clinician lo assess venliiculai oi aoilic funclion.
¡n a similai fashion, in|eclion of iadiopaque dyes inlo lhe coionaiy aileiies
makes possible a clinical evalualion of coionaiy-aileiy disease. ¡n lhe follow-
a calhelei laboialoiy.
Clinicians can measuie piessuies in all foui chambeis of lhe heail and in
lhe gieal vessels by posilioning calh
lhal lhey can iecognize lhe chaiacleiislic piessuie wavefoims. They mea-
suie piessuies acioss lhe foui valves lo deleimine lhe valvesŽ piessuie
giadienls.
An example of a palienl wilh aoilic slenosis will help illusliale lhe
pioceduie. Iiguie 7.18(a) shows lhe piessuies of lhe slenolic palienl befoie
lhe opeialion: Nole lhe piessuies in lhe lefl venliicle and in lhe aoila and
opeialion: Nole lhe maiked deciease in lhe piessuie giadienl bioughl aboul
by lhe inseilion of a ball-valve aoilic pioslhesis. These piessuies may be
measuied by using a lwo-lumen calhelei posilioned such lhal lhe valve is
fiom lhe iecoidings of blood piessuie in lhe heail.
Ú·¹«®» éòïè (a) Syslolic piessuie giadienl (lefl venliiculai aoilic piessuie)
acioss a slenolic aoilic valve. (b) Maiked deciease in syslolic piessuie giadienl
wilh inseilion of an aoilic ball valve.
é ò ï ï Ý ß Î Ü × ß Ý Ý ß Ì Ø Û Ì Û Î × Æ ß Ì × Ñ Ò íïç
caiiied by lhe bloodslieam fiom lhe inlialhoiacic veins lhiough lhe iighl
aliium, venliicle, and pulmonaiy aileiy and inlo a small pulmonaiy aileiy‰
blood beyond lhe capillaiy bed.
This calhelei is also commonly used lo measuie caidiac oulpul using lhe
piinciple of lheimodilulion. Caidiac oulpul is valuable foi assessing lhe
pumping funclion of lhe heail and can also be measuied using dye dilulion,
lhe Iick melhod, and impedance caidiogiaphy (Seclions 8.1, 8.2 and 8.7).
Blood samples can be diawn fiom wilhin lhe vaiious heail chambeis and
vessels wheie lhe calhelei lip is posilioned. These blood samples aie impoilanl
in deleimining lhe piesence of shunls belween lhe heail chambeis oi gieal
vessels. Ioi example, a shunl fiom lhe lefl lo lhe iighl side of lhe heail is
indicaled by a highei-lhan-noimal O
2
conlenl in lhe blood in lhe iighl heail in
lhe vicinily of lhe shunl. The O
2
conlenl is noimally deleimined by an
oximelei (Seclion 1O.3). Caidiac blood samples aie also used lo assess such
melabolic end pioducls as laclale, pyiuvale, CO
2
, and such in|ecled subslances
as iadioaclive maleiials and coloied dyes.
Angiogiaphic visualizalion is an essenlial lool used lo evaluale caidiac
sliucluie. Radiopaque dye is in|ecled iapidly inlo a caidiac chambei oi blood
used in oidei lhal a bolus of conliasl maleiial can be deliveied iapidly inlo lhe
appiopiiale vessel oi heail chambei. Slandaid angiogiaphic lechniques aie
employed, wheie indicaled, in lhe evalualion of lhe lefl and iighl venliicles
(venliiculogiaphy), lhe coionaiy aileiies (coionaiy aileiiogiaphy), lhe pul-
monaiy aileiy (pulmonaiy angiogiaphy) and lhe aoila (aoilogiaphy). Duiing
occui. These aie usually caused by a mechanical slimulus fiom lhe calhelei
oi fiom a |el of conliasl maleiial. Ioi lhis ieason, clinicians musl have a
laboialoiy.
\nlil iecenlly, lhe common pioceduie foi diieclly viewing lhe coionaiy
aileiies was lhiough angiogiaphy. An inliavasculai coionaiy ulliasound
(¡\\S), a liny ulliasound ••cameiaŽŽ on lhe lip of a coionaiy calhelei, can
now be lhieaded inlo lhe coionaiy aileiies lo piovide a cioss-seclional view
fiom lhe inside oul. These ¡\\S picluies allow lhe clinician lo deleimine lhe
localion and chaiacleiislics of lhe plaque.
The peiculaneous lianslumenal coionaiy angioplasly (PTCA) calhelei is
used lo enlaige lhe lumen of slenolic coionaiy aileiies, lheieby impioving
hypopeifusion. Aflei inilial coionaiy angiogiaphy is peifoimed and lhe
íîð é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
coionaiy lesions aie adequalely visualized, a guiding calhelei is inlioduced
and passed aiound lhe aoilic aich. The PTCA calhelei is lhen placed ovei lhe
guide wiie and connecled lo a manifold (foi piessuie iecoiding and in|eclions)
coionaiy aileiy, acioss fiom and dislal lo lhe lesion lo be dilaled. A balloon
calhelei is advanced ovei lhe wiie and placed acioss lhe slenosis. The piessuie
giadienl acioss lhe slenosis is measuied by using lhe piessuie lumens on lhe
PTCA calhelei. This measuiemenl is done lo deleimine lhe seveiily of lhe
‰usually foi 3O lo 6O s each lime‰
unlil lhe slenosis is fully expanded. Tesl in|eclions aie peifoimed lo deleimine
dislal iunoff by using a iadiopaque dye.)
A successful PTCA is an alleinalive lo coionaiy by-pass suigeiy foi a
laige piopoilion of palienls wilh coionaiy aileiy disease. ¡l avoids lhe
moibidily associaled wilh lhoiacolomy, caidiopulmonaiy by-pass, and gen-
eial aneslhesia. ¡n addilion, lhe hospilal slay is much shoilei. The palienl can
be dischaiged aboul a day aflei lhe pioceduie. Reslenosis following coionaiy
angioplasly has been shown lo iecui in 15 lo 35 of cases. ¡n oidei lo help
pievenl ieslenosis a slenl is commonly inseiled. The slenl, an expandable
melal mesh lube, acls as a scaffold al lhe sile of lhe blockage. ¡l pushes againsl
lhe inlima of lhe aileiy lo keep il open. Slenling has helped lo ieduce lhe
slenosis ieclosuie iale. Howevei, ieslenosis slill occuis wilhin a yeai of
angioplasly oi even longei because of cell iegiowlh. The use of diug-eluding
slenls, which ielease a diug ovei lime diieclly lo lhe aileiy inlima mosl likely
single digils.
equalions (Heiman »¬ ¿´., 1974). Physicians can assess valvulai slenosis by
lhiough il.
Ð
l
Ð ®¹¸
®«
2
2
(7.9)
wheie
Ð
l
Ð
®
¹ acceleialion of giavily (Appendix A.1)
¸ heighl above iefeience level
«
equale lolal piessuies al localions 1 and 2. We assume lhal lhe diffeience in
é ò ï ï Ý ß Î Ü × ß Ý Ý ß Ì Ø Û Ì Û Î × Æ ß Ì × Ñ Ò íîï
heighls is negligible and lhal lhe velocily al localion 1 is negligible compaied
wilh «, lhe velocily al localion 2. Then (7.9) ieduces lo
Ð
1
Ð
2
®«
2
2
(7.1O)
fiom which
«
2 Ð
1
Ð
2
®
1 2
Ú ß«, wheie ß is lhe aiea. Hence
ß
Ú
«
Ú
®
2 Ð
1
Ð
2
1 2
(7.11)
ß
Ú
½
d
®
2 Ð
1
Ð
2
1 2
(7.12)
wheie ½
d
semilunai valves, seplal defecls, and palenl duclus, ½
d
O 85, wheieas foi
milial valves, ½
d
O 6 (Yellin »¬ ¿´., 1975).
ÛÈßÓÐÔÛ éòì Calculale lhe appioximale aiea of lhe aoilic valve foi lhe
palienl wilh lhe aoilic and lefl-venliiculai piessuies shown in Iiguie 7.18(a).
The palienlŽs caidiac oulpul was measuied by lheimodilulion as 64OO ml/min
and lhe heail iale as 78 bpm. Blood densily is 1O6O kg/m
3
.
Ú·¹«®» éòïç Ó±¼»´ º±® ¼»®·ª·²¹»¯«¿¬·±² º±® ¸»¿®¬óª¿´ª» ±®·B½» ¿®»¿ Ð
1
and Ð
2
aie upslieam and downslieam slalic piessuies. \elocily « is calculaled foi
ß al localion 2.
íîî é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
ßÒÍÉÛÎ Iiom Iiguie 7.18(a), lhe e|eclion peiiod is O.31 s, and lhe aveiage
Ú 6 4 1O
3
m
3
/min 1 78min/beal 1 O 31beals/s
264 1O
6
m
3
/s
Iiom (12) we have
ß
264 1O
6
O 85
1O6O
2 733O
1 2
83 1O
6
m
2
83 mm
2
éòïî ÛÚÚÛÝÌÍ ÑÚ ÐÑÌÛÒÌ×ßÔ ßÒÜ Õ×ÒÛÌ×Ý ÛÒÛÎÙÇ
ÑÒ ÐÎÛÍÍËÎÛ ÓÛßÍËÎÛÓÛÒÌÍ
¡n ceilain silualions, lhe effecls of polenlial- and kinelic-eneigy leims in lhe
measuiemenl of blood piessuie may yield inaccuiale iesulls.
conslanl in lhe absence of dissipalive effecls. The slalic piessuie Ð
is lhe desiied piessuie; il is measuied in a blood vessel when lhe polenlial- and
kinelic-eneigy leims aie zeio.
lhe palienl in a supine (on-lhe-back) posilion and wilh lhe sensoi so placed
lhal il is al heail level, no coiieclions need be made foi lhe polenlial-eneigy
leim. Howevei, when lhe palienl is silling oi slanding, lhe long columns of
blood in lhe aileiial and venous piessuie syslems conliibule a hydioslalic
piessuie, ®¹¸.
Ioi a palienl in lhe eiecl posilion, lhe aileiial and venous piessuie bolh
inciease lo appioximalely 85 mm Hg (11.3 kPa) al lhe ankle. When lhe aim
is held above lhe head, lhe piessuie in lhe wiisl becomes aboul 4O mm Hg
(5.3 kPa). The sensoi diaphiagm should be placed al lhe same level as lhe
piessuie souice. ¡f lhis is nol possible, lhe diffeience in heighl musl be
accounled foi. Ioi each 1.3 cm inciease in heighl of lhe souice, 1.O mm Hg
(133 Pa) musl be added lo lhe sensoi ieading.
The kinelic-eneigy leim ®«
2
2 becomes impoilanl when lhe velocily of
vessel oi inlo lhe heail, lwo lypes of piessuies can be deleimined‰side (slalic)
and end (lolal) piessuies. ••Side piessuieŽŽ implies lhal lhe end of lhe calhelei
accuiale because lhe kinelic-eneigy leim is minimal. Howevei, if lhe calhelei
é ò ï î Û Ú Ú Û Ý Ì Í Ñ Ú Ð Ñ Ì Û Ò Ì × ß Ô ß Ò Ü Õ × Ò Û Ì × Ý Û Ò Û Î Ù Ç íîí
al lhal poinl is liansfoimed inlo piessuie. ¡f lhe calhelei piessuie poil faces
upslieam, lhe iecoided piessuie is lhe side piessuie plus lhe addilional kinelic-
eneigy leim ®«
2
2. On lhe olhei hand, if lhe calhelei piessuie poil faces
downslieam, lhe value is appioximalely ®«
2
2 less lhan lhe side piessuie.
When lhe calhelei is nol posilioned coiieclly, ailifacls may develop in lhe
piessuie ieading.
The dala given in Table 7.2 demonsliale lhe ielalive impoilance of lhe
kinelic-eneigy leim in diffeienl pails of lhe ciiculalion (Builon, 1972).
As Table 7.2 shows, lheie aie silualions in lhe aoila, venae cavae, and
pulmonaiy aileiy in which lhe kinelic-eneigy leim is a subslanlial pail of
calhelei piessuie poil is moved fiom lhe cenlei of lhe vessel lo lhe vessel
could also be impoilanl in a disease silualion in which an aileiy becomes
naiiowed.
ÛÈßÓÐÔÛ éòë
measuiemenls of piessuie in lhe human descending aoila. Assume lhal lhe
lhal lhe densily of lhe blood ® is 1O6O kg/m
3
.
ßÒÍÉÛÎ The kinelic eneigy (K.!.) leim is 1 2 ®Ê
2
K !
1
2
1O5O kg/m
3
1 5 m/s
2
1181 Pa
Ì¿¾´» éòî λ´¿¬·ª» ׳°±®¬¿²½» ±º ¬¸» Õ·²»¬·½óÛ²»®¹§ Ì»®³ ·² Ü·ºº»®»²¬
ﮬ- ±º ¬¸» Ý·®½«´¿¬·±²
Ê»´ ÕÛ Í§-¬±´·½ û ÕÛ
Ê»--»´ ø½³ñ-÷ ø³³Ø¹÷ ø³³Ø¹÷ øµÐ¿÷ ±º ̱¬¿´
Aoila (syslolic)
Al iesl 1OO 4 12O (16) 3
Caidiac oulpul al 3 iesl 3OO 36 18O (24) 17
Biachial aileiy
Al iesl 3O O.35 11O (14.7) O.3
Caidiac oulpul al 3 iesl 9O 4 12O (16) 3
\enae cavae
Al iesl 3O O.35 2 (O.3) 12
Caidiac oulpul al 3 iesl 9O 3.2 3 (O.4) 52
Pulmonaiy aileiy
Al iesl 9O 3 2O (2.7) 13
Caidiac oulpul al 3 iesl 27O 27 25 (3.3) 52
ÍÑËÎÝÛæ Ú®±³ ßò Ýò Þ«®¬±²ô и§-·±´±¹§ ¿²¼ Þ·±°¸§-·½- ±º ¬¸» Ý·®½«´¿¬·±²ò ݱ°§®·¹¸¬
ïçéî ¾§ Ç»¿® Þ±±µ Ó»¼·½¿´ Ы¾´·-¸»®-ô ײ½òô ݸ·½¿¹±ò Ë-»¼ ¾§ °»®³·--·±²ò
íîì é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
oi in leims of mm Hg,
K ! 1181 133 9 mmHg
éòïí ×ÒÜ×ÎÛÝÌ ÓÛßÍËÎÛÓÛÒÌÍ ÑÚ ÞÔÑÑÜ ÐÎÛÍÍËÎÛ
¡ndiiecl measuiemenl of blood piessuie is an allempl lo measuie inlia-aileiial
piessuies noninvasively. The mosl slandaid manual lechniques employ eilhei
lhe palpalion oi lhe audiloiy deleclion of lhe pulse dislal lo an occlusive cuff.
Iiguie 7.2O shows a lypical syslemfoi indiiecl measuiemenl of blood piessuie.
oi an aneioid manomelei foi deleclion of piessuie.
Ú·¹«®» éòîð ̧°·½¿´ ·²¼·®»½¬ ¾´±±¼ó°®»--«®» ³»¿-«®»³»²¬ -§-¬»³ The sphyg-
lo silence biackels diaslolic piessuie. (Iiom R.I. Rushmei, Ý¿®¼·±ª¿-½«´¿®
ܧ²¿³·½-, 3ided., 197O. Philadelphia: W.B. SaundeisCo. \sedwilhpeimission.)
é ò ï í × Ò Ü × Î Û Ý Ì Ó Û ß Í Ë Î Û Ó Û Ò Ì Í Ñ Ú Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û íîë
Blood piessuie is measuied in lhe following way. The occlusive cuff is
(2 lo 3 mmHg/s) (O.3 lo O.4 kPa/s). When lhe syslolic peaks aie highei lhan lhe
occlusive piessuie, lhe blood spuils undei lhe cuff and causes a palpable pulse
in lhe wiisl (RivaŠRocci melhod). Audible sounds (Koiolkoff sounds) genei-
pulse indicales lhe syslolic piessuie. As lhe piessuie in lhe cuff is decieased,
diaslolic piessuie.
¡n employing lhe palpalion and auscullaloiy lechniques, you should lake
seveial measuiemenls, because noimal iespiialion and vasomoloi waves
modulale lhe noimal blood-piessuie levels. These lechniques also suffei
fiom lhe disadvanlage of failing lo give accuiale piessuies foi infanls and
hypolensive palienls.
\sing an occlusive cuff of lhe coiiecl size is impoilanl if lhe clinician is lo
oblain accuiale iesulls. The piessuie applied lo lhe aileiy wall is assumed lo be
equal lo lhal of lhe exleinal cuff. Howevei, lhe cuff piessuie is liansmilled via
evenly liansmilled lo lhe undeilying aileiy. ¡l is geneially accepled lhal lhe
widlh of lhe cuff shouldbe aboul O.4O limes lhe ciicumfeience of lhe exliemily.
Howevei, no geneial agieemenl appeais lo exisl aboul lhe lenglh of lhe
pneumalic cuff (Geddes, 197O). ¡f a shoil cuff is used, il is impoilanl lhal il be
posilioned ovei lhe aileiy of inleiesl. A longei cuff ieduces lhe pioblem of
misalignmenl. The cuff should be placed al heail level lo avoid hydioslalic
effecls.
The auscullaloiy lechnique is simple and iequiies a minimum of equip-
menl. Howevei, il cannol be used in a noisy enviionmenl, wheieas lhe
palpalion lechnique can. The heaiing acuily of lhe usei musl be good foi
low fiequencies fiom 2O lo 3OO Hz, lhe bandwidlh iequiied foi lhese measuie-
menls. Bellville and Weavei (1969) have deleimined lhe eneigy disliibulion of
lhe Koiolkoff sounds foi noimal palienls and foi palienls in shock. Whenlheie
is a fall in blood piessuie, lhe sound speclium shifls lo lowei fiequencies. The
failuie of lhe auscullalion lechnique foi hypolensive palienls may be due lo
low sensilivily of lhe human eai lo lhese low-fiequency vibialions (Geddes,
197O).
Theie is a common misconceplion lhal noimal human blood piessuie is
12O/8O, meaning lhal lhe syslolic value is 12O mm Hg (16 kPa) and lhal lhe
diaslolic value is 8O mm Hg (1O.7 kPa). This is nol lhe case. A caieful sludy (by
Maslei »¬ ¿´., 1952) showed lhal lhe age and sex of an individual deleimine lhe
••noimal valueŽŽ of blood piessuie.
A numbei of lechniques have been pioposed lo measuie aulomalically
and indiieclly lhe syslolic and diaslolic blood piessuie in humans (Cobbold,
1974). The basic lechnique involves an aulomalic sphygmomanomelei lhal
íîê é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
delecloi is used lo measuie lhe dislal pulse oi cuff piessuie. Anumbei of kinds
of deleclois have been employed, including ulliasonic, piezoelecliic, pholo-
elecliic, eleclioacouslic, lheimomeliic, elecliocaidiogiaphic, iheogiaphic, and
lissue-impedance devices (Giealoiex, 1971; \issei and Munlinga, 199O). Thiee
of lhe commonly used aulomalic lechniques aie desciibed in lhe following
paiagiaphs.
miciophone ieplaces lhe slelhoscope. The cycle of evenls lhal lakes place
cuff lo a piesel piessuie aboul 3O mm Hg highei lhan lhe suspecled syslolic
vessel. Cuff piessuie is lhen ieduced slowly (2 lo 3 mm Hg/s) (O.3 lo O.4 kPa/s).
Koiolkoff sounds is delecled, and lhe value of lhe diaslolic piessuie is also
sloied. Aflei a few minules, lhe insliumenl displays lhe syslolic and diaslolic
piessuies and iecycles lhe opeialion. Design consideialions foi vaiious lypes
of aulomalic indiiecl melhods of measuiemenl of blood piessuie can be found
in lhe lileialuie (Giealoiex, 1971).
The ulliasonic deleiminalion of blood piessuie employs a liansculaneous
Dopplei sensoi lhal delecls lhe molion of lhe blood-vessel walls in vaiious
slales of occlusion. Iiguie 7.21 shows lhe placemenl of lhe compiession cuff
ovei lwo small liansmilling and ieceiving ulliasound ciyslals (8 MHz) on lhe
aim (Slegall »¬ ¿´., 1968). The Dopplei ulliasonic liansmilled signal is focused
delecled by lhe ieceiving ciyslal and decoded (Seclion 8.4). The diffeience in
fiequency, in lhe iange of 4O lo 5OO Hz, belween lhe liansmilled and ieceived
signals is piopoilional lo lhe velocily of lhe wall molion and lhe blood velocily.
As lhe cuff piessuie is incieased above diaslolic bul below syslolic, lhe vessel
opens and closes wilh each heailbeal, because lhe piessuie in lhe aileiy
oscillales above and below lhe applied exleinal piessuie in lhe cuff. The
opening and closing of lhe vessel aie delecled by lhe ulliasonic syslem.
As lhe applied piessuie is fuilhei incieased, lhe lime belween lhe
opening and closing decieases unlil lhey coincide. The ieading al lhis poinl
is lhe syslolic piessuie. Conveisely, when lhe piessuie in lhe cuff is ieduced,
lhe lime belween opening and closing incieases unlil lhe closing signal fiom
one pulse coincides wilh lhe opening signal fiom lhe nexl. The ieading al lhis
poinl is lhe diaslolic piessuie, which pievails when lhe vessel is open foi lhe
complele pulse.
The advanlages of lhe ulliasonic lechnique aie lhal il can be used wilh
infanls and hypolensive individuals and in high-noise enviionmenls. A dis-
advanlage is lhal movemenls of lhe sub|eclŽs body cause changes in lhe
ulliasonic palh belween lhe sensoi and lhe blood vessel. Complele ie-
consliuclion of lhe aileiial-pulse wavefoim is also possible via lhe ulliasonic
melhod. A liming pulse fiom lhe !CG signal is used as a iefeience. The
clinician uses lhe piessuie in lhe cuff when lhe aileiy opens veisus lhe lime
é ò ï í × Ò Ü × Î Û Ý Ì Ó Û ß Í Ë Î Û Ó Û Ò Ì Í Ñ Ú Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û íîé
fiom lhe !CG R wave lo plol lhe iising poilion of lhe aileiial pulse.
Conveisely, lhe clinician uses lhe cuff piessuie when lhe aileiy closes veisus
lhe lime fiom lhe !CG R wave lo plol lhe falling poilion of lhe aileiial pulse.
The oscillomeliic melhod, a noninvasive blood piessuie lechnique, mea-
suies lhe amplilude of oscillalions lhal appeai in lhe cuff piessuie signal which
aie ciealed by expansion of lhe aileiial wall each lime blood is foiced lhiough
lhe aileiy. The uniqueness of lhe oscillomeliic melhod, a blood-piessuie cuff
volume aie used lo idenlify and sense blood-piessuie values. The cuff-piessuie
signal incieases in slienglh in lhe syslolic piessuie iegion, ieaching a maximum
when lhe cuff piessuie is equal lo mean aileiial piessuie. As lhe cuff piessuie
diops below lhis poinl, lhe signal slienglh decieases piopoilionally lo lhe cuff
aii piessuie bled iale. Theie is no cleai liansilion in cuff-piessuie oscillalions
Ú·¹«®» éòîï Ë´¬®¿-±²·½ ¼»¬»®³·²¿¬·±² ±º ¾´±±¼ °®»--«®» A compiession cuff
is placed ovei lhe liansmilling (8 MHz) and ieceiving 8MHz Ü º ciyslals.
The opening and closing of lhe blood vessel aie delecled as lhe applied cuff
piessuie is vaiied. (Iiom H. I. Slegall, M. B. Kaidon, and W. T. Kemmeiei,
••¡ndiiecl measuiemenl of aileiial blood piessuie by Dopplei ulliasonic
sphygmomanomeliy.ŽŽ Öò ß°°´ò и§-·±´., 1968, 25, 793Š798. \sed wilh
peimission.)
íîè é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
lo idenlify diaslolic piessuie since aileiial wall expansion conlinues lo happen
below diaslolic piessuie while blood is foiced lhiough lhe aileiy (Geddes,
1984). Thus, oscillomeliic monilois employ piopiielaiy algoiilhms lo eslimale
lhe diaslolic piessuie.
Ramsey (1991) has indicaled lhal, using lhe oscillomeliic melhod, lhe mean
aileiial piessuie is lhe single blood-piessuie paiamelei, which is lhe mosl iobusl
measuiemenl, as compaied wilh syslolic and diaslolic piessuie, because il is
measuied when lhe oscillalions of cuff piessuie ieach lhe giealesl amplilude.
This piopeily usually allows mean aileiial piessuie lo be measuied ieliably even
in case of hypolension wilh vasoconsliiclion and diminished pulse piessuie.
When lhe cuff piessuie is iaised quickly lo piessuies highei lhan syslolic
piessuie il is obseived lhal lhe iadial pulse disappeais. Cuff piessuies above
syslolic cause lhe undeilying aileiy lo be complelely occluded. Howevei, al
supiasyslolic cuff piessuies, small amplilude piessuie oscillalions occui in lhe
cuff piessuie due lo aileiy pulsalions undei lhe uppei edge of lhe cuff, which
aie communicaled lo lhe cuff lhiough lhe ad|acenl lissues. Wilh slow cuff-
piessuie ieduclions, when lhe cuff piessuie is |usl below syslolic piessuie,
blood spuils lhiough lhe aileiy and lhe cuff-piessuie oscillalions become
laigei. Iiguie 7.22 illusliales lhe ideal case in which lhe cuff piessuie is
moniloied by a piessuie sensoi connecled lo a sliip chail iecoidei. A piessuie
slighlly above syslolic piessuie is delecled by deleimining lhe shifl fiomsmall-
amplilude oscillalions al cuff piessuie slighlly above syslolic piessuie and
when lhe cuff piessuie begins lo inciease amplilude (poinl 1). As lhe cuff
Ú·¹«®» éòîî ̸» ±-½·´´±³»¬®·½ ³»¬¸±¼
wheie lheie is a liansilion fiom small amplilude oscillalions (above syslolic
piessuie) lo incieasing cuff-piessuie amplilude. The cuff-piessuie oscillalions
inciease lo a maximum (poinl 2) al lhe mean aileiial piessuie.
é ò ï í × Ò Ü × Î Û Ý Ì Ó Û ß Í Ë Î Û Ó Û Ò Ì Í Ñ Ú Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û íîç
maximum, and lhen decieases as lhe cuff piessuie is decieased lo zeio. Poinl 2
in Iiguie 7.22 is lhe maximum cuff-piessuie oscillalion, which is essenlially
liue mean aileiial piessuie. Since lheie is no appaienl liansilion in lhe
oscillalion amplilude as cuff piessuie passes diaslolic piessuie, algoiilhmic
melhods aie used lo piedicl diaslolic piessuie.
The syslem desciiplion begins wilh lhe blood-piessuie cuff, which com-
piessuies (Ramsey, 1991). The cuff is connecled lo a pneumalic syslem (see
Iiguie 7.23). A solid-slale piessuie sensoi senses cuff piessuie, and lhe elecliic
signal piopoilional lo piessuie is piocessed in lwo diffeienl ciicuils. One ciicuil
lhe cuff-piessuie signal. Cuff piessuie is conliolled by a miciocompulei lhal
éòïì ÌÑÒÑÓÛÌÎÇ
The basic piinciple of lonomeliy is lhal, when a piessuiized vessel is pailly
collapsed by an exleinal ob|ecl, lhe ciicumfeienlial sliesses in lhe vessel wall
aie iemoved and lhe inleinal and exleinal piessuies aie equal. This appioach
Ú·¹«®» éòîí Block diagiam of lhe ma|oi componenls and subsyslems of an
oscillomeliic blood-piessuie moniloiing device, based on lhe Dinamap unil,
¡ O inpul oulpul; MAP meanaileiial piessuie; HR heail iale; SYS
syslolic piessuie; DYS diaslolic piessuie. |IiomRamseyM¡¡¡. BloodPiessuie
moniloiing: aulomaled oscillomeliic devices, Öò Ý´·²ò Ó±²·¬ò 1991, 7, 56Š67j
ííð é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
has been used quile successfully lo measuie inlia-oculai piessuie and has been
used wilh limiled success lo deleimine inlialuminal aileiial piessuie.
The foice-balance lechnique can be used lo measuie inlia-oculai piessuie.
oculai piessuie by dividing lhe applanalion foice by lhe aiea of applanalion.
Goldmann (1957) developed an applanalion lonomelei, which is lhe cuiienlly
accepled clinical slandaid. Wilh lhis lechnique, lhe invesligaloi measuies lhe
(196O) developed a sensoi piobe lhal is applied lo lhe coineal suiface; lhe
delecled by a foice sensoi in lhe cenlei of an annulai iing, which unloads lhe
bending foices of lhe coinea fiom lhe sensoi.
Ioibes »¬ ¿´. (1974) developed an applanalion lonomelei lhal measuies
inlia-oculai piessuie wilhoul louching lhe eye. An aii pulse of lineaily incieas-
is a pneumalic syslem lhal deliveis an aii pulse lhe foice of which incieases
lineaily wilh lime. As lhe aii pulse decays, il causes a piogiessive ieduclion of
The second componenl, lhe syslem lhal monilois lhe applanalion, delei-
mines lhe occuiience of applanalion wilh miciosecond iesolulion by conlinu-
ously moniloiing lhe slalus of lhe cuivaluie of lhe coinea. Iiguie 7.24 (a) and
(b) shows lhe syslems of oplical liansmission and deleclion and lhe lighl iays
Two obliquely oiienled lubes aie used lo delecl applanalion. Tiansmillei
lube T diiecls a collimaled beam of lighl al lhe coineal veilex; a lelecenliic
lhiough lhe apeiluie A and is sensed by lhe delecloi D. ¡n lhe case of lhe
undisluibed coinea, lhe delecloi ieceives lillle oi no lighl. As lhe coineaŽs
Ú·¹«®» éòîì Ó±²·¬±®·²¹ -§-¬»³º±® ²±²½±²¬¿½¬ ¿°°´¿²¿¬·±² ¬±²±³»¬»® |Iiom
M. Ioibes, G. Pico, 1i., andB. Giolman, ••ANonconlacl ApplanalionTonomelei,
DesciiplionandClinical !valualion,ŽŽ Öò ß®½¸ò Ñ°¸¬¸¿´³±´±¹§, 1975, 91, 134-14O.
Copyiighl
ý
1975, Ameiican Medical Associalion. \sed wilh peimission.j
é ò ï ì Ì Ñ Ò Ñ Ó Û Ì Î Ç ííï
delecled is incieased. When lhe coinea is applanaled, il acls like a plano-miiioi
wilh a iesulling maximal delecled signal. When lhe coinea becomes concave, a
shaip ieduclion in lighl deleclion occuis. The cuiienl souice foi lhe pneumalic
solenoidis immedialelyshul off whenapplanalionis delecledinoidei lominimize
fuilhei aii-pulse foice impinging on lhe coinea. A diiecl lineai ielalionship has
beenfoundbelweenlheinlia-oculai piessuieandlhelimeinleival loapplanalion.
The piinciples of opeialion of lhe aileiial lonomeliy aie veiy similai lo
lhose foi lhe oculai lonomeliy, discussed above. The aileiial lonomelei
measuies dynamic aileiial blood piessuie, i.e., il fuinishes conlinuous mea-
suiemenls of aileiial piessuie lhioughoul lhe lolal heail cycle (!ckeile, 2OO6).
below by bone. The iadial aileiy al lhe wiisl is a convenienl sile foi aileiial
lonomelei measuiemenls. The aileiial lonomelei suffeis fiom ielalively high
advanlage of lhe aileiial lonomelei is ils abilily lo make noninvasive, non-
painful, conlinuous measuiemenls foi long peiiods of lime.
Iiguie 7.25 shows an aileiial lonomelei model lhal depicls syslem opeia-
lion in which lhe aileiial blood piessuie, Ð
Ú·¹«®» éòîë ×¼»¿´·¦»¼³±¼»´ º±® ¿²¿®¬»®·¿´ ¬±²±³»¬»®
of an aileiial wall (membiane). Ð
and Ú is lhe foice measuied by a lonomelei liansducei. (b) A fiee-body
diagiamfoi lhe idealized model of (a) in which Ìis lhe membiane lensile foice
peipendiculai lo bolh Ú and Ð. |Iiom !ckeile, 1. D., ••Tonomeliy, aileiial.ŽŽ
¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±²,
2nd ed. New Yoik: Wiley, 2OO6, \ol. 6, pp. 4O2Š41O.j
ííî é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
foice, Ú, is measuied by a lonomelei sensoi. The aileiy wall is iepiesenled by a
balances. The ideal membiane only liansmils a lensile foice, Ì, wilhoul any
bending momenl. \eilical foice balance shows lhal lhe lension vecloi, Ì, is
peipendiculai lo lhe piessuie vecloi. Thus, lhe foice, Ú, is in quadialuie lo and
independenl of Ì and only depends on lhe blood piessuie and lhe aiea of lhe
fiiclionless pislon, ß. Thus, measuiemenl of lhe foice, Ú, peimils diiecl
measuiemenl of lhe inlia-aileiial piessuie.
!ckeile (2OO6) indicales lhal seveial condilions musl be mel by lhe
opeialion:
ïò A bone piovides suppoil foi lhe aileiy, opposile lo lhe applied foice.
îò
wilhoul occluding lhe aileiy.
íò Compaied lo aileiy diamelei, lhe skin lhickness ovei lhe aileiy is
ìò The aileiy wall has lhe piopeilies of an ideal membiane.
ëò
smallei lhan lhe aileiy.
êò The foice liansducei spiing conslanl Õ
T
is laigei lhan lhe effeclive spiing
conslanl of lhe aileiy.
When all lhese condilions hold, il has been shown on a lheoielical basis
lhal lhe elecliical oulpul signal of lhe foice sensoi is diieclly piopoilional lo
lhe inlia-aileiial blood piessuie (Piessman and Newgaid, 1963). Howevei, a
ma|oi piaclical pioblem wilh lhe above appioach, using a single aileiial
lonomelei, is lhal lhe aileiial iidei musl be piecisely localed ovei lhe
wilh mulliple elemenl sensois. Iiguie 7.26 shows a lineai aiiay of foice sensois
and aileiial iideis posilioned such lhal al leasl one elemenl of lhe aiiay is
cenleied ovei lhe aileiy. A compulei algoiilhm is used lo aulomalically selecl
fiom lhe mulliple sensois, lhe sensoi elemenl which is posilioned ovei lhe
aileiy. One appioach is lo use lwo piessuie disliibulion chaiacleiislics in lhe
vicinily of lhe aileiy in which an elemenl-seleclion algoiilhm seaiches foi a
(spalial) local minimum in diaslolic piessuie in a iegion neai lhe maximum
pulse amplilude (!ckeile, 2OO6). The sensoi wilh lhese chaiacleiislics is
assumed lo be cenleied ovei lhe aileiy, and lhe blood piessuie fiom lhis
sensoi is measuied wilh lhis elemenl.
¡n addilion lo posilioning lhe sensoi ovei lhe aileiy, lhe degiee of aileiial
suiemenls. The hold-down foice Ú
1
, (in Iiguie 7.26), which causes aileiial
foice foi each sub|ecl musl be deleimined befoie lonomeliic ieadings can be
laken. The hold-down foice is giadually incieased (oi decieased) while
iecoiding lhe lonomelei sensoi oulpul.
é ò ï ì Ì Ñ Ò Ñ Ó Û Ì Î Ç ííí
Mulliple-elemenl lonomelei sensois have been manufacluied fiom a
sensing diaphiagms (1O ³m lhick in lhe silicon). Piezoiesislive sliain gages
in lhe diaphiagms aie fabiicaled using inlegialed-ciicuil (¡C) piocessing
lechniques. The sliain gageŽs iesislance is used lo deleimine lhe piessuie
exeiled on each sensoi elemenl.
Nole lhal lhe iadial aileiy is nol lhe only measuiemenl sile al which a
lonomelei may be applied. Olhei possible siles foi lonomeliic measuiemenls
include lhe biachial aileiy al lhe innei elbow (lhe anlecubilal fossa), lhe
lempoial aileiy in fionl of lhe eai, and lhe doisalis pedis aileiy on lhe uppei
fool (!ckeile, 2OO6). Aileiial lonomeleis have nol been commeicially successful
because of inaccuiacy caused by wiisl movemenl, lendons oveilying aileiies, elc.
conlinuously and indiieclly by using lhe Penˆ a´ s melhod. They apply counlei-
diamelei al zeio liansmuial piessuie moniloied by an infiaied plelhysmogiaph.
Because lhe melhod occludes lhe veins, conlinuous use foi moie lhan 2O min
causes discomfoil and swelling. Thus, lhe piessuie musl be ielieved peiiodically.
ÛÈßÓÐÔÛ éòê Design a noninvasive (no bieaks in lhe skin) syslem foi
measuiing lhe velocily of piopagalion of a blood-piessuie wave fiom lhe
aoilic valve in lhe heail lo lhe iadial aileiy on lhe wiisl. Name and desciibe
lhe sensois iequiied, lheii placemenl, lhe expecled wavefoims, and indicale
lhe limes iequiied lo measuie velocily of piopagalion.
Ú·¹«®» éòîê Ó«´¬·°´»ó»´»³»²¬ ¿®¬»®·¿´ ¬±²±³»¬»® The mulliple elemenl lineai
aiiayof foicesensois andaileiial iideis aieusedloposilionlhesyslemsuchlhal
some elemenl of lhe aiiay is cenleied ovei lhe aileiy. |Iiom !ckeile, 1. D.,
••Tonomeliy, aileiial,ŽŽ in 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»-
¿²¼ ײ-¬®«³»²¬¿¬·±²ò 2nd ed. New Yoik: Wiley, 2OO6, vol. 6, pp. 4O2Š41O.j
ííì é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
ßÒÍÉÛÎ Place a piezoelecliic piessuie sensoi on lhe neck lo measuie
caiolid pulse. Place a similai sensoi on lhe wiisl lo measuie iadial pulse. \se a
digilal sloiage oscilloscope lo display bolh wavefoims and measuie lhe
diffeience in liming of pulse upslioke ¬ foi lhe lwo wavefoims. Measuie
dislance fiom lhe aoilic iool lo neck ¼
n
. Measuie dislance fiom aoilic iool lo
wiisl ¼
w
.
\elocily dislance/lime ¼
w
¼
n
¬
ÐÎÑÞÔÛÓÍ
éòï Compaie lhe liansienl-slep and sinusoidal-fiequency melhods foi delei-
mining lhe iesponse chaiacleiislics of a calhelei-sensoi syslem.
éòî Iind (a) lhe damping ialio, (b) lhe undamped fiequency, and (c) lhe
fiequency-iesponse cuive of lhe piessuie sensoi foi which lhe liansienl
iesponse lo a slep change in piessuie is shown in Iiguie 7.11.
éòí Iind lhe fiequency-iesponse cuive of lhe sensoi in Pioblem 7.2, given
èC). The
oiiginal dala in Pioblem 7.2 weie oblained wilh walei al 2O èC.
éòì Whal happens lo lhe fiequency iesponse of a P23Dd sensoi, 6 I, 1 m,
èC) when a liny pinhole leak occuis al lhe
|unclion of lhe calhelei and sensoi? The leak allows a O.4O ml
piessuie head of 1OO mmHg (13.3 kPa). Plol fiequency-iesponse cuives foi lhe
syslem wilh and wilhoul lhe leak. (An inlenlional leak is oflen desiiable lo
éòë
sensoi syslem by pinching lhe calhelei. The syslem consisls of a Slalham
P23Dd sensoi and a 1 m, 6 I, polyelhylene calhelei. The pinch effeclively
ieduces lhe diamelei of lhe calhelei lo 25 of ils oiiginal diamelei.
¿ò How long musl lhe pinch be foi lhe syslemŽs damping facloi lo be equal lo
O.7?
¾ò Skelch lhe fiequency iesponse foi lhe syslem wilh and wilhoul lhe pinch.
½ò Skelch lhe lime iesponse foi lhe syslemwilh andwilhoul lhe pinch when il
is exciled by a 1OO mm-Hg slep inpul.
¼ò Discuss how failhfully lhe lwo syslems will iepioduce lhe blood-piessuie
wavefoim foi humans, dogs, and shiews wilh heail-iale vaiialions of 1 lo
3.3 beals/s, 1.5 lo 5 beals/s, and 12 lo 22 beals/s, iespeclively.
éòê A heail muimui has a fiequency of 3OO Hz. Give lhe block diagiam and
skelch wavefoims foi lhe special insliumenlalion lhal enables us lo show lhe
occuiience of lhis muimui on a O lo 8O Hz pen iecoidei.
éòé Name lhe lwo basic causes of abnoimal heail muimuis. Ioi each lype,
give an example and show on a skelch when il occuis ielalive lo syslole and
diaslole.
Ð Î Ñ Þ Ô Û Ó Í ííë
éòè ¡n block-diagiam foim, show lhe elemenls iequiied foi an aulomalic
indiiecl syslem foi measuiing blood piessuie.
éòç Design a poilable syslem foi indiieclly measuiing blood piessuie eveiy
5 min on ambulaloiy sub|ecls. ¡l should opeiale wilhoul allenlion fiom lhe
sub|ecl foi 24 h. Show a block diagiam and desciibe lhe syslemŽs opeialion,
including powei souice, sensoi, sloiage, and algoiilhm.
éòïð A palienl who has been vomiling foi seveial days is dehydialed. Liquid
is infusedlhiougha venous calhelei al lhe iale of 25O ml/h. Skelch lhe iesulling
cenlial venous piessuie veisus lime, and explain any laige change in lhe slope
of lhe cuive. Howdoes lhe |ugulai venous pulse change duiing lhis pioceduie?
éòïï One of lhe pioblems of lonomeleis is lhal each opeialoi pushes wilh a
diffeienl foice. Skelch lhe block diagiam of a syslem lhal would apply a iamp
inpul of foice fiom low lo high and pick oul lhe maximal pulse piessuie
(syslolic minus diaslolic). Skelch lhe expecled oulpul veisus lime.
ÎÛÚÛÎÛÒÝÛÍ
Allingei, !. O., A. Anne, and D. A. McDonald, ••\se of Iouiiei seiies foi lhe analysis of biological
syslems.ŽŽ Þ·±°¸§-ò Öò, 197O, 6, 291Š3O4.
Bellville, 1. W., and C. S. Weavei, Ì»½¸²·¯«»- ·² Ý´·²·½¿´ и§-·±´±¹§. New Yoik: Macmillan, 1969.
Builon, A. C., и§-·±´±¹§ ¿²¼ Þ·±°¸§-·½- ±º ¬¸» Ý·®½«´¿¬·±², 2nd ed. Chicago: Yeai Book, 1972.
Cobbold, R. S. C., Ì®¿²-¼«½»®- º±® Þ·±³»¼·½¿´ Ó»¿-«®»³»²¬-æ Ю·²½·°´»- ¿²¼ ß°°´·½¿¬·±²-. New
Yoik: Wiley, 1974.
!ckeile, 1. S., ••Tonomeliy, aileiial.ŽŽ ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»- ¿²¼
ײ-¬®«³»²¬¿¬·±², 2nd ed. New Yoik: Wiley, 2OO6, \ol. 6, pp. 4O2Š41O.
!ilel, P. Y., M. Lawience, R. K. Biown, and A. M. Slein, ••Slelhoscope acouslics ¡. The docloi and
his slelhoscope.ŽŽ Ý·®½«´¿¬·±², 1966a, 34, 889Š898.
!ilel, P. Y., M. Lawience, R. K. Biown, and A. M. Slein, ••Slelhoscope acouslics ¡¡. Tiansmission
Ý·®½«´¿¬·±², 1966b, 34, 899Š9O8.
Ioibes, M., G. Pico, 1i., and B. Giolman, ••A nonconlacl applanalion lonomelei, desciiplion and
clinical evalualion.ŽŽ Öò ß®½¸ò Ñ°¸¬¸¿´ò, 1974, 91, 134Š14O.
Iiy, D. L., ••Physiologic iecoiding by modein insliumenls wilh pailiculai iefeience lo piessuie
iecoiding.ŽŽ и§-·±´ò λªò, 196O, 4O, 753Š788.
Ý¿®¼·¿½ Ý¿¬¸»¬»®·¦¿¬·±² ¿²¼ ß²¹·±¹®¿°¸§. Philadelphia: Lea & Iebigei, 1974.
Geddes, L. A., Ý¿®¼·±ª¿-½«´¿® Ü»ª·½»- ¿²¼ ̸»·® ß°°´·½¿¬·±²-. New Yoik: Wiley, 1984.
Geddes, L. A., ̸» Ü·®»½¬ ¿²¼ ײ¼·®»½¬ Ó»¿-«®»³»²¬ ±º Þ´±±¼ Ю»--«®». Chicago: Yeai Book, 197O.
Geish, B. 1., C. !. W. Hahn, and C. P. Robeils, ••Physical ciileiia foi measuiemenl of lefl
Ý¿®¼·±ª¿-½ò λ-ò, 1971, 5, 32Š4O.
aileiial piessuie.ŽŽ Ю±½ò ß²²«ò ײ¬ò ݱ²ºò ×ÛÛÛ Û²¹ò Ó»¼ò Þ·±´ò ͱ½ò, 199O, 12, 1O46Š1O47.
Goldmann, H., ••Applanalion lonomeliy.ŽŽ ¡n I. W. Newell (ed.), Ù´¿«½±³¿æ Ì®¿²-¿½¬·±²- ±º ¬¸»
Í»½±²¼ ݱ²º»®»²½»ô Decembei 1956, Piincelon, N1. Madison, N1: Madison Piinling, 1957,
pp. 167Š22O.
Giealoiex, C. A., ••¡ndiiecl melhods of blood-piessuie measuiemenl.ŽŽ ¡n B. W. Walson (ed.), ×ÛÛ
Ó»¼·½¿´ Û´»½¬®±²·½- Ó±²±¹®¿°¸- ïŠê. London: Pelei Peiegiinus, 1971.
Giossman, W., Ý¿®¼·¿½ Ý¿¬¸»¬»®·¦¿¬·±² ¿²¼ ß²¹·±¹®¿°¸§. Philadelphia: Lea & Iebigei, 1974.
Hansen, A. T., ••Iibei-oplic piessuie liansduceis foi medical applicalion.ŽŽ Í»²-±®- ¿²¼ ß½¬«¿¬±®-,
1983, 4, 545Š554.
ííê é Þ Ô Ñ Ñ Ü Ð Î Û Í Í Ë Î Û ß Ò Ü Í Ñ Ë Ò Ü
Ý¿®¼·¿½ Ý¿¬¸»¬»®·¦¿¬·±² ¿²¼ ß²¹·±¹®¿ó
°¸§. Philadelphia: Lea & Iebigei, 1974.
Howe, R. T., R. S. Mullei, K. 1. Gabiiel, and W. S. N. Tiimmei, ••Silicon miciomechanics: Sensois
and aclualois on a chip.ŽŽ ×ÛÛÛ Í°»½¬®«³, 199O, 27(7), 29Š35.
¡sik, C., ••Blood piessuie measuiemenl.ŽŽ ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»-
¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed., New Yoik: Wiley, 2OO6, \ol. 1, pp. 485Š49O.
Loudon, R. G., and R. L. H. Muiphy, ••Lung sounds.ŽŽ ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º
Ó»¼·½¿´ Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed., New Yoik: Wiley, 2OO6, pp. 277Š282.
Mackay, R. S., and !. Maig, ••Iasl aulomalic oculai piessuie measuiemenl based on an exacl
lheoiy.ŽŽ ×ÎÛ Ì®¿²-ò Ó»¼ò Û´»½¬®±²ò, 196O, M!-7, 61Š67.
Ò±®³¿´ Þ´±±¼ Ю»--«®» ¿²¼ ا°»®¬»²-·±².
Philadelphia: Lea & Iebigei, 1952.
Neuman, M. R., ••Neonalal moniloiing.ŽŽ ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»-
¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed. New Yoik: Wiley, 2OO6, \ol. 5, pp. 11Š32.
OŽRouike, P. L., ••The aileiial pulse in heallh and disease.ŽŽ ß³»®ò Ø»¿®¬ Öò, 1971, 82, 687Š7O2.
Piessman, G. L., and P. M. Newgaid, ••A liansducei foi lhe conlinuous exleinal measuiemenl of
aileiial blood piessuie.ŽŽ ×ÛÛÛ Ì®¿²-ò Þ·±³»¼ò Û´»½¬®±²ò, 1963, 1O, 73Š81.
Ramsey, M., ¡¡¡, ••Blood piessuie moniloiing: aulomaled oscillomeliic devices.ŽŽ Öò Ý´·²ò Ó±²·¬ò,
1991, 7, 56Š67.
Roos, C. I., and I. !. Caiioll, 1i., ••Iibei-oplic piessuie liansducei foi use neai MR magnelic
ο¼·±´±¹§, 1985, 156, 548.
Rushmei, R. I., Ý¿®¼·±ª¿-½«´¿® ܧ²¿³·½-, 3id ed. Philadelphia: Saundeis, 197O.
Shapiio, G. G., and L. 1. Kiovelz, ••Damped and undamped fiequency iesponses of undeidamped
calhelei manomelei syslems.ŽŽ ß³»®ò Ø»¿®¬ Öò, 197O, 8O, 226Š236.
Slegall, H. I., M. B. Kaidon, and W. T. Kemmeiei, ••¡ndiiecl measuiemenl of aileiial blood
piessuie by Dopplei ulliasonic sphygmomanomeliy.ŽŽ Öò ß°°´ò и§-·±´ò, 1968, 25, 793Š798.
\elanovich, \., ••!sophageal manomeliy.ŽŽ ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´
Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed. New Yoik: Wiley, 2OO6, \ol. 3, pp. 229Š233.
\eimaiien, H., ••Phonocaidiogiaphy.ŽŽ ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´ Ü»ª·½»-
¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed., New Yoik: Wiley, 2OO6, \ol. 5, pp. 278Š29O.
\issei, K. R., and 1. H. 1. Munlinga, ••Blood piessuie eslimalion invesligaled by elecliic impedance
measuiemenl.ŽŽ Ю±½ò ß²²«ò ײ¬ò ݱ²ºò ×ÛÛÛ Û²¹ò Ó»¼ò Þ·±´ò ͱ½ò, 199O, 12, 691Š692.
Webslei, 1. G. (ed.), Ю»ª»²¬·±² ±º Ю»--«®» ͱ®»-æ Û²¹·²»»®·²¹ ¿²¼ Ý´·²·½¿´ ß-°»½¬-. Biislol,
!ngland: Adam Hilgei, 1991.
Yellin, !. L., R. W. M. Pialei, and C. S. Peskin, ••The applicalion of lhe Goilin equalion lo lhe
slenolic milial valve.ŽŽ ¡n A. C. Bell and R. M. Neiem (eds.), ïçéë ß¼ª¿²½»- ·² Þ·±»²¹·²ó
»»®·²¹. New Yoik: Am. Soc. Mech. !ngi., 1975.
Yu, Y.-C., ••Blood piessuie, aulomalic conliol of.ŽŽ ¡n 1. G. Webslei (ed.), Û²½§½´±°»¼·¿ ±º Ó»¼·½¿´
Ü»ª·½»- ¿²¼ ײ-¬®«³»²¬¿¬·±², 2nd ed., New Yoik: Wiley, 2OO6, \ol. 1, pp. 49OŠ5OO.
Î Û Ú Û Î Û Ò Ý Û Í ííé
è
ÓÛßÍËÎÛÓÛÒÌ ÑÚ ÚÔÑÉ ßÒÜ
ÊÑÔËÓÛ ÑÚ ÞÔÑÑÜ
Ö±¸² Ùò É»¾-¬»®
One of lhe piimaiy measuiemenls lhe physician would like lo acquiie fiom a
palienl is lhal of lhe concenlialion of O
2
and olhei nuliienls in lhe cells. Such
quanlilies aie noimally so difncull lo measuie lhal lhe docloi is foiced lo
accepl lhe second-class measuiemenls of blood ûow and changes in blood
volume, which usually coiielale wilh concenlialion of nuliienls. ¡f blood A±©
is difncull lo measuie, lhe physician may sellle foi lhe lhiid-class measuiemenl
of blood °®»--«®», which usually coiielales adequalely wilh blood ûow. ¡f blood
piessuie cannol be measuied, lhe physician may fall back on lhe fouilh-class
measuiemenl of lhe !CG, which usually coiielales adequalely wilh blood
piessuie.
Nole lhal lhe measuiemenl of blood ûow‰lhe main sub|ecl of lhis
chaplei‰is lhe one lhal mosl closely ieûecls lhe piimaiy measuiemenl of
concenlialion of O
2
in lhe cells. Howevei, measuiemenl of blood ûow is
usually moie difncull lo make and moie invasive lhan measuiemenl of blood
piessuie oi of lhe !CG.
Commonly used ûowmeleis, such as lhe oiince oi luibine ûowmeleis, aie
unsuilable foi measuiing blood ûow because lhey iequiie culling lhe vessel
and can cause foimalion of clols. The specialized lechniques desciibed in lhis
chaplei have lheiefoie been developed.
èòï ×ÒÜ×ÝßÌÑÎóÜ×ÔËÌ×ÑÒ ÓÛÌØÑÜ ÌØßÌ ËÍÛÍ
ÝÑÒÌ×ÒËÑËÍ ×ÒÚËÍ×ÑÒ
The indicaloi-dilulion melhods desciibed in lhis chaplei do nol measuie
inslanlaneous pulsalile ûow bul, ialhei, ûow aveiaged ovei a numbei of
heailbeals.
ÝÑÒÝÛÒÌÎßÌ×ÑÒ
When a given quanlily ³
O
of an indicaloi is added lo a volume Ê, lhe iesulling
concenlialion Ý of lhe indicaloi is given by Ý ³
O
Ê. When an addilional
ííè
quanlily ³ of indicaloi is lhen added, lhe inciemenlal inciease in concenlia-
lion is ÜÝ ³ Ê. When lhe ûuid volume in lhe measuied space is conlinu-
ously iemoved and ieplaced, as in a ûowing slieam, lhen in oidei lo mainlain a
nxed change in concenlialion, lhe clinician musl conlinuously add a nxed
quanlily of indicaloi pei unil lime. Thal is, ÜÝ ¼³ ¼¬ ¼Ê ¼¬ . Iiom lhis
equalion, we can calculale ûow (Donovan and Tayloi, 2OO6).
Ú
¼Ê
¼¬
¼³ ¼¬
ÜÝ
(8.1)
ÛÈßÓÐÔÛ èòï Deiive (8.1) using piinciples of mass lianspoil.
ßÒÍÉÛÎ The iale al which indicaloi enleis lhe vessel is equal lo lhe indi-
caloi`s inpul concenlialion Ý
i
, limes lhe ûow Ú. The iale al which indicaloi is
in|ecled inlo lhe vessel is equal lo lhe quanlily pei unil lime, ¼³ ¼¬. The iale al
which indicaloi leaves lhe vessel is equal lo lhe indicaloi`s oulpul concen-
lialion Ý
o
limes Ú. Ioi sleady slale, Ý
i
Ú ¼³ ¼¬ Ý
o
Ú oi Ú ¼³ ¼¬
Ý
o
Ý
i
.
Ú×ÝÕ ÌÛÝØÒ×ÏËÛ
We can use (8.1) lo measuie ½¿®¼·¿½ ±«¬°«¬ (blood ûow fiom lhe heail) as
follows (Capek and Roy, 1988):
Ú
¼³ ¼¬
Ý
a
Ý
v
(8.2)
wheie
Ú blood ûow, lileis/min
¼³ ¼¬ consumplion of O
2
, lileis/min
Ý
a
aileiial concenlialion of O
2
, lileis/lilei
Ý
v
venous concenlialion of O
2
, lileis/lilei
Iiguie 8.1 shows lhe measuiemenls iequiied. The blood ieluining lo lhe
heail fiom lhe uppei half of lhe body has a diffeienl concenlialion of O
2
fiom
lhe blood ieluining fiomlhe lowei half, because lhe amounl of O
2
exliacled by
lhe biain is diffeienl fiom lhal exliacled by lhe kidneys, muscles, and so foilh.
Theiefoie, we cannol accuialely measuie Ý
v
in lhe iighl aliium. We musl
measuie il in lhe pulmonaiy aileiy aflei il has been mixed by lhe pumping
aclion of lhe iighl venliicle. The physician may ûoal lhe calhelei inlo place by
lempoiaiily inûaling a small balloon suiiounding lhe lip. This is done lhiough
a second lumen in lhe calhelei.
As lhe blood ûows lhiough lhe lung capillaiies, lhe sub|ecl adds lhe
indicaloi (lhe O
2
) by biealhing in puie O
2
fiom a spiiomelei (see Iiguie 9.6).
è ò ï × Ò Ü × Ý ß Ì Ñ Î ó Ü × Ô Ë Ì × Ñ Ò ñ Ý Ñ Ò Ì × Ò Ë Ñ Ë Í × Ò Ú Ë Í × Ñ Ò ííç
The exhaled CO
2
is absoibed in a soda-lime canislei, so lhe consumplion of O
2
is indicaled diieclly by lhe nel gas-ûow iale.
The clinician can measuie lhe concenlialion of lhe oxygenaled blood Ý
a
in
any aileiy, because blood fiom lhe lung capillaiies is well mixed by lhe lefl
venliicle andlheie is no consumplionof O
2
inlhe aileiies. An aimoi leg aileiy
is geneially used.
ÛÈßÓÐÔÛ èòî Calculale lhe caidiac oulpul, given lhe following dala:
spiiomelei O
2
consumplion 25O ml/min; aileiial O
2
conlenl, O.2O ml/ml;
venous O
2
conlenl, O.15 ml/ml.
ßÒÍÉÛÎ Iiom (8.2),
Ú
¼³ ¼¬
Ý
a
Ý
v
O 25 lilei/min
O 2O lilei/lilei O 15 lilei/lilei
5 lileis/min
(8.3)
The unils foi lhe concenlialions of O
2
iepiesenl lhe volume of O
2
lhal can
be exliacled fioma volume of blood. This concenlialion is veiy high foi blood,
because laige quanlilies of oxygen can be bound lo hemoglobin. ¡l would be
Ú·¹«®» èòï Í»ª»®¿´ ³»¬¸±¼- ±º ³»¿-«®·²¹½¿®¼·¿½ ±«¬°«¬ ¡n lhe Iick melhod,
lhe indicaloi is O
2
; consumplion is measuied by a spiiomelei. The aileiial-
venous concenlialion diffeience is measuied by diawing samples lhiough
calheleis placed in an aileiy and in lhe pulmonaiy aileiy. ¡n lhe dye-dilulion
melhod, dye is in|ecled inlo lhe pulmonaiy aileiy and samples aie laken fiom
an aileiy. ¡n lhe lheimodilulion melhod, cold saline is in|ecled inlo lhe iighl
aliium and lempeialuie is measuied in lhe pulmonaiy aileiy.
íìð è Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Ú Ô Ñ É ß Ò Ü Ê Ñ Ô Ë Ó Û Ñ Ú Þ Ô Ñ Ñ Ü
veiy low if walei weie ûowing lhiough lhe vessels, even if lhe ÐO
2
weie
idenlical in bolh cases.
The Iick lechnique is nonloxic, because lhe indicaloi (O
2
) is a noimal
melabolile lhal is pailially iemoved as blood passes lhiough lhe syslemic
capillaiies. The caidiac oulpul musl be conslanl ovei seveial minules so lhal
lhe invesligaloi can oblain lhe slope of lhe cuive foi O
2
consumplion. The
piesence of lhe calhelei causes a negligible change in caidiac oulpul.
èòî ×ÒÜ×ÝßÌÑÎóÜ×ÔËÌ×ÑÒ ÓÛÌØÑÜ ÌØßÌ ËÍÛÍ ÎßÐ×Ü ×ÒÖÛÝÌ×ÑÒ
ÛÏËßÌ×ÑÒ
The conlinuous-infusion melhod has been laigely ieplaced by lhe iapid-
in|eclion melhod, which is moie convenienl. A bolus of indicaloi is iapidly
in|ecled inlo lhe vessel, and lhe vaiialion in downslieam concenlialion of lhe
indicaloi veisus lime is measuied unlil lhe bolus has passed. The solid line in
Iiguie 8.2 shows lhe ûuclualions in concenlialion of lhe indicaloi lhal occui
aflei lhe in|eclion. The dolled-line exlension of lhe exponenlial decay shows
lhe cuive lhal would iesull if lheie weie no ieciiculalion. Ioi lhis case we can
calculale lhe ûow as oullined in lhe following paiagiaphs.
An inciemenl of blood of volume ¼Ê passes lhe sampling sile in lime ¼¬.
The quanlily of indicaloi ¼³ conlained in ¼Ê is lhe concenlialion Ý(¬) limes
lhe inciemenlal volume. Hence ¼³ Ý ¬ ¼Ê. Dividing by ¼¬, we oblain
¼³ ¼¬ Ý ¬ ¼Ê ¼¬. Bul ¼Ê ¼¬ Ú
i
, lhe inslanlaneous ûow; lheiefoie
Ú·¹«®» èòî ο°·¼ó·²¶»½¬·±²·²¼·½¿¬±®ó¼·´«¬·±²½«®ª» Aflei lhe bolus is in|ecled
al lime ß, lheie is a lianspoilalion delay befoie lhe concenlialion begins iising
al lime Þ. Aflei lhe peak is passed, lhe cuive enleis an exponenlial decay
iegion belween Ý and Ü, which would conlinue decaying along lhe dolled
cuive lo ¬
1
if lheie weie no ieciiculalion. Howevei, ieciiculalion causes a
second peak al Û befoie lhe indicaloi becomes lhoioughly mixed in lhe blood
al Ú. The dashed cuive indicales lhe iapid ieciiculalion lhal occuis when lheie
is a hole belween lhe lefl and iighl sides of lhe heail.
è ò î × Ò Ü × Ý ß Ì Ñ Î ó Ü × Ô Ë Ì × Ñ Ò ñ Î ß Ð × Ü × Ò Ö Û Ý Ì × Ñ Ò íìï
¼³ Ú
i
Ý ¬ ¼¬. ¡nlegialing ovei lime lhiough ¬
l
, when lhe bolus has passed lhe
downslieam sampling poinl, we oblain
³
¬
1
O
Ú
i
Ý ¬ ¼¬ (8.4)
wheie ¬
1
is lhe lime al which all effecls of lhe nisl pass of lhe bolus have died
oul (poinl Û in Iiguie 8.2). The mixing of lhe bolus and lhe blood wilhin lhe
heail chambeis and lhe lungs smoolhs oul minoi vaiialions in lhe inslanla-
neous ûow Ú
i
pioduced by lhe heailbeal. Thus we can oblain lhe aveiage ûow
Ú fiom
Ú
³
¬
1
O
Ý ¬ ¼¬
(8.5)
The inlegialed quanlily in (8.5) is equal lo lhe shaded aiea in Iiguie 8.2,
andwe can oblain il by counling squaies oi using a planimelei. Acompulei can
exliapolale lhe dolled line in ieal lime and compule lhe ûow.
¡f lhe inilial concenlialion of indicaloi is nol zeio‰as may be lhe case
when lheie is iesidual indicaloi lefl ovei fiom pievious in|eclions‰lhen (8.5)
becomes
Ú
³
¬
1
O
ÜÝ ¬ ¼¬
(8.6)
ÜÇÛ Ü×ÔËÌ×ÑÒ
A common melhod of clinically measuiing caidiac oulpul is lo use a
coloied dye, ·²¼±½§¿²·²» ¹®»»² (caidiogieen). ¡l meels lhe necessaiy
iequiiemenls foi an indicaloi in lhal il is (1) ineil, (2) haimless, (3) mea-
suiable, (4) economical, and (5) always inliavasculai. ¡n addilion, ils
oplical absoiplion peak is 8O5 nm, lhe wavelenglh al which lhe oplical
absoiplion coefncienl of blood is independenl of oxygenalion. The dye is
available as a liquid lhal is diluled in isolonic saline and in|ecled diieclly
lhiough a calhelei, usually inlo lhe pulmonaiy aileiy. Aboul 5O' of lhe
dye is excieled by lhe kidneys in lhe nisl 1O min, so iepeal deleiminalions
aie possible.
The plol of lhe cuive foi concenlialion veisus lime is oblained fiom a
conslanl-ûow pump, which diaws blood fiom a calhelei placed in lhe femoial
oi biachial aileiy. Blood is diawn lhiough a coloiimelei cuvelle (Iiguie 2.17),
which conlinuously measuies lhe concenlialion of dye, using lhe piinciple of
absoiplion pholomeliy (Seclion 11.1). The 8O5 nm channel of a lwo-channel
blood oximelei can be used foi measuiing dye-dilulion cuives. The clinician
íìî è Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Ú Ô Ñ É ß Ò Ü Ê Ñ Ô Ë Ó Û Ñ Ú Þ Ô Ñ Ñ Ü
calibiales lhe coloiimelei by mixing known amounls of dye and blood and
diawing lhem lhiough lhe cuvelle.
The shape of lhe cuive can piovide addilional diagnoslic infoimalion. The
dashed cuive in Iiguie 8.2 shows lhe iesull when a lefl-iighl shunl (a hole
belween lhe lefl and iighl sides of lhe heail) is piesenl. Blood ieciiculales
faslei lhan noimal, iesulling in an eailiei ieciiculalion peak. When a iighl-lefl
shunl is piesenl, lhe delay in lianspoil is abnoimally shoil, because some dye
ieaches lhe sampling sile wilhoul passing lhiough lhe lung vessels.
ÌØÛÎÓÑÜ×ÔËÌ×ÑÒ
The mosl common melhod of measuiing caidiac oulpul is lhal of in|ecling a
bolus of cold saline as an indicaloi. A special foui-lumen calhelei (Tiaulman
and D`ambia, 2OO6) is ûoaled lhiough lhe biachial vein inlo place in lhe
pulmonaiy aileiy. A syiinge foices a gas lhiough one lumen; lhe gas inûales a
small, doughnul-shaped balloon al lhe lip. The foice of lhe ûowing blood
caiiies lhe lip inlo lhe pulmonaiy aileiy. The cooled saline indicaloi is in|ecled
lhiough lhe second lumen inlo lhe iighl aliium. The indicaloi is mixed wilh
blood in lhe iighl venliicle. The iesulling diop in lempeialuie of lhe blood is
delecled by a lheimisloi localed neai lhe calhelei lip in lhe pulmonaiy aileiy.
The lhiid lumen caiiies lhe lheimisloi wiies. The fouilh lumen, which is nol
used foi lhe measuiemenl of lheimodilulion, can be used foi wilhdiawing
blood samples. The calhelei can be lefl in place foi aboul 24 h, duiing which
lime many deleiminalions of caidiac oulpul can be made, somelhing lhal
would nol be possible if dye weie being used as lhe indicaloi. Also, il is nol
necessaiy lo puncluie an aileiy.
We can deiive lhe following equalion, which is analogous lo (8.6).
Ú
Ï
®
b
Ý
b
¬
1
O
ÜÌ
b
¬ ¼¬
m
3
/s (8.7)
wheie
Ï heal conlenl of in|eclale, 1 Ê
i
ÜÌ
i
®
i
½
i
®
¾
densily of blood, kg/m
3
½
¾
specinc heal of blood, 1/(kg K)
When an invesligaloi uses lhe lheimodilulion melhod, lheie aie a numbei
of pioblems lhal cause eiiois. (1) Theie may be inadequale mixing belween
lhe in|eclion sile and lhe sampling sile. (2) Theie may be an exchange of heal
belween lhe blood and lhe walls of lhe heail chambei. (3) Theie is heal
exchange lhiough lhe calhelei walls befoie, duiing, and aflei in|eclion.
Howevei, lhe insliumenl can be calibialed by simullaneously peifoiming
dye-dilulion deleiminalions and applying a coiieclion facloi lhal coiiecls
foi seveial of lhe eiiois.
è ò î × Ò Ü × Ý ß Ì Ñ Î ó Ü × Ô Ë Ì × Ñ Ò ñ Î ß Ð × Ü × Ò Ö Û Ý Ì × Ñ Ò íìí
èòí ÛÔÛÝÌÎÑÓßÙÒÛÌ×Ý ÚÔÑÉÓÛÌÛÎÍ
The elecliomagnelic ûowmelei measuies inslanlaneous pulsalile ûow of blood
and lhus has a giealei capabilily lhan indicaloi-dilulion melhods, which measuie
only aveiage ûow. ¡l opeiales wilh any conduclive liquid, such as saline oi blood.
ÐÎ×ÒÝ×ÐÔÛ
The elecliic geneialoi in a cai geneiales elecliicily by induclion. Coppei wiies
move lhiough a magnelic neld, culling lhe lines of magnelic ûux and inducing
an emf in lhe wiie. This same piinciple is exploiled in a commonly used blood
ûowmelei, shownin Iiguie 8.3. ¡nsleadof coppei wiies, lhe ûowmelei depends
on lhe movemenl of blood, which has a conduclance similai lo lhal of saline.
Iaiaday`s law of induclion gives lhe foimula foi lhe induced emf.
»
L
1
O
« Þ ¼Ô
wheie
Þ magnelic ûux densily, T
Ô lenglh belween elecliodes, m
« inslaneous velocily of blood, m/s
Ú·¹«®» èòí Û´»½¬®±³¿¹²»¬·½ A±©³»¬»® When blood ûows in lhe vessel wilh
velocily « and passes lhiough lhe magnelic neld Þ, lhe induced emf » is
measuied al lhe elecliodes shown. When an ac magnelic neld is used, any ûux
lines culling lhe shaded loop induce an undesiied liansfoimei vollage.
íìì è Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Ú Ô Ñ É ß Ò Ü Ê Ñ Ô Ë Ó Û Ñ Ú Þ Ô Ñ Ñ Ü
Ioi a unifoim magnelic neld Þ and a unifoim velocily pionle «, lhe induced
emf is
» ÞÔ« (8.8)
wheie lhese lhiee componenls aie oilhogonal.
Lel us now considei ieal ûowmeleis, seveial of which exhibil a numbei of
diveigences fiom lhis ideal case. ¡f lhe vessel`s cioss seclion weie squaie and
lhe elecliodes exlended lhe full lenglh of lwo opposile sides, lhe ûowmelei
would measuie lhe coiiecl aveiage ûowfoi any ûowpionle. The elecliodes aie
small, howevei, so velocilies neai lhem conliibule moie lo lhe signal lhan do
velocilies failhei away.
Iiguie 8.4 shows lhe weighling funclion lhal chaiacleiizes lhis effecl foi
ciiculai geomeliy. ¡l shows lhal lhe pioblem is less when lhe elecliodes aie
localed oulside lhe vessel wall. The insliumenl measuies coiieclly foi a
unifoim ûow pionle. Ioi axisymmeliic nonunifoim ûow pionles, such as
lhe paiabolic ûow pionle iesulling fiom laminai ûow, lhe insliumenl mea-
suiemenl is coiiecl if « is ieplaced by «, lhe aveiage ûow velocily. Because we
usually know lhe cioss-seclional aiea ß of lhe lumen of lhe vessel, we can
mulliply ßby « lo oblain Ú, lhe volumeliic ûow. Howevei, in many localions of
Ú·¹«®» èòì Solid lines show lhe weighling funclion lhal iepiesenls ielalive
velocily conliibulions (indicaled by numbeis) lo lhe lolal induced vollage foi
elecliodes al lhe lop and bollom of lhe ciiculai cioss seclion. ¡f lhe vessel wall
exlends fiom lhe oulside ciicle lo lhe dashed line, lhe iange of lhe weighling
funclion is ieduced. (Adapled fiom 1. A. Sheicliff, ̸» ̸»±®§ ±º Û´»½¬®±ó
³¿¹²»¬·½ Ú´±© Ó»¿-«®»³»²¬, ý 1962, Cambiidge \niveisily Piess.)
è ò í Û Ô Û Ý Ì Î Ñ Ó ß Ù Ò Û Ì × Ý Ú Ô Ñ É Ó Û Ì Û Î Í íìë
blood vessels in lhe body, such as aiound lhe cuive of lhe aoila and neai ils
bianches, lhe velocily pionle is asymmeliic, so eiiois iesull.
Olhei faclois can also cause eiioi.
ïò Regions of high velocily geneiale highei inciemenlal emfs lhan iegions of
low velocily, so ciiculaling cuiienls ûow in lhe liansveise plane. These
cuiienls cause vaiying diops in iesislance wilhin lhe conduclive blood and
suiiounding lissues.
îò The ialio of lhe conduclivily of lhe wall of lhe blood vessel lo lhal of lhe
blood vaiies wilh lhe ¸»³¿¬±½®·¬ (peicenlage of cell volume lo blood
volume), so lhe shunling effecls of lhe wall cause a vaiiable eiioi.
íò Iluid oulside lhe wall of lhe vessel has a giealei conduclivily lhan lhe
wall, so il shunls lhe ûow signal.
ìò The magnelic-ûux densily is nol unifoim in lhe liansveise plane; lhis
accenluales lhe pioblem of ciiculaling cuiienl.
ëò The magnelic-ûux densily is nol unifoim along lhe axis, which causes
ciiculaling cuiienls lo ûow in lhe axial diieclion.
To minimize lhese eiiois, mosl woikeis iecommend calibialion foi animal
woik by using blood fiom lhe animal‰and, wheie possible, lhe animal`s own
vessels also. Blood oi saline is usually collecled in a giadualed cylindei and
limed wilh a slopwalch.
Ü×ÎÛÝÌóÝËÎÎÛÒÌ ÚÔÑÉÓÛÌÛÎ
The ûowmelei shown in Iiguie 8.3 can use a dc magnelic neld, so lhe oulpul
vollage conlinuously indicales lhe ûow. Allhough a few eaily dc ûowmeleis
weie buill, none weie salisfacloiy, foi lhe following lhiee ieasons. (1) The
vollage acioss lhe elecliode`s melal-lo-solulion inleiface is in seiies wilh
lhe ûow signal. !ven when lhe ûowmelei has nonpolaiizable elecliodes,
lhe iandom diifl of lhis vollage is of lhe same oidei as lhe ûow signal, and
lheie is no way lo sepaiale lhe lwo. (2) The !CG has a wavefoim and
fiequency conlenl similai lo lhal of lhe ûow signal; neai lhe heail, lhe
!CG`s wavefoim is much laigei lhan lhal of lhe ûow signal and lheiefoie
causes inleifeience. (3) ¡n lhe fiequency iange of inleiesl, O lo 3O Hz, 1 º noise
in lhe amplinei is laige, which iesulls in a pooi SNR.
ßÔÌÛÎÒßÌ×ÒÙóÝËÎÎÛÒÌ ÚÔÑÉÓÛÌÛÎ
The clinician can eliminale lhe pioblems of lhe dc ûowmelei by opeialing lhe
syslem wilh an ac magnel cuiienl of aboul 4OO Hz. Lowei fiequencies iequiie
bulky sensois, wheieas highei fiequencies cause pioblems due lo sliay capaci-
lance. The opeialion of lhis caiiiei syslem iesulls in lhe ac ûow vollage shown
in Iiguie 8.5. When lhe ûow ieveises diieclion, lhe vollage changes phase by
18Oè, solhe phase-sensilive demodulaloi (desciibedin Seclion3.15) is iequiied
lo yield diieclional oulpul.
íìê è Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Ú Ô Ñ É ß Ò Ü Ê Ñ Ô Ë Ó Û Ñ Ú Þ Ô Ñ Ñ Ü
Allhough ac opeialion is supeiioi lo dc opeialion, lhe new pioblem of
¬®¿²-º±®³»® ª±´¬¿¹» aiises. ¡f lhe shaded loop shown in Iiguie 8.3 is nol exaclly
paiallel lo lhe Þ neld, some ac magnelic ûux inleisecls lhe loop and induces a
liansfoimei vollage piopoilional lo ¼Þ ¼¬ in lhe oulpul vollage. !ven when
lhe elecliodes and wiies aie caiefully posilioned, lhe liansfoimei vollage is
usually many limes laigei lhan lhe ûow vollage, as indicaled in Iiguie 8.5. The
amplinei vollage is lhe sum of lhe liansfoimei vollage and lhe ûow vollage.
Theie aie seveial solulions lo lhis pioblem. (1) ¡l may be eliminaled al lhe
souice by use of a °¸¿²¬±³ »´»½¬®±¼». One of lhe elecliodes is sepaialed inlo
Ú·¹«®» èòë Û´»½¬®±³¿¹²»¬·½ A±©³»¬»® ©¿ª»º±®³- The liansfoimei vollage
is 9Oè oul of phase wilh lhe magnel cuiienl. Olhei wavefoims aie shown solid
foi foiwaid ûow and dashed foi ieveise ûow. The galed signal fiom lhe galed-
sine-wave ûowmelei includes less aiea lhan lhe in-phase signal fiom lhe
quadialuie-suppiession ûowmelei.
è ò í Û Ô Û Ý Ì Î Ñ Ó ß Ù Ò Û Ì × Ý Ú Ô Ñ É Ó Û Ì Û Î Í íìé
lwo elecliodes in lhe axial diieclion. Two wiies aie led some dislance fiom lhe
elecliodes, and a polenliomelei is placed belween lhem. The signal fiom lhe
polenliomelei wipei yields a signal coiiesponding lo a phanlom`` elecliode,
which can be moved in lhe axial diieclion. The shaded loop in Iiguie 8.3 can
lhus be lilled foiwaid oi backwaid oi placed exaclly paiallel lo lhe Þ neld.
(2) Nole in Iiguie 8.5 lhal we can sample lhe composile signal when lhe
liansfoimei vollage is zeio. Al lhis lime lhe ûow vollage is al ils maximum,
and lhe iesulling ¹¿¬»¼ -·¹²¿´ measuies only lhe ûow vollage. Howevei, if
undesiied phase shifls cause lhe galing lo be done even a few degiees away
fiom lhe piopei lime, laige eiiois and diifls iesull. (3) The besl melhod foi
ieducing lhe effecls of liansfoimei vollage is lo use lhe ¯«¿¼®¿¬«®»ó-«°°®»--·±²
ciicuil shown in Iiguie 8.6.
The magnilude of lhe vollage in lhe liansfoimei al lhe amplinei oulpul
is delecled by lhe quadialuie demodulaloi, which has a full-wave-ieclined
oulpul. This is low-pass-nlleied lo yield a dc vollage, which is lhen modu-
laled by lhe quadialuie geneialoi lo pioduce a signal piopoilional lo lhe
liansfoimei vollage. The signal is fed lo a balancing coil on lhe inpul
liansfoimei, lhus balancing oul lhe liansfoimei vollage al lhe inpul. Wilh
enough gain in lhis negalive-feedback loop, lhe liansfoimei vollage al lhe
amplinei oulpul is ieduced by a facloi of 5O. This low liansfoimei vollage
pievenls oveiloading of lhe in-phase demodulaloi, which exliacls lhe
desiied in-phase ûow signal shown in Iiguie 8.5. By choosing low-noise
I!Ts foi lhe amplinei inpul slage, lhe piopei luins ialio on lhe slep-up
liansfoimei (Seclion 3.13), and full-wave demodulalois, we can oblain an
excellenl SNR.
Some ûowmeleis, unlike lhe sine-wave ûowmeleis desciibed pieviously,
use -¯«¿®»ó©¿ª» »¨½·¬¿¬·±². ¡n lhis case lhe liansfoimei vollage appeais as a
veiy laige spike, which oveiloads lhe amplinei foi a shoil lime. Aflei lhe
amplinei iecoveis, lhe ciicuil samples lhe squaie-wave ûow vollage and
Ves-
sel
Amplifier
In-phase
demodulator
Low-
pass
filter
Low-
pass
filter
Output
Quadrature
demodulator
Quadrature
generator
Magnet
current
driver
Oscillator
90° phase
Ú·¹«®» èòê The quadialuie-suppiession ûowmelei delecls lhe amplinei
quadialuie vollage. The quadialuie geneialoi feeds back a vollage lo balance
oul lhe piobe-geneialed liansfoimei vollage.
íìè è Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Ú Ô Ñ É ß Ò Ü Ê Ñ Ô Ë Ó Û Ñ Ú Þ Ô Ñ Ñ Ü
piocesses il lo oblain lhe ûow signal. To pievenl oveiload of lhe amplinei,
¬®¿°»¦±·¼¿´ »¨½·¬¿¬·±² has also been used.
ÛÈßÓÐÔÛ èòí On a common lime scale, skelch lhe wavefoims foi lhe
magnel cuiienl, ûow signal, and liansfoimei vollage foi lhe following eleclio-
magnelic ûowmeleis: (1) galed sine wave, (2) squaie wave, and (3) liapezoi-
dal. ¡ndicale lhe besl lime foi sampling each ûow signal.
ßÒÍÉÛÎ Ioi galed sine wave, wavefoims aie exaclly like lhose in Iiguie
8.5. Sample lhe composile signal when lhe liansfoimei vollage is zeio.
Tiansfoimei vollage is piopoilional lo ¼Þ ¼¬. Taking lhe deiivalive of squaie
wave Þ yields spikes al liansilions. Because lhe amplinei is nol peifecl, lhese
lake lime lo decay. Besl lime lo sample is neai lhe end of liansfoimei vollage
O. Tiapezoidal Þ yields ieasonable ¼Þ ¼¬, so sample duiing lime lians-
foimei vollage O.
ÐÎÑÞÛ ÜÛÍ×ÙÒ
A vaiiely of piobes lo measuie blood ûow have been used (Cobbold, 1974).
The elecliodes foi lhese piobes aie usually made of plalinum. Besl iesulls aie
oblained when lhe elecliodes aie plalinized (elecliolylically coaled wilh
plalinum) lo piovide low impedance and aie iecessed in a cavily lo minimize
lhe ûowof ciiculaling cuiienls lhiough lhe melal. When lhe elecliodes musl be
exposed, biighl plalinum is used, because lhe plalinized coaling weais off
anyway. Biighl plalinum elecliodes have a highei impedance and a highei
noise level lhan plalinized ones.
Some piobes do nol use a magnelic coie, bul lhey have lowei sensilivily. A
common °»®·ª¿-½«´¿® °®±¾» is shown in Iiguie 8.7, in which a loioidal
laminaled Peimalloy coie is wound wilh lwo opposilely wound coils. The
è ò í Û Ô Û Ý Ì Î Ñ Ó ß Ù Ò Û Ì × Ý Ú Ô Ñ É Ó Û Ì Û Î Í íìç
iesulling magnelic neld has low leakage ûux. To pievenl capacilive coupling
belween lhe coils of lhe magnel and lhe elecliodes, an eleclioslalic shield is
placed belween lhem. The piobe is insulaled wilh a polling maleiial lhal has a
veiy high iesislivily and impeimeabilily lo sall walei (blood is similai lo
saline).
The open slol on one side of lhe piobe makes il possible lo slip il ovei a
blood vessel wilhoul culling lhe vessel. A plaslic key may be inseiled inlo lhe
slol so lhal lhe piobe enciicles lhe vessel. The piobe musl nl snugly duiing
diaslole so lhal lhe elecliodes make good conlacl. This iequiies some con-
sliiclion of an aileiy duiing syslole, when lhe diamelei of lhe aileiy is aboul
7'giealei. Piobes aie made in 1 mm inciemenls in lhe iange of 1 lo 24 mm lo
ensuie a snug nl on a vaiiely of sizes of aileiies. To be able lo measuie any size
of aileiy iequiies a consideiable expendiluie foi piobes: ¡ndividual piobes
lypically cosl $5OO each. The piobes do nol opeiale salisfacloiily on veins,
because lhe elecliodes do nol make good conlacl when lhe vein collapses.
Special ûow-lhiough piobes aie used oulside lhe body foi measuiing lhe
oulpul of caidiac-bypass pumps.
èòì ËÔÌÎßÍÑÒ×Ý ÚÔÑÉÓÛÌÛÎÍ
The ulliasonic ûowmelei, like lhe elecliomagnelic ûowmelei, can measuie
inslanlaneous ûow of blood. The ulliasound can be beamed lhiough lhe skin,
lhus making liansculaneous ûowmeleis piaclical. Advanced lypes of ullia-
sonic ûowmeleis can also measuie ûow pionles. These advanlages aie making
Ú·¹«®» èòé The loioidal-lype cuff piobe has lwo opposilely wound windings
on each half of lhe coie. The magnelic ûux lhus leaves lhe lop of bolh sides,
ûows down in lhe cenlei of lhe cuff, enleis lhe base of lhe loioid, and ûows up
lhiough bolh sides.
íëð è Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Ú Ô Ñ É ß Ò Ü Ê Ñ Ô Ë Ó Û Ñ Ú Þ Ô Ñ Ñ Ü
lhe ulliasonic ûowmelei lhe sub|ecl of inlensive developmenl. Lel us examine
some aspecls of lhis developmenl.
ÌÎßÒÍÜËÝÛÎÍ
Ioi lhe liansducei lo be used in an ulliasonic ûowmelei, we selecl a piezo-
elecliic maleiial (Seclion 2.6) lhal conveils powei fiom elecliic lo acouslic
foim (Chiislensen, 1988). Lead ziiconale lilanale is a ciyslal lhal has lhe
highesl conveision efnciency. ¡l can be molded inlo any shape by melling. As il
is cooled lhiough lhe Cuiie lempeialuie, il is placed in a sliong elecliic neld lo
polaiize lhe maleiial. ¡l is usually foimed inlo disks lhal aie coaled on opposile
faces wilh melal elecliodes and diivenby an eleclionic oscillaloi. The iesulling
elecliic neld in lhe ciyslal causes mechanical consliiclion. The pislonlike
movemenls geneiale longiludinal plane waves, which piopagale inlo lhe
lissue. Ioi maximal efnciency, lhe ciyslal is one-half wavelenglh lhick. Any
cavilies belween lhe ciyslal and lhe lissue musl be nlled wilh a ûuid oi waleiy
gel in oidei lo pievenl lhe high ieûeclive losses associaled wilh liquidgas
inleifaces.
Because lhe liansducei has a nnile diamelei, il will pioduce diffiaclion
palleins, |usl as an apeiluie does in oplics. Iiguie 8.8 shows lhe oulline of lhe
beam palleins foi seveial liansducei diameleis and fiequencies. ¡n lhe ²»¿®
B»´¼, lhe beamis laigely conlainedwilhina cylindiical oulline and lheie is lillle
spieading. The inlensily is nol unifoim, howevei: Theie aie mulliple maxi-
mums and minimums wilhin lhis iegion, caused by inleifeience. The neai neld
exlends a dislance ¼
nf
given by
¼
nf
Ü
2
4
(8.9)
wheie Ü liansducei diamelei and wavelenglh.
Ú·¹«®» èòè Neai and fai nelds foi vaiious liansducei diameleis and fiequen-
cies. Beams aie diawn lo scale, passing lhiough a 1O mm-diamelei vessel.
Tiansducei diameleis aie 5, 2, and 1 mm. Solid lines aie foi 1.5 MHz, dashed
lines foi 7.5 MHz.
è ò ì Ë Ô Ì Î ß Í Ñ Ò × Ý Ú Ô Ñ É Ó Û Ì Û Î Í íëï
¡n lhe º¿® B»´¼ lhe beam diveiges, and lhe inlensily is inveisely piopoi-
lional lo lhe squaie of lhe dislance fiom lhe liansducei. The angle of beam
diveigence º, shown in Iiguie 8.8, is given by
sinº
1 2
Ü
(8.1O)
Iiguie 8.8 indicales lhal we should avoid lhe fai neld because of ils lowei
spalial iesolulion. To achieve neai-neld opeialion, we musl use highei fie-
quencies and laigei liansduceis.
To selecl lhe opeialing fiequency, we musl considei seveial faclois. Ioi a
beam of conslanl cioss seclion, lhe powei decays exponenlially because of
absoiplion of heal in lhe lissue. The absoiplion coefncienl is appioximalely
piopoilional lo fiequency, so lhis suggesls a low opeialing fiequency. How-
evei, mosl ulliasonic ûowmeleis depend on lhe powei scalleied back fiom
moving ied blood cells. The backscalleied powei is piopoilional lo º
4
, which
suggesls a high opeialing fiequency. The usual compiomise diclales a fie-
quency belween 2 and 1O MHz.
ÌÎßÒÍ×ÌóÌ×ÓÛ ÚÔÑÉÓÛÌÛÎ
Iiguie 8.9(a) shows lhe liansducei aiiangemenl used in lhe liansil-lime
ulliasonic ûowmelei (Chiislensen, 1988). The effeclive velocily of sound in
lhe vessel is equal lo lhe velocily of sound, ½, plus a componenl due lo «, lhe
Ú·¹«®» èòç Ë´¬®¿-±²·½ ¬®¿²-¼«½»® ½±²B¹«®¿¬·±²- (a) A liansil-lime piobe
iequiies lwo liansduceis facing each olhei along a palh of lenglh Ü inclined
fiom lhe vessel axis al an angle º. The halched iegion iepiesenls a single
acouslic pulse liaveling belween lhe lwo liansduceis. (b) ¡n a liansculaneous
piobe, bolh liansduceis aie placed on lhe same side of lhe vessel, so lhe piobe
can be placed on lhe skin. Beam inleiseclion is shown halched. (c) Any
liansducei may conlain a plaslic lens lhal focuses and naiiows lhe beam.
(d) Ioi pulsed opeialion, lhe liansducei is loaded by backing il wilh a mixluie
of lungslen powdei in epoxy. This incieases losses and loweis Ï. Shaded
iegion is shown foi a single lime of iange galing. (e) A shaped piece of Lucile
on lhe fionl loads lhe liansducei and also iefiacls lhe beam. (f) A liansducei
placed on lhe end of a calhelei beams ulliasound down lhe vessel. (g) Ioi
pulsed opeialion, lhe liansducei is placed al an angle.
íëî è Ó Û ß Í Ë Î Û Ó Û Ò Ì Ñ Ú Ú Ô Ñ É ß Ò Ü Ê Ñ Ô Ë Ó Û Ñ Ú Þ Ô Ñ Ñ Ü
velocily of ûow of blood aveiaged along lhe palh of lhe ulliasound. Ioi
laminai ûow, « 1 33 «, and foi luibulenl ûow, « 1 O7 «, wheie « is lhe
velocily of lhe ûow of blood aveiaged ovei lhe cioss-seclional aiea. Because
lhe ulliasonic palh is along a single line ialhei lhan aveiaged ovei lhe cioss-
seclional aiea, « diffeis fiom «. The liansil lime in lhe downslieam ( ) and
upslieam ( ) diieclions is
¬
dislance
conduclion velocily
Ü
½