P.

S.N.
A
COLLEGEOFENGI
NEERI
NGANDTECHNOLOGY,
DINDI
GUL624622

DEPARTMENTOFBI
OMEDI
CALENGI
NEERI
NG

LABORATORYMANUAL

BM8611-DI
AGNOSTI
CANDTHERAPEUTI
CEQUI
PMENTLAB

Name:
………………………………………….
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..

Year
:………………………….
.Br
anch&Sec……………………

Rol
lNo…………………………………………………………….

Reg.
No:
…………………………………………………………….
 I
NSTRUCTI
ONSTOTHESTUDENTS

Do’
s Don’
ts
1.Ber
egul
art
othel
ab. 1.Donotexceedt
hev
olt
ageRat
ing.
2.Fol
l
owpr
operDr
essCode. 2.Av
oidl
ooseconnect
ionsandshor
t
3.Mai
ntai
nSi
l
ence. ci
rcui
ts.
4.Knowt
het
heor
ybehi
ndt
he 3.Donott
hrowt
heconnect
ingwi
res
exper
imentbef
orecomi
ngt
othel
ab. t
ofl
oor
.
5.I
dent
if
ythedi
ff
erentl
eadsor 4.Donotcomel
atet
othel
ab.
t
ermi
nal
sorpi
nsoft
hecomponent
s 5.
Donotwr
it
eany
thi
ngont
het
abl
e
bef
oremaki
ngconnect
ion.
6.Av
oid unnecessar
ytal
ki
ng whi
l
e
doi
ng
t
heexper
iment
.
7.Handl
ethei
nst
rument
spr
oper
ly.
8.Keept
heTabl
ecl
ean.
9.Takeasi
gnat
ureoft
heI
nchar
ge
bef
oret
aki
ngt
heki
t/
component
s.
10.
Aft
ert
hecompl
eti
onoft
he
exper
iment
sswi
tchof
fthepower
suppl
yandr
etur
ntheappar
atus.
11.
Arr
anget
hechai
rs/
stool
sand
equi
pmentpr
oper
lybef
orel
eav
ing
t
hel
ab.

*
Student
sshoul
dgettheobser
vat
ionnotebookcor
rect
edwi
thi
ntwoday
sandsubmi
t
t
hecomplet
edrecor
dswhencomet otheLabor
ator
y.
 P.
S.N.
ACOLLEGEOFENGI
NEERI
NGANDTECHNOLOGY,
DINDI
GUL

Depar
tmentofBi
oMedi
cal
Engi
neer
ing

BM8611-DI
AGNOSTI
CANDTHERAPEUTI
CEQUI
PMENTLAB
Year
:II
IBME Semest
er:
VI

Li
stofExper
iment
sfort
heAcademi
cyear2021-
2022(
Even)

CYCLEI

1Measur
ementofVi
sual
l
yEv
okedPot
ent
ial
2.Gal
vani
cSki
nResi
stance(
GSR)measur
ement
3.Wor
kingofShor
twav
eDi
ather
my
4.Wor
kingofUl
tr
asoni
cDi
ather
my
5.Measur
ementofv
ari
ousPhy
siol
ogi
cal
Signal
susi
ngBi
otel
emet
ry
6.St
udyofHemodi
aly
sisModel
7.El
ect
ri
cal
Saf
etymeasur
ement
.
8.Measur
ementofRespi
rat
orypar
amet
ersusi
ngSpi
romet
ry.
CYCLEI
I

9.St
udyofMedi
cal
Simul
ator
10.Anal
yzet
hewor
kingofESU–Cut
ti
ngandCoagul
ati
onmodes
11.Recor
dingofAudi
ogr
am
12.Recor
dingandanal
ysi
sofPacemakerSi
mul
ator
13.Det
ect
ionofFi
bri
l
lat
ionusi
ngDef
ibr
il
lat
or
14.Anal
ysi
sofECG,
EEGandEMGsi
gnal
s
15.St
udyofVent
il
ator
s
16.St
udyofUl
tr
asoundScanner
s
17.St
udyofHear
tLungmachi
neModel
AUGMENTEDEXPERI
MENTS

18.St
udyofEndoscopy

19.St
udyofPhy
siot
her
apyEqui
pment
 CONTENT

Page
ExptNo. Dat
e Nameoft
heExper
iment Si
gnat
ure
No.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.
 17.

MEASUREMENTOFVI
SUALLYEVOKEDPOTENTI
AL
AI
M
Tomeasur
eandr
ecor
dvi
sual
l
yev
okedpot
ent
ial
byEEGsy
stem
APPARATUSREQUI
RED
1.Di
ff
erent
ial
ampl
i
fier
2.Not
chf
il
ter
3.DSO
4.Vi
sual
sti
mul
ator
5.Connect
ingcabl
es
THEORY
RECORDI
NGOFEVOKEDPOTENTI
ALS
I
fanext
ernalst
imul
usi
sappl
i
edt
othesensor
yar
eaofbr
ain,i
trespondsbypr
oduci
ng
an el
ect
ri
calpot
ent
ialknow ast
he “
evoked pot
ent
ial
”.The mostf
requent
lyused ev
oked
pot
ent
ial
sforcl
i
nicalt
est
ing i
ncl
udebr
ainst
em audi
tor
yev
oked r
esponses,v
isualev
oked
r
esponsesandsomat
osensor
yev
okedpot
ent
ial
s.
Ev
okedpot
ent
ialr
ecor
dedatt
hesur
faceoft
hebr
ain,i
sthei
ntegr
atedr
esponseoft
he
act
ionofmanycel
l
s.Theampl
i
tudeoft
heev
okedpot
ent
iali
soft
heor
derof10mi
crov
olt
s.The
ev
okedpot
ent
ial
sar
egener
all
ysuper
imposedwi
thel
ect
roencephal
ogr
ams.Ther
efor
e,i
tis
necessar
ytor
emov
ethe EEG byan av
eragi
ng t
echni
que whi
l
e maki
ng ev
oked pot
ent
ial
measur
ement
s.Si
ncebackgr
oundEEGandot
herunwant
edsi
gnal
sof
tenappeari
rr
egul
ar,
ordo
notsy
nchr
oni
zet
ost
imul
i
,theymar
kedl
yreducedbyav
eragi
ngacr
ossmul
ti
plet
ri
als.I
ngener
al,
av
eragi
ngr
educesnoi
sepr
opor
ti
onalt
othesquar
erout
eoft
henumberoft
ri
als.Mostoft
he
i
mpr
ovement
sinsi
gnal
-t
o-noi
ser
ati
ooccurwi
thi
n40t
o100t
ri
als.
Si
ncemanyev
okedpot
ent
ialcomponent
sar
eofshor
tdur
ati
on,about2mst
o1sec,
r
api
dsampl
i
ngr
atesar
eneededt
o di
git
all
yrecor
dsuchl
ow l
evelpot
ent
ial
s.Usual
l
y,t
he
sampl
i
ngr
atei
s1000/
s.Theampl
i
tudeofev
okedpot
ent
ialar
enor
mal
l
ymeasur
edonav
ert
ical
scal
ewi
thsampl
epoi
ntsmeasur
edasbi
tsonal
ogar
it
hmi
cresol
uti
onscal
e.Resol
uti
onof
v
olt
agei
susual
l
ysuf
fi
cientwi
than8-
bitr
ecor
ding,al
though10-
to-
16bi
tA/
D sy
stemsar
e
becomi
ngav
ail
abl
e

Bl
ockDi
agr
am
 Fi
g.1.Bl
ockdi
agr
am ofaVi
sual
l
yEv
okedPot
ent
ial
syst
em

Thr
eeel
ect
rodespi
ckupaone-
channelEEGsi
gnal
.Thi
ssi
gnali
sthenf
il
ter
edt
hrough
60Hznot
chf
il
terand pr
esent
ed t
otheev
oked pot
ent
ialav
eragi
ng comput
er.Ther
aw or
ongoi
ngEEGsi
gnali
sav
ail
abl
eatt
he60Hzf
il
terout
put
.Thecomput
ercanbesetf
oregt
ogi
ve
100t
ri
ggerpul
sest
othev
isualst
imul
ator
.Eachbr
ainr
esponsei
saddedsy
nchr
onousl
ywi
th
eacht
ri
ggeri
nthecomput
er.Thecomput
erout
puti
sthensummedr
esponsepot
ent
ialdi
vi
ded
byt
henumberofr
esponses.Thi
sinf
ormat
ioncanbeonmagnet
ict
apeorhar
dcopi
edont
othe
st
ri
p-char
trecor
der
.A 5µVp-
pcal
i
brat
ionsi
gnalcanbeusedt
otestt
heav
eragi
ngpr
ocess
accur
acy
.

Pr
ocedur
e
 Swi
tchont
hev
isualsi
mul
atorbyconnect
ingt
hepowercor
dtot
hemachi
neandmai
n
suppl
y,
 Putt
hesuppl
yswi
tchatONposi
ti
ont
omaket
hemachi
neON,
 Focust
hel
i
ghtonpat
ient
’sf
ace
 Measur
etheev
okedpot
ent
ialsi
gnalbyusi
ngel
ect
rodespl
acedonei
thersi
deoff
ront
al
head
  Si
gnali
sthenf
il
ter
edt
hrough60Hznot
chf
il
terandpr
esent
edt
otheev
okedpot
ent
ial
av
eragi
ngcomput
er,
 Connectout
putoft
heEEGsy
stem t
otheDSO,
 Thedi
git
aldi
spl
aywi
l
lshowt
hev
ari
ousr
esponsewav
epat
ter
nonosci
l
loscope,
 Not
edownt
heampl
i
tudeandt
imeofEEGsi
gnal
s.

Resul
t

S.
no St
ateofSubj
ect Resi
stance

1 Dr
yski
n

2 Wetski
n

Fi
g1.
GALVANI
CRESI
STANCEMEASUREMENT

Obser
vat
ion

Subj
ectName: Age: Hei
ght
: Wei
ght
:
 GALVANI
CSKI
NRESI
STANCE(
GSR)MEASUREMENT

AI
M
Tomeasur
etheel
ect
ri
calski
nconduct
ivi
tyf
rom t
hef
ingerusi
nggal
vani
cski
n
r
esi
stancemet
er.
APPARATUSREQUI
RED
1.Gal
vani
cski
nresi
stancemet
er-1no.
2.Ski
nel
ect
rodes-2no.
3.CRO–1no.
4.Pr
obes.
THEORY
TheGal
vani
cSki
nResponse(
GSR)i
soneofsev
eralel
ect
roder
malr
esponses
(
EDRs)
.EDRsar
echangesi
ntheel
ect
ri
calpr
oper
ti
esofaper
son’
sski
ncausedbyan
i
nter
act
ion bet
ween env
ironment
alev
ent
s and t
he i
ndi
vi
dual
’
s psy
chol
ogi
calst
ate.
Humanski
nisagoodconduct
orofel
ect
ri
cit
yandwhenaweakel
ect
ri
calcur
renti
s
del
i
ver
edt
otheski
n,changesi
ntheski
n’
sconduct
ionoft
hatsi
gnalcanbemeasur
ed.
The v
ari
abl
ethati
s measur
ed i
s ei
therski
nresi
stance ori
tsr
eci
p-r
ocal
,ski
n
conduct
ance.Accor
dingt
oOhm’
sLaw,
ski
nresi
stance(
R)equal
sthev
olt
age(
V)appl
i
ed
bet
weent
woel
ect
rodesont
heski
ndi
vi
dedbyt
hecur
rentpassedt
hrought
heski
n(I
).
Thel
awcanbeexpr
essedasR=V/
I
A GSR ampl
i
fier
,li
ket
heonet
hatwi
l
lbeusedi
nthi
sexper
iment
,appl
i
esa
const
antv
olt
aget
otheski
nthr
oughel
ect
rodes.Thev
olt
agei
ssosmal
lthati
tcannotbe
per
cei
ved.Thecur
rentt
hatf
lowst
hrought
heski
n,ast
hev
olt
agei
sappl
i
ed,canbe
det
ect
edanddi
spl
ayed.Becauset
heconst
antv
olt
ageappl
i
edt
otheski
nisknownand
t
hecur
rentf
lowcanbemeasur
ed,
theski
n’
sconduct
ancecanbedet
ermi
nedbyt
heGSR
ampl
i
fier
.Theout
putoft
heGSRampl
i
fieri
stheski
n’
sconduc-t
anceexpr
essedi
nuni
ts
cal
l
edmi
croSi
emens(
µS)
.

Twot
ypesofski
nconduct
ancear
echar
act
eri
zed,t
oni
candphasi
c.Toni
cski
n
conduct
ancei
sthebasel
i
nel
evelofski
nconduct
ance,i
ntheabsenceofanypar
ti
cul
ar
di
scr
eteenv
ironment
alev
ent
,andi
sgener
all
yref
err
edt
oasSki
nConduct
anceLev
el
(
SCL)
.Eachper
son

hasa di
ff
erentSCL,wi
tht
ypi
calt
oni
clev
elsr
angi
ng f
rom 10-50 µS.Toni
cski
n
conduct
ance l
evel
svar
yov
ert
imei
nindi
vi
dual
sdependi
ngonhi
sorherpsy
chol
ogi
cal
st
ateandaut
onomi
cregul
ati
on.

Phasi
c ski
n conduct
ance i
sthe t
ype t
hatchanges when ev
ent
stake pl
ace.
Di
scr
eteenv
ironment
alst
imul
i(si
ght
s,sounds,smel
l
s,et
c.)wi
l
lev
oket
imer
elat
ed
changesi
nski
nconduct
ance.Thesear
egener
all
yref
err
edt
oasSki
nConduct
ance
Responses(
SCRs)
.SCRsar
eincr
easesi
ntheconduct
anceoft
heski
nwhi
chmayl
ast10-
20secondsf
oll
owedbyar
etur
ntot
het
oni
corbasel
i
nel
evelofski
nconduct
ance(
SCL)
.
Thesephasi
cchangesar
eof
tensi
mpl
ycal
l
edGSRs.I
ndi
vi
dual
swi
l
lshowspont
aneous
GSRs,t
hatar
e notev
entr
elat
ed,t
ovar
ying degr
ees.The t
ypi
calf
requency of
spont
aneousGSRsi
sbet
weenoneandt
hreepermi
nut
e.Someper
sonsar
ehi
ghl
y
r
eact
ive wi
th consi
d-er
abl
e spont
aneous gener
ati
on ofGSRs,and ot
her
s hav
ea
r
elat
ivel
yst
eadyt
oni
clev
elofski
nconduct
ancewi
thoutspont
aneousGSRs.Someof
t
hesei
ndi
vi
dual
dif
fer
encesar
edi
scussedi
nanot
hersect
ionoft
hisexper
iment
.
Thepar
amet
ersofev
ent
-r
elat
edGSRst
hatcanbequant
if
iedar
e:ampl
i
tude,i
n
mi
croSi
emens;andl
atency
,ri
set
ime,andhal
f-
recov
eryt
ime,i
nseconds.Theampl
i
tude
ofanev
ent
-r
elat
edGSRi
sthedi
ff
erencebet
weent
het
oni
cski
nconduct
ancel
evel
,att
he
t
imet
her
esponsewasev
oked,andt
heski
nconduc-t
anceatt
hepeakoft
her
esponse.
Lat
encyi
sthet
imebet
weent
hest
imul
usandt
heonsetoft
heev
ent
-r
elat
edGSR;
TheEl
ect
roder
mal
Syst
em
Theski
nisat
hree-
lay
ered(
epi
der
mis,der
mis,subder
mis)adapt
iveor
ganwhi
ch
ai
dsi
nthemai
nte-
nanceoft
hebody
’swat
erbal
anceandcor
etemper
-at
ure.These
f
unct
ionsar
ecar
ri
edoutbybl
oodv
essel
sandeccr
inesweatgl
ands.Thebl
oodv
essel
s
const
ri
ctanddi
l
atet
odel
i
verbl
oodf
lowt
othesur
faceoft
hebodyf
orheatconser
vat
ion
orl
oss.Theeccr
inesweatgl
andsf
unct
iont
ocoolt
hebodybydeposi
ti
ngmoi
stur
eon
t
heski
nsur
facet
hroughduct
s(i
ntheder
mis)andsweatpor
es(
int
heepi
der
mis)
.The
gl
ands,whi
char
elocat
edi
nthesubder
misov
ermostoft
hebody
,ar
eaboutt
ent
imes
mor
e denseont
hepal
marsur
faceoft
hehandsandsol
esoft
hef
eet
.

Duet
other
esponseoft
heski
nandmuscl
eti
ssuet
oext
ernal
andi
nter
nal
sti
mul
i
,
t
heconduct
ancecanv
arybysev
eralmi
crosi
emens.Whencor
rect
lycal
i
brat
ed,t
he
dev
ice can measur
ethese subt
le di
ff
erences.Ther
eisar
elat
ionshi
p bet
ween
sy
mpat
het
icact
ivi
tyandemot
ionalar
ousal
,al
thoughonecannoti
dent
if
ywhi
chspeci
fi
c
emot
ioni
sbei
ngel
i
cit
ed.TheGSRi
shi
ghl
ysensi
ti
vet
oemot
ionsi
nsomepeopl
e.Fear
,
anger
,st
art
ler
esponseandor
ient
ingr
esponsear
eal
lamongt
her
eact
ionswhi
chmay
pr
oducesi
mil
arski
nconduct
ancer
esponses.Theser
eact
ionsar
eut
il
izedaspar
toft
he
pol
ygr
aphorl
i
edet
ect
or.

Ski
nconduct
ancer
esponsei
nregul
arsubj
ect
sdi
ff
erswhengi
venf
airandunf
air
of
fer
s,r
espect
ivel
y.Howev
er,psy
chopat
hshav
ebeenshownt
ohav
enodi
ff
erencei
n
ski
nconduct
ancebet
weenf
airandunf
airof
fer
s.Thi
smayi
ndi
cat
ethatt
heuseofl
i
e
det
ect
orsr
ely
ing on ski
n conduct
ivi
tygi
ves psy
chopat
hs an adv
ant
age t
hatnon-
psy
chopat
hsdonothav
eincr
imi
nal
inv
est
igat
ions.
Pr
ocedur
e
 Connectt
hei
nst
rument
stot
hemai
ns.
 Connectt
heDSOt
othei
nst
rumentandSwi
tchont
heDSO.
 Connectt
heGSRout
putandgr
oundt
otheDSO.
 Connectt
heel
ect
rodest
othesy
stem,nowcl
eant
heski
nwher
etheel
ect
rodei
s
t
obepl
aced,
readt
het
her
mal
resi
stance,
 Wett
hesur
faceoft
hef
inger
swhi
char
eincont
actwi
tht
heel
ect
rodes.Agai
n
measur
etheski
nresi
stance.
 Sett
hehi
ghandl
owcont
rol
knobasperr
equi
rement
.
 Bef
orer
emov
ingt
heel
ect
rodes,
ret
urnt
hesensi
ti
vi
tyset
ti
ngt
ozer
o.

Resul
t

METHODOFAPPLYI
NGELECTRODEI
NSHOTRWAVEDI
ATHERMY

TREATMENTCONDENSERMETHOD
SHORTWAVEDI
ATHERMYUNI
T
 WORKI
NGOFSHORTWAVEDI
ATHERMY

AI
M
To f
ind t
he cur
rentpr
oduced atv
ari
ous di
stance ofel
ect
rode pads byShor
twav
e
Di
athermyuni
t.

APPARATUSREQUI
RED
1.Shor
twavedi
ather
myuni
t-
1no.
2.El
ect
rodepads-
2no.
3.Connect
ingcabl
es.
THEORY

SHORTWAVEDI
ATHERMY

Thet
erm‘
diat
her
my’means“
thr
oughheat
ing”orpr
oduci
ngandheat
ingdi
rect
lyi
nthe
t
issueoft
hebody
.Ext
ernal
l
yappl
i
edsour
cesofheatl
i
kehott
owel
s,i
nfr
aredl
ampsandel
ect
ri
c
heat
ingpadsof
tenpr
oducedi
scomf
ortandski
nbur
ns.Butwi
thdi
ather
myt
echni
que,t
he
subj
ect
’sbodybecomesapar
toft
heel
ect
ri
calci
rcui
tandt
heheati
spr
oducedwi
thi
nthebody
andt
ransf
err
edt
hrought
heski
n.Theadv
ant
ageoft
hedi
ather
myuni
tist
hatt
het
reat
mentcan
becont
rol
l
edpr
eci
sel
y.Thel
ocal
i
zat
ionoft
heheatt
othepar
ti
cul
arr
egi
oncanbet
reat
edby
car
efulpl
acementofel
ect
rodes.Theheat
ingoft
het
issuei
scar
ri
edoutbyhi
ghf
requency
al
ter
nat
ingcur
rentwhi
chgener
all
yhasaf
requencyof27.
12MHzandawav
elengt
hof11m.
Cur
rentofsuchhi
ghf
requenci
esdonotst
imul
atemot
ororsensor
yner
vesnordot
heypr
oduce
anymuscl
econt
ract
ion.Thus,whensuchacur
renti
spassedt
hrought
hebodyt
her
eisno
di
scomf
ortcausedt
othepat
ient
.

Thebodypar
ttobet
reat
edi
spl
acedbet
weent
wocapaci
torpl
ates.Heati
sgener
atedas
t
hehi
gh-
fr
equencywav
est
rav
elt
hrough t
hebodyt
issuesbet
ween t
hepl
ates.Shor
twav
e
di
ather
myi
smostof
tenusedt
otr
eatar
easl
i
ket
hehi
p,whi
chi
scov
eredwi
thadenset
issue
mass.I
tis al
so used t
otr
eatpel
vi
cinf
ect
ions and si
nusi
ti
s.The t
reat
mentr
educes
i
nfl
ammat
ion.Mostmachi
nesf
unct
ionat27.
33megaher
tz.Shor
tWav
edi
ather
mycur
renti
sa
hi
ghf
requencyal
ter
nat
ingcur
rent
.Theheatener
gyobt
ainedf
rom t
hewav
eisusedf
orgi
vi
ng
r
eli
eft
othepat
ient
.It
sfr
equencyi
s27,
120,
000cy
clespersecondandt
hewav
elengt
his11
met
er.

Apai
rofel
ect
rodesconnect
edatt
heout
putofar
adi
ofr
equencyosci
l
lat
ori
sposi
ti
onedont
he
bodyov
ert
her
egi
ont
obet
reat
ed.TheR.
F.ener
gyheat
sthet
issuesandpr
omot
esheal
i
ngof
t
hei
njur
edt
issuesandi
nfl
ammat
ions.
TABULATI
ON

SI
.No Nameofthe Dist
ance Power Ti
me Curr
ent
st
udent
s between (Wat
t) (
s) (
mA)
t
wopads

Vi
va
1.Dif
fer
ent
iatepadanddiscel
ect
rodes.
Sl
.no Padelect
rode Di
scel
ect
rode

2.Whati
sthepr
inci
pleofdi
ather
my?

3.Li
stt
het
ypesofdi
ather
my.

4.Whatar
etheappl
i
cat
ionsofdi
ather
my?

5.Whycur
rentofhi
ghf
requencyi
sused?
Tuni
ng:Anyshor
twav
ether
apyuni
twoul
dgi
veoutt
hedesi
redener
gyt
othepat
ientonl
yifand
asl
ongast
heuni
tiscor
rect
lyt
unedt
otheel
ect
ri
calv
aluesoft
heobj
ect(
par
toft
hebody
).
Ther
efor
e,t
uni
ngmustbecar
eful
l
ycar
ri
edoutatt
hebegi
nni
ngoft
het
reat
mentandshoul
dbe
moni
tor
eddur
ingt
reat
ment
.

Appl
i
cat
ionofEl
ect
rodes:Theout
putoft
heshor
twav
edi
ather
mymachi
nei
sconnect
edt
o
met
alel
ect
rodeswhi
char
eposi
ti
onedont
hebodyov
ert
her
egi
ont
obet
reat
ed.Whenusi
ngt
he
500W y
ouhav
etheopt
iont
ouseei
therpadel
ect
rodesordi
skel
ect
rodes.

PadEl
ect
rodes:Theel
ect
rodesdonotdi
rect
lycont
actt
heski
n.Usual
l
ylay
ersoft
owelar
e
i
nter
posedbet
weent
hepadandt
hesur
faceoft
hebody
.Thepadsar
epl
acedsot
hatt
he
posi
ti
onoft
hebodyt
obet
reat
edi
ssandwi
chedbet
weent
hem.Thi
sar
rangementi
scal
l
edt
he
condensermet
hod.Themet
alpadsactast
wopl
atesandt
hebodyt
issuesbet
weent
hepadsas
di
elect
ri
coft
hecapaci
tor
.Whent
her
adi
ofr
equencyout
puti
sappl
i
edt
othepads,
thedi
elect
ri
c
l
ossesmani
festt
hemsel
vesasheati
nthei
nter
veni
ngt
issues.Thedi
elect
ri
clossesmaybedue
t
oionsandr
otat
ionofdi
pol
esi
nthet
issuef
lui
ds(
elect
rol
ytes)andmol
ecul
ardi
stor
ti
oni
not
her
t
issueswhi
char
evi
rt
ual
l
yinsul
ator
y,l
i
kef
ats.Asagener
alr
ules,t
heel
ect
rodesshoul
dbe
l
argert
hant
hest
ruct
uret
hati
sbei
ngt
reat
edandbot
hshoul
dbet
heel
ect
rodesoft
hesame
si
ze.

Di
scEl
ect
rodes:Thedi
scel
ect
rodesar
efi
xedonamul
tiposi
ti
onar
m.I
tisv
eryeasyt
oadj
ust
t
heel
ect
rodest
othear
eat
obet
reat
edot
hepat
ient
.Theangl
eoft
hear
m andhei
ghtcanbe
adj
ust
ed.Thedi
scel
ect
rodesar
eideal
l
ysui
tedwheny
ouwoul
dli
ket
otr
eatt
hepat
ientwi
thout
hav
ingt
omakeanycont
ractont
hesur
face.Asmal
lai
rgapcoul
dbemai
ntai
nedsi
ncet
hehi
gh
f
requencyel
ect
romagnet
icwav
es,penet
rat
ethr
ought
heai
rtot
hepat
ient
’sbody
.Thespeci
all
y
desi
gneddi
scel
ect
rodesar
ecomf
ort
abl
efort
reat
ingt
hecont
our
soft
hebody
.
A shor
twav
edi
ather
myuni
tisadev
icedesi
gnedt
ogener
ater
adi
ofr
equencyr
adi
ati
onand
t
ransf
eri
t,v
iacabl
esandel
ect
rodes,t
othear
eat
obet
reat
ed.Theuni
tscanbeoper
atedi
n
ei
theracont
inuouswav
eorpul
sedmodebutbot
hpr
oduceheati
ndeept
issue.
TWOFORMSOFSHORTWAVEDI
ATHERMY:
Theuni
tscanbeoper
atedi
nei
ther
 Cont
inuousmode
 Pul
sedmode
Twobasi
cty
pesofel
ect
rodes(
appl
i
cat
ors)ar
einuse:
 Capaci
tor
-t
ype
 I
nduct
ort
ype.
I
nthef
ir
stcaset
issueheat
ingi
sbasi
cal
l
yduet
other
adi
ofr
equencyel
ect
ri
cfi
eld,whi
l
efort
he
i
nduct
iveel
ect
rodes(
coi
l
s),heat
ing occur
sbyacombi
nat
ionofel
ect
ri
cfi
eld ef
fect
sand
cur
rent
sinducedi
nthet
issuebyt
hemagnet
icf
iel
d.Theheat
ingpr
ofi
l
eoft
het
womechani
sms
i
ssomewhatdi
ff
erent
.Thesedev
icesar
ecapabl
eofgener
ati
ngasuf
fi
cient
lyhi
ghl
evelof
r
adi
ati
ont
hatt
her
emaybecausef
orconcer
nfort
hesaf
etyoft
hegonadsand,i
nthecaseof
pr
egnantpat
ient
s,t
hef
oet
us.I
mpr
operuseoft
hemachi
nemayr
esul
tinbur
nsand/
orscal
ds
anddeept
issueoror
gandamage.I
tmustbenot
edt
hatt
hel
evelofr
adi
ati
onpr
esenti
nthe
v
ici
nit
yofadi
ather
myuni
tmaybei
ncr
easedbyt
hepr
esenceofnear
bymet
all
i
cobj
ect
sorot
her
uni
tsorbyr
efl
ect
ionf
rom t
hewal
l
.
Car
emustbet
akent
oensur
ethatt
heshor
twav
eradi
ati
ondoesnotcausei
nter
fer
ence
wi
thot
herequi
pment
.SWDi
smostcommonl
yusedf
ort
her
mot
her
apyataf
requencyof27.
12
MHz.Shor
twav
edi
ather
myheat
sthet
issuebycausi
ngosci
l
lat
ionsofel
ect
romagnet
icener
gy
ofhi
ghf
requenci
es.Thephy
siol
ogi
cef
fect
soft
emper
atur
eoccuratt
hesi
teoft
heappl
i
cat
ion
andi
ndi
stantt
issue.
APPLI
CATI
ONS

The shor
twav
e di
ather
myhas sev
eralappl
i
cat
ions i
ncl
udi
ng t
reat
mentofbur
sui
ts,
Capsul
i
tisf
ract
ure,Ost
emy
eli
ti
sinj
uri
es,st
rai
ns,spr
ains and di
slocat
ions br
achi
alPl
exus
Neur
it
is,
Fibr
osi
ti
s,My
osi
ti
s,My
lagi
a,Rheumat
ism,
Ver
icose,
Ulcer
sGi
nusi
ti
s,Ot
it
ismedi
aet
c.,

CONTRAI
NDI
CATI
ONSFORSHORTWAVETHERAPY

Shor
twav
edi
ather
myshoul
dnotbeusedt
otheposi
ti
onofbodywhi
chhasadef
ect
ive
ar
ter
ialbl
oodsuppl
y.I
tshoul
dnotbeusedonabdomenorpel
vi
sdur
ingpr
egnancy
.Iti
ssaf
ert
o
av
oidt
heappl
i
cat
ionsofdi
ather
myt
oar
easwher
eisl
ossofsensat
ion.I
tshoul
dnotbeusedi
n
r
egi
onofmal
i
gnantgr
owt
hs.I
tdev
ital
i
zedt
het
issuesandr
ender
sthem mor
esuscept
ibl
eto
damage.So,shor
twav
e di
ather
my shoul
d notbe appl
i
ed t
o ar
eas r
ecent
ly exposed t
o
t
her
apeut
icdosesofX-
ray
s.I
tisunsaf
etoappl
yshor
twav
edi
ather
myt
opat
ient
swhoar
e
unabl
etounder
standt
hedegr
eeofheat
ingr
equi
redandt
henecessi
tyofr
epor
ti
ngi
fitshoul
d
becomeexcessi
ve.Fort
hisr
easonsmal
lchi
l
drenandment
aldef
ect
ivesar
enotsui
tabl
efor
t
reat
ment
.Si
mil
arl
yiti
snotsaf
etot
reatunconsci
ouspat
ient
sandt
hosewhoar
eli
abl
etol
ose
consci
ousnesssuchasepi
l
ept
ics.

PRECAUTI
ONS

 Met
alf
urni
tur
eshoul
dnotbeusedf
orkeepi
ngt
heshor
twav
edi
ather
my.
PROCEDUREFORSHORTWAVEDIATHERMY
 Tur
npowercont
rol
tomi
nimum posi
ti
on.
 Swi
tchont
hemai
nsswi
tch.Thepi
l
otRFl
ampi
ntheswi
tchgl
ows.
 Tur
nti
mercl
ockwi
set
othedesi
redt
reat
mentt
ime.
 Tur
npowercont
rol
clockwi
set
il
ldesi
redout
puti
ssel
ect
ed.
 Fort
hesel
ect
edpower
,pl
acet
het
reat
edar
eabet
weent
het
woel
ect
rodepads
 sot
hatt
heneedl
eoft
hemet
eri
ndi
cat
escur
renti
nmA.
 Af
tercompl
eti
onoft
het
reat
mentt
urnt
hepowerr
egul
atort
oit
smi
nimum posi
ti
onand
swi
tchof
fthemai
nsaf
ter10t
o15mi
nut
es.

RESULT
BLOCKDI
AGRAM

Mai
nvol
tage Ti
mer Hal
fwav
erect
if
ier

Osci
l
loscope

Ful
lwav
erect
if
ier

Pi
ezocr
yst
al Powerampl
i
fier
 Exp:
Dat
e:

WORKI
NGOFULTRASONI
CDI
ATHERMY

AI
M
To f
ind t
hemechani
calv
ibr
ati
on pr
oduced byt
heul
tr
asoni
ctr
ansducerf
orv
ari
ous
Power
s

APPARATUSREQUI
RED

1.Ul
trasoni
cther
apyunit-1no.
2.Ul
trasoni
cTransducer
-1no.
3.Connecti
ngcables

THEORY

Thet
erm di
ather
mymeanst
houghheat
ingorpr
oduci
ngdeepheat
ingdi
rect
lyi
nthe
t
issuesoft
hebody
.Theheal
i
ngef
fectpr
oducedbecauseoful
tr
asoni
cener
gyabsor
pti
on
pr
oper
tyoft
het
issues.Theef
fectoful
tr
asoni
candt
het
issuesi
sthust
hehi
ghspeedv
ibr
ati
on
ofmi
cromassage.Massagehast
hemodal
i
tyi
nphy
sicalmedi
cinehasbeenusedi
nthe
t
reat
mentofsof
tti
ssue,
lesi
onsf
orent
ri
es.

Ul
tr
asoni
cener
gyenabl
est
hismassaget
obecar
ri
edoutf
ir
stt
ogr
eat
erdept
hthani
spossi
ble
manual
l
y,andsecondatt
imes.Whenpr
essur
ecan’
tbeexer
tedbyhandbecauseofi
ntol
erabl
e
pai
ncausedt
othepat
ient
.Thet
her
malef
fectoful
tr
asoundar
edependentont
heamountof
ener
gyabsor
bed t
he l
engt
h oft
ime oft
he ul
tr
asound appl
i
cat
ion and f
requencyoft
he
ul
tr
asoundgener
ator
.

Ul
tr
asoni
cgener
atesorconduct
edont
hepi
ezoel
ect
ri
cel
ect
ri
cef
fect
.Ahi
ghf
requencyal
ter
ing
cur
rent(
eg 0.
75-
3.0MHZ)
.i
s appl
ytot
he cr
yst
alwhose acoust
icv
ibr
ati
on causes t
he
mechani
calv
ibr
ati
onoft
het
ransducerheadwhi
chi
tsel
flocat
eddi
rect
lyi
nfr
ontoft
hecr
yst
al.
Thesemechani
calv
ibr
ati
onst
henpasst
hroughamet
alcapandbodyi
ntobodyt
issuest
hrough
a coupl
i
ng medi
um.The t
her
apeut
ic ul
tr
asoni
cint
ensi
tyv
ari
es f
rom 0.
5-3.
0wat
t/Cm2.
Appl
i
cat
ionr
angef
rom 7-
130mm i
ndi
a
DOSAGECONTROL
 Thedosagecanbecont
rol
l
edbyv
ary
ingoneoft
hef
oll
owi
ngv
ari
abl
es

1.Fr
equencyofult
rasound
2.I
ntensit
yofult
rasound
3.Durat
ionoft
heexposure

Unl
i
ket
heoper
ati
onoft
heshor
twav
edi
ather
my,not
uni
ngi
snecessar
ywhi
l
ethet
reat
menti
s
pr
ogr
ess.Theoper
ati
ngf
requencyi
sal
sonotcr
it
ical
.Theout
putpowerofanul
tr
asoni
cther
apy
uni
tcanbev
ari
edcont
inuousl
ybet
ween0-
3wat
ts/
cm.

TABULATI
ON

SI
.No Ti
me(
s) Powercontr
ol Vi
brat
ion
2
(N/
cm )

Vi
va

1.Whatpr
oduceshi
ghf
requencyal
ter
nat
ingcur
rent
?

2.Whatar
ethef
act
orsconsi
der
edf
orul
tr
asounddosagecont
rol
?

3.Howi
sul
tr
asoundsuper
iorov
ershor
twav
eul
tr
asound?

4.Whati
sthef
unct
ionofaf
ull
wav
eandhal
fwav
erect
if
ier
?
 5.Li
stt
heusesoful
tr
asounddi
ather
my.

CI
RCUI
TDESCRI
PTI
ON

Thehear
toft
hesy
stem i
sti
medosci
l
lat
orwhi
chpr
oducest
heel
ect
ri
calosci
l
lat
ionof
r
equi
redf
requency
.Theosci
l
lat
orout
puti
sgi
vent
othepowerampl
i
fierwhi
chder
ivest
he
pi
ezoel
ect
ri
c cr
yst
alst
o gener
ate ul
tr
asound wav
es.Powerampl
i
ficat
ion i
s achi
eved by
r
epl
aci
ngt
het
ransi
stori
nat
ypi
calLCt
unedcol
pit
tosci
l
lat
orby4powert
ransi
stor
spl
acedi
na
br
idgeconf
igur
ati
on.Thedel
i
ver
yoft
heul
tr
asoundspowert
oapat
ienti
stobedonef
oragi
ven
t
ime.Thi
siscont
rol
l
edbyi
ncor
por
ati
ngat
imert
oswi
tchont
heci
rcui
t.Thet
imercanbe
mechani
cal
l
yspr
ingl
oadedt
ypeoranel
ect
roni
cone,al
l
owi
ngt
imeset
ti
ngsf
rom 0t
o30
mi
nut
es.

PROCEDURE

 Connectt
heul
tr
asoni
ctr
ansducert
othepoweruni
t,pl
aceul
tr
asoni
ctr
ansducert
othe
pat
ient
'sbodywher
etr
eat
menti
stobegi
ven,
 Theul
tr
asoni
ctr
ansducerpr
oducesmechani
cal
vibr
ati
on,
 Setpowercont
rol
todesi
redposi
ti
on.Gener
all
y1wat
tpersq.
cm i
ssuf
fi
cient
,
 Ther
equi
redt
imeandf
requencyar
esetf
ort
reat
ment
,
 Not
edownt
hemodeofv
ibr
ati
on.

RESULT
 Acqui
sit
ionofv
ari
ousphy
siol
ogi
cal
par
amet
ers

Obser
vat
ion

Blood
Nameofthe Hear
t Respir
ator
y
Sl
.No SPO2 Pr
essure Temper
atur
e
st
udent
,Age,
ID Rate Rate
(S/D)
 MEASUREMENTOFVARI
OUSPHYSI
OLOGI
CALSI
GNALSUSI
NGBI
OTELEMETRY
AI
M

To r
ecor
d t
he v
ari
ousphy
siol
ogi
calpar
amet
erssuchasECG,Hear
trat
e,Oxy
gen
Sat
urat
ionr
ate(
SpO2)
,Bl
oodPr
essur
e-St
oli
cPr
essur
e(NS)
,Di
ast
oli
cPr
essur
e(ND)
,Mean
Pr
essur
e(NM)andTemper
atur
ebyusi
ng ECG r
ecor
dsanddet
ectt
heQRS wav
etoanal
yse
t
heel
ect
ri
cal
act
ivi
tyofhear
tmuscl
e.

APPARATUSREQUI
RED
1.Pat
ientmoni
tor
ingsy
stem
2.BPpat
ientpr
obe
3.Temper
atur
esensor
4.ECGconnect
orwi
thl
eads
5.SP02sensor

PRI
NCI
PLE
Thel
i
fest
ylechangesi
nhumansov
ert
hepastf
ew decadeshav
eledt
oincr
easei
n
car
dio-
vascul
ardi
seases.Li
fest
ylechangesl
i
keunheal
thyf
oodi
ntake,
lesserphy
sicalexer
cises
et
c hav
e cont
ri
but
ed t
o sev
eralcar
dio-
vascul
ardi
seases l
i
ke ar
ter
ioscl
erosi
s,hi
gh bl
ood
pr
essur
eet
c.Pol
l
uti
on,
duet
orapi
dindust
ri
ali
zat
ion,
hascont
ri
but
edt
orespi
rat
orydi
sor
der
s.A
r
obustmedi
calmoni
tor
ingdev
iceshoul
dbeabl
etopr
ovi
dei
ntel
l
igentdi
agnosi
sbasedon
accur
ateanal
ysi
sofphy
siol
ogi
calpar
amet
ersi
nreal
-t
ime.Att
hesamet
ime,suchdev
icemust
beabl
etoadaptt
othechar
act
eri
sti
csofaspeci
fi
cpat
ientanddesi
reddi
agnost
icneeds,and
cont
inuet
ooper
ateev
eni
npr
esenceofunexpect
edar
ti
fact
sandacci
dent
aler
ror
s.Thi
spaper
pr
esent
sthedesi
gnconsi
der
ati
onsofapat
ientmoni
tor
ingsy
stem whi
chmoni
tor
sthemul
ti
ple
par
amet
ersl
i
keel
ect
rocar
diogr
am (
ECG)
,hear
trat
e,bl
oodoxy
gensat
urat
ionl
evel(
SpO2)and
bl
oodpr
essur
e.Thesy
stem hasbeenev
aluat
edbyt
echni
calv
eri
fi
cat
ion,cl
i
nicalt
est
,anduser
sur
vey
.

I
NTRODUCTI
ON
Today
,mor
eandmor
eint
rahospi
talt
ranspor
tofpat
ient
sisr
equi
redi
nor
dert
oper
for
m
speci
alex
ami
nat
ion ort
her
apy
.The keyt
o success ofal
lcr
it
icalcar
etr
anspor
tist
he
cont
inuous moni
tor
ing ofv
italsi
gns i
ncl
udi
ng el
ect
rocar
diogr
aphy (
ECG)
,bl
ood oxy
gen
sat
urat
ionbypul
seoxi
met
ry(
SpO2)
,hear
trat
e(HR)
,andbl
oodpr
essur
e(BP)
.Per
sonal
i
zed
heal
thmoni
tor
ingdev
icesar
eusef
uli
near
lyi
dent
if
icat
ionofmedi
calcondi
ti
onsandf
aci
l
itat
ion
ofconv
ent
ionalcl
i
nicaldi
agnosi
spr
ocessesbyanal
yzi
ngenv
ironment
alandphy
siol
ogi
caldat
a
andpr
ovi
dingi
ntel
l
igentdi
agnost
icassessmentandal
ertf
eedback,ei
thert
othepat
ientor
di
rect
lyt
otheheal
thcar
epr
ofessi
onal
s.Suchdev
icemustbeabl
etoadaptt
oani
ndi
vi
dual
’
s
phy
siol
ogi
calchar
act
eri
sti
csanddi
ff
erentdi
agnost
icneedswhi
l
econst
ant
lydel
i
ver
ingt
rust
-
wor
thyanal
yses ev
en i
n pr
esence ofunexpect
ed ar
ti
fact
s and acci
dent
aler
ror
s.Heal
th
moni
tor
ingdev
ices,
prov
idi
ngt
hef
oll
owi
nguni
quef
eat
ures:
 Pat
ient
-speci
fi
c moni
tor
ing byi
ntegr
ati
on ofan ef
fect
ive setofbi
omedi
calsi
gnal
pr
ocessi
ngt
echni
quesi
ntoacust
om pr
ocessi
ngel
ementt
hatcanbeconf
igur
edf
or
pat
ientspeci
fi
cmoni
tor
ingofdi
ff
erentmedi
cal
condi
ti
ons.
 Mul
ti
-par
amet
ermoni
tor
ingbyconcur
rentanal
ysi
sofdi
ff
erentphy
siol
ogi
calsi
gnal
s
usi
ngmul
ti
plepr
ocessi
ngel
ement
sandf
usi
onoft
hei
rresul
ts.
 Ef
fi
cientMoni
tor
ingoft
heopt
imi
zedpr
ocessi
ngel
ement
stopr
ovi
def
lexi
bil
i
tywhi
l
e
meet
ingper
for
mance,
cost
,andener
gyconst
rai
nts.
FUNCTI
ONSOFPATI
ENTMONI
TORI
NGSYSTEM

Mul
ti
-par
amet
erpat
ientmoni
torcanmoni
tor
:
ECG: Hear
tRat
e(HR)
2-
channel
ECGwav
efor
m
RESP:Respi
rat
ionRat
e(RR)
Respi
rat
ionWav
efor
m
SpO2: Oxy
genSat
urat
ion(
SpO2)
,Pul
seRat
e(PR)
SpO2Pl
ethy
smogr
am
NI
BP: Sy
stol
i
cPr
essur
e(NS)
,Di
ast
oli
cPr
essur
e(ND)
,MeanPr
essur
e(NM)

TEMP:Channel
-1Temper
atur
e(T1)
,Channel
-2Temper
atur
e(T2)
,
 Temper
atur
eDi
ff
erencebet
weent
wochannel
s(TD)
SCREENDI
SPLAY
Mul
ti
-par
amet
erpat
ientmoni
tori
sequi
ppedwi
thahi
gh-
resol
uti
onmul
ti
col
orTFTLCD
scr
een.Thepat
ientpar
amet
ers,
wav
efor
ms,
alar
m messages,
bednumber
,ti
me,
moni
torst
atus
andot
herdat
acanber
efl
ect
edf
rom t
hescr
een.Thescr
eeni
sdi
vi
dedi
ntot
hreear
eas:
1.I
nfor
mat
ionAr
ea,
2.Wav
efor
m Ar
ea,
3.Par
amet
erAr
ea.
1.I
nfor
mat
ionAr
ea
TheI
nfor
mat
ionAr
eai
satt
het
opandbot
tom oft
hescr
een,di
spl
ayi
ngoper
ati
ng
st
ateoft
hemoni
torandst
atusoft
hepat
ient
.Thei
nfor
mat
ionar
eacont
ainsnameand
t
ypeofpat
ient
,dat
e,t
ime,powersuppl
y,st
atusofbat
ter
y,si
gnsi
ndi
cat
ingt
heoper
ati
ng
st
atusoft
hemoni
torandt
hesensor
sar
edi
spl
ayedatt
her
ightsi
deofpat
ientname,
Alar
m
messagei
sdi
spl
ayedatt
her
ightmostar
eaand“
FREEZE”appear
swhent
hewav
efor
ms
ar
efr
ozen.
2.Wav
efor
m Ar
ea

Si
xwav
efor
mscanbedi
spl
ayedatt
hesamet
ime.Thesequenceofwav
efor
mscanbe
adj
ust
ed.Undert
hemaxi
mum conf
igur
ati
on,
thesy
stem candi
spl
ay2ECGwav
efor
ms,
SpO2
wav
efor
m,Respi
rat
ionwav
efor
m(canbef
rom ECGmodul
e),
and2I
BPwav
efor
ms.

2 3.Par
amet
erAr
ea
Par
amet
erar
ea i
s on t
he r
ightofWav
efor
m ar
ea,and par
amet
ers ar
e di
spl
ayed
cor
respondi
ngt
owav
efor
msbasi
cal
l
y.Theyar
e:
ECG:
 Hear e-(
tRat –ni
t:bpm)
4
 ST-
segmentanal
ysi
sofChannel ST2-(
1&2–ST1, –ni
t:mV)
 PVCs(
Premat
ureVent
ri
cul
arCont
ract
ion)ev s-(
ent –ni
t:t
imes/
minut
e)
Oxy
genSat
urat
ionSpO2
 SpO2-(
–ni
t:%)
NI
BP–BLOODPRESSURE
 Sy
stol
i
cpr
essur
e,Meanpr
essur
e,Di
ast
oli
cpr e-(
essur –ni
t:mmHgorkPa)
TEMPERATURE:
 Temper
atur
eofchannel
1andchannel
2andt
hei
rtemper
atur
edi
ff
erence:
T1,
T2,
 TD-(
–ni
t:
Cor
F).
RESPI
RATI
ONRATE
 Respi
rat
i e-(
onRat –ni
t:br
eat
h/mi
nut
e)

ECG/
RESPMONI
TORI
NG
 Moni
tor
ingt
heECG pr
oducesacont
inuouswav
efor
m oft
hepat
ient
's’
ardi
acel
ect
ri
c
act
ivi
tyt
o enabl
eanaccur
ateassessmentofhi
scur
rentphy
siol
ogi
calst
ate.Onl
ypr
oper
connect
ionoft
heECGcabl
escanensur
esat
isf
act
orymeasur
ement
.Ont
heNor
malDi
spl
ay,
Themoni
torpr
ovi
desdi
spl
ayof2-
channel
ECGwav
efor
ms.
 Thepat
ientcabl
econsi
stsof2par
ts
Thecabl
ethatconnect
stot
hemoni
tor
;
Thel
eadsett
hatconnect
stot
hepat
ient
.
 Usi
nga3-
leadset
,onewav
efor
misdi
spl
ayedont
hescr
een.Usi
nga5-
leadset
,the
ECGcander
iveupt
otwowav
efor
msf
rom t
wodi
ff
erentl
eads.Forr
equest
edl
ead,
youmay
choosef
rom t
hel
eftsi
deofECGwav
efor
m.
 Themoni
tordi
spl
ayst
heHear
tRat
e(HR)
,STsegmentandAr
rhy
thmi
aanal
ysi
s.
 Al
loft
hepar
amet
ersabov
ecanbesetasal
arm par
amet
ers.

Moni
tor
ingPr
ocedur
e

1.Pr
epar
ethepat
ient
's’
ki
npr
iort
opl
aci
ngt
heel
ect
rodes.
 Theski
nisapoorconduct
orofel
ect
ri
cit
y;t
her
efor
epr
epar
ati
onoft
hepat
ient
's’
ki
nis
i
mpor
tantt
ofaci
l
itat
egoodel
ect
rodecont
actt
oski
n.
 Shav
ehai
rfr
om si
tes,
ifnecessar
y.
 Washsi
test
hor
oughl
ywi
thsoapandwat
er.(
Nev
eruseet
herorpur
eal
cohol
,because
t
hisi
ncr
easesski
nimpedance)
.
 Rubt
heski
nbr
iskl
ytoi
ncr
easecapi
l
lar
ybl
oodf
lowi
nthet
issuesandr
emov
eski
nscur
f
andgr
ease.
2.At
tachcl
i
porsnapt
oel
ect
rodespr
iort
opl
acement
.
3.Putt
heel
ect
rodesont
hepat
ient
.Bef
oreat
tachi
ng,
appl
ysomeconduct
ivej
ell
yont
he
el
ect
rodesi
ftheel
ect
rodesar
enotel
ect
rol
ytesel
f-
suppl
i
ed.
4.Connectt
heel
ect
rodel
eadt
othepat
ient
'
s’abl
e.
Pl
aci
ngt
heEl
ect
rodesf
orECGMoni
tor
ing
El
ect
rodepl
acementf
or3-
leadset
:
 Red(
R)el
ect
rode-B–pl
acedneart
her
ightshoul
der
,di
rect
lybel
owt
hecl
avi
cle.
 Yel
l
ow(
L)el
ect
rode-B–pl
acedneart
hel
eftshoul
der
,di
rect
lybel
owt
hecl
avi
cle.
 Gr
een(
F)el
ect
rode-B–pl
acedont
hel
efthy
pogast
ri
um.
 Fi
g1:
Elect
rodePl
acementf
or3-
leadSet

SpO2MONI
TORI
NG

SpO2Pl
ethy
smogr
am measur
ementi
sempl
oyedt
odet
ermi
net
heoxy
gensat
urat
ionof
hemogl
obi
nint
hear
ter
ialbl
ood.I
f,f
orexampl
e,97% hemogl
obi
nmol
ecul
esi
nther
edbl
ood
cel
l
soft
hear
ter
ialbl
oodcombi
newi
thoxy
gen,
thent
hebl
oodhasaSpO2oxy
gensat
urat
ionof
97%.TheSpO2numer
icont
hemoni
torwi
l
lread97%.
TheSpO2numer
icshowst
heper
cent
age
ofhemogl
obi
nmol
ecul
eswhi
chhav
ecombi
nedwi
thoxy
genmol
ecul
est
ofor
m oxy
hemogl
obi
n.
TheSpO2/
PLETHpar
amet
ercanal
sopr
ovi
deapul
ser
atesi
gnal
andapl
ethy
smogr
am wav
e.
Wor
king
 Ar
ter
ialoxy
gensat
urat
ioni
smeasur
ed byamet
hod cal
l
ed pul
seoxi
met
ry.I
tisa
cont
inuous,non-
inv
asi
vemet
hodbasedont
hedi
ff
erentabsor
pti
onspect
raofr
educed
hemogl
obi
nandoxy
hemogl
obi
n.I
tmeasur
eshowmuchl
i
ght
,sentf
rom l
i
ghtsour
ceson
onesi
deoft
hesensor
,ist
ransmi
tt
edt
hroughpat
ientt
issue(
suchasaf
ingeroranear
),
t
oar
ecei
veront
heot
hersi
de.
 Theamountofl
i
ghtt
ransmi
tt
eddependsonmanyf
act
ors,mostofwhi
char
econst
ant
.
Howev
er,
oneoft
hesef
act
ors,
thebl
oodf
lowi
nthear
ter
ies,
var
ieswi
tht
ime,
becausei
t
i
spul
sat
ing.Bymeasur
ingt
hel
i
ghtabsor
pti
ondur
ingapul
sat
ion,
iti
spossi
blet
oder
ive
t
heoxy
gensat
urat
ionoft
hear
ter
ialbl
ood.Det
ect
ingt
hepul
sat
iongi
vesaPLETH
wav
efor
m andpul
ser
atesi
gnal
.
 TheSpO2v
alueandt
hePLETHwav
efor
m canbedi
spl
ayedont
hemai
nint
erf
ace.
Moni
tor
ingPr
ocedur
e

SpO2pl
ethy
smogr
am measur
ement
1.Swi
tchont
hemoni
tor
.
2.At
tacht
hesensort
otheappr
opr
iat
esi
teoft
hepat
ientf
inger
.
3.Pl
ugt
heconnect
oroft
hesensorext
ensi
oncabl
eint
otheSpO2socketont
heSpO2modul
e.

Fi
g2:
Mount
ingt
heSensor
NI
BP[
NONI
NVASI
VEBLOODPRESSURE]MONI
TORI
NG

TheNon-
inv
asi
veBl
oodPr
essur
e(NI
BP)modul
emeasur
est
hebl
oodpr
essur
eusi
ngt
he
osci
l
lomet
ri
cmet
hod.I
tisappl
i
cabl
eforadul
t,pedi
atr
ic,
andneonat
alusage.
Moni
tor
ingPr
ocedur
e

1.Tost
artamanual
measur
ing:

 Access NI
BP SETUP menu and pi
ck t
he I
NTERVAL i
tem.Sel
ectt
he MANUAL
sel
ect
ion.Then pr
esst
heSTART but
ton on t
hef
rontpanelt
o st
arta manual
measur
ement
.
 Dur
ingt
hei
dleper
iodofaut
omeasur
ingpr
ocess,pr
esst
heSTARTbut
tonont
he
f
rontpanelatanyt
imet
ost
artamanualmeasur
ement
.Thenpr
esst
heSTART
but
tonont
hef
rontpanelt
ost
opmanualmeasur
ementandt
hesy
stem cont
inues
execut
esaut
o-measur
ingpr
ogr
am accor
dingt
osel
ect
edt
imei
nter
val
.
2.Tost
opamanual
measur
ing
 Repr
esst
heSTARTbut
tonont
hef
rontpanel
agai
n.
 Fi
g3:
Measur
ingcuf
f
Measur
ementLi
mit
ati
ons
1.Pat
ientMov
ement
Measur
ement
swi
l
lbeunr
eli
abl
eormaynotbepossi
blei
fthepat
ienti
smov
ing,
shi
ver
ingor
hav
ingconv
ulsi
ons.Thesemot
ionsmayi
nter
fer
ewi
tht
hedet
ect
ionoft
hear
ter
ial
pressur
e
pul
ses.I
naddi
ti
on,
themeasur
ementt
imewi
l
lbepr
olonged.
2.Car
diacAr
rhy
thmi
a'
s
Measur
ement
swi
l
lbeunr
eli
abl
eandmaynotbepossi
blei
fthepat
ient
's’
ardi
acar
rhy
thmi
a
hascausedani
rr
egul
arhear
tbeat
.Themeasur
ingt
imet
huswi
l
lbepr
olonged.
3.Hear
t-
lungMachi
ne
Measur
ement
swi
l
lnotbepossi
blei
fthepat
ienti
sconnect
edt
oahear
t-
lungmachi
ne.
4.Pr
essur
eChanges
Measur
ement
swi
l
lbeunr
eli
abl
eandmaynotbepossi
blei
fthepat
ient
's’
l
oodpr
essur
eis
changi
ngr
api
dlyov
ert
heper
iodoft
imedur
ingwhi
cht
hear
ter
ial
pressur
epul
sesar
ebei
ng
anal
yzedt
oobt
aint
hemeasur
ement
.
5.Hear
tRat
eExt
remes
Measur
ement
scannotbemadeatahear
trat
eofl
esst
han40bpm andgr
eat
ert
han240
bpm.
TEMPMONI
TORI
NG

TwoTEMPprobescanbeusedsimul
taneousl
ytomeasuret
woTEMPdat as,
andgett
he
t
emper
atur
edi
ffer
ence.Di
sposabl
eTEMPpr obecanonl
ybeusedoncef
oronepati
ent
.

Gener
alpr
ocedur
e

1.Connectal
ltheel
ect
rodes,
tempsensor
,NI
BPcuf
f,pul
sepr
obet
osubj
ect
2.Makesur
ethemoni
tori
sreadywi
thpowersuppl
y.
3.Openhal
termoni
torsof
twar
e,af
terent
erpat
ientdet
ail
sthencl
i
ckst
artmoni
tor
ing
4. Sav
etheECGwav
efor
msal
ongwi
thot
herphy
siol
ogi
cal
par
amet
ersv
alue

Resul
t

Hemodi
aly
sisuni
t
 STUDYOFHEMODI
ALYSI
SMODEL

AI
M
Tost
udypr
inci
pleandwor
kingHemodi
aly
sismodel
.
APPARATUSREQUI
RED
1.Di
aly
ser
2.Bl
oodpump
3.Hepar
inpump
4.Sal
i
nesol
uti
ont
ube
5.Cat
het
ers
THEORY
Hemodial
ysisi
scommonl ycal
l
edki dneydi
alysi
s.Itisaprocessofpuri
fyi
ngthebl
oodofa
per
sonwhoseki dney
sarenotworkingnormally
.Itisamet hodthati
susedtoachi
evet
he
ext
racor
poreal
remov al
ofwasteproductssuchascr eat
ini
neandur ea.

I
NTRODUCTI
ON

 Hemodial
ysi
sr emoveswastesandwaterbyci
rcul
ati
ngbloodout
sidet
hebody
t
hrough an exter
nalf
il
tercal
led adi
aly
zer
,thatcontai
nsasemiper meabl
e
membrane

 Bloodf l
owsi nonedir
ecti
onandthedial
ysat
eflowsint
heopposit
e.Thecount er
-
currentflowofthebloodanddial
ysatemaximi
zestheconcent
rat
iongradientof
solutesbetweent hebl
oodanddialysat
e,whi
chhelpstoremovemoreur eaand
creatini
nefrom t
heblood

 Theconcentr
ationsofsolut
es(forexampl
epot assi
um,phosphor
us,andur
ea)
areundesi
rablyhighintheblood,butlow orabsentinthedial
ysi
ssolut
ion,
di
aly
sisi
sani ncreasi
ngl
ycommont ypeoft
reat
ment .

 Thedi
alysi
ssolut
ionhaslevel
sofminer
alsli
kepotassi
um andcal
cium t
hatar
e
si
mil
artothei
rnatur
alconcent
rat
ioni
nheal
thybl
ood.

DEFI
NITI
ON

Thewor dhemodi
aly
sis,
hemomeansbloodanddial
ysi
smeandif
fusi
onofsol
utemol ecules
thr
oughasemi per
meablemembr
ane,normal
lypassi
ngfr
om t
hesideofhi
gherconcentrati
on
tothatofl
ower

Semi membr aneisonethatal

lowst
hepassageofcert
ainsmal
lermol
ecul
esofsuch
cry
stall
oidsasGLUCOSEandUREA, butpr
event
spassageofl
argermol
ecul
essuchascol
l
oidal
pl
asmapr ot
einsandprotopl
asm

PRI
NCI
PLE
  Thepr
inci
pleofHemodi
aly
sisi
nvol
vesdi
ff
usi
onofsol
utesacr
ossasemi
per
meabl
e
membr
ane.
 I
tut
il
izescount
ercur
rentf
low,
wher
ethedi
aly
sat
eisf
lowi
ngi
ntheopposi
tedi
rect
iont
o
bl
oodf
lowi
ntheext
racor
por
eal
cir
cui
t.
 Count
er-
cur
rentf
lowmai
ntai
nst
heconcent
rat
iongr
adi
entacr
osst
hemembr
aneata
maxi
mum andi
ncr
easest
heef
fi
ciencyoft
hedi
aly
sis.
 I
tinv
olv
est
hreeki
ndsofpr
ocess1.Di
ff
usi
on2.Osmosi
sand3.Ul
tr
afi
l
trat
ion
PURPOSE

Whenthenephronsi
nthekidneysar
ef ai
l
ureornotworki
ngpr
oper
ly,
thei
onsl
i
ke
pot
assi
um,cr
eati
nineetcar
edecreases.I
tleadstor
enalfai
l
ure

1.Nephr
otoxi
ns

2.Di
abet
ic

3.Nephr
opat
hy

4.Hy
per
tensi
on

5.Gl
omer
ulonephr
it
is

6.Cy
sti
cki
dneydi
sease

TYPESOFDI
ALYSI
S
1.Hemodi
aly
sis
2.Per
it
oneal
dial
ysi
s
3.Hemof
il
tr
ati
on
4.Hemodi
afi
l
trat
ion
5.I
ntest
inal
dial
ysi
s
PROCEDURE

1.Indi
alysi
sprocedur
e,weshoul
dcl
eant
hedi
sposabl
etubi
ngsandf
il
terwi
th
ster
il
izi
ngfl
uid.

2.Measur
ebasi
cpar
amet
ersl
i
kewei
ght
,bl
oodpr
essur
eandt
emper
atur
eofpat
ient

3.Forfist
ulaprocedur
econnectcannul
atovei
nofarmsorl
egs.Forcat
het
er
procedureconnectcannul
atolar
geveini
nchest

4.Makesur
ethatconnect
ionf
orm acompl
etel
oop,
thenst
artt
het
imerand
di
aly
sat
epump.

5.Hemodi
aly
sisi
sunderpr
ocess

6.Per
iodi
cal
l
ycheckbl
oodpr
essur
eforev
eryhal
fanhour
.Ifl
evel
sisgetl
owl
eads
 t
ocr
ampi
ng,
nausea,
dizzi
ness,
li
ght
headnessandunconsci
ousness.

7.Attheendoftheprocedur
eti
me, t
hepatienti
sdi sconnect
edfr
om thepl
umbli
ng.
Neddlewoundsarebandagedwithgauze,hel
df orforupto1hourwit
hdi
rect
pr
essuretostopbl
eedingandthentappedinplace.

8.Carest
affver
if
iesthatt
hepati
enti
sincondi
ti
onsuitabl
eforl
eavi
ng.Thepati
ent
mustbeabletostandonthei
rown,needtomaint
ainbloodpr
essure,
weightand
temper
atur
e

RI
SKS
1.Anemi
a:duet
othepr
ocedur
eassoci
atedbl
oodl
ossandmi
l
def
fectpr
oducei
n
oxy
gen
t
ranspor
tat
ionsy
stem.
2.Hemat
ocr
it
:RBCl
evel
isgetl
owduet
othedef
ici
encyofhar
moneer
ythr
opoi
eti
n
3.Cr
amps,
Nausea,
vomi
ti
ng,
andheadache:
thesecanbecausedbyv
ari
ousf
act
ors
suchasdi
aly
sat
eused,
composi
ti
onofdi
aly
zermembr
ane,wat
erqual
i
tyi
nthe
di
aly
sisuni
t,andt
heul
tr
afi
l
trat
ionr
ateoft
het
reat
ment
.
4.Hy
pot
ensi
on:
wit
hregul
arhemodi
l
aysi
str
eat
ment
,pat
iemt
sar
eatr
iskf
or
hy
pot
ensi
on,
asuddendr
opi
nbl
oodpr
essur
e.Thi
scanbeof
tencont
rol
l
edby
medi
cat
ion
5.I
nfect
ion:
pat
ient
scanal
sogeti
nfect
ionst
hroughsur
roundi
ngs.Ther
oom and
ar
eausedf
orpat
ient
smustbekeptcl
ean.
6.I
nfect
iousdi
seases:
ther
eisagr
eatdeal
ofbl
oodexposur
einv
olv
edi
ndi
aly
sis
t
reat
ment
,asl
i
ghtr
iskofcont
ract
inghepat
it
isBandhepat
it
isC.t
hehepat
it
isB
v
acci
nat
ioni
srecommendedf
ormostpat
ient
s.
ADVANTAGES

 Lowmor
tal
i
tyr
ate

 Bet
tercont
rol
ofbl
oodpr
essur
eandabdomi
nal
cramps

 Lessdi
etr
est
ri
cti
on

 Bet
tersol
utecl
earanceef
fectf
ort
hedai
lyhemodial
ysi
s:bet
tert
oler
ance
andfewercompl
icati
onswithmor
efr
equentdi
aly
sis

DI
SVANTAGES
 Requi
resmor
esuppl
i
essuchashi
ghwat
erqual
i
tyandel
ect
ri
cit
y

 Requi
resr
eli
abl
etechnol
ogyl
i
kedi
aly
sismachi
nes

 Compl
expr
ocedur
e
  Needmor
eti
met
ocl
eandi
aly
sismachi
ne

RESULT
Thust
hehemodi
aly
zeruni
twor
kingpr
ocedur
ewasst
udi
edwi
thspeci
fi
cemphasi
stowar
dsi
ts
r
isks,
adv
ant
ages,
disadv
ant
agesandcl
i
nical
appl
i
cat
ionswer
est
udi
ed.
 LEAKAGECURRENTANDELECTRI
CALSAFETYMEASUREMENT

AI
M

Tost
udyaboutt
heuseofasaf
ewor
kpl
ace,
elect
ri
cal
saf
etyr
egul
ati
ons,
elect
ri
cal
hazar
ds,
andt
heuseofsaf
ewor
kpr
ocedur
esandpr
otect
iveequi
pment
.

APPARATUSREQUI
RED

El
ect
ri
cal
Saf
etyMeasur
ementki
t:

TopPanel

1.Tosuppl
yswi
tch-Topr
ovi
depowersuppl
ytoi
nst
rumentundert
est
2.Neut
ral
swi
tch -Todi
sconnectneut
ral
connect
ion
3.Ear
thswi
tch -Todi
sconnectEar
thconnect
ion
4.Pol
ari
tyswi
tch -Tor
ever
sel
i
neandneut
ral
connect
ion
Fr
ontPanel

1.Di
spl
ay -Mi
croammet
erdi
spl
ayr
ange0-
1mA,
micr
oammet
eri
nput
2.LEDi
ndi
cat
or-Mai
nssuppl
yst
atus
3.I
nsul
ati
ont
est
er
S1-chassi
stogr
oundi
mpedancei
ndi
cat
or
L1–Li
neconnect
ionofi
nst
rumentundert
estwi
thr
espectt
ogr
ound.
4.I
sol
ati
ont
est
er–Toconnectanyoft
hepat
ientl
eadsf
rom i
nst
rumentundert
est
5.Resetswi
tch -Toappl
y120vDC
6.Leakagecur
rentt
est
er–Tot
estanyt
wopat
ientl
eads
 BackPanel
I
nputsuppl
ysocket
:
 ACsocketi
sforconnect
ing230vACsuppl
ythr
oughmai
nscabl
ewi
thaf
use
of500mA.
 ON/
OFF swi
tch i
s pr
ovi
ded on t
he f
rontpanelt
o swi
tch ON/
OFF t
he
i
nst
rument
OPERATI
NGI
NSTRUCTI
ONS

Testpr
ocedur
eforconf
ir
mingmai
nssuppl
yst
atus

 Connectt
hei
nst
rumentt
o230vAC mai
nsandswi
tchont
hei
nst
rumentf
rom back
panel
.
 Checkt
hemai
nssuppl
yst
atuswi
thf
rontpanel
LED’
s.
 Mat
cht
heLED’
swi
thst
atusi
ndi
cat
edont
oppanel
.
 I
frequi
redt
akecor
rect
iveact
iont
ogetnor
mal
pol
ari
tyandnor
mal
groundedsuppl
y.

Vi
va

1.Whati
sisol
ati
on?

2. Whati
sleakagecur
rent
?

3.Li
stt
hehazar
dsofl
eakagecur
rent
.

4.Howi
stheel
ect
ri
cal
saf
etyofequi
pmentmeasur
ed?
 5.Whati
sinsul
ati
on?

Testpr
ocedur
eforconf
ir
mingi
nsul
ati
onst
atus

 Connecti
nst
rumentundert
estt
opowerout
letf
rom t
hebackpanel
ofanal
yzer
.
 Connectcr
ocodi
l
ecabl
efr
om backpanelchassi
ssockett
ochassi
soft
hei
nst
rument
undert
est
.
 Keept
oppanel
suppl
yswi
tchi
nOFFposi
ti
on
 S1shoul
dgl
ow,i
ndi
cat
ingchassi
stogr
oundr
esi
stanceofl
esst
han1ki
fnott
ake
cor
rect
iveact
ion
 S2shoul
dgl
ow i
ndi
cat
ingl
i
nepi
nofsuppl
ywi
reoft
hei
nst
rumentundert
esti
smor
e
t
han1megwi
thr
espectt
ogr
ound,
ifnott
akecor
rect
iveact
ion.
Testpr
ocedur
eforconf
ir
mingi
sol
ati
onst
atus

 Putsuppl
yswi
tchont
oppanelt
o‘ON’posi
ti
onsot
hatt
hei
nst
rumentundert
esti
s
swi
tchedON.
 Keepneut
ral
,ear
thandpol
ari
tyswi
tchesi
nnor
mal
posi
ti
on.
 Connectanyoft
hepat
ientl
eadst
oinputofi
sol
ati
ont
est
er.
 Connectmi
croamper
etoi
nputofmi
croammet
er.
 Pr
essr
esetswi
tch,mi
croammet
erwi
l
ldi
spl
ayl
eakagecur
rentoft
hatpar
ti
cul
arsl
ead
wi
thr
espectt
ogr
ound.
 Checkt
hiscur
rentf
orpr
operi
sol
ati
on,
ifnott
akecor
rect
iveact
ion.
 Repeatt
heabov
epr
ocedur
efr
om 1-
6wi
thneut
ralswi
tchi
nopenposi
ti
onand/
orwi
th
ear
thswi
tchi
sopenposi
ti
onand/
orpol
ari
tyswi
tchi
nopenposi
ti
on.
Testpr
ocedur
eforconf
ir
mingLeakagecur
rentt
est
er
  Suppl
yswi
tch–ON
 Neut
ral
/Ear
th/
Pol
ari
tyswi
tchesar
einnor
mal
posi
ti
on.
 Connectanyt
wopat
ientl
eadst
olead1&2i
nput
.
 Connectmi
croamper
etomi
croammet
eri
nput
.
 Mi
croammet
erwi
l
ldi
spl
ayl
eakagecur
rent
.
 Checkt
hiscur
rentf
orsaf
etyr
ange,
ifnott
akecor
rect
iveact
ion.
 Repeatt
hispr
ocedur
ewi
thneut
ral
and/
orpol
ari
tyswi
tchi
nrev
erseposi
ti
on.

RESULT

BLOCKDI
AGRAM

SPI
ROMETRYGRAPHS
 FVCGRAPH

MEASUREMENTOFRESPI
RATORYPARAMETERSUSI
NGSPI
ROMETRY
AI
M
Tor
ecor
dthechangesi
npul
monar
yvol
umeandcapaci
ti
esbyusi
ngSpi
romet
er.
APPARATUSREQUI
RED
1.Peakf
lowmet
er
2.Mout
hpi
ece
3.USBcabl
e
4.Comput
er.
THEORY
Spi
romet
ryi
sthemostcommonoft
hePul
monar
yFunct
ionTest
s(PFTs)
,measur
ing
l
ungf
unct
ion,speci
fi
cal
l
ythemeasur
ementoft
heamount(
vol
ume)and/
orspeed(
fl
ow)ofai
r
t
hatcan be i
nhal
ed and exhal
ed.Spi
romet
ryi
s an i
mpor
tantt
oolused f
orgener
ati
ng
pneumot
achogr
aphswhi
char
ehel
pfuli
nassessi
ngcondi
ti
onssuchasast
hma,pul
monar
y
f
ibr
osi
sandcy
sti
cfi
brosi
s.Thespi
romet
ryt
esti
sper
for
medusi
ngadev
icecal
l
edaspi
romet
er,
whi
chcomesi
nsev
eraldi
ff
erentv
ari
eti
es.Mostspi
romet
ersdi
spl
ayt
hef
oll
owi
nggr
aphs,
cal
l
edspi
rogr
ams.
 Av
olume-
ti
mecur
ve,showi
ngv
olume(
li
ter
s)al
ongt
heY-
axi
sandt
ime(
seconds)
al
ongt
heX-
axi
s
 Af
low-
vol
umel
oop,whi
chgr
aphi
cal
l
ydepi
ctst
her
ateofai
rf
low ont
heY-
axi
sand
t
het
otal
vol
umei
nspi
redorexpi
redont
heX-
axi
s
For
cedVi
talCapaci
ty(
FVC)
:Thebasi
cfor
cedv
olumev
italcapaci
ty(
FVC)t
estv
ari
es
sl
i
ght
lydependi
ngont
heequi
pmentused.Gener
all
y,t
hepat
ienti
saskedt
otaket
hedeepest
br
eat
htheycan,andt
henexhal
eint
othesensorashar
daspossi
ble,f
orasl
ongaspossi
ble.I
t
i
ssomet
imesdi
rect
lyf
oll
owedbyar
api
dinhal
ati
on(
inspi
rat
ion)
,inpar
ti
cul
arwhenassessi
ng
possi
bleupperai
rwayobst
ruct
ion.Somet
imes,t
het
estwi
l
lbepr
ecededbyaper
iodofqui
et
br
eat
hingi
nandoutf
rom t
hesensor(
ti
dalv
olume)
,ort
her
api
dbr
eat
hin(
for
cedi
nspi
rat
ory
par
t)wi
l
lcomebef
oret
hef
orcedexhal
ati
on.Dur
ingt
het
est
,sof
tnosecl
i
psmaybeusedt
o
pr
eventai
rescapi
ngt
hrought
henose.Fi
l
termout
hpi
ecesmaybeusedt
opr
eventt
hespr
eadof
mi
croor
gani
sms,
par
ti
cul
arl
yfori
nspi
rat
orymaneuv
ers.
Tur
bineTr
ansducer
:Thet
ransducerwhi
chi
susedi
nspi
romet
ryi
stur
binet
ransducer
.It
conv
ert
sthef
low ofai
r,br
eat
hedbyt
hepat
ient
,agai
nstaf
ri
cti
onl
essr
otat
ingv
anei
ntoan
el
ect
ri
cal
signal
whi
chi
susedt
opr
oducer
elev
antpl
ots.
 SVCGRAPH

MVVGRAPH

SPI
ROMETRYRESULTS
Vi
va

1.Whati
saspi
romet
er?

2.Whati
smeantbyt
het
ermsFVC,
SVCandMVV?

3.Whati
sdeadspace?

4.Gi
vet
hef
ormul
aforcal
cul
ati
ngTV,
IRVandERV.

5.Whatar
ethet
ypesofspi
romet
er?

PROCEDURE

 Si
tont
heedgeofy
ourchai
rifpossi
ble,
orsi
tupasf
arasy
oucanbei
nbed.
  Hol
dthei
ncent
ivespi
romet
eri
nanupr
ightposi
ti
on.
 Pl
acet
hemout
hpi
ecei
nyourmout
handseal
yourl
i
pst
ight
lyar
oundy
ourl
i
ps.
 Af
tereachsetof10deepbr
eat
hs,
pract
icecoughi
ngt
obesur
eyourl
ungsi
scl
ear
.Ify
ou
hav
eani
nci
sion,suppor
tyouri
nci
sionwhencoughi
ngbypl
aci
ngapi
l
lowf
ir
mlyagai
nst
i
t.
 Loadt
hepat
ient
’sdet
ail
sie.Name,
age,
sex,
hei
ght
,wei
ght
,pat
ientI
D,et
c.
 Cli
ckontotheFVC(
ForcedVit
alCapaci
ty)graphonthewi
ndow;
thef
orcedexpi
rat
ion
fol
lowedbyfor
cedi
nspir
ati
onwil
lberecordedhere.

 Cl
ickontot
heSVC( Sl
owVit
alCapaci
ty)graphont
hewindow;theSVC,
bei
ngthe
maximum vol
umeofairt
hatcanbeexhaledslowl
yaf
teraslowmaximum i
nhal
ati
onwi
l
l
berecor
dedhere.

 Clickontot
heMVV(Minut
eVenti
lat
oryVol
ume)graphont
hewindow;
themeasur
eof
themaxi mum amountofai
rthatcanbei nhal
edandexhal
edinoneminutewil
lbe
recordedher
e.

 Sav
ether
ecor
dedv
aluesandanal
yzet
hem usi
ngr
espect
ivesof
twar
e.

RESULT
 Exp:
Dat
e:

STUDYOFMEDI
CALSTI
MULATOR

AI
M

Tost
udyandv
eri
fyt
hewor
kingpr
inci
pleofMedi
cal
Sti
mul
ator
-TENS.

APPARATUEREQUI
RED

1.TENSuni
t
2.El
ect
rodes
3.Fl
exi
bleBands
THEORY

I
ntr
oduct
ion:

Medi
calst
imul
atori
sthedev
icei
nwhi
chel
ect
ri
ccur
renti
spr
oducedt
ost
imul
atet
he
par
tsoft
hebodyv
iz.
,muscl
eandner
vesf
ort
her
apeut
icpur
poset
otr
eatpai
n.Tr
anscut
aneous
el
ect
ri
calner
vest
imul
ati
on(
TENS)meanst
het
ransmi
ssi
onofel
ect
ri
calener
gyacr
osst
he
sur
faceoft
heski
ntot
hener
voussy
stem.El
ect
ri
cit
yisanat
uralphenomenonwi
thi
nal
lty
pesi
f
l
i
vingt
issue.Thebr
ainconst
ant
lyr
ecei
vesandi
ntegr
atesel
ect
ri
calsi
gnal
sindi
cat
iveofal
l
env
ironment
al(
ext
ernal
)andbodi
l
y(i
nter
nal
)ev
ent
sincl
udi
ngt
hatofpai
n.Thr
oughouthi
stor
y
manhassoughtr
eli
eff
rom pai
nbyv
ari
ousmeans.Hi
stor
icalr
efer
encest
opai
n-r
eli
evi
ng
modal
i
tiesi
ncl
udeher
bs,pot
ions,heatandcol
dappl
i
cat
ions,acupunct
uret
echni
ques,dr
ugs,
sur
ger
y,medi
tat
ion,hy
pnosi
sandel
ect
ri
cit
y.TENSi
ncor
por
atesanear
lymet
hodofpai
nrel
i
ef
t
hathasnow beenr
efi
nedandsi
mpl
i
fiedf
oreaseofappl
i
cat
ionv
iat
heuseofnew sci
ent
if
ic
andt
echnol
ogi
cal
adv
ances.

TENSPr
inci
ple:

Thegat
econt
rolt
heor
yofpai
n,putf
orwar
dbyRonal
dMel
zackandPat
ri
ckDav
idWal
li
n
1962,i
sthei
deat
hatt
heper
cept
ionofphy
sicalpai
nisnotadi
rectr
esul
tofact
ivat
ionof
noci
cept
ors,buti
nst
eadi
smodul
atedbyi
nter
act
ionbet
weendi
ff
erentneur
ons,bot
hpai
n-
t
ransmi
tt
ingandnon-
pai
n-t
ransmi
tt
ing.Thet
heor
yasser
tst
hatact
ivat
ionofner
vest
hatdonot
t
ransmi
tpai
nsi
gnal
scani
nter
fer
ewi
thsi
gnal
sfr
om pai
nfi
ber
sandi
nhi
bitani
ndi
vi
dual
'
s
per
cept
ionofpai
n.
PAI
NRELI
EFSYSTEM
 Accor
dingt
othegat
econt
rolt
heor
yofpai
n,t
her
eisa"
gat
ingsy
stem"i
nthecent
ral
ner
voussy
stem t
hatopensandcl
osest
oletpai
nmessagest
hrought
othebr
ainort
obl
ock
t
hem.TENSst
imul
atet
heAf
ibr
ewhi
ch"
closet
hegat
e"andr
educepai
n.Themai
nfunct
ionof
TENSi
stor
eli
evet
hesy
mpt
omsofmuscul
arpai
n,poorbl
oodci
rcul
ati
onandpr
ovi
despai
n
management
.

Thr
eeFunct
ionsf
orPai
nRel
i
efar
e:

1.TENSsignal
sheadingt
othebr
ainisfast
erthant
hepainsothatt
hepainf
ulfeel
i
ngis
l
ight
ened.
2.TENSstimul
atesthebr
aint
osecret
eendorphinf
lowi
ngint
othebloodandthespinal
f
lui
d,andt
henr
eli
evest
hepai
n.
3.TENS st
imul
atest
hesy
mpat
het
icner
vet
oremov
ethepai
norst
rai
ncomi
ngf
rom
di
seasesorpr
essur
e.

Pl
acementofEl
ect
rodes

Themostusuali
stosi
teel
ect
rodescl
oset
owher
ethepai
nisper
sei
vedt
obe,
of
tenoneel
ect
rodei
ssi
tedov
ert
hepl
acewher
ethemosti
ntensepai
nisf
eltort
he
gr
eat
estt
ender
nessel
i
cit
ed.

El
ect
rost
imul
ati
onpar
amet
ers

Pul
sef
requency
:

Numberofpul
sesdel
i
ver
edbyt
hemachi
nepersecondandi
sspeci
fi
edi
nHer
tz.I
t
r
angesar
efr
om 2–125Hz

Pul
seDur
ati
on:

Thedur
ati
onofeachpul
seofel
ect
ri
calst
imul
ati
oni
smeasur
edi
nmi
croseconds.I
t
r
angesf
rom 25–500µs

St
imul
ati
onmode

Thest
imul
ati
onmodesdi
ff
ersi
gni
fi
cant
lybymanyf
act
orssuchaspar
amet
erset
ti
ngs,
dept
hoft
issuepenet
rat
ion,el
ect
rodepl
acementt
echni
ques,speedofact
ion,dur
ati
on
ofpai
nrel
i
efandphy
siol
ogi
cal
eff
ect
s.
Vi
va

2.Whati
sthepr
inci
plebehi
ndt
heuseofmedi
cal
sti
mul
ator
?

3.Whati
smeantbyTENS?

4.Li
stt
hef
unct
ionsoft
hepai
nexper
tsy
stem.

5.Whatar
ethev
ari
ousmodesofTENS?

6.Namet
heappl
i
cat
ionsofTENS.
Var
iousmodesusedar
e

1.Conv
ent
ional

2.St
rongl
owr
ate

3.Pul
set
rai
n

4.Br
iefi
ntense

PROCEDURE

1.Connectt
hepat
ientel
ect
rodest
othepat
ientandt
heel
ect
rodewi
rest
otheequi
pment
.
2.Ensur
ebot
htheampl
i
tudeandf
requenci
esar
eatt
hei
rmi
nimal
lev
elposi
ti
on.
3.Connectt
hemai
nscabl
etot
hewal
lsocketandswi
tchont
hemai
nsON/
OFFswi
tch
pr
ovi
dedatt
hef
rontpanel
.
4. Sett
het
her
apyt
imebyusi
ngUP/
DOWNar
rowkey
spr
ovi
dedatt
hef
rontpanel
.
5.Pr
essSTARTkeyt
ost
artt
hest
imul
ati
on.
6.Sel
ectt
her
equi
redf
requency
,pul
sewi
dth,
modul
ati
onmodeandsweept
ime.
7.Sl
owl
yincr
easet
heampl
i
tudecont
rol
sti
l
lthepat
ientf
eel
sthest
imul
ati
onef
fectandi
t
shoul
dbecomf
ort
abl
etohi
m/hi
s.
8.Leav
ethemachi
nei
nthi
scondi
ti
on.
9.Thei
nst
rumentwi
l
laut
omat
ical
l
yswi
tchof
fthest
imul
ati
onatt
heendoft
hesett
her
apy
t
ime.
10.Keept
heampl
i
tudecont
rol
atmi
nimum l
evel
andr
emov
eal
lthewi
res.
11.Swi
tchof
fthei
nst
rument
.

RESULT
Thust
het
reat
mentpr
ocedur
eforr
eli
evi
ngpai
nusi
ngTENSi
sst
udi
ed.
BLOCKDI
AGRAM OFATYPI
CALELECTROSURGERYUNI
T

ELECTROSURGERYUNI
T
Exp:

Dat
e:
FUNCTI
ONI
NGOFESU–CUTTI
NGANDCOAGULATI
ONMODES

AI
M
Tost
udyaboutt
heEl
ect
roSur
gical
Uni
tandi
tsf
unct
ion.

APPARATUSREQUI
RED
1.ESUkit
2.I
nacti
vepad
3.Handpencil
4.Monopolarel
ect
rodes-
bal
l
,needl
e,f
ulgur
ati
on&desi
ccat
ion
5.Bipol
arel
ectr
ode
6.Footswit
ch
7.Connecti
ngcabl
es

THEORY
El
ect
roSur
ger
y:

El
ect
rosur
ger
yist
heappl
i
cat
ionofahi
gh-
fr
equencyel
ect
ri
ccur
rentt
obi
ologi
cal
t
issueasameanst
ocut
,coagul
ate,desi
ccat
e,orf
ulgur
atet
issue.I
tsbenef
iti
ncl
udes
t
heabi
l
ityt
omakepr
eci
secut
swi
thl
i
mit
edbl
oodl
oss.I
nel
ect
rosur
gicalpr
ocedur
es,
t
het
issuei
sheat
edbyanel
ect
ri
ccur
rent
.Al
thoughel
ect
ri
caldev
icesmaybeusedf
or
t
hecaut
eri
zat
ionoft
issuei
nsomeappl
i
cat
ions,el
ect
rosur
ger
yisusual
l
yusedt
oref
er
t
oaqui
tedi
ff
erentmet
hodt
hanel
ect
rocaut
ery
.Thel
att
erusesheatconduct
ionf
rom a
pr
obeheat
edt
oagl
owi
ngt
emper
atur
ebyadi
rectcur
rent(
muchi
nthemannerofa
sol
der
ingi
ron)
.Thi
smaybeaccompl
i
shedbydi
rectcur
rentf
rom dr
y-cel
l
sinapenl
i
ght
-
t
ypedev
ice.El
ect
rosur
ger
y,bycont
rast
,usesal
ter
nat
ingcur
rentt
odi
rect
lyheatt
he
t
issuei
tsel
f.Whent
hisr
esul
tsi
ndest
ruct
ionofsmal
lbl
oodv
essel
sandhal
ti
ngof
bl
eedi
ng,
iti
stechni
cal
l
yapr
ocessofel
ect
rocoagul
ati
on.

El
ect
ro sur
ger
yiscommonl
yused i
n der
mat
ologi
cal
,gy
necol
ogi
cal
,car
diac,
pl
ast
ic,ocul
ar,spi
ne,ENT,max
il
lof
aci
al,or
thopedi
c,ur
ologi
cal
,neur
o and gener
al
sur
gicalpr
ocedur
esaswel
lascer
tai
ndent
alpr
ocedur
es.El
ect
rosur
ger
yisper
for
med
usi
nganel
ect
rosur
gicalgener
ator(
also r
efer
red t
o aspowersuppl
yorwav
efor
m
gener
ator
)andahandpi
ecei
ncl
udi
ngoneorsev
eralel
ect
rodes,
somet
imesr
efer
redt
o
asanRFKni
fe.Theappar
atuswhenusedf
orcut
ti
ngorcoagul
ati
oni
nsur
ger
yisst
il
l
of
tenr
efer
redt
oinf
ormal
l
ybysur
geonsasa"
Bov
ie"af
tert
hei
nvent
or.

VARI
OUSTYPESOFELECTROSURGERYTECHNI
QUE

MONOPOLARELECTROSURGERYTECHNI
QUE

BI
POLARELECTROSURGERYTECHNI
QUE
Var
ious Types of
El
ectr
osur
gery Techni
que
Incut
ti
ng mode,elect
rode
t
ouches t
he t
issue, and
suf
fi
cient
lyhi
ghpowerdensi
tyi
sappl
i
edt
ovapor
izei
tswat
ercont
ent
.Si
ncewat
er
v
apori
snotconduct
iveundernor
malci
rcumst
ances,el
ect
ri
ccur
rentcannotf
low
t
hrought
hev
aporl
ayer
.Ener
gydel
i
ver
ybey
ondt
hev
apor
izat
iont
hreshol
dcancont
inue
i
fsuf
fi
cient
lyhi
ghv
olt
agei
sappl
i
ed(
>+/
-200V)t
oioni
zev
aporandconv
erti
tint
oa
conduct
ivepl
asma.Vaporandf
ragment
soft
heov
erheat
edt
issuear
eej
ect
ed,f
ormi
ng
acr
ater
.El
ect
rodesur
facesi
ntendedt
obeusedf
orcut
ti
ngof
tenf
eat
ureaf
inerwi
reor
wi
rel
oop,
asopposedt
oamor
efl
atbl
adewi
thar
oundedsur
face.
Coagul
ati
on i
s per
for
med usi
ng wav
efor
ms wi
th l
ower av
erage power
,
gener
ati
ng heati
nsuf
fi
cientf
orexpl
osi
vev
apor
izat
ion,butpr
oduci
ng a t
her
mal
coagul
um i
nst
ead.
El
ect
rosur
gical
desi
ccat
ionoccur
swhent
heel
ect
rodet
ouchest
het
issueopent
o
ai
r,andt
heamountofgener
atedheati
slowert
hant
hatr
equi
redf
orcut
ti
ng.Thet
issue
sur
faceandsomeoft
het
issuemor
edeept
othepr
obedr
iesoutandf
ormsacoagul
um
(
adr
ypat
chofdeadt
issue)
.Thi
stechni
quemaybeusedf
ort
reat
ingnodul
esundert
he
ski
nwher
emi
nimal
damaget
otheski
nsur
facei
sdesi
red.
I
nful
gur
ati
onmode,
theel
ect
rodei
shel
dawayf
rom t
het
issue,
sot
hatwhent
he
ai
rgapbet
weent
heel
ect
rodeandt
het
issuei
sioni
zed,anel
ect
ri
car
cdi
schar
ge
dev
elops.I
nthi
sappr
oacht
hebur
ningt
othet
issuei
smor
esuper
fi
cial
,becauset
he
cur
renti
sspr
eadov
ert
het
issuear
eal
argert
hant
het
ipofel
ect
rode.Undert
hese
condi
ti
ons,super
fi
ci
alski
nchar
ri
ngorcar
boni
zat
ioni
sseenov
erawi
derar
eat
han
whenoper
ati
ngi
ncont
actwi
tht
hepr
obeandt
hist
echni
quei
sther
efor
eusedf
orv
ery
super
fi
cialorpr
otr
usi
vel
esi
onssuchasski
ntags.I
oni
zat
ionofanai
rgapr
equi
res
v
olt
agei
nthekVr
ange.
Besi
dest
het
her
malef
fect
sint
issue,el
ect
ri
cfi
eldcanpr
oducepor
esi
nthe
cel
l
ularmembr
anes-aphenomenoncal
l
edel
ect
ropor
ati
on.Thi
sef
fectmayaf
fectcel
l
s
bey
ondt
her
angeoft
her
mal
damage.
PURPOSEOFELECTROSURGI
CALUNI
TS

ESU’
sar
e used f
orsur
gicalcut
ti
ng ort
o cont
rolbl
eedi
ng bycausi
ng coagul
ati
on
(
hemost
asi
s)att
hesur
gicalsi
te.Theydel
i
verhi
gh-
fr
equencyel
ect
ri
calcur
rent
sandv
olt
ages
t
hroughanact
iveel
ect
rode,causi
ngdesi
ccat
ion,v
apor
izat
ion,orchar
ri
ngoft
het
argett
issue.
ESU’
sar
eausef
ult
ooli
nal
laspect
soft
hesur
gicalar
ena:f
rom t
hemostbasi
cwar
tremov
al,
spi
derv
eins,orhai
rremov
ali
nadoct
or’
sof
fi
ce;t
othemosti
ntr
icat
eopenhear
t,or
thopedi
c,
andt
ranspl
antpr
ocedur
es.

ELECTROSURGI
CALWAVEFORMS

OBSERVATI
ON

Handpenci
lel
ect
rode

Power(
W) Cut
ti
ngmode Power(
W) Bl
endi
ngmode

Monopol
arel
ect
rode Bi
pol
arel
ect
rode

Power(
W) Cutmode Bl
endmode Power(
W) Bl
endmode
PRI
NCI
PLESOFOPERATI
ON

Monopol
arEl
ect
rosur
ger
y:I
n monopol
arel
ect
rosur
ger
y,t
issue i
s cutand coagul
ated by
compl
eti
nganel
ect
ri
calci
rcui
tthati
ncl
udesahi
gh-
fr
equencyosci
l
lat
orandampl
i
fier
swi
thi
n
t
heESU,t
hepat
ientpl
ate,t
heconnect
ingcabl
es,andt
heel
ect
rodes.I
nmostappl
i
cat
ions,
el
ect
ri
ccur
rentf
rom t
heESUi
sconduct
edt
hrought
hesur
gicalsi
tewi
thanact
ivecabl
eand
el
ect
rode.The el
ect
rosur
gicalcur
renti
sthen di
sper
sed t
hrough t
he pat
ientt
oar
etur
n
el
ect
roder
etur
ningt
heener
gyt
othegener
atort
ocompl
etet
hepat
h.Monopol
arel
ect
rosur
ger
y
has t
he means ofdel
i
ver
ing ener
gyt
othe t
issue t
hrough sev
eralmodal
i
ties (
modes of
oper
ati
on)
:pur
ecut
,bl
endedcut
,desi
ccat
ion(
orpi
npoi
nt)
,andspr
ay(
orf
ulgur
ati
on)
.The
del
i
ver
ysy
stem oft
hemonopol
arel
ect
rosur
gicalgener
atorcanbeahandcont
rol
l
edpenci
l
(
reusabl
eordi
sposabl
e)oraf
ootcont
rol
l
edpenci
l
.Anumberofaccessor
iescanbeadapt
edt
o
t
hef
ootcont
rol
out
putj
ackt
odel
i
verener
gyt
hroughanumberofi
nst
rument
s.
Bi
pol
arEl
ect
rosur
ger
y:I
nbi
pol
arel
ect
rosur
ger
y,t
woel
ect
rodes(
gener
all
ythet
ipsofapai
r
f
orcepsorsci
ssor
s)ser
veast
heequi
val
entoft
heact
iveanddi
sper
siv
eleadsi
nthemonopol
ar
mode.Bi
pol
arel
ect
rosur
ger
ydoesnotr
equi
reapat
ientpl
ate.El
ect
rosur
gicalcur
renti
nthe
pat
ienti
srest
ri
ctedt
oasmal
lvol
umeoft
issuei
nthei
mmedi
ater
egi
onofappl
i
cat
ionoft
he
f
orceps.Thi
saf
for
dsgr
eat
ercont
rolov
ert
hear
eat
obecoagul
ated.Damaget
osensi
ti
ve
t
issuesi
ncl
osepr
oxi
mit
ytot
hei
nst
rumentcanbeav
oided.Ther
eisl
esschanceofcur
rent
capaci
ti
vel
yordi
rect
lyar
cingt
osur
roundi
ngst
ruct
uressuchast
hebowel
.Pat
ientbur
nsar
e
v
irt
ual
l
yel
i
minat
ed.
El
ect
rosur
gical
Wav
efor
ms
El
ect
rosur
gicalgener
ator
scanpr
oduceav
ari
etyofwav
efor
msandeachwav
efor
m
cr
eat
esdi
ff
erentt
issue r
esul
ts.The cut
ti
ng cur
rentwi
l
lcutt
he t
issue butpr
ovi
desl
i
ttl
e
hemost
asi
s.Thecoagul
ati
oncur
rentpr
ovi
descoagul
ati
onbutdoesnotal
l
ow f
orsmoot
h
cut
ti
ng.Thebl
endcur
renti
sani
nter
medi
atecur
rentbet
weent
hecut
ti
ngandcoagul
ati
on
cur
rent
sbuti
snotacombi
nat
ionoft
het
woast
henamemi
ghti
mpl
y.I
tisacut
ti
ngcur
renti
n
whi
cht
hedut
ycy
cle(
ti
mecur
renti
sact
ual
l
yfl
owi
ng)i
sreducedf
rom 100per
centoft
het
imet
o
appr
oxi
mat
ely50per
centoft
het
ime(
dependsonmanuf
act
urer
).
The“
off
”ti
meal
l
owst
het
issuet
ocoolcr
eat
ingsomehemost
asi
s.I
tisi
mpor
tantt
o
know t
hatt
he“
Blend”cur
rent
sinESUsar
edel
i
ver
edonl
ywhent
hecutbut
ton/
foot
swi
tchi
s
act
ivat
ed.Depr
essi
ngt
hecoagbut
ton/
foot
swi
tchwi
l
ldel
i
vert
hecoagorspr
aycoagcur
rent
.
SAFETYPRECAUTI
ONS

 Di
ather
mymayi nt
erf
erewit
hthepat
ient
simpl
ant
edwi
thcar
diacpacemakerand
wi
thsyri
ngepumpfuncti
on.
 The diat
her
myelectr
ode shoul
d notcome i
n di
rectcontactwi
ththe metal
prost
hesisori
mplant
sbecauseitwil
lcauset
hecur r
enttoarcfr
om el
ectr
ode
ontothemetal
oft
heimplant.

Vi
va

1. Def
inet
hepr
inci
pleofESU.

2. Whatar
etheappl
i
cat
ionsofESU?

3. Li
stt
hedi
ff
erentt
ypesofel
ect
rosur
ger
y.
 4. Howi
sel
ect
rosur
ger
ysuper
iorov
erconv
ent
ional
sur
ger
y?

5. Whati
sful
gur
ati
on?

 Theout
putci
rcui
tofdi
ather
myuni
tshoul
dbei
sol
atedandi
nsul
atedf
rom l
ow
f
requencypr
imar
yandsecondar
yvol
tages.
 El
ect
rosur
gicaluni
tmaycausebur
nsduet
oexcesscur
rentdensi
tyoccur
sat
di
sper
siv
eel
ect
rodeduet
olackofadequat
econt
actwi
tht
het
issueandr
iskof
bur
nsmayal
sooccurbecauseofpr
esenceofmoi
stur
e.
 Dur
ingsur
ger
y,t
heout
putofel
ect
rosur
gicaluni
tshoul
dnotbei
ncr
easedt
o
obt
aindesi
redsur
gicalef
fectandt
heabnor
malpowerset
ti
ngsi
ndi
cat
est
hat
t
her
eissomef
aul
twhi
chmustbei
dent
if
ied.
 Theel
ect
rosur
gicaluni
tsofi
sol
atedout
putt
ypeshoul
dbeusedast
heypr
ovi
de
pr
otect
ionagai
nstf
ibr
il
lat
ion.
PROCEDURE
 Connectal
lthecabl
est
otheESU.
 Pl
acet
hesampl
e(soaporpot
atoi
spr
efer
red)ont
hei
nact
ivepad.
 Swi
tchONt
hedev
ice.
 Sett
hepowerf
ort
her
espect
ivemode.
 Cut
ti
ng,bl
endi
ngorcoagul
ati
oncanbeper
for
medont
hesampl
eint
hreedi
ff
erent
modes:
- usi
ngt
hehandpenci
lwi
tht
hehel
pofhandswi
tchorf
ootswi
tch
- usi
ngt
hemonopol
arorbi
pol
aract
iveel
ect
rode
  Obser
vet
her
esul
tont
hesampl
e.

RESULT

ANATOMYOFEAR

AUDI
OMETER
BLOCKDI
AGRAM

Exp:
Dat
e:

RECORDI
NGOFAUDI
OGRAM

AI
M

Topl
ott
heaudi
ogr
am oft
hesubj
ectusi
nganaudi
omet
er.
APPARATUSREQUI
RED

1.Digi
talaudiometersetup
2.Headphones
3.Boneconduct or
4.Microphone
5.Pati
entresponseswi t
ch
6.Connectingcabl
es
THEORY

Thehumanearhast
hreemai
nsect
ions,whi
chconsi
stoft
heout
erear
,themi
ddl
eear
,
andt
hei
nnerear
.Soundwav
esent
ert
heout
erearandt
rav
elt
hrought
heearcanalt
othe
mi
ddl
eear
.Theearcanalchannel
sthewav
est
otheear
drum,at
hin,sensi
ti
vemembr
ane
st
ret
chedt
ight
lyov
ert
heent
rancet
othemi
ddl
eear
.Thewav
escauset
heear
drum t
ovi
brat
e.I
t
passest
hesev
ibr
ati
onsont
othehammer
,oneoft
hreet
inybonesi
ntheear
.Thehammer
v
ibr
ati
ngcausest
heanv
il
,thesmal
lbonet
ouchi
ngt
hehammer
,tov
ibr
ate.Theanv
ilpasses
t
hesev
ibr
ati
onst
othest
ir
rup,
anot
hersmal
lbonewhi
cht
ouchest
heanv
il
.Fr
om t
hest
ir
rup,
the
v
ibr
ati
onspassi
ntot
hei
nnerear
.Thest
ir
rupt
ouchesal
i
qui
dfi
l
ledsackandt
hev
ibr
ati
ons
t
rav
eli
ntot
hecochl
ea,whi
chi
sshapedl
i
keashel
l
.Insi
det
hecochl
ea,t
her
ear
ehundr
edsof
speci
alcel
l
sat
tachedt
oner
vef
iber
s,whi
chcant
ransmi
tinf
ormat
iont
othebr
ain.Thebr
ain
pr
ocessest
hei
nfor
mat
ionf
rom t
heearandt
hisdi
sti
ngui
shesbet
weendi
ff
erentt
ypesof
sounds.
Ai
randboneconduct
ion:

Ai
rconduct
ion,bydef
ini
ti
on,i
sthet
ransmi
ssi
onofsoundt
hrought
heext
ernaland
mi
ddl
eeart
othei
nter
nalear
.Boneconduct
ion,
ont
heot
herhand,
ref
erst
othet
ransmi
ssi
onof
soundt
othei
nter
nal
earmedi
atedbymechani
cal
vibr
ati
onoft
hecr
ani
albonesandsof
tti
ssues.
Themosti
mpor
tantdi
agnost
icdi
ff
erent
ialf
rom t
hest
andpoi
ntoft
hef
unct
ionalhear
ingt
est
sis
t
her
elat
ionshi
pbet
weenai
randboneconduct
ionacui
ty.Themeasur
ementofhear
ingconsi
sts
oft
wopar
amet
ers:
thef
requencyorpi
tchoft
hesoundandt
hei
ntensi
tyorl
oudnessofasound.
Thedev
iceusedt
omeasur
eresponsest
osoundi
scal
l
edanaudi
omet
er.Responsest
othe
t
onespr
esent
edt
hrought
heaudi
omet
erar
erecor
dedonagr
aphcal
l
edanaudi
ogr
am.

OBSERVATI
ON
Subj
ectName: Age: Hei
ght
:

S.
no Fr
equency Deci
bel
(Hz) (db)
Wi
thoutmaski
ng Wi
thmaski
ng

R L R L

1 125

2 250

3 500

4 750

5 1K

6 1.
5K
 7 2K

8 3K

9 4K

10 5K

MODELGRAPH

Fr
equencyResponseChar
act
eri
sti
csofEar

THEAUDI
OGRAM

Anaudiogr
am isagr aphthatchar t
st hewayaper sonr espondstospecifi
c
soundscal l
edpuretones.I
tisdesignedt orecordt heresponsesforthemechani calpar
t
ofhear i
ng.Whent herei
ssuspicionorconf irmationthatonecochl eahear sbett
erthan
theot hercochleaatagi venf r
equency ,maski ng( narr
ow bandorspeechnoi se)is
presentedtothebettereartokeepi toccupied.Maski ngisgeneral
lypr esent
edthrough
oneear phoneandapur etoneorspeechi spr esentedt hr
oughtheopposi t
eearphoneor
aboneosci ll
ator
.

Theresponseschar
tedontheaudi
ogr
am def
inelev
elsofheari
ngforeach
ear
.Foradults,normalheari
ng and degr
eeofhear
ing lossfal
lint
ot hefoll
owing
cat
egor
ies:

0dB-20dB.
..
..
..Nor
malheari
ng
20dB-40dB.
..
..
..Mil
dheari
ngloss
40dB-55dB.
..
..
..Moder
ateheari
ngloss
55dB-70dB.
..
..
..Moder
atel
yseverehear
ingl
oss
 70dB-90dB.
..
..
..Severehear
ingloss
>90dB.
..
..
..Profoundheari
ngloss

PROCEDURE

Topl
otaudi
ogr
am oft
hesubj
ectusi
ngai
rconduct
ionpur
etoneaudi
omet
er

 Connectthesockett ot
hebackpanel oftheaudiometer.
 SwitchONt hedev i
ceandsel ectt heairconduct i
onmode.
 Weart heheadphoneandsel ectt hemodeofsound- puretoneorspeech( use
microphone)
 Adjustthefrequencyandi ntensi tyofsoundandmeasur ethedecibelrangeat
whichitisheardforbot
ht hel eftandt her i
ghtear.
 Usemaski ngt oasui tabl
el ev elsot hatitdoesnotcausedi scomfor
tt othe
subjectandrecordthesoundhear dindecibelsforbot
htheleftandtheri
ghtear.
 Plotthegraphoff r
equencyv ersusout putdBl evelf
orboththeleftandtheri
ght
earwithandwi t
houtmaski ng.

Vi
va

1. Whati
sanaudi
omet
er?

2. Def
ineanaudi
ogr
am.
3. Howi
ssoundt
ransmi
tt
edt
hrought
heear
?

4. Li
stt
her
angeofsounddBf
ornor
mal
hear
ingandhear
ingl
oss.

5. Whati
sthef
unct
ionofmaski
ng?
RESULT

BLOCKDI
AGRAM

Pati
ent Exter
nal Digi
tal
pacemaker pacemaker stor
age
si
mulator osci
lloscope

ELECTRI
CALACTI
VITYOFTHEHEART
 Exp:
.
  Dat
e:
RECORDI
NGANDANALYSI
SOFPACEMAKERSI
MULATOR

AI
M

Toanal
yzet
hef
unct
ionofpacemakersi
mul
atoratv
ari
oushear
trat
esandr
ecor
dtheECG
wav
efor
minnor
mal
,tachy
car
dia,
brady
car
diaandAVBl
ockcondi
ti
ons.
APPARATUSREQUI
RED

1.Pacemakersi
mul
ator
-1no.
2.Di
git
alsi
gnal
osci
l
loscope-1no.
 3.Connect
ingcabl
es
THEORY

Thepacemakeri
sanel
ect
ri
cst
imul
atort
hatpr
oducesper
iodi
cel
ect
ri
cpul
ses.That
pul
sei
sto el
ect
rodesl
ocat
ed i
nthesur
faceoft
hehear
t(ext
ernal
l
y).Thest
imul
ust
hus
conduct
edt
othehear
tandhear
tcont
ract
,thi
sel
ect
ri
cst
imul
ati
onef
fectcanbeusedi
ndi
sease
st
atesi
nwhi
cht
hehear
tisnotst
imul
atedatt
hepr
operr
ateoni
tsown.Anasy
nchr
onous
pacemakeri
sonet
hati
sfr
eer
unni
ng.I
tsel
ect
ri
cst
imul
usappear
satauni
for
mrat
eregar
dless
ofwhati
sgoi
ngi
nthehear
torr
estoft
hebody
.Itt
her
efor
egi
vesaf
ixedhear
trat
e.I
nter
nal
(
Impl
ant
abl
e)pacemakeri
spackagedi
nmet
alpackages.Ti
tani
um andst
ainl
essst
eelar
e
commonl
yusedf
orpackage.Speci
alel
ect
ronbeam orl
aserwel
dingt
echni
queshasbeenused
t
osealt
hesepackageswi
thoutdamagi
ngt
heel
ect
roni
cci
rcui
tandpowersour
ce.Thesemet
al
packagest
akeupl
essv
olume.Whent
henat
uralpacemakerf
ail
stogener
atet
heel
ect
ri
cal
i
mpul
ses,ort
hepul
sesar
ebl
ockedcompl
etel
yori
nter
mit
tent
ly,anel
ect
roni
cpacemakermust
bei
mpl
ant
edt
oper
for
mthi
sfunct
ion.Thi
sel
ect
roni
cpacemakerwor
ksi
nwhi
cht
hesame
mannerast
henat
uralpacemaker
.Thei
mpl
ant
edpacemakerpr
oducesanel
ect
ri
cali
mpul
seat
af
ixedr
ate,
tost
imul
atet
hehear
tmuscl
esandcausesi
ttocont
ract
.
Ther
ear
ethr
eet
ypesofcar
diacdi
sor
der
s:
Br
ady
car
dia(
"hear
tsl
owness"
)isdef
inedasar
est
inghear
trat
eoff
ewert
han60beat
s
permi
nut
e,t
houghi
tissel
dom sy
mpt
omat
icunt
ilt
her
atedr
opsbel
ow 50beat
/mi
n.I
tmay
cause"
hear
tat
tacks"(
i.
e.car
diacar
rest
)insomepat
ient
s.Thi
soccur
sbecausebr
ady
car
dia
maynotbepumpi
ngenoughoxy
gent
othei
rhear
tcausi
nghear
tat
tack-
li
kesy
mpt
oms.I
t
somet
imesr
esul
tsi
nfai
nti
ng,
shor
tnessofbr
eat
h,andi
fsev
ereenough,
deat
h.Tr
ainedat
hlet
es
ory
oungheal
thyi
ndi
vi
dual
smayal
sohav
easl
ow r
est
inghear
trat
e.Rest
ingbr
ady
car
diai
s
of
tenconsi
der
ednor
mali
fthei
ndi
vi
dualhasnoot
hersy
mpt
omssuchasf
ati
gue,weakness,
di
zzi
ness,l
i
ght
headedness,f
aint
ing,chestdi
scomf
ort
,pal
pit
ati
ons orshor
tness ofbr
eat
h
associ
atedwi
thi
t.

TABULATI
ON

AVBl
ock Tachy
car
dia Br
ady
car
dia

Ampl
i
tude Ti
me(
ms) Ampl
i
tude Ti
me(
ms) Ampl
i
tude Ti
me(
ms)
(
mV) (
mV) (
mV)
Thet
ermr
elat
ivebr
ady
car
diai
susedt
oexpl
ainahear
trat
ethat
,whi
l
enotact
ual
l
ybel
ow 60
beat
spermi
nut
e,i
sconsi
der
edt
oosl
owf
ort
hei
ndi
vi
dual
'
scur
rentmedi
cal
condi
ti
on.
An at
ri
ovent
ri
cul
arbl
ock(
orAV bl
ock)i
nvol
vest
he i
mpai
rmentoft
he conduct
ion
bet
weent
heat
ri
aandv
ent
ri
clesoft
hehear
t.St
rongv
agalst
imul
ati
onmaypr
oduceAVbl
ock.
Thechol
i
ner
gicr
ecept
ort
ypesaf
fect
edar
ethemuscar
ini
crecept
ors.Ther
ear
ethr
eet
ypes:
 Fi
rstdegr
eeAVbl
ock-PRi
nter
val
great
ert
han0.
20sec.
 Seconddegr
eeAVbl
ock-Ty
pe1:Pr
ogr
essi
vepr
olongat
ionofPRi
nter
valwi
thdr
opped
 beat
s.Ty
pe2:
PRi
nter
val
remai
nsunchangedpr
iort
othePwav
ewhi
chsuddenl
yfai
l
sto
conductt
othev
ent
ri
cles.
 Thi
rddegr
eeAVbl
ocks-Noassoci
ati
onbet
weenPwav
esandQRScompl
exes.
Tachy
car
diat
ypi
cal
l
yref
erst
oahear
trat
ethatex
ceedst
henor
malr
angef
orar
est
ing
hear
trat
e(hear
trat
einani
nact
iveorsl
eepi
ngi
ndi
vi
dual
).I
tcanbev
erydanger
ousdependi
ng
onhowhar
dthehear
tiswor
kingandt
heact
ivi
ty.Theuppert
hreshol
dofanor
malhumanhear
t
r
atei
susual
l
ybaseduponage:
 1–2days:
>159beat
spermi
nut
e(bpm)
 3–6days:
>166bpm
 1–3weeks:
>182bpm
 1–2mont
hs:
>179bpm
 1–2y
ear
s:>151bpm
 5–7y
ear
s:>133bpm
 8–11y
ear
s:>130bpm
 12–15y
ear
s:>119bpm
 >15y
ear
s–adul
t:>100bpm
Whent
hehear
tbeat
srapi
dly
,thehear
tpumpsl
essef
fi
cient
lyandpr
ovi
desl
essbl
ood
f
low t
other
estoft
hebody
,incl
udi
ngt
hehear
tit
sel
f.Thei
ncr
easedhear
trat
eal
sol
eadst
o
i
ncr
easedwor
kandoxy
gendemandf
ort
hehear
t(my
ocar
dium)
,whi
chcanl
eadt
orat
erel
ated
I
schemi
athusper
hapscausi
ngahear
tat
tack(
myocar
diali
nfar
cti
on)i
fitper
sist
s.Thi
soccur
s
becauset
hedecr
easedf
lowofnecessar
yoxy
gent
othehear
tcausesmy
ocar
dialcel
l
stobegi
n
t
odi
eof
f.Acut
ely
,thi
sleadst
oangi
na;
andchr
oni
cal
l
ytoi
schemi
chear
tdi
sease.

Vi
va

1.Whati
sapacemaker
?
 2.Whati
sneedofapacemaker
?

3.Whati
sbr
ady
car
dia?Dr
awi
tswav
efor
m.

4.Whati
stachy
car
dia?Expl
ainwi
thagr
aph.

5.Whati
sAVbl
ock?

PROCEDURE

 Connectt
hei
nst
rument
stot
hemai
n;putal
lknobsatzer
oposi
ti
on.
 Connectt
hesi
mul
atorout
putt
otheext
ernal
pacemakerandDSO,
 Recor
dtheECGwav
efor
msi
nNor
mal
,Tachy
car
dia,Br
achy
car
diaandAVbl
ockusi
ng
appr
opr
iat
eswi
tchesi
nthesi
mul
ator
.
  Not
edownt
heampl
i
tudeandt
imedur
ati
onf
orv
ari
ousabnor
mal
wav
efor
ms.

RESULT

WORKI NG
PRI
NCIPLEOFA
DEFI
BRILLATOR
 DETECTI
ONOFFI
BRI
LLATI
ONUSI
NGDEFI
BRI
LLATOR
AI
M
 Todet
ectat
ri
alf
ibr
il
lat
ionandv
ent
ri
cul
arf
ibr
il
lat
ionusi
ngdef
ibr
il
lat
orsi
mul
ator

APPARATUSREQUI
RED

1.Di
git
alCRO
2.DCDef
ibr
il
lat
or
3.Def
ibr
il
lat
orsi
mul
ator
4.CROpr
obe
5.Connect
ingwi
res
THEORY
Def
ibr
il
lat
ioni
sthepr
ocessi
nwhi
chel
ect
ri
caldev
icecal
l
edadef
ibr
il
lat
orsendsan
el
ect
ri
cshockt
ohear
ttost
opanar
rhy
thmi
aresul
ti
ngi
nret
urnofpr
oduct
ivehear
trhy
thm.A
por
tabl
edef
ibr
il
lat
ori
susedi
nanat
temptt
orecei
veamanwhohadahear
tat
tackbef
orehei
s
t
ransf
ormedt
oemer
gencyr
oom.Car
diacar
rhy
thmi
ast
hatpr
eventhear
tfr
om pumpi
ngbl
oodt
o
bodycancausei
rr
ever
sibl
edamaget
omaj
oror
gansi
ncl
udi
ngbr
ainandhear
t.

Thesear
rhy
thmi
asi
ncl
udev
ent
ri
cul
art
achy
car
dia,f
ibr
il
lat
ionandcar
diacout
put
.Deat
hcan
occuri
nmi
nut
esunl
esspr
oduct
ivehear
trhy
thm abl
etogener
ateapul
sei
srest
oredt
hrough
def
ibr
il
lat
ion.Thesy
stem shoul
dincl
udeear
lyoccur
,ear
lycar
diopul
monar
yresusci
tat
ion,ear
ly
def
ibr
il
lat
ionandear
lyadv
ancedcar
diaccar
e
DEFI
BRI
LLATORS
Def
ibr
il
lat
ors del
i
vera br
iefel
ect
ri
c shock t
o hear
twhi
ch enabl
es hear
ts nat
ural
pacemakert
oregai
ncont
rolandest
abl
i
shapr
oduct
ivehear
trhy
thm.I
tisanel
ect
roni
cdev
ice
t
hati
ncl
udesdef
ibr
il
lat
orpaddl
esandel
ect
rocar
diogr
am moni
tor
ing.

Dur
ingext
ernaldef
ibr
il
lat
ion,t
hepaddl
esar
epl
acedonpat
ient
’schestwi
thconduct
ing
gelensur
inggoodcont
actwi
thski
n.Def
ibr
il
lat
ioncont
inuesunt
ilpat
ient
’scondi
ti
onst
abi
l
izes
(
or)pr
ocedur
eis or
der
ed t
o be di
scont
inued.The car
e gi
ver
sver
if
ylackofpul
se whi
l
e
v
isual
i
zingECGassur
escont
actwi
thpat
ienti
sdi
scont
inuedanddel
i
vert
heel
ect
ri
cchar
ge.

TABULATI
ON

Nor
mal At
ri
alf
ibr
il
lat
ion Vent
ri
cul
arf
ibr
il
lat
ion
 Ener
gydi
schar
ge: Ener
gydi
schar
ge:

Amp(
v) Ti
me(
s) Amp(
v) Ti
me(
s) Amp(
v) Ti
me(
s)

Vi
va

1.Howdoesadef
ibr
il
lat
orwor
k?

2.Whatar
etheexpect
edr
isksdur
ingt
hepr
ocedur
e?

3.Whathappensdur
ingat
ri
aldef
ibr
il
lat
ion?

4.Def
inedef
ibr
il
lat
ion.

5.Whati
sthepr
ocedur
eforext
ernal
def
ibr
il
lat
ion?

RI
SKS

Ski
nbur
nsf
rom def
ibr
il
lat
orpaddl
esar
emostcommoncompl
i
cat
ionsofdef
ibr
il
lat
ion
ot
herr
isksi
ncl
udei
njur
ytohear
tmuscl
es,
abnor
mal
hear
trhy
thm andbl
oodcel
l
s.
NORMALRESULTS

Def
ibr
il
lat
orper
for
medt
othatl
i
fet
hreat
eni
ngar
rhy
thmi
aismostl
i
kel
ytobeef
fect
ive
wi
thi
nthef
ir
stt
oxi
ns,pr
event
ingbr
aini
njur
yanddeat
hbyr
etur
ningt
hehear
ttoapr
oduct
ive
r
hyt
hm abl
etopr
oducepul
se.Medi
cat
ionst
oimpr
ovecar
diacf
unct
ionandpr
eventaddi
ti
onal
ar
rhy
thmi
asar
efr
equent
lyadmi
nist
ered.

Somecar
diacf
unct
ion maybel
ostduet
o act
ualdef
ibr
il
lat
ion,butal
so associ
ated wi
th
under
lyi
ngdi
sease.At
ri
aldef
ibr
il
lat
ioni
ssuccessf
ulatr
est
ori
ngcar
diacout
put
,al
l
evi
ati
on
shor
tnessofbr
eat
handdecr
easi
ngt
heoccur
renceofcl
otf
ormat
ioni
naor
ta.

PROCEDURE

 Connectal
li
nst
rument
sbyusi
ngcabl
esandCROpr
obes
 Sett
hehear
trat
eandt
hreshol
dtomi
nimum v
alue
 Thent
akenor
mal
ECGwav
efor
m
 Setmodet
oat
ri
alf
ibr
il
lat
ionandnot
eampl
i
tudeandt
ime
 Byusi
ngDCdef
ibr
il
lat
or,
char
geanddi
schar
get
heener
gyt
opat
ientsi
mul
atort
oobt
ain
nor
mal
wav
efor
m
 Thenagai
nsetmodet
ovent
ri
cul
arf
ibr
il
lat
ionandnot
eampl
i
tudeandt
ime
 Agai
nDCdef
ibr
il
lat
ori
susedt
ochar
geanddi
schar
get
heener
gyt
opat
ientsi
mul
atort
o
obt
ainnor
mal
wav
efor
m
 Dr
awwav
efor
mforeachv
alue

RESULT

Bl
ockDi
agr
am
PHYSOLOGICALWAVENATUREOFECG
NormalECGwav eCharact
eri
sti
cs:
 PRI nt
erval
:0.12-0–20sec
 QRSDur ati
on: 0.
06-0–10sec
 QTI nt
erval(
QTc≤0.40sec)
 QT≤0. 38@ 80bpm
 QT≤0. 42@ 60bpm
Obser
vati
on

WAVE AMPLI
TUDE(
mv) TI
ME(
ms)
P-
Wave
QRSCompl
ex
T-
Wave
 ANALYSI
SOFECG,
EEGANDEMGSI
GNALS
AI
M
Tomeasur
eandanal
yzet
hebi
ologi
cal
signal
ssuchasECG,
EEGandEMG
si
gnal
s
APPARATUSREQUI
RED
1.ECG,
EEG,
EMGsi
mul
atorset
up
2.ECG,
EEG,
EMGel
ect
rodes
3.Connect
ingcabl
esandpr
obe
4.DSO
ECGTHEORY
TheECGi
sani
nst
rumentwhi
chr
ecor
dst
heel
ect
ri
cal
act
ivi
tyoft
hehear
t.Theel
ect
ri
cal
si
gnal
sfr
om t
hehear
tchar
act
eri
sti
cal
l
ypr
oceedst
henor
malmechani
calf
unct
ionand
moni
tor
ing oft
hesesi
gnal
shasgr
eatcl
i
nicalsi
gni
fi
cance.ECG pr
ovi
desv
aluabl
e
i
nfor
mat
ionaboutwi
der
angeofcar
diacdi
sor
der
ssuchaspr
essur
eofof
teni
nact
ive
par
torenl
argementoft
he hear
tmuscl
es.Theyar
e used i
n cat
het
eri
zat
ion l
abs,
cor
onar
ycar
euni
tsandf
orr
out
inedi
agnost
icappl
i
cat
ioni
ncar
diol
ogy
.Thus,
acar
diac
moni
tori
sspeci
fi
cal
l
yusef
ulf
ormoni
tor
ingpat
ient
swi
thcar
diacpr
obl
emsandt
he
speci
alar
easi
nthehospi
tal
swher
etheyar
egener
all
yusedar
eknownascar
diaccar
e
uni
tsorcor
onar
ycar
euni
ts(
CCU)
.
ECGi
susedi
ngat
ed-
acqui
sit
ionst
udi
est
osy
nchr
oni
zei
magecol
l
ect
ionwi
tht
he
car
diaccy
cledef
inedbyECGR-
wav
e.Thet
ypi
calECGwav
econsi
stsofPwav
e,QRS
compl
exandT-
wav
e.Theel
ect
ri
calpot
ent
ial
soft
hehear
tar
emeasur
edbypl
aci
ng
sui
tabl
eel
ect
rodes.

EEGTHEORY
EEGi
sani
nst
rumentf
orr
ecor
dingt
heel
ect
ri
calact
ivi
tyoft
hebr
ain,bysui
tabl
y
pl
aci
ngsur
faceel
ect
rodesont
hescal
p.I
tdescr
ibet
hegener
alf
unct
ionoft
hebr
ain
act
ivi
ty,
ist
hesuper
imposedwav
eofneur
onpot
ent
ial
soper
ati
ngi
nanon-
synchr
oni
sed
manneri
nthephy
sicalsense.I
tisanef
fect
ivemet
hodofdi
agnosi
ngmanyneur
ologi
cal
i
l
lnessanddi
seases,suchasepi
l
epsy
,tumour
,cer
ebr
ovascul
arl
esi
ons,i
schemi
aand
pr
obl
emsassoci
atedwi
tht
rauma.
 Sev
eralt
ypesofel
ect
rodesmaybeusedt
orecor
dEEG.Thesei
ncl
ude:Peeland
St
ickel
ect
rodes,
Sil
verpl
atedcupel
ect
rodesandNeedl
eel
ect
rodes.

Elect
rode Fi
l
ter
s
montage
sel
ector Hi-
pass Low-
pass Not
ch
Sensi
ti
vi
ty

El
ect
rode
Test
/cal
i
brat
e
Wr
it
inguni
t

ADC Char
t I
nk-
wri
ti
ng

Dr
iver

Comput
er
Osci
l
loscope

EEGwav
efor
m

Bl
ockDi
agr
am

STUDYOFBRAI
NWAVES
Waves Frequency Occurence
Normallyinoccpiti
alr
egion.
Al
phawav
es 8-
13Hz
Duri
ngsl eep,awakeinaqui et
,resti
ngstat
e.
Normallyinpariet
alandfrontalregi
on.
Bet
awav
es 13-
30Hz
Duri
ngint ensementalacti
vity
,tensi
on.
 Nor
mallyi
npari
etal
andtempor alr
egi
on.
Thet
awav
es 4-
8Hz
Dur
ingemoti
onalst
ress,
frust
rati
on.

Nor mallyoccursinpremat
urebabies,
inf
ant
s,
Del
tawav
es 0.
5-4Hz
sleepi
ngadul t
s.
EEGmayber
ecor
dedbypi
ckingupt hevoltagedif
fer
encebetweenanacti
veel
ect
rode
ont
hescal
pwi
thr
espectt
oar
efer
enceel
ect
rodeont
heearl
obeoranypar
toft
hebody
.
Thi
sty
peofr
ecor
dingi
scal
l
ed‘
monopol
ar’r
ecor
ding.Howev
er‘
bipol
ar’r
ecor
dingi
s
mor
epopul
arwher
eint
hev
olt
agedi
ff
erencebet
weent
woscal
pel
ect
rodesi
srecor
ded.

Ther
ecor
dedr
epr
esent
ati
onofbi
oel
ect
ri
cpot
ent
ial
sgener
atedbyt
heneur
onal
act
ivi
tyoft
hebr
aini
scal
l
edt
heel
ect
roencephal
ogr
aphyabbr
evi
atedasEEG.EEG
pot
ent
ial
smeasur
edatt
hesur
faceoft
hescal
p,act
ual
l
yrepr
esentt
hecombi
nedef
fect
ofpot
ent
ialf
rom awi
der
egi
onoft
hecer
ebr
alcor
texandf
rom v
ari
ouspoi
ntsbeneat
h
EEGwav
efor
ms.

Cer
tai
nchar
act
eri
sti
csofEEGwav
efor
m canber
elat
edt
oepi
l
ept
icsei
zur
esand
sl
eep.Adr
owsyper
sonof
tenpr
oducesal
argeamountofact
ivi
tyi
ntheact
ivi
tyi
nthe
r
angeof8-
13Hz.Whent
heper
sonbegi
nst
ofal
lasl
eep,
theampl
i
tudeandf
requencyof
t
hewav
efor
m decr
easesandi
nli
ghtsl
eep,l
argeampl
i
tude,l
ow f
requencywav
efor
m
emer
ges.Deepersl
eepgener
all
yresul
tsi
nev
ensl
owerandhi
gherampl
i
tudewav
es.
Theper
iodofhi
ghf
requencyEEGt
hatoccur
sdur
ingsl
eepi
scal
l
edpar
adoxi
calsl
eep.
Thewav
efor
mvar
iesgr
eat
lywi
tht
hel
ocat
ionoft
hemeasur
ingel
ect
rodeont
hesur
face
oft
hescal
p.

EEG pat
ter
npot
ent
ial
shav
erandom appear
ingwav
efor
mswi
thpeak-
peak
ampl
i
tuder
angi
ngf
rom l
esst
han10µvt
oov
er100µvandbandwi
dthofEEGsi
gnali
s
f
rom bel
ow1Hzt
oov
er100Hz.10–20el
ect
rodepl
acementsy
stem i
sused.

EMGTHEORY
The bi
oel
ect
ri
c pot
ent
ial
s associ
ated wi
th muscl
e act
ivi
ty const
it
ute
el
ect
romy
ogr
aphyabbr
evi
atedEMG.Theymaybemeasur
edont
hesur
faceoft
hebody
neart
he muscl
e ofi
nter
est
.The pot
ent
ialf
rom t
he l
arge muscl
esi
nter
face wi
th
at
tempt
stomeasur
eEMGwav
efor
mist
hei
nst
ant
aneoussum ofal
lact
ionpot
ent
ial
occur
sinbot
hposi
ti
veandnegat
ivepol
ari
ti
esatagi
venpai
rofel
ect
rodes.Peak
ampl
i
tudesv
aryf
rom 10Hzt
o300Hzi
srequi
redf
orf
ait
hful
repr
oduct
ion.Theampl
i
tude
ofEMGmeasur
ementmusthav
ehi
ghgai
n,hi
ghi
nputi
mpedanceanddi
ff
erent
iali
nput
wi
thgoodcommonmoder
eject
ionr
ati
o.TheEMG wav
efor
m appear
smuchl
i
kea
r
andom wav
efor
m wi
tht
heener
gyofsi
gnal
s,af
unct
ionoft
heamountofmuscl
e
act
ivi
tyandel
ect
rodepl
acement
s.TheEMG canbequant
izedbyt
hemeasur
ement
i
ntegr
ati
onandpower
.ThusEl
ect
romy
ogr
aphi
sat
echni
queofr
ecor
dingel
ect
ri
cal
act
ivi
tyoft
hemuscl
e.
Muscl
econt
ract
ioni
sar
esul
toft
hest
imul
ati
onsf
rom t
hemot
orneur
ons.
Vol
unt
arymuscl
econt
ract
ioni
susedt
omov
ethebodyandcanbef
inel
ycont
rol
l
ed,
suchasmov
ement
sof

Obser
vat
ionf
orEEG

Wav
es Ampl
i
tude(
V) Ti
me(
s) Fr
equency
(Hz)

Al
pha

Bet
a

Thet
a

Del
ta

Bl
ockDi
agr
am

Bat
ter
y(10–12)

Di
git
alStor
age
EMGAmpl
i
fier Osci
ll
oscope

Bat
ter
y(10–12)
 Bl
ockDi
agr
am ofEMG

Tabul
ati
on

Condi
ti
on Ampl
i
tude(
mV) Ti
me(
ms)

Nor
mal

St
ressed

t
hef
ingerorgr
ossmov
ement
sthatoft
hebi
cepsandt
ri
ceps.Ther
ear
ethr
eet
ypesof
muscl
econt
ract
ions.
I
somet
ri
ccont
ract
ion– i
nisomet
ri
ccont
ract
ion,t
hemuscl
eiscont
ract
edwhi
l
ethe
l
engt
hoft
hemuscl
eisunchanged.Thesecont
ract
ionsar
eusedi
npost
ural
cont
rol
.
Concent
ri
ccont
ract
ion–i
toccur
swhent
hel
engt
hoft
hemuscl
eshor
tendur
ingt
he
cont
ract
ion.Theamountoft
heav
ail
abl
emuscul
arener
gyi
nconcent
ri
ccont
ract
ioni
s
l
esst
hant
hei
somet
ri
ccont
ract
ionduet
oener
gyl
ossr
elat
edt
otheshor
teni
ngoft
he
muscl
e.
Eccent
ri
ccont
ract
ion-i
toccur
swhent
hel
engt
hoft
hemuscl
eincr
easesdur
ingt
he
cont
ract
ion.Theconcent
ri
candeccent
ri
ccont
ract
ionsar
eal
soknownasun-
isomet
ri
c
cont
ract
ion.
ECGPr
ocedur
e

1.Connectt
heECGel
ect
rodet
othegi
venuni
t.

2.Connectt
hepr
obeoft
heECGuni
ttoosci
l
loscope(
DSO)
.

3.Obser
vet
hewav
efor
m oft
heECGuni
t.

4.Af
tert
heacqui
sit
ionofgoodwav
efor
ms,
freezeandst
oret
hewav
efor
m.

5.Not
ethehear
trat
e,ampl
i
tudeandt
imeper
iodf
orv
ari
ousi
nter
val
sofP,
Q,RS,
T
ofECGwav
efor
m.

6.St
oret
hewav
efor
msf
orf
utur
eref
erenceusi
ngPendr
ive.
 7.Remov
etheel
ect
rodeandt
urnof
ftheuni
tpr
oper
ly

EEGPr
ocedur
e

1.Connectt
heEEGel
ect
rodet
othegi
vensi
mul
atorset
up.

2.Connectt
hewav
efor
m oft
heEEGsi
mul
atort
oosci
l
loscope(
DSO)
.

3.Obser
vet
hewav
efor
m oft
heEEGsi
mul
atorf
orv
ari
ouscondi
ti
onsbysel
ect
ing
pai
rofel
ect
rodeusi
ngmont
agesel
ect
orknob.

4.Af
tert
heacqui
sit
ionofgoodwav
efor
ms,
freezeandst
oret
hewav
efor
m.

5.Obser
vet
hedi
ff
erentf
requencycomponent
s.Anal
yset
heal
pha,bet
a,del
taand
t
het
acomponent
sint
hef
requencyspect
rum anddet
ermi
net
hecomponent
whi
chi
sdomi
nat
ed.

6.Repeatt
hepr
ocedur
efordi
ff
erentst
atus(
awake,sl
eepi
nganddr
owsy
)oft
he
subj
ect
.

7.St
oret
hewav
efor
msf
orf
utur
eref
erenceusi
ngPendr
ive.

8.Remov
etheel
ect
rodeandt
urnof
fthesi
mul
atorpr
oper
ly

EMGPr
ocedur
e

1.Fol
l
owt
hepat
ientpr
epar
ati
onst
epscar
eful
l
ybef
orer
ecor
ding.

2.Bat
ter
yisconnect
edt
otheEMGsi
mul
ator
.

3.Connectt
heEMGel
ect
rodet
othegi
vensubj
ect
.

4.Connectt
hewav
efor
m oft
heEMGmodul
etoosci
l
loscope(
DSO)
.

5.Obser
ve t
he wav
efor
m of t
he EMG modul
e f
or i
ts cl
ari
ty/
basel
i
ne
shi
ft
/noi
se/
leadconf
igur
ati
onandi
fiti
snotcl
ear
,conf
ir
mthepl
acementand
at
tachmentofel
ect
rodes.

6.Af
tert
heacqui
sit
ionofgoodwav
efor
ms,
freezeandst
oret
hewav
efor
m.
 7.Checkt
hemuscl
eresponsef
ornor
mal
andst
resscondi
ti
on.

8.Pl
ott
heEMGampl
i
tudei
nbot
hcases.

9.St
oret
hewav
efor
msf
orf
utur
eref
erenceusi
ngPendr
ive.

10.
Remov
etheel
ect
rodeandt
urnof
fthesi
mul
atorpr
oper
ly.

RESULT
 VENTI
LATORUNI
T

Bl
ockDi
agr
am ofVent
il
ator

STUDYOFVENTI
LATORS

AI
M

Tost
udyt
hewor
kingpr
inci
pleofVent
il
ator
s.

APPARATUEREQUI
RED
 1.Compr
essi
ble 
air
 r
eser
voi
rort
urbi
ne,
2.Ai
rand 
oxy
gensuppl
i
es,
3.Asetofv
alv
esandt
ubes
4.Adi
sposabl
eorr
eusabl
e"pat
ientci
rcui
t
THEORY

I
ntr
oduct
ion:

Vent
il
ati
on ar
etopr ovi
deadequat
eoxygenat
ionandv ent
il
ati
on,reduceourpatient
's
workofbreathi
ng,andtomi ni
mizet
hedamagetothelungcausedbyt heventi
l
atorknownas
vent
il
atori
nducedlungi
njur
y.

Pr
inci
ple:

Av enti
l
atorisamachi nethatsuppor
tsbreat
hing.It’
salsocall
edabr eathi
ngmachi neor
r
espir
ator.Thesemachi nesar emai nl
yusedi nhospital
s.Venti
lat
orswi l
lgetoxy genintothe
l
ungs,remov ecarbondioxi
def r
om thebody,hel
ppatientbreat
heeasier,
andbr eat
hef orpeopl
e
Whohav elostallabi
li
tytobreatheonthei
rown.

Aventil
atorisoft
enusedf orshortperi
ods,suchasduringsurgerywhenyou’reunder
gener
alanesthesiaordur
ingtr
eatmentforaseriousl
ungdiseaseorothercondi
ti
onthataff
ects
normalbr
eathing.Somepeoplemaysuf ferfr
om aconditi
onwheretheyneedt ouseventi
l
ators
foral
ongperiodorev enf
ortherestofthei
rli
ves.

Wor
king:

Av entil
atorusespressur
etobl
owairi
ntot
helungs.Thi
spressur
eisknownas
posi
ti
vepr essure.Apatientusual
l
yexhal
est
heairont hei
rown,butsometi
mesthe
vent
il
atordoesitforthem t
oo.

Theamountofoxy genthepat i
entrecei
vescanbecont r
oll
edt hroughamoni tor
connectedt othev enti
lator.I
fthepat i
ent’
sconditionispar ti
cular
lyfragil
e,themonitor
wil
lbesetupt osendanal armtot hecaregi
ver,
indicati
ngani ncreaseinairpressur
e.
Themachi newor ksbybr ingingoxygent ot helungsandt aki
ngcar bondioxide
outoft helungs.Thi sall
owsapat i
entwhohast roublebreathingt oreceivetheproper
amountofoxy gen.Italsohel psthepat i
ent’
sbodyt oheal,si
ncei tel
iminatestheextra
energyoflaboredbr eat
hing.

Av enti
latorblowsai ri
ntotheairwayt hroughabr eat
hingtube.Oneendoft he
tubei
sinsertedi nt
opatient’
swindpipeandt heot herendisattachedt ot
hevent
il
ator
.
Thebreathi
ngt ubeservesasanai rwaybyl ettingairandoxy genf r
om thev
enti
lat
or
fl
owsintothel ungs.Dependingonthepatient’smedicalcondit
ion,theymaybeableto
usearespir
atorymaski nsteadofthebreat
hingt ubes.

Themai
ncomponent
soft
hev
ent
il
ator
Twogassuppl
i
es:

Thefir
stoneistoprovi
deoxygen,theotheri
stoprov i
decompressedair(acompressormaybe
order
edasanal t
ernat
eairsource)
.Pneumati
csy st
em:Sy st
em thatmixesthegases,generates
fl
ow wav ef
orms,del
iv
ersv ol
umes,andmeasur epr essur
es.Patientser
vicesyst
ems:Sy stem
thatr
outesthemixedgasestoandf r
om thepat
ient
.

Key
boar
danddi
spl
aypanel
s:

I
tisusedt ospecif
ytheoper at
ionmodeofpneumati
csyst
em,monitorpat
ientandv ent
il
ator
perf
ormance,and not if
yt he operat
or wi
th al
arms when specif
ied problems occur.
Microprocessorel
ectr
onics:contr
olandmoni
tort
hepneumati
csystem,thekey boar
ddisplay
panel,andtheuti
li
typanel
.

PowerRequi
rement
s:
Ingeneral,thev ent
il
ator
’selectr
icalandel
ectr
onicsy
stemsoperat
ewi t
hDCpower .However
,
theoptionalcompr essor,t
heexhal ati
onfi
l
ter
,andthehumidi
fi
eroutl
etar epowerbywallAC
curr
ent.Internal
batter
iesprovidereser
vepowertomemoryi
nthemicroprocessorel
ect
roni
cs.

Mi
cropr
ocessor
:

I
tr ecei
vesinf
ormationfrom keyboard,uti
l
itypanel,DCpowersuppl y
,andmemor yas
wellasfrom pressur
eswi tchesandt emperat
ure/f
low sensorsinthepneumat icsy st
em.The
micropr
ocessormoni torst he i
nformati
on from t hese sources and performs necessary
cal
culat
ionsbasedonpr ogramsst or
edi nmemor y.Asar esul
toft hesecalculat
ions,st
atus
i
nformationandcontr
ol si
gnalsaresenttothepneumat i
csy st
em andtot hedi
splays.

GasSuppl
ySy
stem:
Bothairandoxy genenterthevent
il
atorthroughfil
tersthatremovepar
ti
culat
ematter
(
lar
gert han 0.
3 mi crons)and condensed moisturein aerosolform.(Bul
kwat ermustbe
r
emov edfrom wallairsourceswit
haseparatewat ertr
ap).
Theopt i
onalcompr
essorenabl
est
he
v
entil
atortooperateindependentl
yofcompressedwal lai
r.

Themi ni
mum oper ati
ngpressureforwall
-suppl
iedairoroxy genis35PSI( Poundper
SquareInch);themaximum i s100PSI.1PSI=6.89Kpa=51. 7mmHgI nter
nalpresetregulat
ors
reduceinternalsupplypressureto10PSI .Theopt i
onalcompr essorproducesapr essureof
approxi
mat ely10 PSI .An automati
c gas-suppl
yswi tchi
ng circui
tprovides foremer gency
operati
onwhenev ergassuppl yinl
etpressur
eorcompr essorpressurefall
sbelowapr escri
bed
range(thi
smaybel essthantheminimum operati
ngpressure).

Pat
ientSer
viceSy
stem:

Itconsi
stsofHumi di
fierci
rcui
t,forwarmingandhumidi
fyi
ngtheinspi
rat
ory
gases.Pat
ientser
viceci
rcui
t,fort
ransport
ingAirfr
om t
hepneumaticsy
stem t
ot he
pati
entandbackt ot hev enti
latorNebul izercircuit
,foraddingmedi cati
onst othegas;
andexhal ati
onf l
ow ci rcuit,formoni toringandcal culati
ngthev ol
umeofexhal edgas.
Thesy st
em al socont ainsf i
ltersini tsi nspi
ratoryandexpi rator
yl i
mbst hatconfi
ne
bacter
ialcontami nati
oni nthehumi dif
ierandpat i
entser v
iceci
rcuit
.
Acheckv alve,thatpr ev ent
sr eversegasf low;andanexhal ati
onv alv
et hatseal
s
thesystem dur ingi nspi rati
onandmai ntainsPEEP.Thei nter
nalexhalationv al
veis
housedint heexhal ationcompar tment .Becauseexhal ati
oncompar tmentcomponent s
arethelastel ement si nt heexpi ratoryl i
mb( downst ream from theheat edexhalati
on
bacter
iafilt
er)
,theydon’ tneedt obecleanedandst eri
li
zed.

Thepat i
entservicesy st
em consistsof :Humi dif
iercircui
t,forwar mi ng and
humidifyi
ngtheinspi
ratorygases.Pat i
entserv
icecircuit
,fortransporti
ngAi rfrom t he
pneumat icsy
stem t
ot hepat i
entandbackt otheventil
atorNebul i
zercircui
t,foradding
medicationstothegas;andexhal ati
onf l
ow ci
rcui
t,formoni tori
ngandcal culatingt he
vol
umeofexhal edgas.Thesy st
em alsocontai
nsfil
tersini t
sinspir
atoryandexpi r
atory
l
imbst hatconfi
nebacterial
contaminati
oninthehumi dif
ierandpat i
entservi
ceci rcuit
.

Pneumat
icsy
stem:

Pneumat
ic sy
stem Oxy
gen i
s pr
ovi
ded byan ext
ernalsuppl
y.The pr
imar
y
pneumat
icssy
stem consi
stsoft
wopar
all
elci
rcui
tsonef
oroxy
genandonef
orai
r.An
i
mpor
tantel
ementoft
hepneumat
icsy
stem i
sthet
wopr
opor
ti
onalsol
enoi
dval
ves
(
PSOLs)
,whi
chpr
eci
sel
ycont
rol
thef
lowdel
i
ver
edt
othepat
ient
.
Ai
r and oxy
gen f
low sensor
s pr
ovi
de f
eedback,whi
ch i
s used by t
he
mi
cropr
ocessort
ocont
rolt
hePSOLS.Asar
esul
t,t
hev
ent
il
atori
sabl
etosuppl
yai
rand
oxy
gent
o apat
ientaccor
dingt
orequi
rement
spr
e-sel
ect
edbyanoper
atoratt
he
v
ent
il
atorkey
boar
d.Theout
putofmi
xedai
randoxy
genpassest
hroughapat
ient
sy
stem ex
ter
nal
tot
hev
ent
il
ator
;thi
spat
ientsy
stem maybecomposedoft
ubi
ng,
fil
ter
s,
anebul
i
zer
,wat
ert
raps,
andahumi
dif
ier
.
Thepat
ientexhal
est
hegast
hrought
heopenedexhal
ati
onv
alv
e.Thi
sval
vei
s
par
toft
hev
ent
il
atori
nuni
tsequi
ppedwi
thi
nter
nalexhal
ati
onv
alv
es.I
tispar
toft
he
pat
ientsy
stem i
nvent
il
ator
swi
thoutt
hisi
nter
nal
val
ve.
Thepneumat
icsy
stem i
scomposedoft
hef
oll
owi
ngsubsy
stems:
 Wal
lGasSuppl
ySy
stem
 Mot
orCompr
essorSy
stem
 Fl
owCont
rol
Syst
em
  Exhal
ati
onSy
stem
 PEEP/
CPAPSy
stem
 Saf
etyVal
veSy
stem
 Pat
ientSy
stem

RESULT
Thust
hewor
kingpr
inci
pleofv
ent
il
atorpneumat
icsy
stem wasst
udi
ed.

STUDYOFULTRASOUNDSCANNER&DI
SPLAY
AI
M:
Tost
udyt
hepr
inci
ple,
wor
kingandt
heappl
i
cat
ionsofUl
tr
asoundScannerandi
tsdi
spl
ay
THEORY:
I
ntr
oduct
ion
Moder
ntechnol
ogyi
sdr
ivi
ngmedi
calul
tr
asoundmachi
nest
onew hei
ght
sofper
for
mance,
r
esul
ti
ngi
nimageswi
thnewl
evel
sofcl
ari
tyandr
esol
uti
on.Ul
tr
asoundi
susedf
ori
magi
ngi
n
car
diac,obst
etr
ic,andmanyot
herdi
agnost
icar
eas.Ev
enast
heabi
l
iti
esoft
hemachi
nes
i
ncr
ease,t
hecostofmachi
nesi
scomi
ngdown.Al
thoughul
tr
asoundr
eli
essubst
ant
ial
l
yon
di
git
alpr
ocessi
ng,
thekeyt
oit
sper
for
mancel
i
esi
naheav
il
yanal
ogt
echnol
ogy
.
Obt
aini
nganI
mage
I
magesar
eobt
ainedbysweepi
nganar
rowbeam ofacoust
icener
gyi
ntoal
i
vingbody
andanal
yzi
ngt
hepat
ter
noft
heener
gyr
efl
ect
edbackbyst
ruct
ureswi
thi
nthebody
,muchl
i
ke
sear
chr
adar
.Si
ncet
her
ecei
vi
ngt
ransducer
sar
edeal
i
ngwi
thanal
ogsi
gnal
s,butt
heanal
ysi
sis
per
for
meddi
git
all
y,t
hesi
gnal
smustbedi
git
ized.El
ect
ri
calpul
sesar
eappl
i
edt
opi
ezoel
ect
ri
c
cer
ami
cel
ement
stogener
atet
heener
gyatt
ransmi
tt
edf
requenci
esf
rom 2t
o20MHz.The
f
requencyuseddependsont
heappl
i
cat
ion.Hi
gherf
requenci
espr
ovi
det
hebestr
esol
uti
onbut
hav
elesspenet
rat
ion,si
ncet
heyat
tenuat
efast
erast
hesi
gnal
smov
ethr
ought
hebody
.Ther
e
ar
eli
mit
sonhowst
rongt
hehi
gh-
fr
equencypul
secanbe,
becauseexcessi
veamount
sofpower
ar
eunheal
thyf
ort
hepat
ient
.Themostcommonl
yusedf
requenci
esr
angef
rom 2t
o7MHz.
Ret
urnl
evel
srangef
rom 1-
Vechoesneart
hesur
faceoft
hebodyt
olesst
han10µVf
or
i
magesdeepwi
thi
nthebody
.Thesi
gnal
sar
econduct
edt
oandf
rom t
hecer
ami
cel
ement
sin
t
hehandpi
ecet
othef
ront
-endel
ect
roni
csv
iaacabl
e,whi
chwi
l
lbesubj
ectt
onoi
seand
at
tenuat
ion.Thewi
der
angeofsi
gnal
smustbeampl
i
fiedt
o2Vf
ordr
ivi
ngananal
og-
to-
digi
tal
conv
ert
er.Toaccompl
i
sht
his,at
ime-
gai
ncompensat
ion(
TGC)ampl
i
fieri
sused.Powerl
evel
s,
f
requenci
esused,
ampl
i
ficat
ion,
andbeam f
ocusdet
ermi
net
hecl
ari
tyoft
hei
mage.
THEOVERALLSYSTEM
Bl
ockdi
agr
am showst
heel
ement
sofasy
stem:
transducer
,mul
ti
plexer
,tr
ansmi
tt
erand
i
tsbeam - f
ormi
ng
appar
atus,

t
ransmi
t/
recei
ve(
T/R)swi
tches,
low-
noi
seampl
i
fier
,si
gnal
-andi
mage-
processi
ngdi
spl
ay,
audi
o,A/
Dconv
ert
erandi
tsdr
iver
,theTGCampl
i
fier
.
Pr
obe
Ul
tr
asoni
ctr
ansducer
sar
eusedf
orav
ari
etyofappl
i
cat
ionswhi
chr
equi
redi
ff
erent
char
act
eri
sti
cs.An ul
tr
asound t
ransducert
ransmi
ts ul
tr
asoni
c wav
es i
ntot
he t
issue and
r
ecei
vesul
tr
asoni
cechoeswhi
char
eref
lect
edf
rom t
het
issue.Thet
ransducermaybepl
aced
onabodysur
faceori
nser
tedi
ntoapat
ient
'
sbodyi
nasel
ect
edi
magi
ngr
egi
on.Ul
tr
asoni
c
i
magi
ng sy
stems,ascommonl
yused f
ormedi
cali
magi
ng,r
equi
rean ar
rayoful
tr
asoni
c
t
ransducer
scont
ainedwi
thi
napr
obet
opr
ovi
dest
eer
ingandf
ocusi
ngoft
heul
tr
asoni
cbeam.
Ul
tr
asoni
cdi
agnost
ici
magi
ngsy
stemsper
for
m ul
tr
asoni
cimagi
ngandmeasur
ement
soft
he
humanbodyt
hrought
heuseoful
tr
asoundpr
obes.Ul
tr
asoundpr
obesar
eusedt
ovi
ew t
he
i
nter
nalst
ruct
ureofabodybycr
eat
ingascanpl
aneorv
olume,
whi
chi
spr
oducedf
rom anar
ray
oft
ransducer
s.Ul
tr
asoundpr
obesar
egener
all
yusedext
ernalt
othebodyi
nnon-
inv
asi
ve
pr
ocedur
es butcan al
so be used i
nter
nalt
othe body bei
ng exami
ned dur
ing sur
gical
pr
ocedur
es.Anul
tr
asoundpr
obeusual
l
ycompr
isesatl
eastonet
ransducerel
ement
,ty
pical
l
y
f
ormed ofPZT mat
eri
al.Oneoft
hemor
especi
ali
zed t
ypesoful
tr
asound pr
obesi
sthe
t
ransesophagealpr
obe(
TEEPr
obe)whi
chi
susedendoscopi
cal
l
y,f
orexampl
e,f
orul
tr
asoni
c
i
magi
ngoft
hehear
t.Tr
ansesophagealecho(
TEE)car
diogr
aphyi
sanest
abl
i
shedt
echni
quei
n
t
hear
eaofcar
diaci
magi
ngandi
nvol
vest
hei
nser
ti
onofanul
tr
asoundpr
obei
ntoasubj
ect
's
esophagust
oscant
hehear
tfr
om i
nsi
det
heesophagus.Theul
tr
asoundpr
obeempl
oysa
t
ransducerar
rayt
oobt
ainat
wo-
dimensi
onal
cross-
sect
ional
imageoft
hesubj
ect
'shear
t.
Beam St
eer
ingandFocus
I
ntheol
dday
sofr
adar
,adi
shorabanana-
shapedant
ennawoul
drot
ate,l
ooki
ngf
or
t
arget
sinal
ldi
rect
ions.Asi
tsl
owl
ysweptar
ound,
amagnet
ronwoul
dfi
repul
sesofener
gyi
nto
t
hesky
.Tr
avel
i
ngatt
hespeedofl
i
ght
,ref
lect
edener
gywoul
dcomebackt
other
ecei
verbef
ore
t
heant
ennamov
edoutofsy
nc.Nowaday
s,t
her
otat
ioni
spr
oducedbyphasedar
ray
s.The
beam i
smani
pul
atedbyv
ary
ingt
hephaseandpoweroft
hesi
gnalbet
weenant
ennar
adi
ator
s,
andt
hebeam i
ssweptar
oundt
heskywi
thoutanymov
ingpar
ts.Thi
sist
hesamemet
hodused
bymedi
calul
tr
asoundt
osweepabeam ofacoust
icener
gyar
oundt
hebody
.Ther
ewi
l
lbe
pr
ogr
ammed phase and ampl
i
tude shi
ft
s bet
ween t
he pul
ses ofener
gydel
i
ver
ed t
othe
pi
ezoel
ect
ri
cel
ement
sar
ray
edi
nthet
ransducerhead.Thi
swi
l
lresul
tinani
nci
dentbeam of
ener
gydi
rect
edal
ongal
i
nei
ntot
hebody
.Thebeam wi
l
lbesweptbackandf
ort
hint
hebody
l
i
ket
her
adaracr
osst
hesky
.
MuxandT/
RSwi
tch
Thesi
gnal
stobet
ransmi
tt
edmustpassf
rom t
hepowerampl
i
fiert
ocer
ami
csandt
he
r
ecei
vedsi
gnalf
rom cer
ami
cst
other
ecei
ver
.Si
ncet
he100-
VTr
ansmi
tandmi
crov
olt
-l
evel
Recei
ve si
gnalmustpass t
hrough t
he same cabl
e,a T/
R swi
tch (
transmi
t/
recei
ve)and
mul
ti
plexer(
mux)ar
erequi
redt
ost
eert
hesi
gnal
s.
Recei
verBeam For
ming
Thebeam i
sfocusedbydel
ayi
ngeachoft
hechannel
ssot
hatt
her
etur
npul
sesf
rom t
he
f
ocalpoi
nt(
orar
ea)ar
ri
veatt
hepr
ocessoratt
hesamet
ime.Themachi
newi
l
lest
abl
i
sht
he
f
ocalar
eaassetbyt
heoper
ator
.Beam f
ormi
ngi
scur
rent
lydonewi
thanal
ogand/
ordi
git
al
t
echni
ques.Themachi
newi
l
ladj
ustt
hedel
ayr
equi
redf
orf
ocusi
ncal
cul
ati
ngt
heposi
ti
onof
t
hesweepl
i
ne.I
twi
l
lcomput
ethecor
respondi
ngpi
xel
soft
hedi
spl
aybyusi
ngt
hedel
ay
r
equi
redbyeachchannel
tof
ocust
hei
mage.

Beam f
ocususi
ngv
ari
abl
edel
ay
Ti
meGai
nCont
rol
(TGC)
TheTGC(
ti
megai
ncompensat
ion)ampl
i
fieri
sacr
uci
all
i
nki
ntheul
tr
asoundsi
gnal
pat
h.I
tmusthav
etheabi
l
ityt
oampl
i
fysi
gnal
srangi
ngf
rom af
ewmi
crov
olt
sto1v
oltupt
oone
ort
wov
olt
sfort
heADC.Thi
sgai
nwi
l
lbeexponent
ial
l
yincr
easedal
ongeacht
ransmi
t/
recei
ve
sweepl
i
ne.Att
henearendoft
hewedge,
thegai
nwi
l
lbev
eryl
ow.I
twi
l
lhav
etopr
ocesst
he1-
V
r
etur
nsi
gnalr
ightaf
tert
he100-
Vcer
ami
cexci
tat
ionpul
se.Ast
imeaf
tert
heexci
tat
ionpul
se
passes,t
hegai
nwi
l
lbeswepti
ntov
eryhi
ghl
evel
s.Thi
smustbedonewhi
l
emai
ntai
ningv
ery
l
ownoi
set
oav
oidmaski
ngl
ow-
lev
elsi
gnalcomi
ngf
rom deepwi
thi
nthebody
.Theoper
atorwi
l
l
adj
ustt
heTGCampl
i
fiercont
rol
toi
mpr
ovet
hequal
i
tyoft
hei
mage.
TheA/
DConv
ert
er
Ther
ear
emanysour
cesofnoi
set
hatcombi
neatt
hei
nputoft
heADC,i
ncl
udi
ngbody
t
issue,gai
nst
agesandcabl
enoi
se.Ast
hel
astl
i
nki
nthechai
n,i
tisi
mpor
tantt
hatt
heADC
i
tsel
fhav
elownoi
se.I
tsnoi
semustnotbeconf
usedwi
tht
hesur
viv
ingsi
gnalcomi
ngf
rom t
he
ot
hercomponent
s.Quant
izat
ionnoi
sei
simpr
ovedbyusi
nghi
gherr
esol
uti
onconv
ert
ers.Many
ul
tr
asounddesi
gner
sar
econcer
nedwi
thhar
moni
cdi
stor
ti
onandar
ti
fact
satf
requenci
escl
ose
t
othef
undament
al.I
ntheFFTpl
ot,
thear
easneart
hebaseoft
hef
undament
alf
requencyspi
ke
mustbev
eryqui
etandf
reeofspur
ioussi
gnal
s,of
tencausedbyADC
Di
spl
ay
Oncet
hepoi
ntshav
ebeenscanned,
theymustbedi
spl
ayed.I
twi
l
lcal
cul
atet
hel
ocat
ion
ofat
argetont
hescr
eenbasedont
het
imedel
aysf
rom el
ementt
oel
ementi
nther
ow of
cer
ami
csi
nthehandpi
ece.I
tjudgesdept
hbasedonhowl
ongi
ttookt
hesi
gnalt
ocomeback
f
rom eachcer
ami
cel
ement
.Thepi
xelv
alueswi
l
lber
eadoutofmemor
yandmodul
atet
heCRT
t
race.
BASI
COPERATI
ONPROCEDURE

Power

Whenthesyst
em t
esti
s
ov
er,ent
eri
ntotheBmode

Bui
ldnew
pati
entdat
a
Scanni
ng

Backt
oscanni
ng

Pr
obeset
ti
ng

Regul
atei
magequal
i
ty

Fr
eezecur
renti
mage

Measur
ement

Bodymar
k&I
mage
APPLI
CATI
ONS
 Measur
ementofobst
etr
ics.
 Measur
ementofgy
necol
ogy
.
 Measur
ementofur
ology
.
 Measur
ementofcar
diol
ogy
.
 Measur
ementofSmal
lPar
ts(
AbdomenScan)

RESULT
ThusUl
tr
asoundt
ransducer
,Scanneranddi
spl
aysy
stem wasst
udi
edwi
thspeci
fi
cemphasi
s
t
owar
dsi
tswor
king,
pri
nci
pleandcl
i
nical
appl
i
cat
ions.
Bl
ockdi
agr
am ofhear
tlungmachi
ne
 STUDYOFHEARTLUNGMACHI
NE
AI
M
Tost
udyt
hewor
kingpr
inci
pleofHear
tLungMachi
ne

APPARATUEREQUI
RED
4.Oxy
genat
or
5.Heatexchanger
6.Bl
oodpump
7.Fi
l
ter
8.Cannul
a
THEORY
Pr
inci
ple
Car
diopul
monar
y by
pass 
(CPB)i
sat
echni
quei
nwhi
cha 
machi
net
empor
ari
l
ytakesov
ert
he
f
unct
ionoft
he 
hear
t 
and 
l
ungs 
dur
ingsur
ger
y,mai
ntai
ningt
heci
rcul
ati
onofbl
oodandt
he
oxy
gencont
entoft
hepat
ient
'
sbody
.TheCPBpumpi
tsel
fisof
tenr
efer
redt
oasa 
hear
t–l
ung
machi
ne 
or"
thepump"
.
Bl
ockDi
agr
am Descr
ipt
ion
Themai
ncomponent
sofahear
t-
lungmachi
neandt
hei
rfunct
ionsar
ebr
ief
lydescr
ibedbel
ow.
1.
Rol
l
erPump:
Thepumpcomf
ortf
requent
lyconsi
stsofnumer
ousr
evol
vi
ngmot
orpumpst
hatper
ist
alt
ical
l
y
‘
massage’
tubi
ng.Pumpi
ngact
ionoccur
sbecauset
her
oll
ersont
her
otat
ingar
m compr
isest
he
t
ubi
ngscar
ryi
ngt
hebl
oodandf
orcest
hebl
oodaheadoft
hecompr
essedsect
ion.Thi
sact
ioni
s
cal
l
edper
ist
alt
icact
ionandt
hisl
eadst
oapul
sat
il
efl
owofbl
oodt
hrought
het
ubi
ngs.Thehear
t
-
lungmachi
neusesf
ivepumpheadsnor
mal
l
y.
I
nsomecasesweusecent
ri
fugal
pumpsf
ort
hesaf
eguar
dingandcont
rol
ofbl
oodf
lowdur
ing
t
hesur
gical
procedur
e.Bychangi
ngt
heRPM ofpumphead,
bloodf
lowi
smai
ntai
ned.Thi
ski
nd
ofpumpi
ngact
ioni
smeasur
edt
obebet
tert
otheact
ionofr
oll
erpumpsbecausei
tpr
oduces
l
essdamaget
othebl
ood.
2.Oxy
genat
or:
 
Theoxy
genat
ori
spl
annedt
omov
eoxy
gent
othei
nfusedbl
oodandt
akeawaycar
bondi
oxi
de
f
rom v
enousbl
ood.Sosi
mpl
ytheoxy
genat
orassembl
yal
l
owst
ooxy
genat
ethebl
ood.Bubbl
e
oxy
genat
ors,
membr
aneoxy
genat
orsandhepar
incoat
edbl
oodoxy
genat
orsar
ethedi
ff
erent
t
ypesofoxy
genat
ors.Oft
hem,
hepar
incoat
edbl
oodoxy
genat
orsar
ethecommonl
yusedone
ast
heypr
eventbl
oodcoat
ing.

Vi
va

1.Whati
sthepr
inci
plebehi
ndt
hehear
tlungmachi
ne?

2.Whatar
ethet
ypesofoxy
genat
ors?

3.Li
stt
hef
unct
ionsofheatexchanger
.

4.Whati
sthef
unct
ionofoxy
genat
or?

5.Li
stt
het
ypesofbl
oodpumps.
3.HeatExchanger
:
Heatexchanger
sper
mitbodyandor
gant
emper
atur
est
obeat
tuned.Theuncompl
i
cat
edheat
exchangedesi
gni
sacont
ainerofwat
er.Ast
hebl
oodt
ransf
erst
hrought
het
ubi
ngposi
ti
onedi
n
t
hebat
h,t
hebl
oodt
emper
atur
ewi
l
lal
ter
.Amor
ecompl
exsy
stem separ
atedt
hebl
oodand
wat
eri
nter
facewi
thamet
all
i
cbar
ri
er.Ast
hewat
ert
emper
atur
eischanged,
thebl
ood
t
emper
atur
eal
sochanges,
whi
chi
ntur
nchangest
het
issuet
emper
atur
e.Oncet
het
issue
t
emper
atur
ereachest
hedesi
redl
evel
,thewat
ert
emper
atur
eismai
ntai
ned.Heatexchanger
s
canbeoft
wot
ypesnamel
ypl
atet
ypeandcoi
lty
pe.I
npl
atet
ypeofheatexchanger
s,t
wo
sheet
sofmet
alsar
eusedandt
heyar
ecoat
edwi
thanon–t
hrombogeni
csubst
ance.Thi
s
conf
igur
ati
onof
fer
sgoodef
fi
cientt
ransf
erofheat
.Coi
lconf
igur
ati
onconsi
stsofahol
l
owcoi
l
t
hroughwhi
chwat
erci
rcul
ates.Thedi
sadv
ant
ageoft
hist
ypei
siti
sanondi
sposabl
euni
tand
i
sver
ydi
ff
icul
ttocl
ean.
4.Temper
atur
eCont
rol
l
er:
Dur
ingt
het
imet
hepat
ientusesahear
t-
lungmachi
ne,
bodyt
emper
atur
eist
obemai
ntai
nedat
anor
mal
range.Thi
suni
tal
l
owst
hepumpoper
atort
okeept
hebl
oodatapr
opert
emper
atur
e.
5.Bl
oodandOxy
genDi
sper
sionPl
ates:
I
nahear
t–l
ungmachi
ne,
thegasbubbl
esar
edi
sper
sedi
ntot
hev
enousbl
oodi
nthebubbl
e
col
umnandact
sasv
ehi
clesf
orbot
hoxy
genandcar
bondi
oxi
de.Her
eoxy
gendi
ff
usesf
rom t
he
bubbl
eint
othebl
oodf
il
m sur
roundi
ngt
hebubbl
e.Var
ioust
ypesofdi
sper
sionpl
atesar
eused.
6.Reser
voi
r:
Ar
eser
voi
rgat
herbl
ooddr
ainedf
rom t
hev
enousf
low.Reser
voi
rar
rangesi
ncl
udeopenor
cl
osedsy
stems.Theopensy
stem di
spl
aysdemar
cat
ionscor
respondi
ngt
obl
oodv
olumei
nthe
cont
ainer
.Thedesi
gni
sopent
oenv
ironmentper
mit
ti
ngbl
oodt
ocr
osswi
thenv
ironment
al
gases.Thecl
osedsy
stem cont
ainsabagandi
tel
i
minat
est
heai
r-
bloodi
nter
face.Vol
umei
s
measur
edbywei
ghtorchangei
nradi
usoft
hecont
ainer
.
7.Ny
lonMeshFi
l
ter
s:
Theny
lonmeshf
il
ter
susedi
nhear
t-
lungmachi
nesar
eat
tunedwi
thabr
oadchoi
ceofsol
vent
s.
Theyar
epar
ti
cul
arl
yusedf
orgat
her
ingofal
gaeandcel
l
s,at
om anal
ysi
s,bi
gpar
ti
cul
ate
f
il
tr
ati
on,
pref
il
tr
ati
onofsol
vent
sandsoon.
8.Cannul
ae:
 
Numer
ouscannul
aear
esewni
ntot
hesuf
fer
ingpat
ient
’sbodyi
nadi
ver
sit
yofposi
ti
on
dependi
ngont
heki
ndofsur
ger
y.Av
enouscannul
atakesawayt
heoxy
gendest
it
utebl
oodf
rom
t
hepat
ient
’sbodyandanar
ter
ial
cannul
aissewni
ntot
hesuf
fer
ingpat
ient
’sbodyt
oimpar
t
oxy
genr
ichbl
ood.Thecannul
aut
il
izedt
oret
urnoxy
genat
edbl
oodi
sfr
equent
lyi
nser
tedi
nthe
r
isi
ngaor
ta.
 
RESULT
Thust
hewor
kingofhear
tlungmachi
newasst
udi
ed.

Endoscopypr
obe
 AUGMENTEDEXPERI
MENTS

STUDYOFENDOSCOPY

AI
M
Tost
udyt
hewor
kingpr
inci
pleofEndoscopy

APPARATUEREQUI RED
1.Endoscopyuni
t

THEORY
Endoscopyi st hei nser ti
onofal ong,t hintubedi rectlyi ntot hebodyt oobser v
ean
i
nternal organort issuei ndet ai
l.
Endoscopesar emi ni
mal lyinv asiveandcanbei nser t
edi ntot heopeni ngsoft he
bodysuchast hemout horanus.
Al t
er nat ivel y, theycanbei nser tedintosmal lincisions, forinstance, inthekneeor
abdomen.Sur ger ycompl eted t hrough a smal li ncision and assi sted with special
i
nstrument s, suchast heendoscope, iscalled  keyhol esur ger y.
Endoscopyi susef ulf ori nvestigatingmanysy st emswi thint hehumanbody ;these
areasinclude:
 Ga str oint est i
nal t ract: esophagus, st omach, and duodenum
(esophagogast r
oduodenoscopy ), smal l i ntestine ( ent eroscopy )
, l arge
intest ine/ col on( colonoscopy ,si gmoi doscopy ),bileduct ,rect um ( r
ectoscopy),
andanus( anoscopy )
.
 Re spi rator yt ract: Nose( r
hinoscopy ),lowerr espi rator yt ract(bronchoscopy )
.
 E ar:Ot oscopy
 Ur i
nar yt r act : Cyst oscopy
 F emal e r epr oduct ive t ract ( gynoscopy ): Cer v i
x ( colposcopy ), uterus
(hy ster oscopy ),fall
opi antubes( fal
loposcopy ).
 Th roughasmal lincision:Abdomi nalorpel v iccav ity( lapar oscopy ),i
nteri
orofa
joint( ar thr oscopy ),organsoft hechest( t
hor acoscopyandmedi ast
inoscopy )
.
Anendoscopecanconsi stoff oll
owi ngcomponent s
•Ar igidorf lexi blet ube
•Al ightdel iv er ysy st em t oclarifytheor ganorobj ecti ni nspect ion.Thel ightsource
is usual lyout sidet hebodyandt hel i
ghti schar act eristicall
ydi rectedthroughan
 opti
calfibersystem
•Alenssy stem tr
ansmi t
ti
ngtherepresent
ati
ont othevi
ewerthroughthefi
berscope
•Anadditionalchannel t
opermitentr
yofmedi cali
nstr
umentsormani pul
ator
s.
Worki
ng
1.Oneoft hetwomai nendoscopecablescar
ries 
l
ight 
fr
om abr i
ghtl
ampi nthe
oper
atingroom i nt
othebody ,
il
luminat
ingthecavit
ywheretheendoscopehas
beeninserted.

2.Thelightbouncesal ongt hewal lsoft hecablei

ntothepat i
ent'
sbodycav it
y.
3.Thedi seasedori nj
ur edpar tofthepat i
ent
'sbodyisil
l
umi natedbyt heli
ght
shi
ningi n.
4.Li
ghtr ef l
ectedoffthebodypar tt r
av el
sbackupasepar atefiber-
opticcabl
e,
bounci ngof ft
heglasswal lsasi tgoes.
5.Thelightshi nesint
ot hephy si
cian'sey epi
ecesoheorshecanseewhat 's
happeni nginsidethepat ient'
sbody .Sometimesthefiber
-opticcableisdir
ected
i
ntoa  videocamer a (whichdi splayswhat '
shappeningona  t
elevi
sion monit
or)or
a 
CCD  (whichcancapt ur
ei magesl ikea di
git
alcamera orfeedthem intoa
comput erforvari
ouski ndsofi mageenhancement ).

Ri
sksofendoscopymayi nclude:
 Ov er-sedat ion,althoughsedat i
onisnotalwaysnecessary
 F eeli
ngbl oatedf orashor tti
meaf tert
heprocedure
 Mi ldcr ampi ng
 An umbt hroatf oraf ewhour sduet ot
heuseofl ocalanestheti
c
 I nfect i
on oft he ar ea ofi nvesti
gat
ion:this mostcommonl y occurs when
addi ti
onalpr ocedur esar ecar ri
ed outatt hesamet ime.Thei nfect
ionsare
nor mal lymi norandt reatablewithacourseofantibi
otics
 Pe rsistentpai nint hear eaoft heendoscopy
 Pe rforationort earoft helini
ngoft hestomachoresophagusoccur sin1i never
y
2,500- 11,000cases
 I nternalbl eeding,usual l
y mi nor and sometimes t reatabl
e by endoscopic
caut erization
 Co mpl icationsr elatedt opreexisti
ngcondit
ions
Vi
va

1.Whati
sthepr
inci
plebehi
ndt
heendoscopy
?

2.Whatar
ethecomponent
sofendoscope?

3.Whati
sri
gidendoscope?
 4.Whati
sfl
exi
bleendoscope?

5.Li
stt
her
isksofendoscopy
.

RESULT
Thusthewor
kingofEndoscopywasst
udi
ed.

STUDYOFPHYSI
OTHERAPYEQUI
PMENTS
AI
M
Tost
udyt
hewor
kingandpr
inci
pleofPhy
siot
her
apy
.
THEORY
Def
ini
ti
on:
Phy
siot
her
apycanbedef
inedasa 
tr
eat
mentmet
hodt
hatf
ocusesont
hesci
enceof
mov
ement
 andhel
pspeopl
etor
est
ore,
mai
ntai
nandmaxi
mizet
hei
rphy
sicalst
rengt
h,f
unct
ion,
mot
ionandov
eral
lwel
l
-bei
ngbyaddr
essi
ngt
heunder
lyi
ngphy
sical
issues.
Phy
siot
her
apyTr
eat
ment
:
WhatCondi
ti
onsdoPhy
siot
her
api
stsTr
eat
?
Phy
siot
her
api
sts 
areexper
ts 
atpr
ovi
dingphy
siot
her
apyt
reat
ment
 f
or:
 Pr
event
ingi
njur
yanddi
sabi
l
ity
;
 Managi
ngacut
eandchr
oni
ccondi
ti
ons;
 I
mpr
ovi
ngandmai
ntai
ningopt
imal
phy
sical
per
for
mance;
 Rehabi
l
itat
ingi
njur
yandt
heef
fect
sofdi
seaseordi
sabi
l
ity
;
 Educat
ingpat
ient
stopr
eventr
e-occur
renceofani
njur
y.
Pat
ient
smayber
efer
redt
oorseekassi
stancef
rom aphy
siot
her
api
stf
ora 
var
iet
yof
heal
thi
ssues 
andr
ecei
vev
aluabl
eassi
stance.
Phy
siot
her
api
stsof
fert
reat
ment
srel
ati
ngt
othef
oll
owi
ngcondi
ti
ons:
 Car
dior
espi
rat
ory
: 
Prov
idi
ng suppor
t,pr
event
ion and r
ehabi
l
itat
ion f
orpeopl
e
suf
fer
ingf
rom di
seasesandi
njur
iest
hataf
fectt
hehear
tandl
ungs,suchas
ast
hma.
  Cancer
,pal
l
iat
ive car
e and l
ymphedema:
 
Treat
ing,managi
ng orpr
event
ing
f
ati
gue,
pai
n,muscl
eandj
ointst
if
fness,
anddecondi
ti
oni
ng.
 I
ncont
inence:
 
Managi
ngandpr
event
ingi
ncont
inenceandpel
vi
cfl
oordy
sfunct
ion.
 Women’
s heal
th concer
ns:
 
Addr
essi
ng heal
thi
ssues sur
roundi
ng pr
egnancy
,
bi
rt
h,post
-par
tum car
e,br
east
feedi
ng,menopause,bedwet
ti
ng,pr
olapsed,l
oss
ofbl
adderorbowel
cont
rol
.
 Muscul
oskel
etal
:
 Pr
event
ingandt
reat
ingcl
i
ent
swi
thmuscul
oskel
etalcondi
ti
ons
suchasneckandbackpai
n.
 Neur
ologi
cal
:
 Pr
omot
ingmov
ementandqual
i
tyofl
i
fei
npat
ient
swhohav
ehad
sev
erebr
ainorspi
nalcor
ddamagef
rom t
rauma,
orwhosuf
ferf
rom neur
ologi
cal
di
seasessuchasst
roke,
Par
kinson’
sdi
seaseandmul
ti
plescl
erosi
s.
 Or
thopedi
c: 
Hel
ping pat
ient
spr
eventormanageacut
eorchr
oni
cor
thopedi
c
condi
ti
onssuchasar
thr
it
isandamput
ati
ons.
 Pai
n: 
Managi
ngorpr
event
ingpai
nandi
tsi
mpactonf
unct
ioni
npat
ient
s.
Phy
siot
her
apy
 Techni
ques:
WhatTechni
quesDoPhy
siot
her
api
stsUse?
Phy
siot
her
api
stsempl
oyav
ari
etyoft
echni
ques,
dependi
ngont
henat
ureoft
hei
njur
yor
pr
obl
em t
heyar
etr
eat
ing.Themostcommonphy
siot
her
apyt
echni
quesar
e:
 Manualmani
pul
ati
on:
 
Mov
ingj
oint
sandsof
tti
ssuehel
pst
oimpr
oveci
rcul
ati
on,dr
ain
f
lui
dfr
om t
hebody
,andr
elaxov
erl
yti
ghtormuscl
eswi
thspasms.
 El
ect
ri
calner
vest
imul
ati
on:
 
Smal
lel
ect
ri
calcur
rent
sdel
i
ver
edt
oaf
fect
edar
eashel
pst
o
suppr
essandbl
ockpai
nsi
gnal
stot
hebr
ain.
 Acupunct
ure:
 
Needl
es 
sti
mul
atet
he ner
vous sy
stem 
and wor
kto dul
lpai
n,r
elease
muscl
es,
boostt
hei
mmunesy
stem andr
egul
atev
ari
ousbodyf
unct
ions.
 Demonst
rat
ion:
 
Teachi
ng pr
opermov
ementpat
ter
ns al
l
ows pat
ient
sto hel
p heal
t
hemsel
ves.
 Funct
ional
test
ing:
 
Test
ingapat
ientt
oassesshi
s/herphy
sical
abi
l
iti
es.
 Dev
ice pr
ovi
sion:
 
Prescr
ipt
ion,f
abr
icat
ion and appl
i
cat
ion of assi
sti
ve,adapt
ive,
suppor
ti
veandpr
otect
ivedev
icesandequi
pment
.

RESULT
Thust
hewor
king,
treat
mentanduseofphy
siot
her
apyequi
pment
swer
est
udi
ed.