Introduction:

Examples and classification of medical devices:

1. Diagnostic:Microscope ,Syringe,Ph meter ,SPO2, Thermometer (: temp. Sensor +
microcontroller), MRI
2. Treatment : LASIK - radiotherapy
3. Assistive : dialysis - pacemaker - cane - eyeglasses
microcontroller/processor: to interpret and display analysed info on screen for diagnosis
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GENERALISED MEDICAL INSTRUMENTATION SYSTEM
- Every instrumentation system has at least some of the functional components shown in figure
below
- flow of info is from left to right.
- dashed lines means : not essential but usually used
- “ System architecture” instead of block diagram

Measurand:
Examples: Blood oxygen saturation ,Electrical activity of the heart,Tumour

A.Definition:
The Input of whole system
The physical quantity, property, or condition ( parameter) that the system measures to build the
equipment (Project starts from the client)

B.Subjected to constraints :
■ Vary with time and among patients :
- its Dynamic range: range that a device operates in / of interest
■ Accessibility
 ■ Safety

C.The accessibility of the measurand:

■ internal (blood pressure)
■ External on the body surface (electrocardiogram (ECG) potential)
■ emanate from the body (infrared radiation):
- infrared light is emitted by any object that has a temperature
above absolute zero( 0k = -273.15 C).
- ↗ temp. → ↗ heat & ↗ temp. Of blood → ↗ infrared → more
infrared intensity
- Intensity : number of photons
- Gamma rays:
-Rays in general should be emitted from above
downwards(rectal) if rays are rising upwards there is reflux
-Gamma camera/ PET scan : use body radiation, for gamma
camera patient takes a solution and is put under camera
■ derived from a tissue sample

D.measurands categories:
1. Biopotential:
- electric potential in living cells that play often significant role in diagnosis
- are produced as a result of electrochemical activity in excitable cells( nerve cells, muscle
cells, pacemaker cells)
- transmit information(e.g. sensory information in the nervous system or coordination of
blood pumping in the heart)
- main bioelectrical signals are generated by the heart, the brain and the muscles, producing ECGs,
EEGs and EMGs
2. Pressure.
3. Flow
4. dimensions (imaging).
imaging includes:
● Presence ( yes tumour or no tumour )
● Dimensions
ρ𝐿
- When breathing , material expands R= of wire and R increases as wire
𝐴
stretches
- By counting R max we can count respiration rate.
- Gender /age / certain diseases affect breathing rate and heart rate.
- For babies —> girl: 160-180 and boy: 120 ( heart rate)
5. displacement (velocity, acceleration, and force).
6. Impedance:
- has frequency component, impedance means opposes.
- Zc= 1/jwc Zind= jwL
- V=ZI→ inject current → measure V
→ Z is high: no issue
→Z is low: increase in conductance problems.
 - Impedance should be in a certain range
7. Temperature
8. Chemical concentrations:
In middle east genetically we are prone to vitamin D deficiency
Fe in RBC essential for RBC production , so low Fe → anaemia
E.other notes + recall:

ECG: electrical activity of the heart

- P wave: from atrial contraction,

- the QRS complex : from ventricular contraction.
- T wave indicates ventricular repolarization.
- The atria repolarize during the QRS complex and therefore this repolarization cannot be observed separately

×Any changes in amplitude , frequency and period are useful for diagnosis
×ECG is only AP but muscle contraction lead to other peak forming

EEG: the electrical activity of your brain from neurons.

- The difference in potential results from differences in the concentration of ions on either side of the
membrane. (i.e. K+, Na+, Cl−, and Ca2+).
-The resting membrane potential is typically -70 mV relative to the outside

EOG:electrical activity of the eye

(EMG) :EMG Electromyography electrical activity of the muscle in response

to nerve stimulation
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sensor :
A.Transducer: is defined as a device that converts one form of energy to another

b. Sensor converts physical measurand(analog) to electric output (voltage or current)

c. Constraints :
- The sensor should respond only to the form of energy present in the measurand
- If nature of measurand changes → nature of sensor changes i.e:
I.e :We use electrodes for ECG not photosensors for EM
- The sensor should interface with the living system in a way that minimises the energy extracted,
while being minimally invasive

d. Types of sensors:
■ invasive sensors : require physical penetration ,may carry risks.
■ Non-invasive sensors: do not require penetration and are generally safer.
■ Direct sensors:
● provide measurements of the specific property of interest without additional
calculations.
● Measurands are analogical signals.
● Conditions:
○ measurand is readily accessible
● Examples: electrodes measure chemical ( ion concentration) converts it to electrons
We model the skin-electrode interface with:

Capacitor : frequency component , used to study how electrodes act in different frequencies to
check if there are problems .
■ Indirect sensors:
■ direct measurement is not accessible
■ Secondary measurand are related to the desired property either through a known relationship or by
interacting with the desired property.
■ The primary sensing element reads the primary measurand and converts it into a secondary measurand
■ The secondary variable is further converted into an electrical signal by a variable conversion element.

- example:
Diaphragm( primary sensing element) converts Pressure(m1) → displacement
strain gauge (conversion element) converts it to → variation of R and Inject I →measured voltage is
the electric output
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. Signal conditioning :
A.Challenges:
- Biological signal magnitudes are low ( low frequency i.e like 1.5 Hz , low voltage in mv)
- Any measurement includes noise
B.Noise sources:
External: power lines, radio broadcast, cell phone at frequency = 50 Hz/ light
 internal: muscle noise, motion artefact
C.intro:
- Thermometer has + or - 0.1 C accuracy
- Proteins are the building blocks of the body , membrane and antibodies are made of proteins
and proteins at high temperature → denaturate ( irreversible)
→ reading of physiological parameters should be accurate with max 5% error
- Heart beat per minute between 60-90 both ends are an issue
D.Divided into :
1. Signal filtering:
- separate noise from the desired signal using their distinct property e.g. separate high
frequency noise from low frequency signal.
- voltage is easier to amplify and filter so usually electric output = voltage
→ filtering is essential
- How is filtering done:
Fourier: from time → frequency
To know the frequency of the noise and filter based on it
- Important signal values:
- frequency -amplitude
2. Opposing inputs: if DC noise is known, it can be removed from the signal by subtracting
the noise from the signal.
3. Amplify the signal:
- All signals from our body are weak so amplifying is necessary
- Signal processing of small signals leads to its attenuation
- the noise is DC( shift up and down) + AC( distortion/ changes its form)

Distorted vs the input signal

- Offset in devices is to counter the DC noise from outside environment
- Filtering and amplifying are together:

- Amplifiers are cascaded to avoid saturation

- Saturation is when power supply supplies + or - 5 volt then output is + or - 5 volt
Examples:
It was not allowed to enter phones to operations because its radiofrequency (EM) could affect
the devices, now the devices have built in low pass filters that allows using phones in
operations

4. Match the impedance of the sensor to the display:

 - Current takes the easier path so if there is unmatched impedance can lead to current
leakage
- Often, sensor outputs are converted to digital form and processed by microcontroller
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Output display : convey the information obtained by the measurement in a meaningful way (visual,
audible)
a. Numerical Output Display: i.e a numerical value (e.g., "75 bpm") on its screen.
- Discrete Output Display: display only discrete values
- Continuous Output Display: can output any value ( we use this more)
b. Graphical Output Display:
An electrocardiogram (ECG) machine produces a graphical output in the form of heart rate
waveforms.
c. Permanent Output Display:
A patient's medical record is a permanent output display
d. Temporary Output Display: During a surgery, a real-time video feed from an endoscope to
visualise internal organs.
5. Auxiliary elements :
1. Calibration :
-A calibration signal with the properties of the measurand should be applied to the sensor
input or as early in the signal-processing chain as possible.
- Its the process to put several inputs and check output of each and plot their relationship. If
there is error > 5% then optimization is required( fix the design).
- Linear relationship is easier to deal with so its usually our optimal goal
2. Control and feedback:
- For stimulating the system or environment in a way that allows the sensor to
respond and provide measurements
- ,to adjust the sensor and signal conditioner: h
- to direct the flow of output for display, storage, or transmission.
- automatic or manual
3. Storage + Transmission: Data may be stored briefly :
- To meet the requirements of signal conditioning
- to examine data
- Maybe stored before signal conditioning, to check each of its stages the output
4. Radiation , electric current or other applied energy :we have to stimulate to input the
measurand