LAB SESSION MANUAL

REGULAR ACADEMIC YEAR

FIRST TERM 2024:
PHYSIOPATHOLOGY & MEDICAL
EQUIPMENT
Creators: Fernando Villalba-Meneses
Professor

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 Preface

This book contains Lab Sessions for Biomedical Engineering in the School of Biological
Sciences and Engineering from Yachay Tech University, it has been designed to teach
students practical of Physiopathology and Medical Equipment by performing the
experimental activities aligned with the topics, objectives and learning outcomes defined
in the corresponding Syllabus. This manual aims to provide the basic knowledge,
necessary resources, experimental techniques and procedures so they can replicate the
experiment and prepare their respective reports or any other evidence of learning, which
will be evaluated by the assigned professors. As a result, students are expected to be
familiar with the general principles behind each experiment from a lecture course.

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 UITEY-LAB-
LABORATORY SESSION
FORM-01

COURSE Physiopathology and TERM IS20 WRITTEN Byron

Medical Equipment 24 BY Inapanta
& Milena
Salvador
LAB SESSION No. 01 TOPIC Transcutaneous Electrical
Nerve Stimulator (TENS)

1. INTRODUCTION

1.1 What is TENS?

Transcutaneous electrical nerve stimulation, known as TENS, is a

therapy that uses low-voltage electrical current to provide pain relief.
[1] The TENS is a small device that uses electrodes placed on the skin
and connected to the unit via wires to address pain in a target region.
TENS is popular with patients and practitioners because it is
inexpensive, available without prescription, easy to self-administer,
and safe, with limited potential for toxicity or overdose. [2]

1.2 Pathologies where it is used as treatment

Pain relief with conventional TENS is rapid in onset and offset and is maximal
when the patient experiences a strong but non-painful beneath the electrodes. Therefore,
patients may need to administer TENS throughout the day. TENS therapy has been used
to relieve both chronic and acute pain. Some of the most common conditions for which
TENS has been used include:

• Sciatica
• Fibromyalgia
• Tendinitis
• Bursitis
• Low back pain.
• Chronic pelvic pain.
• Sport injuries

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1.3 How does TENS work?

Figure 1. TENS functioning

1.3.1 Paths Position
Before using the machine, it is necessary to turn it off. Then, put the
batteries in or charge the machine following the manual user instructions. After
that, put the lead wires into the connector on each patch. Make sure there are no
bare metal pins exposed. Put the lead wire plugs into the socket on the top of the
TENS unit. Ensure the skin where the pads are applied is clean and dry and there
are no cuts, abrasions, or areas of skin irritation. Then, place the patches on the
skin. The pads must be placed at least 2.5cm (1 inch) apart on either side of the
painful area. Figure b. Could you show the correct places to put the pads
according to the patient's necessity?

Figure 2. Examples of TENS pads placement

NOTE: Never place the pads over:

• The front or sides of the neck

• Temples
• Mouth or eyes
• Chest and upper back at the same time
• Irritated, infected or broken skin
• Varicose veins
• Numb areas

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 1.3.2 Paths Position
To provide good therapy, switch on the TENS machine slowly and turn it up
gradually until the patient feels tingling. The sensation needs to be quite strong
but not uncomfortable. After a few minutes, the sensation will start to drop away
slightly. When this happens, turn the machine up slightly and leave it in use for
the rest of the time. Please do not turn it up too high, as this can cause over-
stimulation, which may worsen pain. There should be no muscle contraction. At
the end of the session, turn the machine off and disconnect the electrodes from
the machine.

1.4 Regulations for the correct use of TENS

TENS is a non-invasive therapy that must be correctly regulated to avoid any damage to
the patient. According to the research, the frequency, intensity, and duration of the
impulses are three factors of great significance in TENS. The high-frequency pulses the
patient will experiment with range from 80 to 120 cycles per second and may help manage
acute pain. Low-frequency pulses range from 1 to 20 cycles per second and are suitable
for treating chronic pain. However, it is difficult to find a single frequency that works
best for every patient, but this range appears to cover most individuals. The intensity of
the current is regulated by the user, according to their necessity. The impulse duration,
the number of microseconds the current enters the skin during each pulse, must last 15-
20 minutes per session.

1.4 Introduction to PROTEUS

The Proteus Design Suite is a proprietary software tool used primarily for electronic
design automation. It is a Windows application for schematic capture, Simulation, and
Printed Circuit Board (PCB) layout design. It can be found in many configurations,
depending on the size of the designs being produced and the requirements for
microcontroller simulation. Electronic design engineers and technicians use the software
to create schematics and electronic prints for manufacturing printed circuit boards and as
a rapid prototyping tool.

2. LEARNING OUTCOMES

a. General Learning Outcomes

• To analyze transcutaneous nerve stimulation by using the software
PROTEUS and analogue graphs.
b. Specific Learning Outcomes
• Familiarization with PROTEUS software.
• Analyze how the PROTEUS software can record relevant data during the
TENS session, such as the duration of therapy, the intensity used, and any
changes in patient perception.

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 3. MATERIALS

Materials for Proteus simulation:

• Switch
• Electrolytic capacitor 100µF
• Ceramic capacitor 100nF
• Ceramic capacitor 10nF
• Ceramic capacitor 4.7nF
• Resistor 100kΩ
• Resistor 47Ω
• Resistor 6.8KΩ
• Potentiometer 10KΩ
• Diode 1N4004
• Transistor NPN BC556
• Voltage transformer 9V

4. METHODS

a. Preliminary section.
In this practice, we replicate a simple circuit to produce Transcutaneous
Electrical Nerve Stimulation. This type of circuit is simple; you only need a
battery, some resistors, some capacitors, and an IC timer 555. Its circuit replicates
a medical device used to treat pathologies related to muscles, such as Sciatica.
The following schema will be used during the laboratory:

Figure 3. TENS MODEL CIRCUIT

i. Explanation of circuit
Figure 1 shows a simple Transcutaneous Nerve Stimulator Circuit using
the Timer IC 555 configured in its standard astable mode. RV1 generates
several frequency output ranges in conjunction with variations in output
frequency pulse widths for implementing the TENs procedures

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 mentioned in the introduction. TR1 produces TENs at the supply voltage
level for maximum effectiveness. The transformer could be any standard
radio output audio transformer or made by winding 10:100 turns of 36
SWG super enamelled wire on a small EE ferrite core. The transformer's
output could be arranged in tiny protruding copper prods, not too sharp
but sufficient for creating a slight digging impression on the skin. It may
be wrapped on the affected area with some suitable cohesive band.

b. During the lab session.

i. Proteus Installation
1) watch the video tutorial
https://www.youtube.com/watch?v=nuu-_TkmjPI

ii. Modelling and simulation of circuit using proteus

1) First, open your Proteus and create a new project.
Remember to run as an administrator

Figure 4 New Proteus project

2) In the left toolbar, click on the P Button and search the

component mentioned in the section Materials on this guide.

Figure 5. Proteus Left Toolbar

3) A new window will appear. In this window, you search for the
electronic components necessary to build a TENS. To search for

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 an element, click the box Keywords and write the keys to find the
components.

Figure 6. Pick devices windows

4) Now, click on accept. Then, visualize that all components are in

the left toolbar.

Figure 7. Picked components

5) Now, you should build the circuit in Figure 3. Also, you should
include a resistance of 4MΩ -16MΩ toe OUT and OUT- to
simulate a body. The final circuit will be like the following
figure.

Figure 7. Circuit modeled in proteus

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6) Well, your circuit is complete. Add voltage probes from the
toolbar in the wires before and after the transformer. Simulate by
clicking the button at the bottom of the windows.

Figure 8. Probes toolbar

Figure 9. Voltage Probes and Simulation started

7) Stop the simulation . Now, you should add an analog graph

(Figure 8) or oscilloscope (Figure 9)

Figure 10. Analog Graph

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 Figure 11. Oscilloscope

8) Finally, run simulation and analyze the waves.

Figure 12. Example of voltage analysis of TENS circuit using analog graph. Specifications: t = -10ms , Red line =
Input voltage transformer, and Green line = output voltage transformer

c. Build model using a protoboard

Now, we build the circuit using a protoboard and real components. In absence
of electronic components use Tinker Cad https://www.tinkercad.com/ Use
Figure 14. As a guide.

Figure 14. Model of circuit in a protoboard using TINKERCAD.

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 5. ACTIVITIES

5.1 Use the modeled circuit from the section 4.1 to answer the next:
1. Take pictures of the oscilloscope or analog graph in different states of
potentiometer:
a. 0% resistance
b. 25% resistance
c. 50% resistance
d. 75% resistance
e. 100% resistance

2. Complete the following table.

Table 1. Data properties in different states of potentiometer

Potentiometer Before Transformer After Transformer

Position Rpot V-max V-min V-max V-min
0%
25%
50%
75%
100%

3. What is danger, the current or voltage? What are the safe limits? This
circuit is safe for the patient?
4. What are min and max frequency of the circuit?
5. The Timer 555 produced square signal. Is it the same visualized in the
oscilloscope or analogue graph? What component could affect the
signal? Explain.
6. What medical treatments using the method of nerve stimulation?
Mention 5 pathologies.

5.2 Using the circuit diagram of the Figure 15. TENS model with 10 electrodes
stimulation performs:

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 Figure 15. TENS model with 10 electrodes stimulation

1. What difference is evident in relation to the first circuit?

2. Do you think it is safer? Explain.
3. Implement the circuit in Proteus. Visualize and analyze the signal, if possible.
Include screenshots.
4. Which treatments use multipoint stimulation? Mention three treatments.

5.3 Include screenshots of your proteus simulation and photos of your practical
work in protoboard (or in Tinker Cad).

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 6. REFERENCES

1. Teoli D, An J. Transcutaneous electrical nerve stimulation. InStatPearls

[Internet] 2021 Nov 4. StatPearls Publishing.
2. Johnson MI, Jones G. Transcutaneous electrical nerve stimulation: current status
of evidence. Pain management. 2017 Jan;7(1):1-4.
3. Swagatam. “Transcutaneous Nerve Stimulator Circuit.” Homemade Circuit
Projects, 26 July 2021, www.homemade-circuits.com/transcutaneous-nerve-
stimulator-circuit.
4. “Transcutaneous Electrical Nerve Stimulation (TENS).” Cleveland Clinic,
my.clevelandclinic.org/health/treatments/15840-transcutaneous-electrical-nerve-
stimulation-tens.

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