OMD551-BASICS OF BIOMEDICAL INSTRUMENTATION

UNIT IV

MEASUREMENT OF NON ELECTRICAL PARAMETERS

Temperature, respiration rate and pulse

rate measurements. Blood Pressure: indirect
methods - Auscultator method, direct methods:
electronic manometer, Systolic, diastolic
pressure, Blood flow and cardiac output
measurement: Indicator dilution, and dye dilution
method, ultrasound blood flow measurement.

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 TEMPERATURE
• Temperature is one of the indicator of the
general well being.
• Two types of temperature measurements
can be obtained from the body.
• Systematic temperature

• Skin Surface temperature

Systematic temperature:
•Systematic temperature is the temperature of the internal region of the
body.
•Usually, the heat is generated by the active tissues of the body and heat
is lost by the body to the environment.
•Measurement of systematic temperature are accomplished by
temperature sensing devices placed in Mouth , Under Armpits (or) in the
rectum.
•Also it is most accurately measured at Tympanic membrane in the ear.

• But, the temperature of the body is maintained carefully. The normal

mouth temperature is 37 degree C.
• The normal underarm & Rectum temperature is about 1
degree C lower than the above temperature.
• The brain contains the temperature control center for the
body.
• Temperature of the body may change due to Environment
conditions like Warm, Cooling , ambient temperature
production of perspiration due to secretion of the sweat
glands and increase circulation of blood.
• The only deviation from normal temperature control is a
rise in temperature called “Fever”.
 Measurement of systemic Body Temperature:
•Mercury thermometer is still the standard method.
•Two types of Temperature sensing devices are,
– Thermocouple
– Thermister.
•Thermocouple:
– A junction of two dissimilar metals that produces
as output voltage nearly proportional to the
temperature at that junction with respect to a
reference junction.

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 • Thermistor:
– A Semi conductor element whose resistance varies with temperature.
– It is used more frequently than thermocouples because of greater sensitivity.
– These are variable resistance devices formed in a disks, beads, rods and other
desired shapes.

– Let,
• - Resistance at reference temperature.
• e- Base of natural algorithm
• B-Temperature Coefficient Ranges from 3000-4000
• T-temperature at which measurement Is taken
• T0-Reference temperature in Kelvin
Selection of Thermistor Probe:
It is based on the following in medical application,
1. Physical Configuration
2. Sensitivity of the device
3. Absolute temperature range
4. resistance range

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 Problems associated with thermistor

• Self heating is very important problem in

thermistor. This problem can be overcome by
limiting the current used in measurement.
• The power dissipation of thermistor is to be
maintained in milli watts range to overcome this
problem.
• Thermistor probe should be chosen correctly
based on 1)Resistance range 2)Sensitivity
 Skin temperature measurement
• Skin temperature is not constant
throughout the body. It is varied from 30
degree C to 35 degree C.
• Various factors affect the skin
temperature are
1)How fat covers over capillary area
2)How the skin portion is exposed to ambient
temperature
3) Blood circulation pattern beneath the skin
• Probe used for measurement: A small flat
thermistor probe is used to measure the skin
temperature.
• Infrared thermometer: It is a device used to
measure skin surface temperature. It is used
to locate breast cancer.
• It is also used to identify the spots in which
blood circulation is poor.
 Fiber optic temperature Sensor
• It is a transducer which converts any form of a signal to an optical
signal in the measurable form.

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 BLOOD PRESSURE
 Blood pressure (BP) is a force exerted by circulating blood on
the walls of blood vessels.
 During each heartbeat, BP varies between a maximum (systolic) and
a minimum (diastolic) pressure.
 Systolic: Maximum pressure reached during cardiac ejection.
 Diastolic: Minimum pressure occurring at the end of a ventricular
relaxation.

Normal blood pressure

 Blood pressure of 140/90

METHODS:
 DIRECT METHOD
 INDIRECT METHOD

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 INDIRECT METHOD
 KOROTOKOFF SOUNDS METHOD
 AUSCULTATORY METHOD
 OSICILLOMETRIC METHOD
 RHEOGRAPHIC METHOD

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 Indirect (or) Non invasive method

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• The sphygmomanometer has expandable pressure cuff and a
mercury or aneroid manometer to measure the pressure in a cuff.
• The cuff consists of a rubber sheet wrapped around the upper
arm straight to heart.
• The cuff is normally expanded manually with rubber pump and
reduces slowly through needle valve.
• When the cuff is placed in the upper arm and expanded arterial
blood can flow but only when the arterial pressure exceeds the
cuff pressure.
• If it exceeds, disturbance is generated at the blood, and it rush
through the arterial opening. During each systole, it generates
the sound called Korotkoff sound is heared by stethoscope.

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• If pressure of the cuff exceeds more there is no sound
produced, now the pressure of the cuff is released, so
slowly it reaches systolic pressure then produces sound.
• When the first sound is heard it is measured as systolic
pressure, it is usually 120mmHg.
• At one particular condition the pressure falls down and
the sound disappears. This value is recorded as diastolic
pressure. Usually 80mmHg.
• Method of locating systolic and diastolic pressure values
by listening the Korotkoff sound is called “Auscultatory
method”.
• An alternative method, the pressure can be identified by
feeling the pulse is called “Palpatory Method”
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 Auscultatory method aneroid
sphygmomanometer with stethoscope

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 MERCURY MANOMETER

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 OSCILLOMETRIC METHOD

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 OSCILLOMETRIC METHOD
 Automated method of non invasive BP
measurement
 It has some distinct advantages over the
auscultatory method
• Sound is not used during measurement
• This technique does not require a microphone
or transducer in the cuff.

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 Disadvantage of oscillometric method as well as auscultatory method is
that the excessive movement or vibration can cause inaccurate readings
PRINCIPLE
 “occluding cuff deflates from a level above the systolic pressure, the
artery walls begin to vibrate as the blood flows through the partially
occluded artery and these vibrations will be sensed in the transducer
system monitoring cuff pressure”
 The cuff pressure at the
point of maximum oscillations
usually corresponds to the
mean arterial pressure.
 The point above the mean
pressure at which the
oscillations begin to rapidly
decease in amplitude correlates
with the diastolic pressure.

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 RHEOGRAPH METHOD
• In this, a set of three electrodes were attached to the cuff are
placed in contact with skin.

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• A high frequency current source at 100KHz is connected to the
electrode A & C.
• The impedance between any two electrodes are measured before
pressurizing the cuffs and it is modulated in accordance with blood
pulsation in the artery.
• Then arterial pulses can be detected by demodulation and
amplification.
• In this diastolic and systolic pressure are showed in the indicators.

Disadvantages:
Does not provide a continuous recording of pressure change.
Little discomfort to the patient.

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 Direct (or) Invasive Method
• It is used when the highest degree of absolute accuracy,
dynamic response and continuous monitoring is required.
• It is used to measure the pressure in deepest region which
can not be done by indirect mean.
• For direct measurement, a needle type probe is directly
inserted through a vein or artery to the area of interest.
• Methods:
– Percutaneous Insertion
– Catheterization (Vessel cut down)
– Implantation of the transducer in a vessel or in the heart.

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 • Through probe only the blood pressure is measured.
• There are two types of probes.
Catheter Tip Probe:
In this the sensor is mounted on the tip of the probe
and pressure applied on it are converted to the
proportional electrical signal.
Fluid filled Catheter Type:
In this transmitted pressure applied on its fluid filled
column to an external transducer.
This transducer converts the applied pressure to
electrical signal.
Then the electrical signals are amplified and displayed.
The following diagram shows the typical setup of a
pressure measurement system by direct method.

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 • Before inserting the catheters into the blood vessel, the
fluid filled should be thoroughly flushed.
• In practice a steady flow of sterile saline passed through
the catheter to prevent blood clotting.
• As the air bubbles dampen the frequency response of
the system, it should be ensured that the system is free
from them.
• The simplified circuit diagram commonly used for
processing the electrical signals received form the
pressure transduces for measurements of arterial
pressure.

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 • The transducer is excited with 5V DC excitation.
• The electrical signals corresponding to the arterial
pressure are amplified in an operational amplifier.
• Modern pre amplifier for transmitting electrical signal is
of isolated type.
• The excitation of the transducer comes from the
amplitude controlled bridge oscillator through an
isolating transformer, which provides an interconnection
between the floating and grounded circuit.
• The input stage is a differential circuit, which amplifies
pressure change and it is sensed from the patient
connected circuit.
• Gain of the amplifier can be adjusted depending upon
the sesnsitivity of the transducer.

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 • There are two type of meters with indicator available to
measure diastolic and systolic pressure.
Case (i)
For the measurement of systolic pressure a
conventional peak reading type voltmeter is used.
when the positive pulse from amplifier is appeared at
A , diode D3 conducts and C3 is charging upto peak
value of input signal , corresponding to systolic value.
c3 and r3 are used to set the time constant RC to get
steady state output in the indicating meter.

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 Case (ii)
A clamping circuit consisting of C1 and D1 is used
to develop a voltage equal to peak to peak value of the
pulse pressure.
Voltage across R1 then D2 conducts and capacitor
charges peak value of the pulse signal.
Then the diastolic pressure is indicated by a second
meter.

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 CARDIAC OUtput
• It is the amount of blood delivered by
the heart to the aorta (it is the main
artery of the body, supplying oxygenated
blood to the circulatory system. In
humans it passes over the heart from
the left ventricle and runs down in front
of the backbone.)
• When the supply of blood from
heart is unable to meet the demand,
which causes ,
– Low Blood Pressure
– Reduced tissue oxygenation
– Poor renal function.
• Blood pumped from the heart with each
beat for adult is between 70 to 100ml
and cardiac output is 4 to 6 liters/min.

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 CARDIAC OUTPUT MEASUREMENT
Cardiac output is measures by using ,
Direct method.
Fick’s method.
Indicator dilution method.
Dye Dilution Method
Thermal dilution method.
Methods of measuring cardiac output based on some other
parameter:
Impedance method.
Ultra sound method
Bio reactance method
Carbon di-oxide rebreathing method
Direct Method:
– In this cardiac output is measuring the stroke volume ( value of
blood pumped from the left ventricle per beat) by the use of an
electromagnetic flow probe placed on the aorta and multiplying it by
the heart rate.
– This method involves in surgery so not preferred for routine
applications.

Fick’s Method:
Output is determined by the analysis of gas-keeping of the organism.
It is measured by continuous flow of oxygen in and out from the blood
and also measure the amount of oxygen before and after passing.
Main disadvantage of this is ,it is complicated and difficult to repeat.

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 INDICATOR DILUTION METHOD
• It is the most popular method.
• It introduces the indicator in the blood.
• Types: Continuous infusion method , bolus Injection Method
• Continuous infusion Method:
It is not widely used due to the indicator re circulate process.
• Bolus Injection Method:
Indicator is injected into a large vein through heart, lungs, left heart then
the indicator appears in the arterial circulation.
• The presence of indicator in the artery is detected by a transducer and
displayed on a chart recorder.
• Cardiac output on chart is in a curve form. this curve is called dilution
curve.

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 INDICATOR DILUTION METHOD

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 DYE DILUTION METHOD

• Most common indicator is Dye (Indocyanine green (Cardio green)) is

used.it has the property of absorbing light in 800nm. Infra red photo
cell transducer is used. Densitometer is used for the measurement of
dye concentration.
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• Densitometer is used for the quantitative measurement of dye
concentration.
• In order to avoid the formation of bubbles, a pot type tube should
be flushed with a solution of silicon.
• A flow of 40ml/min is preferred in order to get a short response
time as possible for the sampling catheter.
• A sampling syringe has a volume of 50ml/min
• The output of the photocell is connected to a low drift amplifier. It
has high input and low output impedance.
• The amplification is directly proportional to the resistance value of
the potentiometer R.
• A potentiometer recorder records the amplified signal on a 200mm
wide recording paper with a speed of 10mm/sec.

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THERMO DILUTION
METHOD
 THERMO DILUTION
METHOD
 10 ml of 5% dextrose in water at Room Temperature is injected as a
thermal indicator into Right Atrium.
 It is then detected in the pulmonary artery by a Thermistor(catheter).

 Difference b/w injector temp & circulating blood temperature in

Pulmonary artery is measured.
 Reduction in temp. is integrated w.r.t time and displayed in o/p.

 The Cardiac output is displayed in two ranges 0-10 l/min and 10-20
l/min.
 Amplifier block is used to remove non-linearity of the thermistor.
 Measurement of Cardiac Output
• Impedance Technique:
Cardiac output can be determined
electronically by the impedance method.
• Ultrasound Method:
Used to measure the velocity of blood flow in
the ascending aorta by the application of
Doppler method.
• Bio reactance method:
A method for non invasive hemodynamic
monitoring is based on bio reactance
method.

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By impedance method
 By impedance method
 4 electrodes are placed, surrounding thorax.
 Electrode pair 1 & 4 used as current electrodes.
 Electrode pair 2 & 3 used to pickup the voltage.
 Resistance(thorax)  R = pL/A
 BLOOD FLOW MEASUREMENT
• The circulatory system of human helps in the flow of blood throughout the body.
• Adequate amount of blood should be supplied for the organs to perform their function.
Improper blood supply results in case of various diseases.
• So blood flow rate can be determined with the help of flowmeters.
TYPES OF MEASUREMENTS:
• Magnetic blood flow meter
• Ultrasonic blood flow meter
– Transit time type
– Doppler Type
• Thermal convection Method
• Radiographic Method
• Indicator dilution method
– Open circulation method
– Closed circulation method

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Magnetic Blood Flow Meter:
•It works on the principle of electromagnetic induction.
•It states that when an electrical conductor is moved through a magnetic
field a voltage is induced in the conductor proportional to the velocity of its
motion.
•In this meter, a permanent magnet is placed around the blood vessel and it
generates a magnetic field perpendicular to the direction of blood flow.
•The voltage induced in the moving column can be measured with the
stationary electrodes placed on the opposite sides of the blood vessel and
perpendicular to the magnetic field.

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Block Diagram Magnetic Blood Flow Meter
• Oscillator is used to drive the magnet also provides a control signal for
the gate.
• It operates at a frequency between 60 Hz and 400Hz.
• The gate detector makes the polarity of the output signal reverse, when
the flow of blood is in reverse direction.
• The flow of pulses can be easily recorded from the frequency response
of the system.
• The average flow of pulses can be obtained with the help of a low pass
filter.

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 ULTRASONIC BLOOD FLOW METER
• Velocity of the blood flow can be determined with a beam of ultrasonic
energy.
• Types:
– Transit time ultrasonic meter
– Doppler Type
Transit time Type:
In this, a pulsed ultrasonic beam is directed at a shallow angle through a
blood vessel and its transmit time is then measured.
When the blood flow is in the direction of energy transmission, the
transit time is short and when the flow of blood is in opposite direction,
the transit time value is greater.

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 ULTRASONIC BLOOD FLOW METER

• Doppler Type:
– This circuit consists of an oscillator operating at a frequency range of
MHz it excites a piezoelectric transducer.
– Transducer is mounted on the wall of an exposed blood vessel and it
sends an ultrasonic beam with a frequency F into the following blood.
– A small part of the transmitted energy is scattered back and received by
the second transducer arranged opposite to the first one.
– The scattering occurs mainly due to the result of moving blood cells, the
reflected signal has a different frequency due to the Doppler effect.

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 ULTRASONIC BLOOD FLOW METER

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 ULTRASONIC BLOOD FLOW METER
• The transmitted frequency is either F+FD or F-FD, Depending on the
direction of blood flow.
• The Doppler component FD is directly proportional to the velocity of
blood flow.
• And part of the transmitted energy reaches the second transducer
directly with the frequency being unchanged.
• After the amplification, the Doppler frequency is obtained at the
output of the detector as the difference between the direct and
scattered signal components.
• The output can be obtained with the help of frequency meter.
• The Doppler signal of the pulsating blood flow can also be heard
with the help of loudspeaker.

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 THERMAL CONVECTION METHOD
• A hot object placed in a colder flowing medium is cooled by thermal convection.
• This principle is applied here, the rate of cooling is proportional to the rate of flow
of the medium.
• The thermistor placed on a blood stream is kept at a constant temperature by a
servo system.
• The rate of flow can be determined by the electrical energy required to maintain
the constant temperature of the thermistor.
• In other method an electric heater is placed between two thermocouples, which
are located by some distance apart along the axis of a blood vessel.
• The blood velocity can be determined by the difference between the upstream
and downstream temperature indicated by the sensor.
• Since it is oldest method of blood flow determination, it is replaced by the
radiographic technique.

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 RADIOGRAPHIC METHOD
• The flow of blood can not be made visible with the help of X-
rays, due to their same density as the surrounding tissues.
• Hence to make the blood flow visible a contrast medium like
iodated organic compound is injected into the blood vessel
so that the circulation pattern can be made to be visible.
• Some times radio isotopes are injected into the blood
circulation which helps in the detection of vascular
obstruction.

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 INDICATOR DILUTION METHOD
• It helps in the determination of rate of blood flow and not the
velocity of blood.
• Any substance having no toxic side effects can be used as an
indicator if it readily mixes with blood and its concentration can be
easily determined after mixing.
• This principle is used in the indicator dilution method. Here the
substance used should be stable but should not be retained in the
body.
• Among various types of indicators indocyanine dye and
cardiogreen are widely used.
• Radioisotopes also been employed for this purpoe.
• Most frequent indicator is isotonic saline.
• Types of measurements: (i) open circulation Method (ii) Closed
circulation method.

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 OPEN CIRCULATION METHOD
• In this, the measurement is made under the assumption that
the blood is not recirculated.
• The indicator is injected into the blood flow continuously at
the beginning time with a constant infusion rate of I grams
per minute.
• A detector measures the concentration of the downstream
from the injection point.
• The output of the detector is connected to the recorder and
here at a certain time after injection the concentration of the
indicator increases and finally reaches a constant value co
milligrams per litre.

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 OPEN CIRCULATION METHOD
• The flow can be determined with the help of injection rate I,
and the measured concentration Co
• Rate of Flow= I( milligrams per minute)/ Co (milligram per
litre)

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 CLOSED CIRCULATION METHOD

• This method states that when a dye or isotope is used as an

indicator, the concentration does not assume a steady state
instead increases in steps whenever the recirculated indicator
again passes the detector.
• This is based on the assumption that the blood is being
recirculated.
• Here at first, the indicator is injected and its concentration is
measured with the help of detector and when the indicator is
again recirculated the concentration increases step by step as
shown in graph.
• The output of the detector is connected to the recorder and the
flow can be determined.
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 CLOSED CIRCULATION METHOD

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 THANKYOU

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