Q1a. What is meant by plumonary and systemic blood circulation?

Draw an engineering
equivalent of the heart showing blood circulation throughout the body.

The essential components of the human cardiovascular system are the heart, blood and blood
vessels. It includes the pulmonary circulation, a "loop" through the lungs where blood is
oxygenated; and the systemic circulation, a "loop" through the rest of the body to provide
oxygenated blood.

Pulmonary circulation: The circulatory system of the lungs is the portion of the cardiovascular
system in which oxygen-depleted blood is pumped away from the heart, via the pulmonary
artery, to the lungs and returned, oxygenated, to the heart via the pulmonary vein. Oxygen
deprived blood from the superior and inferior vena cava enters the right atrium of the heart and
flows through the tricuspid valve (right atrioventricular valve) into the right ventricle, from
which it is then pumped through the pulmonary semilunar valve into the pulmonary artery to the
lungs. Gas exchange occurs in the lungs, whereby CO2 is released from the blood, and oxygen is
absorbed. The pulmonary vein returns the now oxygen-rich blood to the left atrium.

Systemic circulation: The systemic circulation and capillary networks shown and also as separate
from the pulmonary circulation Systemic circulation is the portion of the cardiovascular system
which transports oxygenated blood away from the heart through the aorta from the left ventricle
where the blood has been previously deposited from pulmonary circulation, to the rest of the
body, and returns oxygen-depleted blood back to the heart.

Q1b. What are various types of transducers used in medical instrumentation system? Also
mention their principle of operation.

Transduction involves the conversion of one form of energy into another form. This process
mainly includes a sensing element to sense the input energy and then converting it into another
form by a transduction element. Measurand tell to the property, quantity or state that the
transducer look to translate into an electrical output. Here, this article discusses about what is a
transducer, transducer types, and applications of the transducer. A transducer is an electrical
device which is used to convert one form of energy into another form. In general, these devices
deal with different types of energies such as mechanical, electrical energy, light energy, chemical
energy, thermal energy, acoustic energy, electromagnetic energy, and so on..

Transducer Types and Its Applications

There are a variety of transducer types like pressure transducer, piezoelectric transducer,
ultrasonic transducer, temperature transducer, and so on. Let us discuss the use of different types
of transducers in practical applications.

Transducer Type:

1. Pressure Transducer

Pressure transducer is a special kind of sensor that alters the pressure forced into electrical
signals. These transducers are also called as pressure indicators, manometers, piezometers,
transmitters, and pressure sensors. Pressure transducer is used to measure the pressure of the
specific quantity like gas or liquid by changing the pressure into electrical energy. The different
kinds of these transducers like an amplified voltage transducer, strain-gage base pressure
transducer, millivolt (mv) pressure transducer, 4-20mA pressure transducer and pressure
transducer.

2. Temperature Transducer

Temperature transducer is an electrical device that is used to convert the temperature of a device
into another quantity like electrical energy or pressure or mechanical energy, then the quantity
Temperature transducer is used to measure the temperature of the air such that to control the
temperature of several control systems like air-conditioning, heating, ventilation, and so on.

OR

Q1a. Explain the human Respiratory system with a suitable diagram.

The respiratory system (also respiratory apparatus, ventilatory system) is a biological system
consisting of specific organs and structures used for gas exchange in animals and plants. The
anatomy and physiology that make this happen varies greatly, depending on the size of the
organism, the environment in which it lives and its evolutionary history. In land animals the
respiratory surface is internalized as linings of the lungs. Gas exchange in the lungs occurs in
millions of small air sacs called alveoli
Breathing starts at the nose and mouth. Air inhale into your nose or mouth, and it travels down
the back of your throat and into windpipe, or trachea. Trachea then divides into air passages
called bronchial tubes. For lungs to perform their best, these airways need to be open during
inhalation and exhalation and free from inflammation or swelling and excess or abnormal
amounts of mucus. As the bronchial tubes pass through the lungs, they divide into smaller air
passages called bronchioles. The bronchioles end in tiny balloon-like air sacs called alveoli.
Body has over 300 million alveoli. The alveoli are surrounded by a mesh of tiny blood vessels
called capillaries. Here, oxygen from the inhaled air passes through the alveoli walls and into the
blood. After absorbing oxygen, the blood leaves the lungs and is carried to your heart. Heart then
pumps it through your body to provide oxygen to the cells of your tissues and organs.

Q1b. Explain the process of repolarization and depolarization of cells. Draw a labeled
diagram of action potential waveform.

Depolarization is the change in the electric charge of a cell which makes the inside of the cell
more positive than the outside of the cell. The voltage gated ion channels of the cell open in
response to electrical stimuli, that is, excitatory stimuli which increase the voltage in the cell.
Positive sodium ions rush into the cell from these ion channels and change the electric charge of
the inside of the cell from negative to positive.

Repolarization follows depolarization. Voltage gated sodium ion channels close and potassium
channels open as a result of the increased positive charge inside the cell. Positive potassium ions
move out of the cell, making the inside of the cell more negative; even slightly more negative
than the resting potential due to overshoot (excessive amount of potassium ions rushing out of
the cell), a process called hyperpolarization. The resting potential is later re-established
Resting membrane potential describes the steady state of the cell, which is a dynamic process
that is balanced by ion leakage and ion pumping. Without any outside influence, it will not
change. To get an electrical signal started, the membrane potential has to change. This starts with
a channel opening for Na+ in the membrane. Because the concentration of Na+ is higher outside
the cell than inside the cell by a factor of 10, ions will rush into the cell that are driven largely by
the concentration gradient. Because sodium is a positively charged ion, it will change the relative
voltage immediately inside the cell relative to immediately outside. The resting potential is the
state of the membrane at a voltage of -70 mV, so the sodium cation entering the cell will cause it
to become less negative. This is known as depolarization, meaning the membrane potential
moves toward zero. The concentration gradient for Na+ is so strong that it will continue to enter
the cell even after the membrane potential has become zero, so that the voltage immediately
around the pore begins to become positive. The electrical gradient also plays a role, as negative
proteins below the membrane attract the sodium ion. The membrane potential will reach +30 mV
by the time sodium has entered the cell. As the membrane potential reaches +30 mV, other
voltage-gated channels are opening in the membrane. These channels are specific for the
potassium ion. A concentration gradient acts on K+, as well. As K+ starts to leave the cell, taking
a positive charge with it, the membrane potential begins to move back toward its resting voltage.
This is called repolarization, meaning that the membrane voltage moves back toward the -70 mV
value of the resting membrane potential.

Q2a. What is electrocardiogram? Explain the functioning of ECG machine with the help of
neat block diagram.

An electrocardiogram or ECG is an electrical recording of the heart and is used in the

investigation of heart disease. This application note makes use of a oscilloscope / Data Logger to
read and store electrocardiograms. Electrocardiography is likely to find any very extensive use in
the hospital The electrocardiogram, or ECG / EKG is a surface measurement of the electrical
potential generated by electrical activity in cardiac tissue. Current flow, in the form of ions,
signals contraction of cardiac muscle fibres leading to the heart’s pumping action. Einthoven’s
recording is known as the "three lead" ECG, with measurements taken from three points on the
body. The difference between potential readings from L1 and L2 is what is used to produce the
output ECG trace. The L3 connection establishes a common ground for the body and the
recording device. Establishing the correspondence between the ECG trace and the electrical
events in the heart is known as the inverse problem of electro cardiology: solving for the electric
sources from the potential generated by those sources on the surface of the body.

The circuit was built with some modifications as described below, and a DrDAQ data acquisition
card was used to read out the output signal into a laptop, which effectively functions as a storage
scope. The basic setup is illustrated below.

ECG waveform describe as

 P wave: the sequential activation (depolarization) of the right and left atria
 QRS complex: right and left ventricular depolarization (normally the ventricles are
activated simultaneously)
 ST-T wave: ventricular repolarization
 U wave: origin for this wave is not clear - but probably represents "afterdepolarizations"
in the ventricles
 PR interval: time interval from onset of atrial depolarization (P wave) to onset of
ventricular depolarization (QRS complex)
 QRS duration: duration of ventricular muscle depolarization
 QT interval: duration of ventricular depolarization and repolarization
 RR interval: duration of ventricular cardiac cycle (an indicator of ventricular rate)
 PP interval: duration of atrial cycle (an indicator of atrial rate)
It is important to remember that the 12-lead ECG provides spatial information about the heart's
electrical activity in 3 approximately orthogonal directions:

Bipolar limb leads (frontal plane):

 Lead I: RA (-) to LA (+) (Right Left, or lateral)

 Lead II: RA (-) to LL (+) (Superior Inferior)
 Lead III: LA (-) to LL (+) (Superior Inferior)

Augmented unipolar limb leads (frontal plane):

 Lead aVR: RA (+) to [LA & LL] (-) (Rightward)

 Lead aVL: LA (+) to [RA & LL] (-) (Leftward)
 Lead aVF: LL (+) to [RA & LA] (-) (Inferior)

Unipolar (+) chest leads (horizontal plane):

 Leads V1, V2, V3: (Posterior Anterior)

 Leads V4, V5, V6:(Right Left, or lateral)

Q2b. Describe an ultra sonic blood flow meter and find expression for blood flow.

An ultrasonic flow meter is a type of flow meter that measures the velocity of a fluid with
ultrasound to calculate volume flow. Using ultrasonic transducers, the flow meter can measure
the average velocity along the path of an emitted beam of ultrasound, by averaging the difference
in measured transit time between the pulses of ultrasound propagating into and against the
direction of the flow or by measuring the frequency shift from the Doppler effect. Ultrasonic
flow meters are affected by the acoustic properties of the fluid and can be impacted by
temperature, density, viscosity and suspended particulates depending on the exact flow meter.

Time transit flow meter: Ultrasonic flow meters measure the difference of the transit time of
ultrasonic pulses propagating in and against flow direction. This time difference is a measure for
the average velocity of the fluid along the path of the ultrasonic beam. By using the absolute
transit times both the averaged fluid velocity and the speed of sound can be calculated. Using the
two transit times, the distance between receiving and transmitting transducers and the inclination
angle.

Doppler shift flow meters: Another method in ultrasonic flow metering is the use of the Doppler
shift that results from the reflection of an ultrasonic beam off sonically reflective materials.
Doppler flowmeters are used for slurries, liquids with bubbles, gases with sound-reflecting
particles. This type of flow meter can also be used to measure the rate of blood flow, by passing
an ultrasonic beam through the tissues, bouncing it off a reflective plate, then reversing the
direction of the beam and repeating the measurement, the volume of blood flow can be
estimated. The frequency of the transmitted beam is affected by the movement of blood in the
vessel and by comparing the frequency of the upstream beam versus downstream the flow of
blood through the vessel can be measured. The difference between the two frequencies is a
measure of true volume flow. A wide-beam sensor can also be used to measure flow independent
of the cross-sectional area of the blood vessel.

OR

Q2a. Define the blood pressure. Describe blood pressure measurement by direct and
indirect measurement method.

Arterial pressure is most commonly measured via a sphygmomanometer, which historically used
the height of a column of mercury to reflect the circulating pressure.[1] Blood pressure values
are generally reported in millimetres of mercury (mmHg), though aneroid and electronic devices
do not contain mercury. For each heartbeat, blood pressure varies between systolic and diastolic
pressures. Systolic pressure is peak pressure in the arteries, which occurs near the end of the
cardiac cycle when the ventricles are contracting. Diastolic pressure is minimum pressure in the
arteries, which occurs near the beginning of the cardiac cycle when the ventricles are filled with
blood. An example of normal measured values for a resting, healthy adult human is 120 mmHg
systolic and 80 mmHg diastolic (written as 120/80 mmHg, and spoken as "one-twenty over
eighty").

Direct Measurement

In direct measurement involves the conversion of fluid pressure into an electrical signal via a
transducer that is connected to a patient’s artery. It is commonly used during critical care patient
transfers and has several advantages over traditional non-invasive blood pressure monitoring
techniques. It allows frequent arterial blood sampling. Critical care patients with hemodynamic
instability where continuous blood pressure monitoring is beneficial. Arterial haemorrhage if
the cannula becomes dislodgedor disconnected. Prepare the ‘flush line’ and transducer according
to the product specific operating instructions. Place the transducer at the patient’s phlebostatic
axis Connect the invasive pressure cable to the transducer of the‘flush line’ and to the P1
connection on the monitor. Close the transducer stopcock to the patient. Open the transducer’s
venting stopcock to atmospheric air. Close the transducer’s stopcock to air. The patient’s
pressure waveform should be displayed on the monitor.
Indirect Methhod

In humans, the cuff is normally placed smoothly and snugly around an upper arm, at roughly the
same vertical height as the heart while the subject is seated with the arm supported. Other sites of
placement depend on species, it may include the flipper or tail. It is essential that the correct size
of cuff is selected for the patient. Too small a cuff results in too high a pressure, while too large a
cuff results in too low a pressure. For clinical measurements it is usual to measure and record
both arms in the initial consultation to determine if the pressure is significantly higher in one arm
than the other. A difference of 10 mm Hg may be a sign of coarctation of the aorta. If the arms
read differently, the higher reading arm would be used for later readings.[citation needed] The
cuff is inflated until the artery is completely occluded.

With a manual instrument, listening with a stethoscope to the brachial artery at the elbow, the
examiner slowly releases the pressure in the cuff. As the pressure in the cuffs falls, a
"whooshing" or pounding sound is heard (see Korotkoff sounds) when blood flow first starts
again in the artery. The pressure at which this sound began is noted and recorded as the systolic
blood pressure. The cuff pressure is further released until the sound can no longer be heard. This
is recorded as the diastolic blood pressure. In noisy environments where auscultation is
impossible (such as the scenes often encountered in emergency medicine), systolic blood
pressure alone may be read by releasing the pressure until a radial pulse is palpated (felt). In
veterinary medicine, auscultation is rarely of use, and palpation or visualization of pulse distal to
the sphygmomanometer is used to detect systolic pressure.

Q2b. What is phonocardiograph? Explain the heart sound.

A phonocardiogram (or PCG) is a plot of high-fidelity recording of the sounds and murmurs
made by the heart with the help of the machine called the phonocardiograph; thus,
phonocardiography is the recording of all the sounds made by the heart during a cardiac cycle.
The sounds result from vibrations created by closure of the heart valves, there are at least two:
the first when the atrioventricular valves (tricuspid and mitral) close at the beginning of systole
and the second when the aortic valve and pulmonary valve (semilunar valves) close at the end of
systole. It allows the detection of subaudible sounds and murmurs, and makes a permanent
record of these events. In contrast, the stethoscope cannot always detect all such sounds or
murmurs, and it provides no record of their occurrence. The ability to quantitate the sounds made
by the heart provides information not readily available from more sophisticated tests, and it
provides vital information about the effects of certain drugs on the heart. It is also an effective
method for tracking the progress of the person's disease.[medical citation needed]

Q3a. Explain the working principle for measurement of partial pressure of carbon dioxide
(PCO2) in the blood and describe suitable scheme for it.

Regulation of the amount of carbon dioxide (CO2) in blood, or more precisely of the ratio of
bicarbonate to dissolved carbon dioxide concentration, is essential for maintaining acid-base
balance. CO2 is a major determinant of blood pH because of its conversion to carbonic acid. As
CO2 concentration rises, so does hydrogen ion (H+) concentration. Respiration rate, which is
controlled bypCO2 sensitive chemoreceptors in the brain stem and carotid artery, is increased
ifpCO2 is rising and decreased ifpCO2 is declining. Increased respiratory rate results in
increased rate of CO2 elimination and decreased respiratory rate promotes CO2 retention. A low
CO2 level may be associated with metabolic acidosis or compensated respiratory alkalosis. High
CO2 content may be associated with metabolic alkalosis or compensated respiratory acidosis.

A little of the CO2 remains physically dissolved in blood plasma and an even smaller proportion
binds to NH2 (amino) terminal groups of plasma proteins, forming carbamino compounds.
However, most diffuses down a concentration gradient into red cells, where a small fraction
remains dissolved in the cytoplasm and some is loosely bound to amino terminal groups of
reduced hemoglobin forming carbamino-Hb. Most of the carbon dioxide arriving in red cells is
rapidly hydrated to carbonic acid by the enzyme carbonic anhydrase. At physiological pH almost
all (? 96 %) of this carbonic acid dissociates to bicarbonate and hydrogen ions:
When red blood cells reach the pulmonary circulation, carbon dioxide diffuses from the blood to
alveoli. This loss of carbon dioxide from blood favors reversal of the red cell reaction described
above. Bicarbonate passes from plasma to red cell, buffering hydrogen ions released from
hemoglobin, as it is oxygenated. Reversal of the carbonic anhydrase reaction, results in
production of CO2 that diffuses from red cells to plasma and ultimately to alveoli. Mixed venous
blood arriving at the lungs has a total CO2 content of 23.5 mEq/L whereas arterial blood leaving
the lungs has a total CO2 content of 21.5 mEq/L.

Q3b. Explain the types and principles of chromatography. Discuss in medical application.

Chromatography is an analytical technique commonly used for separating a mixture of chemical

substances into its individual components, so that the individual components can be thoroughly
analyzed. There are many types of chromatography e.g., liquid chromatography, gas
chromatography, ion-exchange chromatography, affinity chromatography, but all of these
employ the same basic principles. Chromatography is a separation technique that every organic
chemist and biochemist is familiar with. I, myself, being an organic chemist, have routinely
carried out chromatographic separations of a variety of mixture of compounds in the lab.

Thin Layer Chromatography: Thin layer chromatography (TLC) plate. This is basically a
rectangular piece of glass plate, coated with a thin layer of silica. I applied a spot of the reaction
mixture just above the base of the plate (denoted with a solid line), and placed the plate in a jar
that contained an appropriate organic solvent (in this case, 1:1 volume by volume mixture of
hexane:ethyl acetate was used), with just enough volume to dip the lower edge of the plate.
Gradually by capillary action, the solvent started rising up the silica plate, and as you can see the
reaction mixture separated into 3 spots with distinct colors by the time the solvent had reached
the solvent front mark.
Column Chromatography: Glass column with a stopcock attached at the bottom, inserted a cotton
plug at the bottom of the column and packed the column with a slurry of silica gel (prepared in
an organic solvent). Once the column was packed, and the solvent volume above the bed reduced
to less than 5 mm, I carefully poured the reaction mixture over the bed of silica from the top of
the column, with the aid of a glass pipette. I opened the stopcock and let the solvent run slowly
through the column. I constantly kept adding solvent from the top of the glass column. The
components that adhere more strongly to the stationary phase travel more slowly compared to
those with a weaker adhesion. Analytical chromatography can be used to purify compounds
ranging from milligram to gram scale.

GAS Chromatography: Gas chromatograph is a chemical analysis instrument for separating

chemicals in a complex sample. A gas chromatograph uses a flow-through narrow tube known as
the column, through which different chemical constituents of a sample pass in a gas stream
(carrier gas, mobile phase) at different rates depending on their various chemical and physical
properties and their interaction with a specific column filling, called the stationary phase. As the
chemicals exit the end of the column, they are detected and identified electronically. The
function of the stationary phase in the column is to separate different components, causing each
one to exit the column at a different time (retention time). Other parameters that can be used to
alter the order or time of retention are the carrier gas flow rate, column length and the
temperature.

In a GC analysis, a known volume of gaseous or liquid analyte is injected into the "entrance"
(head) of the column, usually using a microsyringe. Since each type of molecule has a different
rate of progression, the various components of the analyte mixture are separated as they progress
along the column and reach the end of the column at different times (retention time). A detector
is used to monitor the outlet stream from the column; thus, the time at which each component
reaches the outlet and the amount of that component can be determined. Generally, substances
are identified (qualitatively) by the order in which they emerge (elute) from the column and by
the retention time of the analyte in the column

OR

Q3a. What is magnetic resonance imaging (MRI). Compare MRI and CT Scan Technique.

Medical imaging is the technique and process of creating visual representations of the interior of
a body for clinical analysis and medical intervention, as well as visual representation of the
function of some organs or tissues (physiology). Medical imaging seeks to reveal internal
structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical
imaging also establishes a database of normal anatomy and physiology to make it possible to
identify abnormalities. Although imaging of removed organs and tissues can be performed for
medical reasons, such procedures are usually considered part of pathology instead of medical
imaging.

Comparison CT-Scan and MRI

Comaprision CT Scan MRI

Defination CT Scan works on the same
principle as that of the X-ray,
where the radiowaves are
made to focus on the damaged
part, and the image is created.
The image provided is three
dimension, as well multiple
images are obtained of the
targeted area.
MRI works with the powerful
magnet along with radio
waves and a computer which
shape these magnetic elements
and provide the highly
detailed images of the target
body part.
Radiation In CT Scan the image is
produced by combining
multiple x-rays, during this,
there is exposure to radiation.
Cost Less expensive than MRI.
Uses It is best in viewing the soft
tissue, bones, lungs, tumour,
cancer detection.
Limitation It may sometimes cause the
allergic reaction intravenously
and has the potential to
damage kidneys, especially
the person suffering from
diabetes or any kidney related
problem.
2.CT Scan is not appropriate
at the time of pregnancy.
There is no radiation involved
in the MRI technique, rather
uses strong magnetic field and
radio waves to create the
image of the targeted body
parts.
It is much costly than CT
Scan.
MRI is best in viewing the
slight differences in the soft
tissues, for example, tendons
and ligaments. It is also used
to view the detailed images of
cancer or other neurological
disorder.
The size of the tube creates the
problem in contrast to the size
of the person to be examined,
so for such person open MRI
machines are
used. Although the contrast
dye used may generate
problems to the person
suffering from any kidney or
liver related disease.

Q3b. What is mean by ultrasonic Imaging? Also describe various modes of display of
ultrasounds.

Ultrasound imaging (ultrasonography) is based on reflection in the human body of acoustic

waves with frequency higher than 20 kHz, generally ~ 1-20 MHz. The waves are transmitted and
received in an ultrasound transducer, based on piezoelectric crystals. Signals received are
processed and displayed in many different ways, resulting in different ultrasound modalities, the
most important is the 2D image produced by B mode. Ultrasound imaging plays a crucial and
increasing role in medicine due to low cost, no ionizating radiation and high temporal resolution.
However, recording and interpreting images require training.
The main parts of an ultrasound equipment are the ultrasound transducer or probe, the electrical
control of the probe (including "beam former") and the visualization system. This section will
focus particularly on the visualization system.

There are different ways to visualize the obtained information, which may be called ultrasound
modalities.

A mode: A stands for Amplitude. Information of the reflected signal in a single ultrasound beam
is continually displayed distance from the transducer and intensity are shown by position and
amplitude in a line on an oscilloscope. This mode is mainly of historical interest, may be rarely
used in gynecology or ophthalmology.

B mode: B stands for Brightness. In this case A-mode information from many beams, typically
forming a sector in a plane of the body, is shown as pixel intensity on a monitor. B mode is often
referred to as 2D, and is the most important modality for anatomic assessment and orientation in
the body, also for localising and as a background for display of other information such as
Doppler signals.

M-mode: M stands for motion. This approach is used for the analysis of moving organs. It is
based on A-mode data from a single ultrasound beam that are represented as function of time.
This does not require a sweep through many ultrasound beams which allows for high temporal
resolution.
Q4a. Describe the possibilities of occurrence of micro shock hazards in hospital.

A strong electric shock resulting from current that has passed through the trunk or head, with
contact to the source through intact skin. Under this definition, a macroshock is almost always
lethal due to causing ventricular fibrillation of the heart. The passage of current from one part of
the body to another, especially from arm to arm and therefore through the heart. By this
definition, the magnitude of the current itself (in Amperes) is the most important factor. In
general, the greater the current, the more dangerous a shock is and the more likely it is to be
lethal. Therefore, a high-voltage, low-current shock is not dangerous, but a low-voltage, high-
current shock may cause significant harm or death.

Microshock: all the current applied flows through the heart. The patient has inadvertently
contacted both a source of current (it does not have to be AC, as shown) as well as a common
return pathway during an invasive cardiac medical procedure. If the current flowing is below the
threshold of perception, or the patient is sedated, or anaesthetized, there may be no pain or reflex
response of either arm.
Q4b. Explain the biotelemetry system. Discuss its application.

Biotelemetry is defined as transmitting biological or physiological data from a remote location to

a location that has the capability to interpret the data and affect decision making. Biomedical
telemetry is a special field of biomedical instrumentation that often permits transmission of
biological information from an inaccessible location to a remote monitoring site.
The quantity that could be measured was adaptable to biotelemetry. Measurements that have
been done in biotelemetry can be determined in two categories:
1. Bioelectrical variables, such as ECG, EMG, and EEG.
2. Physiological variables that require transducers, such as blood pressure, gastrointestinal
pressure, blood flow, and temperature. By using suitable transducers, telemetry can be employed
for the measurement of a wide variety of physiological variables.
Transreceiver: The stages of a typical biotelemetry system can be divided into functional blocks,
Physiologicalsignals are obtained from the subject by means of appropriate transducers. Then,
signal is passed through a stage of amplification and processing circuits that include generation
of a subcarrier and modulation stage for transmission. The receiver consists of a tuner to select
transmitting frequency, a demodulator to separate the signal from the carrier wave so as to
display or record it. The transmitter generates the carrier and modulates it. The receiver is
capable of receiving the transmitted signal and demodulating it to recover the information.
Information to be transmitted is impressed upon the carrier by a process known as modulation.
Amplitude-modulated (AM) and frequency-modulated (FM) carriers have been used in
biotelemetry. In an amplitude-modulated system, amplitude of the carrier is caused to vary with
the transmitted information. In a frequency-modulated system, frequency of the carrier is caused
to vary with the modulated signal. In biotelemetry systems, the physiological signal is sometimes
used to modulate a low frequency carrier, called a subcarrier. Radio frequency (RF) carrier of the
transmitter is then modulated by the subcarrier. If several physiological signals are transmitted
simultaneously, each signal is placed on a subcarrier of a different frequency and all of the
subcarriers are combined to simultaneously modulate the RF carrier. This process of transmitting
many channels of data on a single RF carrier is called frequency multiplexing. Frequency
multiplexing is more efficient and less expensive than employing a separate transmitter for each
channel. At the receiver, a multiplexed RF carrier is first demodulated to recover each of the
separate subcarriers and then demodulated to retrieve the original physiological signals.
OR

Q4a. Briefly explain various elements of intensive care units in hospitals.

Intensive care units cater to patients with severe and life-threatening illnesses and injuries, which
require constant, close monitoring and support from specialist equipment and medications in
order to ensure normal bodily functions. They are staffed by highly trained doctors and nurses
who specialise in caring for critically ill patients. ICUs are also distinguished from normal
hospital wards by a higher staff-to-patient ratio and access to advanced medical resources and
equipment that is not routinely available elsewhere. Common conditions that are treated within
ICUs include acute trauma, multiple organ failure and sepsis.

Patients may be transferred directly to an intensive care unit from an emergency department if
required, or from a ward if they rapidly deteriorate, or immediately after surgery if the surgery is
very invasive and the patient is at high risk of complications
Common equipment in an ICU includes mechanical ventilators to assist breathing through an
endotracheal tube or a tracheostomy tube; cardiac monitors including those problems; equipment
for the constant monitoring of bodily functions; a web of intravenous lines, feeding tubes,
nasogastric tubes, suction pumps, drains, and catheters; and a wide array of drugs to treat the
primary condition(s) of hospitalization. Medically induced comas, analgesics, and induced
sedation are common ICU tools needed and used to reduce pain and prevent secondary infections

Q4b. What are the various physiological effect of electric current on human body? Explain
the various method of electrical accident prevention in medical instrumentation system.

There are two fundamental methods of protecting patients against shock. Complete isolation and
insulation from all grounded objects and all sources of electric current Same potential of all
conducting surfaces within reach of the patient. Neither approach can be fully achieved in most
practical environments, so some combination must usually suffice. Protection must include
patient, applicants and third party persons.

Ground-fault circuit interrupters disconnect the source power when a ground fault greater than
about 6 mA occurs. GFCI senses differences in the in-an outgoing current. Most GFCI use
differential transformer and solid-state circuitry. Most GFCI are protectors against macroshocks
as they are usually not as sensitive as 10 μA or the medical equipment has a fault current greater
than that
Most failures of equipment ground occur at the ground contact or in the plug and cable. Molded
plugs should be avoided because of invisible breaks Strain-relief devices are recommended. No
use of three-prong-to-two-prong adapters. Special use of low-leakage power cords. Capacitance-
minimized design. Maximized impedance from patient leads to hot conductors and from patient
leads to chassis ground. Double insulated equipment interconnection of all conducting surfaces.
Separate layer of insulation to prevent contact with conductive surfaces (e.g. non conductive
chassis, switch levers, knobs, etc.)

Q5a. What do you understand by “fibrillation”? Explain capacitive discharge type d.c.
defibrillators with associated circuitry and waveform.

The instrument for administering the shock is called a defibrillator. So it is used to reverse
fibrillation of the heart. Electric shock by defibrillator is used to reestablish normal activity. The
shock can be delivered to the heart by means of electrode placed on chest of the patient (External
defibrillation) or the electrode may be held directly against the heart when the chest is open.
Higher voltage are required for external defibrillation than for internal defibrillation

A Variable auto transformer forms the primary of a high voltage transformer. The output voltage
transformer is rectified by a diode rectifier and is connected to vacuum type high voltage change
over switch. In position 1, the switch is connected to one end of an oil filled micro farad
capacitor. In this position, the capacitor charge to a voltage set by the positioning of the auto
transformer. When the shock is delivered to the patient, a foot switch or a push button mounted
on the handle of the electrode is operated. The high voltage switch change over to position 2 and
the capacitor is discharged across the heart through the electrode.

Q5b. Explain “diathermy”. Describe short wave diathermy process with suitable diagram.

Diathermy is a therapeutic treatment most commonly prescribed for muscle and joint conditions.
It uses a high-frequency electric current to stimulate heat generation within body tissues.
The heat can help with various processes, including: increasing blood flow, elieving pain,
improving the mobility of tissues as they heal

There are three main types of diathermy: shortwave, microwave, and ultrasound.

Shortwave: Shortwave diathermy uses high-frequency electromagnetic energy to generate heat.

It may be applied in pulsed or continuous energy waves. It has been used to treat pain from
kidney stones, and pelvic inflammatory disease. It’s commonly used for conditions that cause
pain and muscle spasms such as:

Microwave: Microwave diathermy uses microwaves to generate heat in the body. It can be used
to evenly warm deep tissues without heating the skin. Since it can’t penetrate deep muscles, it’s
best suited for areas that are closer to the skin, such as the shoulders.

Ultrasound: Ultrasound diathermy uses sound waves to treat deep tissues. Heat is generated by
the vibration of the tissue. This promotes blood flow into the area.

OR

Q5a. What is the need of pacemakers? Explain any one synchronization pacemaker in
detail.

Electrical impulses from the heart muscle cause your heart to beat (contract). This electrical signal
begins in the sinoatrial (SA) node, located at the top of the heart's upper-right chamber (the right
atrium). The SA node is sometimes called the heart's "natural pacemaker."

When an electrical impulse is released from this natural pacemaker, it causes the upper chambers of
the heart (the atria) to contract. The signal then passes through the atrioventricular (AV) node. The
AV node checks the signal and sends it through the muscle fibers of the lower chambers (the
ventricles), causing them to contract. The SA node sends electrical impulses at a certain rate, but
your heart rate may still change depending on physical demands, stress, or hormonal factors.
Sometimes, the SA node does not work properly, causing the heart to beat too fast, too slow, or
irregularly. In other cases, the heart's electrical pathways are blocked, which can also cause an
irregular heart rhythm.A pacemaker is a small device that is run by a battery. It helps the heart beat
in a regular rhythm. Pacemakers can help pace the heart in cases of slow heart rate, fast and slow
 heart rate, or a blockage in the heart's electrical system.

A pacemaker can pace the heart's upper chambers (the atria), the lower chambers (the ventricles),
or both. Pacemakers may also be used to stop the heart from triggering impulses or from sending
extra impulses.A pacemaker is about the size of a matchbox. It is made up of two parts:

 A pulse generator, which includes the battery and several electronic circuits.

 Wires, called leads, which are attached to the heart wall. Depending on the type of
pacemaker you need, there may be one or two leads.

The pacemaker is implanted just near the collarbone. If only one lead is needed, it is placed inside
the lower-right chamber (the right ventricle). If two leads are needed, the other is placed in the
upper-right chamber (the right atrium). The leads are then attached to the pacemaker.Most
pacemaker surgery is done under local anesthesia. This means that you are awake during the
procedure, but the area where the pacemaker is implanted is numbed so you will not feel anything.
The procedure usually takes between one and two hours.Once the pacemaker is implanted, the
leads carry signals back from the heart. The pulse generator "reads" these signals and the batteries
send electrical impulses to the heart to help pace it.Most pacemakers can sense the heart's rhythm
and turn themselves off when the heartbeat is above a certain level. They will turn on again when
the heartbeat is too slow. These types of pacemakers are called demand pacemakers.

Q5b. Explain the functioning of heart lung machine. Discuss the role of instrumentation in
it.

Heart Lung machine bypass the function of both the heart and the lungs. The main components
of a heart–lung machine are a pump (to provide the driving force to the blood in the arterial
system), an oxygenator (for exchange of oxygen and carbon dioxide), and a heat exchanger (to
allow control of temperature of the body). The connecting tubing and filter are other components
of the heart–lung bypass circuit. Venous blood is siphoned from the body via a tube in the right
atrium of the heart, or via two tubes in the major veins which converge on the heart. It is pumped
through the oxygenator and heat exchanger, and returned via a plastic tube into the arterial
system of the body usually at the upper portion of the ascending aorta The design of pump which
is in most common use today is the roller pump — a simple rotating arm carrying rollers which
compress a loop of polymeric tubing against a solid surface. Speed of rotation of the roller-
bearing arm is controlled to allow a pumping rate similar to that of the normal heart at rest .There
are two main types of oxygenator in use at present. ‘Bubble oxygenators’ expose the passing
blood to a stream of gaseous bubbles composed of 95% oxygen and 5% carbon dioxide. Gas
exchange with the blood occurs on the surface of the bubbles and results in reasonably normal
levels of oxygenation of the blood and maintains carbon dioxide in the normal physiological
range. The bubble oxygenator has a sponge-like filter and reservoir to enable gaseous bubbles to
be removed from the oxygenated blood before it is pumped back to the body.
Membrane oxygenators consist of a series of fine tubes which allow diffusion of oxygen and
carbon dioxide between the blood flowing through them and the ventilating gas surrounding
The oxygenator also combines with a heat exchangera system of tubes through which the blood
passes, surrounded by circulating water at controlled temperature. This allows the blood
temperature to be maintained (counteracting the heat loss during the passage of blood through
the heart–lung machine. It also allows deliberate cooling and subsequent rewarming of the blood,
giving the surgeon the option of reducing, or even stopping, the circulation of the blood around
the body for a period of time with safety, because the oxygen requirement of the body is reduced
hypothermia.