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MEDICAL INSTRUMENTATION
Application and Design
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MEDICAL INSTRUMENTATION
Application and Design
FOURTH EDITION
Contributing Authors
John W. Clark, Jr.
Rice University
Michael R. Neuman
Michigan Technological University
Walter H. Olson
Medtronic, Inc.
Robert A. Peura
Worcester Polytechnic Institute
Frank P. Primiano, Jr.
Consultant
Melvin P. Siedband
University of Wisconsin-Madison
John G. Webster
University of Wisconsin-Madison
Lawrence A. Wheeler
Nutritional Computing Concepts
COVER PHOTO Leonardo da Vinci. Drawing of ideal proportions of the human figure according
to Vitruvius’ 1st. century A.D. treatise ‘‘De Architect ura.’’
This book was set in Times Ten by Thomson Digital and printed and bound by Malloy Inc. The
cover was printed by Malloy Inc.
Copyright # 2010, 1997, 1992, 1977 John Wiley & Sons, Inc. All rights reserved. No part of this
publication may be reproduced, stored in a retrieval system or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as
permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the
prior written permission of the Publisher, or authorization through payment of the appropriate per-
copy fee to the Copyright Clearance Center, Inc. 222 Rosewood Drive, Danvers, MA 01923,
website www.copyright.com. Requests to the Publisher for permission should be addressed to the
Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774,
(201)748-6011, fax (201)748-6008, website http://www.wiley.com/go/permissions.
To order books or for customer service please, call 1-800-CALL WILEY (225-5945).
ISBN-13 978-0471-67600-3
10 9 8 7 6 5 4 3 2 1
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PREFACE
EMPHASIS ON DESIGN
Throughout the book, we emphasize design. A scientist or engineer who has
some background in electronics and instrumentation will glean enough infor-
mation, in many of the areas we address, to be able to design medical
instruments. This ability should be especially valuable in those situations—
so frequently encountered—where special instruments that are not commer-
cially available are required.
PEDAGOGY
The book provides 300 homework problems, located at the end of each
chapter, plus 64 in-text worked examples. Problems are designed to cover a
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vi PREFACE
wide variety of applications ranging from analysis of the waves of the electro-
cardiogram to circuit design of biopotential amplifiers and identification of
electric safety hazards.
REFERENCES
Rather than giving an exhaustive list of references, we have provided a list of
review articles and books that can serve as a point of departure for further
study on any given topic.
ORGANIZATION
Each chapter has been carefully reviewed and updated for the fourth edition,
and many new examples and references are included.
Chapter 1 covers general concepts that are applicable to all instrumen-
tation systems, including on the commercial development of medical instru-
ments, on biostatistics, and on the regulation of medical devices. Chapter 2
describes basic sensors, and Chapter 3 presents the design of amplifiers for
them. Chapters 4 through 6 deal with biopotentials, tracing the topic from
the origin of biopotentials, through electrodes, to the special amplifier
design required.
Chapters 7 and 8 cover the measurement of cardiovascular dynamics—
pressure, sound, flow, and volume of blood. Chapter 9 presents the measure-
ment of respiratory dynamics—pressure, flow, and concentration of gases.
Chapter 10 describes the developing field of biosensors: sensors that
measure chemical concentrations within the body via catheters or implants.
Chapter 11 describes that area in the hospital where the greatest number of
measurements is made, the clinical laboratory. Chapter 12 starts with general
concepts of medical imaging and shows their applications to x-ray techniques,
magnetic resonance imaging, positron emission tomography, and Doppler
ultrasonic images.
Chapter 13 deals with devices used in therapy, such as the pacemaker,
defibrillator, cochlear prosthesis, transcutaneous electrical nerve stimulation,
implantable automatic defibrillators, the total artificial heart, lithotripsy, infant
radiant warmers, drug infusion pumps, and anesthesia machines. Chapter 14
presents a guide both to electric safety in the hospital and to minimization of
hazards.
We have used the recommended International System of Units (SI)
throughout this book. In the case of units of pressure, we have presented
both the commonly used millimeters of mercury and its SI unit, the pascal. To
help the reader follow the trend toward employing SI units, the Appendix
provides the most common conversion factors. The Appendix also provides a
number of physical constants used in the book and a list of abbreviations.
A Solutions Manual containing complete solutions to all problems is
available free to adopters of this text.
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PREFACE vii
ACKNOWLEDGMENTS
We would like to thank the reviewers of previous editions.
First Edition Reviewers
David Arnett, Pennsylvania State University
Robert B. Northrup, University of Connecticut (Starrs)
Kenneth C. Mylrea, University of Arizona
Curran S. Swift, Iowa State University
Second Edition Reviewers
Jonathan Newell, Rensselaer Polytechnic Institute
Robert B. Northrup, University of Connecticut (Storrs)
Third Edition Reviewers
Noel Thompson, Stanford University
W. Ed Hammond, Duke University
Robert B. Northrup, University of Connecticut
Richard Jendrucko, University of Tennessee, Knoxville
Fourth Edition Reviewers
Paul J. Benkeser, Georgia Institute of Technology
Lawrence V. Hmurcik, University of Bridgeport
Art Koblasz, Georgia Institute of Technology
Anant Madabhushi, Rutgers University
Andrew Mason, Michigan State University
Ken Meissner, Texas A&M University
Peter Molnar, Clemson University
Homer Nazeran, The University of Texas at El Paso
John A. Pearce, The University of Texas at Austin
Nadine Barrie Smith, The Pennsylvania State University
LIST OF SYMBOLS
a Absorptivity 10.3
a Activity 5.2
a Coefficient 1.10
a Lead vector 6.2
A Absorbance 10.3
A Area 2.2
A Coefficient 1.9
A Gain 3.1
A Percent 1.7
b Coefficient 1.9
b Intercept 1.9
B Coefficient 1.10
B Percent 1.9
B Viscous friction 1.10
B Magnetic flux density 8.3
c Coefficient 7.13
c Specific heat 8.1
c Velocity of sound 8.4
C Capacitance 1.10
C Compliance 7.3
C Concentration 10.3
C Contrast 12.1
d Derivative 1.10
d Diameter 1.10
d Distance 4.1
D Density 12.4
D Detector responsivity 2.17
(Continued )
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x LIST OF SYMBOLS
D d/dt 1.10
D Diameter 5.8
D Diffusing capacity 9.8
D Distance 4.4
E emf 2.7
E Energy 2.13
E Exposure 12.4
E Irradiance 2.17
E Modulus of elasticity 7.3
f Force 2.6
f Frequency 1.10
f Function 4.2
F Filter transmission 2.17
F Flow 7.3
F Force 2.2
F Fraction 12.1
F Molar fraction 9.3
g Conductance/area 4.1
G Conductance 2.9
G Form factor 2.4
G Gage factor 2.2
G Gain 1.7
h Height 7.13
H Feedback gain 1.7
i Current 2.6
I Current 3.7
I Intensity 10.3
j +(–1)1/2 1.10
J Number of standard deviations 12.1
k Constant 6.7
k Piezoelectric constant 2.6
K Constant 1.10
K Number 12.1
K Sensitivity 1.10
K Solubility product 5.3
K Spring constant 1.10
L Inductance 2.4
L Inertance 7.3
L Length 2.2
L Line-source response 12.10
m Average number 12.1
m Mass 7.3
m Slope 1.9
M Mass 1.10
M Measured values 12.2
M Modulation 12.1
M Cardiac vector 6.2
n Number 1.8
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LIST OF SYMBOLS xi
y Output 1.7
Y Admittance 1.9
Y Flow variable 1.9
Y Value 1.8
z Distance 4.1
Z Atomic number 12.6
Z Impedance 1.9
Greek Letters
CONTENTS
Preface v
List of Symbols ix
1 BASIC CONCEPTS OF
MEDICAL INSTRUMENTATION 1
Walter H. Olson
xiii
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xiv CONTENTS
2.9 Thermistors 66
2.10 Radiation Thermometry 69
2.11 Fiber-Optic Temperature Sensors 74
2.12 Optical Measurements 74
2.13 Radiation Sources 75
2.14 Geometrical and Fiber Optics 79
2.15 Optical Filters 82
2.16 Radiation Sensors 83
2.17 Optical Combinations 86
Problems 87
References 88
John G. Webster
CONTENTS xv
Michael R. Neuman
Michael R. Neuman
xvi CONTENTS
Robert A. Peura
John G. Webster
CONTENTS xvii
9 MEASUREMENTS OF THE
RESPIRATORY SYSTEM 377
Robert A. Peura
11 CLINICAL LABORATORY
INSTRUMENTATION 498
Lawrence A. Wheeler
xviii CONTENTS
Melvin P. Siedband
Michael R. Neuman
CONTENTS xix
Walter H. Olson
APPENDIX 676
INDEX 683
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