Bio 2

Biomedical Instrumentation
JSS MAHAVIDYAPEETHA
Sri Jayachamarajendra College of Engineering, Mysore-06
Department of Instrumentation Technology

BIOMEDICAL INSTRUMENTATION
SUBMITTED TO : SHEELA N RAO PREPARED BY : ANAND KUMAR CHANDAN C RAVITEJA V (ROLL NO. 7) (ROLL NO. 15) (ROLL NO. 70)
INTRODUCTION
Recent advances in medical field have been fuelled by the instruments developed by the Electronics and Instrumentation Engineers. Pacemakers, Ultrasound Machine CAT, Medical diagnostic systems are few names which have been contributed by engineers. Now health care industry uses many instruments which are to be looked after by instrumentation engineers. This subject will enable the students to learn the basic principles of different instruments/equipment used in the health care industry. The practical work done in this area will impart skill in the use, servicing and maintenance of these instruments/equipment. Proficiency in this area will widen the knowledge and skill of diploma holders in the field of biomedical instrumentation. Introduction to Biomedical Instruments : BIOLOGY deals with wide spectrum of Life sciences i.e. plants, animals, Insects or in nutshell all living organisms. Study of only human being out of these is Called Medical Science. If we want to study Engineering principles in medical science the resulting subject will be Medical Engineering. If we wish to cover more animals on the earth, the science will be Bio- Medical Engineering. Engineering or Instrumentation is defined as science of using measurements. SCOPE: The study of Engineering principles from Biomedical Engineering involves following interests: * To understand mechanisms, efficiencies & physical changes of various subsystems of the body. * To evolve an instrumentation system for diagnosis, therapy and supplementation of body function. * To obtain qualitative & quantitative knowledge through different instruments which can help for analysis of disorders, and further the Biomechanics of the cure process. The study of medical principles from Biomedical engineering involves following interests: * To Understand above actions & changes in various sub systems of the body in abnormal states i.e. in Pathology. * To obtain qualitative & quantitative knowledge of what drug does to the body ( Pharmacodynamics ) and what body does to the drug ( Pharmacokinetics ) during and ( Pharmacokinetics ) during and after prescription of the drug.
HISTORY Stethoscope, the first medical instrument of its own kind was invented in by French Physician Laennec.Today in 1997 even at a district place in India computer aided tomography equipment is easily available. For many years, the doctors, vaidyas depended upon pulse rate, thermometer and stethoscope , however today hundreds of sophisticated Biomedical instruments are available. BREAK THROUGH A major break through in the form of ECG was invented by Dutch scientist in 1930. It was the first step forward towards modernization of Biomedical Instrumentation. BIOMEDICAL INSTRUMENTATION: It is the branch of science that includes measurements of physiological variables and parameters. BMI provides the tools by which these measurements can be achieved. The following factors must be considered while designing a biomedical instrument: RANGE The range of an instrument is generally considered to include all the levels of input amplitude & frequency over which the device is expected to operate.The objective is to provide an instrument that will give a usable reading from the smallest expected value of the variable or parameter being measured to the largest. SENSITIVITY The sensitivity of an instrument determines how small a variation of a variable or parameter can be really reliably measured. LINEARITY The degree to which variations in the output of an instrument follow input variations is referred to as the linearity of the device. HYSTERESIS It is a characteristic of some instruments where by a given value of the measured variable results in a different reading when reached in an ascending direction from that obtained when it is reached in a descending direction.
FREQUENCY RESPONSE The frequency response of an instrument is its variation in sensitivity over the frequency range of the measurement. It is important to display a wave shape that is a faithful reproduction of the original physiological signal. ACCURACY It is a measure of systemic error. Errors can occur in a multitude of ways. Although not always present simultaneously, the following errors should be considered. 1. Errors due to tolerances of electronic components. 2. Mechanical errors in meter movements. 3. Component errors due to drift or temperature variations. 4. Errors due to poor frequency response. 5. Errors due to change in atmospheric pressure or temperature. 6. Reading errors due to parallel inadequate illuminations or excessively wide ink traces on a pen recording. Two additional sources of Errors are Correct instrument zeroing or making correct baseline. The effect of the instrument on the parameter to be measured & vice versa. ( Specially in measurements in living organism ) SIGNAL TO NOICE RATIO It is important that the signal to noise ratio be high as possible. STABILITY In control engineering, Stability is the ability of a system to resume a steady state conditions following a disturbance at the input rather than be driven into uncontrollable oscillation. ISOLATION Electrical Isolation is to be made for avoiding interference between different instruments used simultaneously. It can be achieved by using magnetic or optional coupling technique or using radio tetermetry.
LIST OF INSTRUMENTS
SINGLE SLICE CT SCANNER ULTRASOUND IMAGING BLOOD GAS ANALYZER BLOOD CELL COUNTER DIALYSIS MACHINE DEFIBRILLATOR DIGITAL BP METER SHORT WAVE DIATHERMY
1. SINGLE SLICE CT SCANNER

Computed tomography (CT) is a medical imaging method employing tomography created by computer processing. Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation. CT produces a volume of data which can be manipulated, through a process known as "windowing", in order to demonstrate various bodily structures based on their ability to block the X-ray beam. Although historically the images generated were in the axial or transverse plane, orthogonal to the long axis of the body, modern scanners allow this volume of data to be reformatted in various planes or even as volumetric (3D) representations of structures. Although most common in medicine, CT is also used in other fields, such as nondestructive materials testing. Another example is archaeological uses such as imaging the contents of sarcophagi.
A patient is receiving a CT scan for cancer. Outside of the scanning room is an imaging computer that reveals a 3D image of the body's interior.
History: In the early 1900s, the Italian radiologist Alessandro Vallebona proposed a method to represent a single slice of the body on the radiographic film. This method was known as tomography. The idea is based on simple principles of projective geometry: moving
Synchronously and in opposite directions the X-ray tube and the film, which are connected together by a rod whose pivot point is the focus; the image created by the points on the focal plane appears sharper, while the images of the other points annihilate as noise. This is only marginally effective, as blurring occurs only in the "x" plane. There are also more complex devices which can move in more than one plane and perform more effective blurring. Tomography had been one of the pillars of radiologic diagnostics until the late 1970s, when the availability of minicomputers and of the transverse axial scanning method, this last due to the work of Godfrey Hounsfield and South African-born Allan McLeod Cormack, gradually supplanted it as the modality of CT. Mathematically, the method is based upon the use of the Radon Transform invented by Johann Radon in 1917. But as Cormack remembered later, he had to find the solution himself since it was only in 1972, that he learned of the work of Radon, by chance. The first commercially viable CT scanner was invented by Sir Godfrey Hounsfield in Hayes, United Kingdom at EMI Central Research Laboratories using X-rays. Hounsfield conceived his idea in 1967. The first EMI-Scanner was installed in Atkinson Morley Hospital in Wimbledon, England, and the first patient brain-scan was done on 1 October 1971. It was publicly announced in 1972. The original 1971 prototype took 160 parallel readings through 180 angles, each 1 apart, with each scan taking a little over 5 minutes. The images from these scans took 2.5 hours to be processed by algebraic reconstruction techniques on a large computer. The scanner had a single photomultiplier detector, and operated on the Translate/Rotate principle. The first CT system that could make images of any part of the body and did not require the "water tank" was the ACTA (Automatic Computerized Transverse Axial) scanner designed by Robert S. Ledley, DDS, at Georgetown University. This machine had 30 photomultiplier tubes as detectors and completed a scan in only 9 translate/rotate cycles, much faster than the EMIscanner. It used a DEC PDP11/34 minicomputer both to operate the servo-mechanisms and to acquire and process the images. The Pfizer drug company acquired the prototype from the university, along with rights to manufacture it. Pfizer then began making copies of the prototype, calling it the "200FS" (FS meaning Fast Scan), which were selling as fast as they could make them. This unit produced images in a 256256 matrix, with much better definition than the EMI-Scanner's 8080.
Working of CT Scanner:
CT scanner with cover removed to show the principle of operation
X-ray slice data is generated using an X-ray source that rotates around the object; X-ray sensors are positioned on the opposite side of the circle from the X-ray source. The earliest sensors were scintillation detectors, with photomultiplier tubes excited by (typically) cesium iodide crystals. Cesium iodide was replaced during the 1980s by ion chambers containing high pressure Xenon gas. These systems were in turn replaced by scintillation systems based on photo diodes instead of photomultipliers and modern scintillation materials with more desirable characteristics. Many data scans are progressively taken as the object is gradually passed through the gantry. Newer machines with faster computer systems and newer software strategies can process not only individual cross sections but continuously changing cross sections as the gantry, with the object to be imaged, is slowly and smoothly slid through the X-ray circle. These are called helical or spiral CT machines. Their computer systems integrate the data of the moving individual slices to generate three dimensional volumetric information (3D-CT scan), in turn viewable from multiple different perspectives on attached CT workstation monitors. This type of data acquisition requires enormous processing power, as the data are arriving in a continuous stream and must be processed in real-time. In conventional CT machines, an X-ray tube and detector are physically rotated behind a circular shroud (see the image above right); in the electron beam tomography (EBT) the tube is far larger and higher power to support the high temporal resolution. The electron beam is deflected in a hollow funnel-shaped vacuum chamber. X-rays are generated when the beam hits the stationary target. The detector is also stationary. This arrangement can result in very fast scans, but is extremely expensive.
CT is used in medicine as a diagnostic tool and as a guide for interventional procedures. Sometimes contrast materials such as intravenous iodinated contrast are used. This is useful to highlight structures such as blood vessels that otherwise would be difficult to delineate from their surroundings. Using contrast material can also help to obtain functional information about tissues. Once the scan data has been acquired, the data must be processed using a form of tomographic reconstruction, which produces a series of cross-sectional images. The most common technique in general use is filtered back projection, which is straight-forward to implement and can be computed rapidly. Mathematically, this method is based on the Radon transform. However, this is not the only technique available: the original EMI scanner solved the tomographic reconstruction problem by linear algebra, but this approach was limited by its high computational complexity, especially given the computer technology available at the time. More recently, manufacturers have developed iterative physical model-based expectationmaximization techniques. These techniques are advantageous because they use an internal model of the scanner's physical properties and of the physical laws of X-ray interactions. By contrast, earlier methods have assumed a perfect scanner and highly simplified physics, which leads to a number of artefacts and reduced resolution - the result is images with improved resolution, reduced noise and fewer artefacts, as well as the ability to greatly reduce the radiation dose in certain circumstances. The disadvantage is a very high computational requirement, which is at the limits of practicality for current scan protocols. Pixels in an image obtained by CT scanning are displayed in terms of relative radiodensity. The pixel itself is displayed according to the mean attenuation of the tissue(s) that it corresponds to on a scale from +3071 (most attenuating) to -1024 (least attenuating) on the Hounsfield scale. Pixel is a two dimensional unit based on the matrix size and the field of view. When the CT slice thickness is also factored in, the unit is known as a Voxel, which is a three dimensional unit. The phenomenon that one part of the detector cannot differentiate between different tissues is called the "Partial Volume Effect". That means that a big amount of cartilage and a thin layer of compact bone can cause the same attenuation in a voxel as hyperdense cartilage alone. Water has an attenuation of 0 Hounsfield units (HU) while air is -1000 HU, cancellous bone is typically +400 HU, cranial bone can reach 2000 HU or more (os temporale) and can cause artifacts. The attenuation of metallic implants depends on atomic number of the element used: Titanium usually has an amount of +1000 HU, iron steel can completely extinguish the X-ray and is therefore responsible for well-known line-artifacts in computed tomograms. Artifacts are caused by abrupt transitions between low- and high-density materials, which results in data values that exceed the dynamic range of the processing electronics.
Pulmonary angiogram :
CT pulmonary angiogram (CTPA) is a medical diagnostic test used to diagnose pulmonary embolism (PE). It employs computed tomography to obtain an image of the pulmonary arteries. It is a preferred choice of imaging in the diagnosis of PE due to its minimally invasive nature for the patient, whose only requirement for the scan is a cannula (usually a 20G).
Example of a CTPA, demonstrating a saddle embolus (dark horizontal line) occluding the pulmonary arteries (bright white triangle)
MDCT (multi detector CT) scanners give the optimum resolution and image quality for this test. Images are usually taken on a 0.625 mm slice thickness, although 2 mm is sufficient. 50 100ml of contrast is given to the patient at a rate of 4 ml/s. The tracker/locator is placed at the level of the pulmonary arteries, which sit roughly at the level of the carina. Images are acquired with the maximum intensity of radio-opaque contrast in the pulmonary arteries. This is done using bolus tracking. CT machines are now so sophisticated that the test can be done with a patient visit of 5 minutes with an approximate scan time of only 5 seconds or less. A normal CTPA scan will show the contrast filling the pulmonary vessels, looking bright white. Ideally the aorta should be empty of contrast, to reduce any partial volume artifact which may result in a false positive. Any mass filling defects, such as an embolus, will appear dark in place of the contrast, filling / blocking the space where blood should be flowing into the lungs.
Abdominal and pelvic

CT is a sensitive method for diagnosis of abdominal diseases. It is used frequently to determine stage of cancer and to follow progress. It is also a useful test to investigate acute abdominal pain (especially of the lower quadrants, whereas ultrasound is the preferred first line investigation for right upper quadrant pain). Renal stones, appendicitis, pancreatitis, diverticulitis, abdominal aortic aneurysm, and bowel obstruction are conditions that are readily diagnosed and assessed with CT. CT is also the first line for detecting solid organ injury after trauma.
Multidetector CT (MDCT) can clearly delineate anatomic structures in the abdomen, which is critical in the diagnosis of internal diaphragmatic and other nonpalpable or unsuspected hernias. MDCT also offers clear detail of the abdominal wall allowing wall hernias to be identified accurately. Oral and/or rectal contrast may be used depending on the indications for the scan. A dilute (2% w/v) suspension of barium sulfate is most commonly used. The concentrated barium sulfate preparations used for fluoroscopy e.g. barium enema are too dense and cause severe artifacts on CT. Iodinated contrast agents may be used if barium is contraindicated (for example, suspicion of bowel injury). Other agents may be required to optimize the imaging of specific organs, such as rectally administered gas (air or carbon dioxide) or fluid (water) for a colon study, or oral water for a stomach study. CT has limited application in the evaluation of the pelvis. For the female pelvis in particular, ultrasound and MRI are the imaging modalities of choice. Nevertheless, it may be part of abdominal scanning (e.g. for tumors), and has uses in assessing fractures.CT is also used in osteoporosis studies and research alongside dual energy X-ray absorptiometry (DXA). Both CT and DXA can be used to assess bone mineral density (BMD) which is used to indicate bone strength, however CT results do not correlate exactly with DXA (the gold standard of BMD measurement). CT is far more expensive, and subjects patients to much higher levels of ionizing radiation, so it is used infrequently.
Advantages and disadvantages:

Advantages over traditional radiography
There are several advantages that CT has over traditional 2D medical radiography. First, CT completely eliminates the superimposition of images of structures outside the area of interest. Second, because of the inherent high-contrast resolution of CT, differences between tissues that differ in physical density by less than 1% can be distinguished. Finally, data from a single CT imaging procedure consisting of either multiple contiguous or one helical scan can be viewed as images in the axial, coronal, or sagittal planes, depending on the diagnostic task. This is referred to as multiplanar reformatted imaging. CT is regarded as a moderate to high radiation diagnostic technique. While technical advances have improved radiation efficiency, there has been simultaneous pressure to obtain higherresolution imaging and use more complex scan techniques, both of which require higher doses of radiation. The improved resolution of CT has permitted the development of new investigations, which may have advantages; compared to conventional angiography for example, CT angiography avoids the invasive insertion of an arterial catheter and guidewire; CT colonography (also known as virtual colonoscopy or VC for short) may be as useful as a barium enema for detection of tumors, but may use a lower radiation dose. CT VC is
increasingly being used in the UK as a diagnostic test for bowel cancer and can negate the need for a colonoscopy. The greatly increased availability of CT, together with its value for an increasing number of conditions, has been responsible for a large rise in popularity. So large has been this rise that, in the most recent comprehensive survey in the United Kingdom, CT scans constituted 7% of all radiologic examinations, but contributed 47% of the total collective dose from medical X-ray examinations in 2000/2001.Increased CT usage has led to an overall rise in the total amount of medical radiation used, despite reductions in other areas. In the United States and Japan for example, there were 26 and 64 CT scanners per 1 million population in 1996. In the U.S., there were about 3 million CT scans performed in 1980, compared to an estimated 62 million scans in 2006. The radiation dose for a particular study depends on multiple factors: volume scanned, patient build, number and type of scan sequences, and desired resolution and image quality. Additionally, two helical CT scanning parameters that can be adjusted easily and that have a profound effect on radiation dose are tube current and pitch. Computed tomography (CT) scan has been shown to be more accurate than radiographs in evaluating anterior interbody fusion but may still over-read the extent of fusion.
2. ULTRASOUND IMAGING
Ultrasound imaging is now in very widespread clinical use. The most important underpinning technologies include transducers, beam forming, pulse compression, tissue harmonic imaging, contrast agents, techniques for measuring blood flow and tissue motion, and three-dimensional imaging. Specialized and emerging technologies include tissue characterization and image segmentation, microscanning and intravascular scanning, elasticity imaging, reflex transmission imaging, computed tomography, Doppler tomography, photoacoustics and thermoacoustics. Phantoms and quality assurance are necessary to maintain imaging performance. Contemporary ultrasonic imaging procedures seem to be safe but studies of bioeffects are continuing. It is concluded that advances in ultrasonic imaging have primarily been pushed by the application of physics and innovations in engineering, rather than being pulled by the identification of specific clinical objectives in need of scientific solutions. Moreover, the opportunities for innovation to continue into the future are both challenging and exciting.
Ultrasonic liver scans, illustrating the improvement in quality which has occurred over the last 25 years. The images are (a) a scan which was considered to be of high quality in the early 1970s and which would have been interpreted as supporting the diagnosis of multiple metastases,
Biomedical Instrumentation (b) a scan made with a modern system, in which a metastasis can just be perceived towards the right side of the patient (i.e., towards the left of the image) and (c) a scan of the same patient, in which this lesion is clearly apparent following the administration of an ultrasonic contrast agent.
Construction and Working : In some respects, the transducer is the most critical component in any ultrasonic imaging system. In other words, such is the state of the art in systems such as electronic circuitry and display technology that it is the performance of the transducer which determines how closely the limits imposed by the characteristics of the tissues themselves can be approached. Nowadays, the transducers which are in clinical use almost exclusively use a piezoelectric material, of which the artificial ferroelectric ceramic, lead zirconate titanate (PZT), is the most common. The ideal transducer for ultrasonic imaging would have characteristic acoustic impedance perfectly matched to that of the (human) body, have high efficiency as a transmitter and high sensitivity as a receiver, a wide dynamic range and a wide frequency response for pulse operation. PZT has much higher characteristic impedance than that of water but it can be made to perform quite well by the judicious use of matching layers consisting of materials with intermediate characteristic impedances. Even better performance can be obtained by embedding small particles or shaped structures of PZT in a plastic to form a composite material: this has a lower characteristic impedance than that of PZT alone, although it has similar ferroelectric properties. Polyvinylidene difluoride (PVDF) is a plastic which can be polarized so that it has piezoelectric properties. The piezoelectric effect can be enhanced by the addition of small quantities of appropriate chemicals. The advantages of this material are that it has a relatively low characteristic impedance and broad frequency bandwidth; it is fairly sensitive as a receiver but rather inefficient as a transmitter. Piezoelectric transducers are normally operated over a band of frequencies centered at their resonant frequency. The resonant frequency of a transducer occurs when it is half a wavelength in thickness. Typically, a PZT transducer resonant at a frequency of, say, 3 MHz is about 650 m thick and this means that it is sufficiently mechanically robust for simple, even manual, fabrication techniques to be employed in probe construction. Higher frequency transducers are proportionally thinner and, consequently, more fragile. The potential of capacitive micromachined ultrasonic transducers (cMUTs) at least partially to replace PZT and PVDF devices in ultrasonic imaging is the subject of current research. A cMUT consists of a micromachined capacitor, typically mounted on a silicon substrate and with a thin electroded membrane as the other plate of the capacitor: this acts as the active surface of the transducer. A dc voltage is applied between the plates of the device; the application of an ac voltage causes the membrane to transmit a corresponding oscillatory force, while a received wave causes a corresponding change in the spacing between the plates, thus generating an electrical signal. cMUTs are adequately sensitive as receivers, but need high voltages to be effective transmitters. Some of the potential advantages of these devices are that they can be fabricated into arrays with integrated electronics and, if manufactured in large quantities, could be
relatively inexpensive. Although some simple probes contain single-element transducers (e.g., one element for transmitting and one for receiving, in a continuous-wave Doppler system), most modern imaging systems use arrays of transducer elements for beam forming.
Beam forming
In ultrasonic imaging, the beam may be scanned through the tissue either by mechanical movement of a single element or an annular array transducer, or by electronic control of a transducer array consisting of a number of small elements. For two-dimensional scanning, the array typically consists of 256 elements. The simplest arrangement is a linear array, within which an aperture is formed from, say, 16 contiguous elements and which is stepped along the array element by element to acquire an image with, in this example. The same number of lines in a sector format can be acquired by curving the array into a segment of a cylinder. A sector scan can also be acquired by controlling the phases of the signals associated with each of the elements in the aperture. Whatever the arrangement, the application of distinct time delays to excite each element focuses the transmitted beam at a particular range. By transmitting several beams in the same position but with different foci, a sharply focused transmitted beam can be synthesized. On reception, the focus can be swept along the beam by dynamically changing the time delays associated with the active transducer elements, so that its position coincides continuously with that of the instantaneous origin of the echoes. Both when transmitting and receiving, the amplitudes of the signals associated with the active elements can be weighted to minimize the amplitudes of the beam side lobes, which are critical in determining the image contrast resolution. Also, the number of elements in the active aperture can be dynamically increased with increasing depth of penetration to maintain a constant f-number, within the limit imposed by the total length of the array and optimized to minimize the effect of tissue inhomogeneity. For three-dimensional imaging, the two-dimensional scan plane produced by a onedimensional linear, curved or phased array can be swept mechanically, either linearly in the orthogonal direction or through a sector. Recently, two-dimensional transducer arrays have been developed. Because of the very large number of transducer elements in these arrays, beam forming in three dimensions can be achieved more economically but with some degradation in performance by sparsely populating the array. For real-time three-dimensional scanning, several transmitting beams can be synthesized simultaneously; a single receiving beam can be associated with each transmitting beam, or, by increasing the width of each transmitting beam, several sharply focused receiving beams can be accommodated simultaneously in each transmitted beam. The beam-forming time delays and aperture apodization functions are digitally controlled. The sampling frequency has to be at least twice the highest ultrasonic frequency, in order to avoid aliasing. Further improvement can be obtained by applying a finite
impulse response digital filter or by demodulating the radio-frequency signals to baseband to obtain quadrature signals so that the associated time delays can be finely adjusted by phase rotation. A very powerful software tool, Field II, has been developed to simulate ultrasonic beam and image formation. The current program assumes linear acoustics and it is freely available under certain restrictions. An intriguing development in high-speed imaging has recently been brought about by the application of limited diffraction beams. A limited diffraction beam can be produced by appropriate excitation of a transducer array. Following the transmission of a single plane wave pulse, the received signals are weighted with limited diffraction beams simultaneously to produce multiple A-lines which can be used to create a complete two-dimensional image.
Pulse compression
Ultrasonic pulse-echo imaging traditionally involves the transmission of as brief a pulse of ultrasound as is consistent with the frequency of ultrasound determined by the required penetration into the tissue. Considerations of the safety of such brief high-powered pulses, the nonlinear properties of tissue and the destruction of contrast agent microbubbles reveal that this approach may often not be optimal. Coded transmission pulses have the potential to increase the penetration depth, to improve the signal-to-noise ratio and/or to increase the image frame rate. The principle is simple. The transmitted pulse has a relatively long duration and low amplitude, in comparison with the traditional brief pulse, and the frequency of the pulse typically is either swept so that it is a chirp, or it is modulated with, for example, a binary code. The signals received as echoes from within the tissues are then correlated with a signal corresponding to that which was transmitted, by means of a matched filter. This has the effect of compressing the received signals so that they correspond to a traditional pulse-echo wavetrain, which can be further processed to provide the image information. Pulse compression schemes of this kind have long been used in radar, sonar and mobile communications systems. The situation in ultrasonic imaging, however, is rather more challenging. In radar and sonar, the purpose is usually to detect isolated targets, whereas, in ultrasonic imaging, virtually the whole of the tissue is occupied by reflectors and scatterers. In ultrasonic imaging, there is strong frequency-dependent attenuation, which is much less of a problem in radar and sonar. Added to this, the bandwidth of ultrasonic transducers is limited.
3. BLOOD GAS ANALYZER The Blood Gas Analyzer should have the following essential components. The quote optional accessories should be submitted.
Essential Components 1.Electrodes The system should be able to measure accurately the following parameters. pH pCO2 pO2 Haematocrit and Hemoglobin Electrolytes, Sodium, Potassium and Chloride Lactate Calcium magnesium
The equipment should possess electrodes with long life of at least 2 years Facility for regular quality assessment of the instrument should be provided by the company.
2. Analyzer controller with soft ware. The Instrument should provide the following calculated parameters. Bicarbonate (HCO3) Standard HCO3 (standard HCO3) Base Excess of Blood (BE) Base Excess of Extra cellular fluid (BE-Ecf) Oxygen Content (O2Ct) Oxygen Saturation (SO2%) Total carbon dioxide (TCO2) Alveolar to Arterial oxygen tension gradient (AaDO2) Arterial Alveolar oxygen tension Ratio (a/A) Oxygen carrying capacity (O2 Cap) PO2/FIO2 Ratio P 5O Respiratory index Anion Gap Plasma Osmolatity pH/pCO2/pO2 Corrected to patient temperature
All results should be available within 3 min. Reagents remaining status should be available on the main screen for easy monitoring and replacement. The instrument should have facilities like monitor screen, external keyboard, mouse, and barcode reader All results should be microprocessor controlled and of latest technology version .The instrument should have the capability to interface a computer and a computer should be supplied for data acquisition and patient record with recommended software. The system should have RS232 serial port. Display language should have English 3. Recording Devices: High end colour inkjet printer. Refilling of cartridges should be possible compatible with ABG machines. 4. Sampler: The sample volume for measuring all parameters should exceed 200 ul The instrument should accept heparinized whole blood, serum or plasma, arterial, mixed venous and capillary sample .It should also provide the facility to measure the above parameters in gases, cerebrospinal fluid, dialysate, pleural fluid and urine.
5. Reagents: The instrument should use liquid calibration for calibration of all measure parameters without use of any gas cylinders or humidifiers The company should supply reagents with the analyzer to run the machine satisfactorily for two years 25 samples / day. The equipment should be incorporated to perform regular calibration satisfactorily .The instrument should have a standby mode (economy mode) with auto wake up facility to optimize the reagent utilization. 6. Waste Bag: The Waste container should be sealed to prevent operator biohazard. 7. Back up power supply: 1 KV UPS systems for blood gas analyzer for a minimum one hour back up. 8. Power requirements: 220-240 V, 50/60 Hz Optional accessories: A computer with facility of data transfer for mass storage of data to interface with the ABG analyzer a) P.C. Monitor 15 Flat b) Processor: Intel Pentium 4, 2.8 GHz with HT c) Mother board: Intel 915 Express Chipset mother board or higher (Compatible with the processor) d) Memory: 512 MB DDR SD RAM or better e) 80 GB Hard Disk f) 144 MB FDD g) DVD &CD Reader & writer for having back up data h) 2 USB, One Parallel & Serial port i) Latest configuration available j) Optical mouse k) Multi media key board Software: a) Windows XP operating system b) compatible software to transfer and analyse data from the ABG machine
4. BLOOD CELL COUNTER

1) Blood contains three cell types: Leukocytes (white blood cells about 10 ums), Erythrocytes (red blood cells about 6 ums), and Platelets (about 1 micron). 2) Abnormally high or low counts of these cells have been important indicators of sickness and infection for many decades so measuring them has become routine. 3) There are a number of qualitative clinical field assays that test for the presence of infection by mixing blood or other body with receptor-coated particles fluids (colloidal gold nanoparticles for example). If antigens are present, they will cause the particles to aggregate. Blood Cell Counting: 1) Usually by two well established methods: Microscopy and Coulter counting. 2) Microscopy is more labor intensive but is better at identifying different types of similar cells. 3) The Coulter Counting method lends itself to automation as well as being paired up with flow cytometry. Coulter Counter:
1. Coulter Counter, though well grounded in the hematology field, has some issues: It requires the use of saline as diluent It clogs. 2. The SPOS method is a particle counting technique with a size range that allows the counting of the various blood cells, but because it is an optically based technique: It does not require the use of saline The optical flow cell is not prone to clogging. It can be paired with dilution systems It has a broader size range that can extend its use beyond counting blood cells
EXTINCTION CURVE OF BLOOD CELLS
1) We used the SPOS technique to analyze whole blood samples that were placed in an electrophoretic-type device which was designed to separate blood by cell type. 2) It was expected that each subsequent fraction would contain decreasing amounts of WBCs 3) Based on Zeta Potential measurements the last fraction was expected to be almost entirely RBCs. Lysing the Red Blood Cells 1) Because of the greater concentration of RBC (500 to1) and their closeness in size to the WBC, WBC and Platelets are counted after lysing the RBC. 2) Lysing destroys the RBC and is thought to only remove the cell walls of WBC preserving them as particles.
5 DIALYSIS MACHINE
During dialysis, your blood is cleaned using a fluid called dialysate, or bath. Wastes and fluids from your blood go into the bath and are drained away. The Dialysis machine controls the flow of the blood and the bath. The dialysis machine has two systems the extracorporeal (outside the body) circuit and the dialysate delivery system. The extracorporeal circuit is the tubing, blood pump, heparin (blood thinner) pump, kidney, and monitors for blood flow, blood pressure, and air bubbles. The dialysate delivery system of the machine mixes the bath with purified water and checks to be sure it is safe.
Depending on the machine and the dialyzer, no more than two cups (one pint) of blood are outside your body during dialysis. Air in your bloodstream is a medical emergency. The air detector checks the blood in the tubing to be sure that air does not get into your bloodstream. The air detector is set before each treatment. Your blood flow rate is how fast the blood pump moves your blood through the machine. Your doctor prescribes your blood flow rate. Ask what it is. Check to be sure your blood flow rate is right at each treatment. Your dialysate, or bath, is prescribed by your doctor. It must have the right chemicals, or it will not clean your blood well enough. Sometimes the wrong ingredients can even hurt you. Learn what the right concentrate is for you, and check it at each treatment.
Hemodialysis
When your kidneys do not work well, dialysis is needed to remove extra fluid and waste products from the body. Hemodialysis is a type of dialysis that uses a machine with an artificial filter to remove wastes and extra fluids from the blood. This treatment also helps control the chemical balance in your body and helps control blood pressure. Each treatment takes about 4 hours and is done 3 times each week.
How Does Hemodialysis Work?

A dialysis machine pumps small amounts of blood out of the body and through a filter called an artificial kidney or dialyzer. This kidney filters extra fluid and wastes from the blood. The blood is then pumped back into your body. Medicine will be given to you to prevent your blood from clotting. Fluid, called dialysate, is added to the dialysis machine to: Help filter out extra fluid and wastes that have built up Add chemicals that your body uses The dialysate is a mixture of water and chemicals that are present in your blood. This fluid can be adjusted, based on your lab values, to give you the best filtering with fewer side effects.
6. DEFIBRILLATOR
Types:
Automated External Defibrillator (AED) Implantable Cardioverter Defibrillator Circuitry: Capacitor stores energy for defibrillation Cap charged to ~1000V Delivers 100-200 J to patient Discharge time ~5-10ms Inductor used to create a finite damped sine wave from DC (Lown waveform) Monophasic vs. Biphasic waveforms Body modeled as impedance Body contacts 25 lbs pressure required to avoid static discharge.
Application:
Gel Lower Resistance Wet vs. Dry Gel Apply Paddles; 25lbs Automatic vs. Manual Electrodes Safer, Better EKG Reading
Internal Units: Only for those who are at severe risk; Ventricular fibrillation (unproductive heartbeat), ventricular tachycardia (abnormally fast heartbeat), long QT syndrome (an inherited heart disease) Placement: Lead Wire from Cephalic vein to heart chamber Electrode implanted lower chamber heart muscle (LV or LA) Tech. Specs Li-Ion Battery Wand Programming over RF Electrodes; Platinum, Silicone Treatment Pacing Regimen Cardioversion Defibrillation
7. DIGITAL BP METER
This application note describes a Digital Blood Pressure Meter concept which uses an integrated pressure sensor, analog signal-conditioning circuitry, microcontroller hardware/software and a liquid crystal display. The sensing system reads the cuff pressure (CP) and extracts the pulses for analysis and determination of systolic and diastolic pressure. This design uses a 50 kPa integrated pressure Sensor (Free scale Semiconductor, Inc.P/N: MPXV5050GP) yielding a pressure range of 0 mm Hg to 300 mm Hg.
This method is employed by the majority of automated non-invasive devices. A limb and its vasculature are compressed by an encircling, inflatable compression cuff. The blood pressure reading for systolic and diastolic blood pressure values are read at the parameter identification point. The simplified measurement principle of the oscillometric method is a measurement of the amplitude of pressure change in the cuff as the cuff is inflated from above the systolic pressure. The amplitude suddenly grows larger as the pulse breaks through the occlusion. This is very close to systolic pressure. As the cuff pressure is further reduced, the pulsation increase in amplitude, reaches a maximum and then diminishes rapidly. The index of diastolic pressure is taken where this rapid transition begins. Therefore, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) are obtained by identifying the region where there is a rapid
increase then decrease in the amplitude of the pulses respectively. Mean arterial pressure (MAP) is located at the point of maximum oscillation. This application note describes a Digital Blood Pressure Meter concept which uses an integrated pressure sensor, analog signal-conditioning circuitry, microcontroller hardware/software and a liquid crystal display. The sensing system reads the cuff pressure (CP) and extracts the pulses for analysis and determination of systolic and diastolic pressure. This design uses a 50 kPa integrated pressure sensor (Freescale Semiconductor, Inc.P/N: MPXV5050GP) yielding a pressure range of 0 mm Hg to 300 mm Hg. CONCEPT OF OSCILLOMETRIC METHOD This method is employed by the majority of automated noninvasive devices. A limb and its vasculature are compressed by an encircling, inflatable compression cuff. The blood pressure reading for systolic and diastolic blood pressure values are read at the parameter identification point. The simplified measurement principle of the oscillometric method is a measurement of the amplitude of pressure change in the cuff as the cuff is inflated from above the systolic pressure. The amplitude suddenly grows larger as the pulse breaks through the occlusion. This is very close to systolic pressure. As the cuff pressure is further reduced, the pulsation increase in amplitude, reaches a maximum and then diminishes rapidly. The index of diastolic pressure is taken where this rapid transition begins. Therefore, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) are obtained by identifying the region where there is a rapid increase then decrease in the amplitude of the pulses respectively. Mean arterial pressure (MAP) is located at the point of maximum oscillation. HARDWARE DESCRIPTION AND OPERATION The cuff pressure is sensed by Freescales integrated pressure X-ducer.. The output of the sensor is split into two paths for two different purposes. One is used as the cuff pressure while the other is further processed by a circuit. Since MPXV5050GP is signal-conditioned by its internal opamp, the cuff pressure can be directly interfaced with an analog-to-digital (A/D) converter for digitization. The other path will filter and amplify the raw CP signal to extract an amplified version of the CP oscillations, which are caused by the expansion of the subjects arm each time pressure in the arm increases during cardiac systole. The output of the sensor consists of two signals; the oscillation signal ( 1 Hz) riding on the CP signal ( 0.04 Hz). Hence, a 2pole high pass filter is designed to block the CP signal before the amplification of the oscillation signal. If the CP signal is not properly attenuated, the baseline of the oscillation will not be constant and the amplitude of each oscillation will not have the same reference for comparison. Figure 1 shows the oscillation signal amplifier together with the filter. Fi
The filter consists of two RC networks which determine two cut-off frequencies. These two poles are carefully chosen to ensure that the oscillation signal is not distorted or lost. The two cut-off frequencies can be approximated by the following equations. Figure 2describes the frequency response of the filter. This plot does not include the gain of the amplifier.
The oscillation signal varies from person to person. In general, it varies from less than 1 mm Hg to 3 mm Hg. From the transfer function of MPXV5050GP, this will translate to a voltage output of 12 mV to 36 mV signal. Since the filter gives an attenuation of 10 dB to the 1 Hz signal, the oscillation signal becomes 3.8 mV to 11.4 mV respectively. Experiments indicate that, the amplification factor of the amplifier is chosen to be 150 so that the amplified oscillation signal is within the output limit of the amplifier (5.0 mV to 3.5 V). Figure 3 shows the output from the pressure sensor and Figure 4 illustrates the extracted oscillation signal at the output of the amplifier.
8.SHORT WAVE DIATHERMY

Acute musculoskeletal injuries can lead to a myriad of secondary problems during recovery and rehabilitation. Loss of joint range of motion is one of the most common obstacles to overcome. When a muscle has been in a limited position or immobilized following injury, shortening occurs, and the muscle becomes tight and resistant to stretch (Alter, 1996). Often, treatment protocols aimed at increasing flexibility while simultaneously decreasing joint stiffness include a combination of heat and stretch. Whirlpools and moist heat packs (Taylor et al., 1995), ultrasound (Wessling et al., 1987; Draper et al., 1998), and diathermy (Peres et al., 2002; Draper et al., 2004; Draper et al., 2002) traditionally have been the modalities used in concert with stretching to promote increased flexibility of a joint. At this time, little research has been conducted on the longevity of flexibility obtained from a regimen of diathermy and stretching. Draper et al. (2002) researched the use of heat (using diathermy) and stretch on hamstring flexibility. Both the stretch only and the heat/stretch groups increased in flexibility, but no method was superior to the other. Draper et al. stated that there were a few limitations in their study that might have affected the outcome. For example, they used a standing leg extended/hip flexion stretch, which according to Sullivan et al. (1992) puts the pelvis in a posterior tilted direction making it inadequate for appropriate hamstring stretching. The back saver sit-and-reach test was used to measure flexibility, which Sullivan also reported to be less effective, because it failed to control pelvic and spinal movements. Draper et al. (2004) corrected for these limitations by stretching the hamstrings using a posteriorly tilted pelvis and by using a more reliable method for measuring hamstring flexibility. The results showed that a diathermy/stretch protocol was far superior than stretching alone in bringing about hamstring flexibility. However, this study also had some limitations. First, this study was not blinded properly because the same person who performed the treatment also measured range of motion. This may introduce tester bias. Second, some subjects complained that the 15 pounds resistance provided by the stretch was too stressful to hold for 10 minutes, which may not have allowed the muscles to relax as much as possible. Third, the study was only performed for one week. Fourth, post treatment measures were only taken 72 hours after the last treatment. Considering the reported differences in flexibility retention at 72 hours by Castro, the lasting effects of the treatment need to be measured over several weeks to gain a greater insight as to the effects of diathermy and stretch.
Problem Statement The purpose of this study is to determine if the use of pulsed shortwave diathermy with long duration static stretching produces increased hamstring flexibility that can be retained longer than static stretching alone. Hypotheses 1. Use of pulsed shortwave diathermy with long duration static stretch will produce greater increases in hamstring flexibility over time than long duration static stretch alone, or control. 2. There is no difference in hamstring flexibility improvement between the three groups. Operational Definitions Pulsed shortwave diathermy - a modality that employs an induction technique and high frequency (27.12 MHz) electromagnetic current to produce deep heating (2-5 cm) in the tissues. Pulse duration of 800 sec at 400 Hz is the minimum parameters required to produce intense heating Hamstring tightness - inability to achieve greater than 160 of knee extension with the thigh at 90 of hip flexion Long duration stretch stretch that lasts longer than 1 minute, for purposes of this study a stretch that will last for 10 minutes.
Assumptions Subjects will not alter their level of activity during the length of the study. Delimitations The only modality being used is pulsed shortwave diathermy. Results may not be generalized to diathermy treatments using a different frequency or different parameters from those we will be using. Only healthy college-age subjects will be used in the study. Results of the study will represent the subjects used and may not be representative of a different age group or subjects with a known pathology other than hamstring tightness. The results cannot be generalized to stretching or measuring techniques outside of those employed in this study. Significance of Study Increased flexibility of the hamstrings is often seen as a preventative measure for injury activity. Hamstring flexibility can reduce low-back pain and result in greater ease of movement. Many hamstring studies have observed that flexibility retention has been for very short periods of time. This study will help determine the effectiveness of diathermy and stretch over an extended time period. The ability to increase and maintain a clients flexibility for an extended period of time will be a valuable tool for those in sports medicine fields and other health care professions.
Other Equipments:
It is well known fact that human body is Bio chemico electro thermo hydraulico pneumatieo physico magnato mechano dynamically engineered machine. To obtain valid measurements from a living human being. It is necessary to have deep understanding of the subject on which the measurements are being made. Within the human body can be found Biological, chemical, electrical, thermal , hydrolical pneumatical, physical, magnetic mechanical & dynamical & many other types of the systems each of them communicates with an external environment & internally with the other systems of the body. By the help of a multilevel control system and communication network, these individual systems are organized to perform many complex functions of the body. Through the integrated operations of all these systems, & their various subsystems, man is able to sustain life, learn to perform usual tasks, acquire personality and behavioral traits , and even reproduce himself.
REFERENCES: Handbook of Bio-Medical Instrumentation- R S Khandpur Biomedical Instrumentation-Dr Nithish V Thakur A complete single source reference for todays latest Biomedical devices Ieeexplore.org www.pdf-searcher.com/biomedical instrumentation wilkipedia.org National Programme on Tele-Enhanced Learning.

Bio 2

Încărcat de

Informații document

Descriere originală:

Titlu original

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Bio 2

Încărcat de

Drepturi de autor:

Formate disponibile

Biomedical Instrumentation

Sri Jayachamarajendra College of Engineering, Mysore-06

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

1. SINGLE SLICE CT SCANNER

Department of Instrumentation Technology

CT scanner with cover removed to show the principle of operation

Abdominal and pelvic

Advantages and disadvantages:

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

4. BLOOD CELL COUNTER

Department of Instrumentation Technology

Department of Instrumentation Technology

EXTINCTION CURVE OF BLOOD CELLS

Department of Instrumentation Technology

How Does Hemodialysis Work?

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

Department of Instrumentation Technology

8.SHORT WAVE DIATHERMY

Department of Instrumentation Technology

S-ar putea să vă placă și