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BOOK REVIEWS “Biomedical Instrumentation and Measurements” (Second edition) by L. Cromwell, F. J. We&e!! and E. A. Pfeiffer, Prentice-Hall Inc., New. Biomedical Instrumentation and Measurements by Leslie Cromwell. Cromwell attended (35 Biomedical Instrumentation homeranking.info lecture notes (Prof Biomedical . Biomedical Instrumentation and Measurements - Free ebook download as PDF File .pdf), Text File .txt) or read book online for free. Biomedical Instrumentation .
By means of this adjustment, the sensitivity of the ECG recorder can be set so that the standardization voltage of 1 mV causes a pen deflection of 10 mm. It operates on the principle that electrical resistance is changed by the stretching of a wire or a piece of semiconductor material. The variabilityfrom one subject to another is even greater. The photomultiplier is still the most sensitive light detector. The gages are isolated from the silicon substrate by reverse-biased diode junctions.
The input to the display device is the modified electric signal from the signal-conditioning equipment. Its output is some form of In the man-instrumentaequipment may include a graphic pen recorder that. Equipment for these functions is often a vital part of the man-instrument system. Also, where automatic storage or processing of data is required, or where computer control is employed, an on-line analog or digital computer may be part of the instrumentation system.
It should be noted that the term. This system usually consists of a feedback loop in which part of the output from the signal-conditioning or display equipment. Within the human body can be found electrical, mechanical, thermal, hydraulic, pneumatic, chemical, and various other types of systems, each of which communicates with an external environment, and internally with the other systems of the body.
By means of a multilevel control system and communications network, these individual systems are organized to perform many complex functions. Through the integrated operation of all these systems, and their various subsystems, man is able to sustain Ufe, learn to perform useful tasks, acquire personality and behavioral traits, and even reproduce himself.
In addition, these various inputs and outputs can be measured and analyzed in a variety of ways. Most are readily accessible for measurement, but some, such as speech, behavior, and appearance, are difficult to analyze and interpret.
Next to the whole being in the hierarchy of organization are the major functional systems of the body, including the nervous system, the cardiovascular system, the pulmonary system, and so on. Each major system is discussed later in this chapter, and most are covered in greater detail in later chapters.
Just as the these. These functional systems can be broken down into subsystems and organs, which can be further subdivided into smaller and smaller units. The process can continue down to the cellular level and perhaps even to the molecular level. The major goal of biomedical instrumentation is to make possible the measurement of information communicated by these various elements.
The problem is, of course, that many of the inputs at the various organizational levels are not accessible for measurement. The interrelationships among elements are sometimes so complex.
Thus, the models in use today contain so many assumptions and constraints that their application is often severely limited. All operations of this highly diversified and very efficient chemical factory are self-contained in that from a single point of intake for fuel food , water, and air, all the.
Moreover, the chemical factory contains all the monitoring equipment needed to provide the degree of control necessary for each chemical operation, and.
The Cardiovascular System engineer, the cardiovascular system can be viewed as a complex, closed. Reservoirs in the system veins acteristics to satisfy certain control.
The four-chamber pump acts as two synchronized but functionally isolated two-stage pumps. The first stage of each pump the atrium collects fluid blood from the system and pumps it into the second stage the ventricle.
The action of the second stage is so timed that the fluid is pumped into the system immediately after it has been received from the first stage. One of the two-stage pumps right side of the heart collects fluid from the main hydraulic system systemic circulation and pumps it through an oxygenation system the lungs. The other pump left side of the heart receives fluid blood from the oxygenation system and pumps it into the main hydraulic system.
The speed of the pump heart rate and its efficiency stroke volume are constantly changed to meet the overall requirements of the system. The fluid blood , which flows in a laminar fashion, acts as a communication and supply network for parts of the system. Carriers red blood cells of fuel suppHes and waste. The fluid also contains mechanisms for repairing small system punctures and for rejecting foreign elements from the system platelets and white blood cells, respectively. Because part of the system is required to work against gravity at times, special one-way valves are provided to prevent gravity from pulling fluid against the direction of flow between pump cycles.
The variables of prime. The passageway divides to carry air into each of the bags, wherein it again subdivides many times to carry air into and out of each of many tiny air spaces pulmonary alveoli within the bags. The dual air input to the system nasal cavities has an alternate vent the mouth for use in the event of nasal blockage and for other special purposes.
In the tiny air spaces of the bags is a membrane interface with the body's hydraulic system through which certain gases can diffuse. Oxygen is taken into the fluid blood from the incoming air, and carbon dioxide is transferred from the fluid to the air, which is exhausted by the force of the pneumatic pump.
The pump operates with a two-way override. An automatic control center respiratory center of the brain maintains pump operation at a speed that is adequate to supply oxygen and carry off carbon dioxide as required by the system. Manual control can take over at any time either to accelerate or to inhibit the operation of the pump.
Automatic control will return, however, if a condition is created that might endanger the system. System variables of primary importance are respiratory rate, respiratory airflow, respiratory volume, and concentration of CO2 in the expired air. This system also has a number of relatively fixed volumes and capacities, such as tidal volume the volume inspired or expired during each normal breath , inspiratory reserve volume the additional volume that can be inspired after a normal inspiration , expiratory special valving.
Its center a self-adapting central information processor or computer the brain. The computer is self adapting in that if a certain section. Almost as fascinating as the central computer are the millions of communication lines afferent and efferent nerves that bring sensory information into, and transmit control information out of the create art, poetry,.
By means of the interconnection patterns, signals from a large number of sensory devices, which detect light, sound, pressure, heat, cold, and certain chemicals, are channeled to the appropriate parts of the computer, where they can be acted upon. Similarly, output control signals are channeled to specific motor devices motor units of the muscles , which respond to the signals with some type of motion or force. Feedback regarding every action controlled by the system is provided to the computer through appropriate sensors.
Information is usually coded in the system by means of electrochemical pulses nerve action potentials that travel along.
The pulses can be transferred from one element of a network to another in one direction only, and frequently the transfer takes place only when there is the proper combination of elements acting on the next element in the chain. Action by some elements tends to inhibit transfer. Both serial and parallel coding are used, sometimes. In addition to the central computer, a large number of simple decision-making devices spinal reflexes are present to control directly certain motor devices from certain sensory inputs.
A number of feedback loops are accomplished by this method. In many. In some cases, however, animal subjects are substituted for humans in order to permit measurements or manipulations that cannot be performed without some risk. Although ethical restrictions sometimes are not as severe with animal subjects, the same basic problems can be expected in attempting measurements from any living system.
Most of these problems were introduced in earher sections of the chapter. However, they can be summarized as follows. In other situations the medical operation required to place a transducer in a position from which the variable can be measured makes the measurement impractical on human subjects, and sometimes even on animals.
Where a variable is inaccessible for measurement, an attempt is often made to perform an indirect measurement. This process involves the measurement of some other related variable that makes possible a usable estimate of the inaccessible variable under certain conditions.
In using indirect measurements, however, one must be constantly aware of the limitations of the substitute variable and must be able to determine when the relationship. In fact, such variables should be considered as stochastic processes. In other words, measurements taken under a fixed set of conditions at one time will not necessarily be the. Here, methods must be employed in order to estimate relation-. The foregoing variability in measured values could be better explained if more were known and understood about the interrelationships within the body.
Physiological measurements with large tolerances are often accepted by the physician because of a lack of this knowledge and the resultant inability to control variations. Better understanding of physiological relationships. Because of the large number of feedback loops involved in the major physiological systems, a severe degree of interaction exists both within a given system and.
Even when attempts are collateral loops appear and some aspects of feedback loop are still present. Also, when one organ or ele-.
In many situations the physical presence of the transducer changes the reading significantly. For example, a large flow. Similarly, an attempt to. This penetration can easily kill the cell or damage it so that it can no longer function normally. Another problem arises from the interaction discussed earlier. Often the presence of. For example, local cooling of the skin, to estimate the circulation in the area, causes feedback that changes the circulation pattern as a reaction to the.
The psychological effect of the measurement can also affect the Long-term recording techniques for measuring blood pressure have shown that some individuals who would otherwise have normal pressures show an elevated pressure reading whenever they are in the physician's of-.
In designing a measurement system, the biomedical instrumentation engineer or technician must exert extreme care to ensure that the effect of the presence of the measuring device is minimal.
Because of the limited amount of energy available in the body for many physiological variables, care must also be taken to prevent the measuring system from loading'' the source of the measured variable. Since many transducers are sensitive to movement, the movement of the subject often produces measuring of a.
For example, resistance measurements require the flow of electric current. Some transducers generate a small amount of heat due to the current flow. In most cases, this energy level is so low that its effect is insignificant. However, in dealing with living cells,.
Similarly, the measurement should not cause undue pain, trauma, or discomfort, unless it becomes necessary to endure these condi-. Fortunately, however, new developments resulting in. In addition, greater knowledge of the physiology of the various systems of the gresses in his. When measurements are made on human beings, one further aspect must be considered. During its earlier days of development biomedical apparatus was designed, tested, and marketed with little specific governmental control.
True, there were the controls governing hospitals and a host of codes and regulations such as those described in Chapter 16, but today a number of new controls exist, some of which are quite controversial.
On the other hand, there is little control on the effectiveness of devices or their side effects. Food and drugs have long been subject to governmental control by a U. In a new addition, the Medical Devices Amendments Public Law , placed all medical devices from the simple to the complex under the jurisdiction of the FDA.
Since then, panels and committees have been formed and symposia have been held by both physicians and engineers. They should always be fully conversant with what is going on and aware of issues and regulations that are brought about by technological, be economic and political realities. Each of the major body systems is discussed by presenting physiobackground information.
Then the variables to be measured are considered, followed by the principles of the instrumentation that could be used.
Finally, appUcations to typical medical, behavioral, and biological logical. The physiological systems from which these variables originate were introduced in Chapter 1.
The principal physiological variables and their methods of measurement are summarized in Appendix B and discussed in detail in. As stated in Chapter a transducer is required to convert each variable into an electrical signal 1 which can be amplified or otherwise processed and then converted into Physiological variables occur in. To conduct its function properly, one or more parameters of the electrical output signal say, its voltage, current, frequency, or pulse width must be a nonambiguous function of the nonelectrical variable at the input.
Ideally, the relationship between output and input should be linear with, for example, the voltage at the output of a pressure transducer being proportional to the applied pressure.
A linear relationship is not always possible. For example, the relationship between input and output may follow a logarithmic funcversion. The two transducer types will nevertheless be described separately in the following sections. In theory active transducers can utilize every for converting nonelectrical energy. It is a characteristic of active transducers that frequently, but not always, the same transduction principle used to convert from a nonelectrical form of energy can also be used in the reverse direction.
For example, a magnetic loudspeaker can also be used in the opposite direction as a microphone. Sometimes different names are used to refer to essentially the same to convert. These principles with the exception of the Volta effect and electrical Chapter 4 are described in later. If an electrical conductor is moved in a magnetic field in such a way that the magnetic flux through the conductor is changed, a voltage is induced which is proportional to the rate of change of the magnetic flux.
Conversely, if a current is sent through the same conductor, a mechanical force is exerted. The result, which depends on the polarities of voltage and current on the electrical side or the directions of force and motion on the mechanical side, is a conversion from electrical to mechanical energy, or vice versa.
All electrical motors and generators and a host of other devices, such as solenoids and loudit. The output voUage in each case is propor-. The most important biomedical apsound microphones, pulse transducers, and electromagnetic blood-flow meters, all described in Chapter 6.
Magnetic induction also plays an important role at the output of many biomedical instrumentation systems. Analog meters using d'Arsonval movements, light-beam galvanometers in photographic recorders, and pen motors in ink or thermal recorders are all based on the principle of magnetic induction and closely resemble the basic transducer configuration shown in.
These microphones use an electret to create an electrostatic field between two capacitor plates. Electrets which are the electrostatic equivalent of magnets are normally in the form of foils of a special plastic material that have been heat-treated while being exposed to a strong electric field. It is conceivable that the principle of the electret microphone could also be applied advantageously to biomedical transducers.
The natural materials in which this piezoelectric effect can be. Piezoelectric properties can be introduced into wafers of barium titanate a ceramic material that is frequently used as a dielectric in disk-type capacitors by heat-treating them in the presence of a strong electric field. The piezoelectric process is reversible.
The top trace shows the force applied to the removed again. While the electrical field. To meet this condition, even for large values of T, it may be necessary to make the amplifier input impedance very large. In some applications, elec2. As an alternative, an external capacitor can be. This effectively increases the capacity of the transducer but also reduces its sensitivity. Because the output voltages of piezoelectric transducers can be very high they have occasionally even been used as high-voltage generators for ignition purposes ,.
Changes of the capacity, and thus the sensitivity, can also be caused by the mechanical movement of attached shielded or coaxial cables which can introduce motion artifacts. Special types of shielded cable that reduce this efthis. If the product oiR and C is of the same order of magnitude as T, the resulting voltage is a compromise between the extremes in the two previous traces, as shown in the appHed force changes as.
Principles of ultrasound and biomedical applications are covered in Chapter 9. The polarity depends on which of the two junctions is warmer. The device formed in this fashion is called a thermocouple, shown in Figure 2. In the case of the thermocouple it.
Actually, the delivery of electrical energy causes the transfer of heat from the hotter to the colder junction; the hotter junction gets cooler while the colder junc-. Because the thermocouple measures a temperature difference rather than an absolute temperature, one of the junctions must be kept at a known reference temperature, usually at the freezing point of fect. Frequently, instead of an icebath for the reference Thermo-voltage.
Because of their low sensitivity, thermocouples are seldom used for measurement of physiological temperatures, where the temperature range is so limited.
Instead, one of the passive transducers described later is usually preferred. Thermocouples have an advantage at very high temperatures where passive transducers might not be usable or sometimes where transducers of minute size are required. The use of the thermoelectric effect to convert from thermal to electrical energy is called the Seebeck effect. In the reverse direction it is called the Peltier effect, where the flow of current causes one junction to heat and the.
When operated into a small load. Passive transducers utilize the principle of controlling a dc excitation voltage or an ac carrier signal. The voltage at the output of the circuit reflects the physical variable.
There are only three passive circuit elements that can be utilized as passive transducers: An ordinary potentiometer, for example, can be used to convert rotary motion or resistive. Similarly, the special linear potentiometers shown in Figure 2.
In resistors this characteristic is a disadvantage; however, in resistive temperature transducers it serves a useful purpose. Temperature transducers are resistivity. In certain semiconductor materials the conductivity light striking the material. This effect.
This type of transducer is very sensitive, but has a somewhat limited frequency response. A different type of photoelectric transducer carriers generated. Although less sensitive than the photoresistive cell, the photodiode has improved frequency response. A photo diode can also be used as a photoelectric transducer without a bias voltage. In this case it operates as an active transducer. The principle of a strain gage can easily be understood with the help of Figure 2.
Figure 2. If it is made of a material having a resistivity of r ohm-cm, its resistance is ment. Either an increase in L or a in an increase in resistance.
The ratio of the resulting. From D. Bartholomew, Electrical Measurement and Instruments. The basic principle of the strain gage can be utilized for transducers in number of different ways. In the mercury strain gage the resistive material consists of a column of mercury enclosed in a piece of silicone rubber tubing.
The use of this type of strain gage for the measurement of physiological variables the diameter of blood vessels was first described by Whitney. A disadvantage is that for practical dimensions the resistance of the mercury columns is inconven-. Metal strain gages can be of two different types: In the unbonded strain gage, thin wire is stretched between insulating posts as shown in Figure 2. In order to obtain a convenient resistance n is a common value , several turns of wire must be used.
If the moving member is. At the same time, resistance changes of the strain gage due to changing temperatures tend to compensate each other. In the form shown, the is. This strain gage is then cemented. Related to the bonded wire strain gage is ihQ foil gage. In this gage the conductor consists of a foil pattern on a substrate of plastic which is manufactured by the same photoetching techniques as those used in printed circuit boards.
This process permits the. If even made can be gages strain silicon measured is also made of silicon be strain is to the structure whose surface e. Such patterns can be obtained using the photolithographic and diffusion techniques developed for the manufacture of integrated circuits.
The gages are isolated from the silicon substrate by reverse-biased diode junctions. Therefore, at least two strain-gage elements are usually used, with the second element either employed strictly for temperature compensation, or that. In principle, the inductance of a coil can be changed either physical dimensions or core. However, in the inductive transducer the core. The inductance can then be measured using an ac signal. Another passive transducer involving inductance is the variable reluctance transducer, in which the core remains stationary but the air gap in the magnetic path of the core is varied to change the effective permeability.
This principle is also used in active transducers in which the magnetic path includes a permanent magnet. The magnitude of the output voltage changes with amount of displacement of the core from its central or neutral position. Because nonlinearities in the magnitudes of Its. Both effects have occasionally been. As with the transducers using an inductive element, it is sometimes not apparent whether a capacitive transducer is of the passive type or is actually an active transducer utiHzing the principle of electric induction.
If there is doubt, an capacitance plethysmograph. Passive transducers utilize ac carriers, whereas a dc bias voltage is used in transducers based on the principle of electric induction. Active circuit elements are those which provide power gain for. Such circuit elements have occasionally been used as transducers. Because, as transducers they employ the principle of carrier modulation the carrier being the plate or collector voltage , these active circuit elements are nevertheless passive transducers,.
A variable-transconductance vacuum tube in which the distance between the control grid and cathode of a vacuum tube was changed by the displacement of a mechanical connection is an early example of this type of transducer. More recently, transistors have been manufactured in which a mechanical force applied to the base region of the planar transistor causes a change. The photomultiplier is still the most sensitive light detector. One of its appHcations for biomedical purposes.
In the photo Darlington, a photo transistor is connected to a second transistor on the same substrate, with the two transistors forming a Darlington circuit. This effectively multiplies the photo current of the. Another semiconductor transducer element is the Hall generator, which provides an output voltage that is proportional to both the applied current and any magnetic field in which it is placed.
Several basic physical variables and the transducers active or passive used to measure them are listed in Table 2. It should be noted that many variables of great interest in biomedical applications, such as pressure and fluid or gas flow, are not included. These and many other variables of interest can be measured, however, by first converting each of them into one of the variables for which basic transducers are available.
Some very in-. A design element frequently used for the conversion of physical variables is the force-summing. When the spring is bent downward, it exerts an upward-directed force that is proportional to the displacement of the end of the spring.
If a force is applied to the end of the spring in a downward direction, the spring bends until its upward-directed force equals the downward-directed appHed force, or, expressed differently, until the vector sum of both forces equals zero. The bending of the spring, for example, results in a surface strain that can be measured by means of bonded strain gages as shown in Figure 2. In this case, the. Sometimes, the terms isotonic and isometric are used to describe the characteristics of these transducers.
Ideally a force transducer would be isometric; that is, it would not yield change its dimensions when a force is applied. On the other hand, a displacement transducer would be isotonic and offer zero or a constant resistance to an applied displacement.
In reality, almost all transducers combine the characteristics of both ideal transducer. With the long, soft spring shown in the upper photograph, the transducer assumes the characteristics of an isotonic displacement transducer. With the short, stiff spring shown in the lower photograph, it becomes an isometric force transducer. A less frequently used type of displacement transducer is shown in Figure 2.
Here the displacement of a spring is used to modulate the intensity of a light beam via a mechanical shutter. This principle. Both operations can readily be performed by electronic methods operating on either analog or digital signals. Because the performance of analog circuits is limited by bandwidth and noise considerations, integration and differentiaIf.
However, the principles listed for these measurements require that part of the transducer be attached to the body structure whose displacement, velocity, or acceleration is to be measured, and that a refer-. Contactless methods for measuring displacement and velocity, based on optical or magnetic principles, are occasionally used. Magnetic methods usually re-.
Flat or corrugated. Although diaphragm-type pressure transducers can be designed on the diameter and stifftransducers are usually used for high ness of the diaphragm, Bourdon tube. It is much more common to measure the pressure relative to atmospheric pressure by exposing one side of the diaphragm to the atmosphere.
In differential pressure transducers the two pressures are applied to opposite sides of the diaphragm. These methods are described in detail in Chapter 6 for blood flow and cardiac output, and in Chapter 8 for the measurement of gas flow as used in measurements in the respiratory. Analog-to-digital con-. Although such transducers verters, described in.
Digital shaft encoder patterns. Courtesy of Itek,. These signals are the bioelectric potentials associated with nerve conduction, brain activity, heartbeat, muscle activity, and so on. Bioelectric potentials are actually ionic voltages produced as a result of the electrochemical activity of certain special types of cells.
Through the use of transducers capable of converting electrical voltages, these natural. The idea of electricity being generated in the body goes back as far as when an Italian anatomy professor, Luigi Galvani, claimed to have.
Einthoven introduced the string galvanometer, that any practical application could be made of these potentials. The advent of the vacuum tube and amplification and, more recently, of solid-state technology has made possible better representation of the bioelectric potentials. These developments,. Neither the exact membrane nor the mechanism by which its permeability is. The membrane of excitable cells readily permits entry of potassium and chloride ions but effectively blocks the entry of sodium ions.
Since the various ions seek a balance between the inside of the cell and the outside, both according to concentration and electric charge, the inability of the sodium to penetrate the membrane results in two conditions.
First, the concentration of sodium ions inside the cell becomes much lower than in the intercellular fluid outside. Since the sodium ions are positive, this would tend to make the outside of the cell more positive than the inside. Second, in an attempt to balance the electric charge, additional potassium ions, which are also positive, enter the cell, causing a higher concentration of potassium on the inside than on the outside. This charge balance cannot be achieved, cipal ions are.
Equilibrium is reached with a potential difference across the membrane, negative. Since measurement of the membrane potential is generally made from inside the This. Figure 3. A cell. This movement of sodium ions into the cell constitutes an ionic current flow that further reduces the barrier of the membrane to sodium ions.
The net result is an avalanche effect in which sodium ions literally rush into the cell to try to reach a balance with the ions outside. At the same time. As a result, the cell has a slightly positive potential on the inside due to the imbalance of potassium ions.
A cell that has been excited and that displays an action potential is said to be depolarized; the process of changing from the resting state to the action potential is called depolarization. Once the rush of sodium ions through the cell membrane has stopped new state of equilibrium is reached , the ionic currents that lowered the barrier to sodium ions are no longer present and the membrane reverts back a. Were this the only effect, however, it would take a long time for a resting potential to develop again.
But such is not the case. By an active process, called a sodium pump, the sodium ions are quickly transported to the outside of the cell, and the cell again becomes polarized and assumes its resting potential. This process is called repolarization.
Although little is known of the exact chemical steps involved in the sodium pump, it is quite generally believed that sodium is withdrawn against both charge and concentration gradients supported by some form of high-energy phosphate compound. The rate of pumping is directly proportional to the sodium concentration in the cell.
Regardless of the method by which a the stimulus provided. This is known as the all-or-nothing The net height of the action potential is defined as the difference between the potential of the depolarized membrane at the peak of the action potential and the resting potential. In potential. The usual velocity range in nerves is from 20 to meters. Propagation through heart muscle is slower, with an average rate from 0.
Special time-delay fibers between the. Although measurement of individual action potentials can be made in types of cells, such measurements are difficult because they require precise placement of an electrode inside a cell. The more common form of measured biopotentials is the combined effect of a large number of action potentials as they appear at the surface of the body, or at one or more elec-.
The exact method by which these potentials reach the surface of the body is not known. A number of theories have been advanced that seem to explain most of the observed phenomena fairly well, but none exactly fits the situation. Many attempts have been made, for example, to explain the biopotentials from the heart as they appear at the surface of the body.
According to one theory, the surface pattern is a summation of the potentials developed by the electric fields set up by the ionic currents that generate trodes inserted into a muscle, nerve, or. This theory, although plausible, fails to explain a terns. Regardless of the method by which these patterns of potentials reach the surface of the body or implanted measuring electrodes, they can be measured as specific bioelectric signal patterns that have been studied extensively and can be defined quite well.
The remainder of this chapter is devoted to a description of each of the more significant bioelectric potential waveforms. The designation of the waveform itself generally ends in the suffix gram, whereas the name of the insidered. For example, the electrocardiogram the. Ranges of amplitudes and frequency spectra for each of the biopotential waveforms described below are included in Appendix B. The two upper chambers, the left and right atria, are synchronized to act together.
Similarly, the two lower chambers, the ventricles, operate together. The right atrium receives blood from the veins of the body and pumps it into the right ventricle. The right ventricle pumps the blood through the lungs, where it is oxygenated. The oxygen-enriched blood then enters the left atrium, from which it is pumped into the left ventricle. The left ventricle pumps the familiarity with the. Once the electrical excitation has passed through the delay line, it is rapidly spread to all parts of both ventricles by the bundle of His pronounced "hiss".
The fibers in this bundle, called Purkinje fibers, divide into two branches to initiate action potentials. The wavefront in the ventricles does not follow along the surface but is perpendicular to. This repolarization follows the depolarization wave by repolarization, however, is not initiated from neighboring muscle cells but terminating at the tip or apex of the heart. These can be identified with events related to the action potential propagation pattern.
To facilitate analysis, the horizontal segment of this waveform preceding the P wave is designated as the baseline or the isopotential line. The shape and polarity of each of these features vary with the location. EEG potentials, measured at the surface of the scalp, actually represent the combined effect of potentials from a fairly wide region of the cerebral cortex and from various points beneath. Experiments have shown that the frequency of the EEG seems to be The wide variation among individuals and the lack of repeatability in a given person from one occasion to another make the establishment of specific relationships difficult.
There are, however, certain characteristic EEG waveforms that can be related to affected by the mental activity of a person. The waveforms associated with the different shown in Figure 3. An alert, wide-awake person usually displays an unsynchronized high-frequency EEG. A drowsy person, particularly one whose eyes are closed, often produces a large amount of epileptic seizures. As the person begins to fall asleep, the amplitude and frequency of the waveform decrease; and in light sleep, a.
Deeper sleep generally even slower and higher-amplitude waves. At certain times,. Portions of some of these ranges have been given special designations, as have certain subbands that fall on or near the stated boundaries. Most humans seem to develop EEG patterns in the alpha range when they are relaxed with their eyes closed. Experiments in biofeedback have shown that under certain condican learn to control their EEG patterns to some extent when information concerning their EEG is fed back to them either visibly or.
Instrumentation for Diagnostic X Rays. The Components of a Biotelemetry System. The Digital Computer. Chemical Tests. Tests on Blood Cells. Physiological Effects of Electrical Current. Shock Hazards from Electrical Equipment. The Blood. Radiation Therapy. Automation of Chemical Tests. Biomedical Computer Applications. Methods of Accident Prevention. Special Techniques. Applications of Telemetry in Patient Care. Implantable Units. Generation of Ionizing Radiation. Instrumentation for the Medical Use of Radioisotopes.
A major reason for this progress has been the marriage of two important disciplines: There are similarities between these two disciplines and there are dif- ferences. The and engineering are both broad. In recent years progress in medical care has been rapid.
They en- disciplines of medicine compass people engaged in a wide spectrum of activities from the basic maintenance of either the body. This fact can be well attested to by the man or woman who has received many more years of useful life because of the help of a pros- thetic device. There is one obvious common denominator: Preface to the First Edition As the world's population grows.
It is broad in its scope. This book has been written to help fill the gap. Unfortunately for those entering this new field. The body itself provides a source of. There is depth where needed. Medical terminology is introduced early. Training in the life sciences includes physiology and anatomy.
This book is primarily intended for the reader with a technical background in electronics or engineering. Variables that are meaningful in describing the body system are discussed.
It has grown out of notes prepared by the various authors as reference material for educational courses. All measurements depend essentially on the detection. These courses have been presented at many levels in both colleges and hospitals. The physiological material is presented in a language that should be readily understood by the technically trained person. There are ample illustrations and references to easily accessible literature where more specialization is required.
It should also be noted that although reference works on physiology are included for those needing further study. An overall view of the physiological systems of the body is presented and then is later reinforced by more detailed explanations in appropriate parts of the text. It also in- troduces the concept of the man-instrument system and the problems en- countered in attempting to obtain measurements from a living body.
The authors believe in a down-to-earth approach. The participants have included engineers. The introductory material is concerned with giving the reader a perspective of the field and a feeling for the subject matter. The presentation is such that persons in the life sciences with some knowledge of instrumentation should have little dif- ficulty using it.
For the engineer or electronics technician the reverse is true. With regard to the major physiological systems of the body. In many examples there are many manufacturers who pro- duce similar equipment. The whole field becomes of no avail unless this topic is understood. These physical variables. One chapter is — devoted to electrodes the transducers for the biopotential signals. Los Angeles. In later chapters the measure- ment of each of these forms of biopotentials is discussed. The fundamental principles and methods of measurement are discussed.
There are certain physical measurements that do not belong to any specific system but could relate to any or all of them.
The final chapter is one of the most important. Electrical safety in the hospital and clinic is of vital concern. It should also prove useful as a reference for medical and paramedical personnel with some knowledge of instruments who need to know more. The physiology of each system is first discussed in general.
Preface to the First Edition xM many types of signals. Such topics include the use of remote monitor- ing by radio techniques commonly known as biotelemetry.
The book has been prepared for a multiplicity of needs. The level is such that it could be used by those taking bioinstrumentation in a community college program. One of the novel ideas developed in this book is the fact that. The background material was developed by the authors in courses presented at California State University. In a work of this nature. For a quick reference. The latter chapters are devoted to special topics to give the reader a true overall view of the field.
This is done in turn for the cardiovascular. Some of these types— the bioelectric potentials responsible for the electrocardiogram.
Pfeiffer Leo B. All companies have been most cooperative. California Leslie Cromwell Fred J. Miss Penelope Linskey. The authors wish to thank Mrs.
Elissa J. Joseph A. Edward Francis. The authors wish to thank all the companies that were willing to supply illustrative material. Weibell Erich A.. Erna Wellenstein for their assistance in typing the manuscript. Irina Cromwell. All of these are acknowledged in the text at appropriate places.
When the authors and publishers decided that a second edition should be prepared much soul searching was necessary to decide on what changes should be made to improve the work. Also there were the constructive criticisms of our colleagues around the world to consider.
Preface to the Second Edition It is extremely gratifying to write a book in a relatively new field and achieve the wide acceptance enjoyed by the first edition of Biomedical In- strumentation and Measurements.
Obviously everything had to be updated. Whereas some changes. Over two thirds of the illustrative photographs are new to reflect the many changes in the field. The authors again wish to thank the many manufacturers for their help and photographs. Paren- theses have been used where two sets of units are mentioned. Taking all these facts together. Irina Cromwell for typing and assembling the manuscript and Mrs. New topics such as echocardiography and computerized axial tomography have been added.
Because intensive care equipment and computers have also changed. Leslie Cromwell Los A ngeles. Kilopascals is rarely used as a measurement for blood pressure. Veterans Administration for encouragement and use of facilities.
Chapters 7 and 15 were virtually re. This book now includes SI Systeme Internationale metric units. Chapter 9 was transformed into a new chapter on non-invasive techniques with the major emphasis on ultra- sonics. Car- diovascular techniques have progressed considerably as reflected in the changes in Chapter 6. Most of the material on physiology and basic principles has not been changed much. We are also indebted to California State University.
The authors also wish to thank Mrs. Erna Wellenstein for helping again in many ways in the preparation of this book. California Fred J Weibell.
The original Chapters 1 and 2 were combined into a new introductory chapter and a new Chapter 2 was written on basic transducers. Elissa Schrader and Mrs. These are individually acknowledged in the text. With respect to criticism. It is a long time since Archimedes and his Greek contemporaries started down the path of scientific discoveries.
Nuclear engineering and aerospace engineering are good examples. Introduction to Biomedical Instrumentation Science has progressed through many gradual states. Engineering has emerged out of the roots of science.
Each of these fields reached a peak of activity and then settled down to a routine. Since World War II there have been a number of overlapping technological ages. The age of computer engineering.
Yet these side ef- fects are minor compared to the benefits that mankind can derive from it. Their recommendation was that bioengineering be defined as ap- plication of the knowledge gained by a cross fertilization of engineering and the biological sciences so that both will be more fully utiHzed for the benefit of man. These categories usually indicate the use of that area of engineering applied to living rather than to physical com- ponents. Bioinstrumentation implies measurement of biological variables.
How- ever. There is one vital advantage that biomedical engineering has over many of the other fields that preceded it: Afew years ago an engineering committee was formed to define bio- engineering. The probability is great that the s will be known as the decade in which the most rapid progress was made in this highly important field.
Many purists have stated that technology is an evil. These problems include air and water pollution. The time for the age of biomedical engineering has now arrived.
One school of thought sub- divides bioengineering into different engineering areas — for example. The prefix bio-.
They must start have at least a B. The latter is usually used in an operative sense. A clinical engineer is a professional who brings to health care facilities a level of education. A biomedical equipment technician BMET is an individual who is knowledgeable about the theory of operation.
This person is not to be confused years of training at a with the medical technologist. The Age of Biomedical Engineering 3 More new applications have emerged. AAMI definition. The level of sophistication of the BMET is usually higher than that of the technologist in terms of equipment. His capabilities may include installation. In late Most go into the profession through the engineering clinical engineers degree route. In addition. In one hospital the title biophysicist is preferred for their biomedical engineers.
This association consists of both engineers and physicians. Improved communication among engineers. These definitions are all noteworthy. This appendix is in two parts: Appendix A. The result is that the engineer.. To help acquaint the reader with this special aspect of biomedical engineering. In addition to the language problem. In some cases.
Another major problem of biomedical engineering involves com- munication between the engineer and the medical profession. Although it is important for the physician to under- stand enough engineering terminology to allow him to discuss problems with the engineer. The language and jargon of the physician are quite different from those of the engineer. Since the physician is often self-employed. With this point in mind.
Many in- struments were developed as early as the nineteenth century— for example. Some of the concepts and features of patient-monitoring systems presently used in hospitals throughout the world evolved from the base of astronaut monitoring. The use of adjunct fields. This process occurred primarily during the s and the results were often disappointing. During the next decade many instrument manufacturers entered the field of medical instrumentation.
Progress was rather slow until after World War II. The Mercury. Many developments with excellent potential seemed to have become lost causes. Development of Biomedical Instrumentation 5 Since the development and use of biomedical instrumentation must be a joint effort of the engineer or technician and the physician or nurse. Although it is true that many of the same components were used. They also encountered a severe communication problem with the medical profession.
The aerospace medicine programs were ex- panded considerably. At that time many technicians and engineers. It was during this period that some pro- gressive companies decided that rather than modify existing hardware. A large measure of help was provided by the U. By being aware of their possible existence. The physiological measurements themselves are summarized in Appendix B. Since pressure can be translated into strain by various means. Another example is the strain gage. It operates on the principle that electrical resistance is changed by the stretching of a wire or a piece of semiconductor material.
In the design or specification of medical instrumentation systems. When suitably excited by a source of constant voltage. Biomedical instrumenta- tion provides the tools by which these measurements can be achieved. The Only the shape and size of principles are the same. Some forms of biomedical instrumentation are unique to the field of medicine but many are adaptations of widely used physical measure- ments. A thermistor.
When the transducer is connected into a typical circuit. For a thermistor. In later chapters each of the major forms of biomedical instrumenta- tion is covered in detail. In some instruments a certain form of nonlinearity is purposely introduced to create a desired effect.
Biometrics 7 1. A sensitivity of 0. The sensitivity directly determines the resolution of the device. Indications of sensitivity are frequently expressed in terms of scale length per quantity to be measured — for example. In a linear system the sensitivity would be the same for all absolute levels of input. Linearity should be obtained over the most important segments. Sensitivity The sensitivity of an instrument determines how small a variation of a variable or parameter can be reliably measured.
Hysteresis Hysteresis from the Greek. Too high a sen- sitivity often results in nonlinearities or instability. The objective should be 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.
Linearity The degree to which variations in the output of an instrument follow input variations is referred to as the linearity of the device. This factor differs from the instrument's range in that sensitivity is not concerned with the absolute levels of the parameter but rather with the minute changes that can be detected. In most measurements.
Mechanical errors in meter movements. Mechanical friction in a meter. Reading errors due to parallax. It is often achieved by balancing the Wheatstone bridge or a similar device. Signal-to-Noise Ratio It is important that the signal-to-noise ratio be as high as possible. In the hospital environment. Errors due to tolerances of electronic components. Errors due to poor frequency response.
An instrument system should be able to respond rapidly enough to reproduce frequency components of the waveform with equal sensitivity. This is especially true in measurements in living organisms and is further discussed later in this chapter. Errors can occur in a multitude of ways. Accuracy Accuracy is a measure of systemic error. Frequency Response The frequency response of an instrument is its variation in sensitivity over the frequency range of the measurement.
Another source of set error is the effect of the instrument on the parameter to be measured. It is important to display a waveshape that is a faithful reproduction of the original physiological signal. Component errors due to drift or temperature variation.
Although not always present simultaneously. It is very important that.
The first concerns correct instrument zeroing. In certain types of instruments. Two additional sources of error should not be overlooked. Isolation Often measurements must be made on patients or experimental animals in such a way that the instrument does not produce a direct electrical connec- tion between the subject and ground. It is also important to know and control the signal-to-noise ratio in the actual environment in which the measurements are to be made.
Electrical isolation can be achieved by using magnetic or optical coupling techniques. This point is discussed in later chapters. The overall system must be sufficiently stable over the useful range. Biometrics 9 tromagnetic. Each component of a measurement system is usually calibrated individually at the factory against a standard. Most instrumentation systems require calibration before they are actually used. Baseline stability is the maintenance of a constant baseline value without drift.
Poor grounding is often a cause of this kind of noise problem. Simplicity All systems and instruments should be as simple as possible to eliminate the chance of component or human error. This step can be done external to the living organism or in situ connected to or within the body.
Telemetry is also used where movement of the person or animal to be measured is essential. This requirement is often necessary for reasons of electrical safety see Chapter 16 or to avoid interference be- tween different instruments used simultaneously. This is a factor that varies with the amount of amplification. Stability In control engineering. Calibration should always. Although thermal noise is often the limiting factor in the detection of signals in other fields of electronics.
When a medical system is assembled. The end product of such an exercise is usually a set of input-output equa- tions intended to define the internal functions of the box. This unknown system. That is. It also contains a powerful computer. These functions may be relatively simple or extremely complex.
Within this box can be found electrical. In fact. To further complicate the situation. The result is that some key relationships cannot be determined or that less accurate substitute measures must be used. MQ introduction to Biomedical Instrumentation be done by using error-free devices of the simplest kind for references. Many of the im- portant variables to be measured are not readily accessible to measuring devices.
The living black box presents other problems. One of the most complex black boxes conceivable is a living organism. The situation is made even worse by the application of the measuring device itself. An example would be that of a complicated. The object is to learn the nature and characteristics of the system. Additional factors that add to the difficulty of obtaining valid measurements are 1 safety considerations.
As indicated earher. The basic objectives of any instrumentation system generally fall into one of the following major categories: Still other problems are associated with such measurements: The function of medical instrumentation is to aid the medical chni- cian and researcher in devising ways of obtaining reliable and meaningful measurements from a living human being.
Because special problems are encountered in obtaining data from liv- ing organisms. Information gathering: In an information-gathering system. This means that many of the measurement techniques normally employed in the instrumentation of nonliving systems cannot be applied in the instru- mentation of humans. There may also be some mechanism for automatic control of certain pro- cesses within the system.
In other words. Introduction to the Man. An instrumentation system is defined as the set of instruments and equipment utilized in the measurement of one or more characteristics or phenomena. Instrument System 11 engineers. Emphasis is placed on ob- taining a limited set of reliable measurements from a large group of patients and on providing the physician with enough information to permit him to make On the other hand.
Clinical instru- ments are used by the physician or nurse. Measurements are made to help in the detection and. In- strumentation for biomedical research can generally be viewed as information- gathering instrumentation. Instrumentation to aid the physician in the diagnosis of disease and other disorders also has widespread use. Measurements are used to determine the ability of a system to meet its functional requirements. Similar instrumen- tation is used in evaluation of the physical condition of patients in routine physical examinations.
In this setting. The general field of biomedical instrumentation involves. The concept of the man-instrument system applies to both clinical and research instrumentation. Instrumentation is used to monitor some process or operation in order to obtain continuous or periodic information about the state of the system being measured. Instrumentation sometimes used to automatically con- is trol the operation of a system based on changes in one or more of the internal parameters or in the output of the system.
Although some in- struments can be used in both areas. Clinical instrumentation is basically devoted to the diagnosis. In some applications. Biomedical instrumentation can generally be classified into two major types: The only real difference having a living is in human being as the subject.
The Subject The subject is the human being on whom the measurements are made. An example would be a device inserted into the bloodstream to measure the pH of the blood directly. The instrumentation used to generateand present this stimulus to the subject is a vital part of the man-instrument system whenever responses are measured..
Components of the Man-Instrument System 13 Measurements which biomedical instrumentation is employed can in also be divided into two categories: The Transducer In general.. An in vivo measurement is one that is made on or within the living organism itself.
The basic components of this system are essentially the same as in any in- strumentation system. In the man-instrument system. The stimulus may be visual e. An example of an in vitro measurement would be the measurement of the pH of a sam- ple of blood that has been drawn from a patient.
Since it is the subject who makes this system different from other in- strumentation systems. Although the man-instrument system described here applies mainly to in vivo measurements. An in vitro measurement is one performed outside the body. The system components are given below. Its output is some form of visual. As indicated in Figure 1. In essence.
Signal-condi- tioning equipment is also used to combine or relate the outputs of two or more transducers. Components of the Man-Instrument System 15 transducer is used to produce an electric signal that is an analog of the phenomenon being measured. The input to the display device is the modified electric signal from the signal-conditioning equipment. Display Equipment To be meaningful.
The transducer may measure temperature. Signal-Conditioning Equipment The part of the instrumentation system that amphfies. Equip- ment for these functions is often a vital part of the man-instrument system. It should be noted that the term recorder is used in two different contexts in biomedical instrumentation. In the man-instrumenta- tion system.
Measurements can be made at various levels of man's hierarchy of organization. This system usually consists of a feedback loop in is which part of the output from the signal-conditioning or display equipment is used to control the operation of the system in some way.
For example. By means of a multilevel control system and communications network. Through the integrated operation of all these systems. Control Devices Where necessary or desirable to have automatic control of the stimulus. Just as the whole person communicates with his environment. These methods of communicating could be regarded as the inputs and outputs of the black box and are illustrated in Figure 1. Each major system is discussed later in this chapter.
Most are readily accessible for measurement. Within the human body can be found electrical. Next to the whole being in the hierarchy of organization are the major functional systems of the body. The major goal of biomedical instrumentation is to make possible the measurement of information communicated by these various elements.
The problem is. Although each of the systems is treated in much more detail in later chapters.
These functional systems can be broken down into subsystems and organs. Communication of man with his environment. The interrelationships among elements are sometimes so complex and involve so many systems that the "laws" and relationships thus far derived are inadequate to define them completely.
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