BIOMEDICAL

ENGINEERING

Electrical ativity of excitable cells

Excitable cells are those that can be stimulated to create a tiny electric current.
Muscle cells and
Nerve cells (neurons) are excitable.
The color photo (courtesy of Julie H. Sandell and Richard H. Masland) is of a single
interneuron in the retina of a rabbit. The cell has been injected with a fluorescent dye
to reveal all its branches. Each of the small knobs at the tips of the branches makes a
synapse with another cell in the retina.
The electric current
in neurons is used to rapidly transmit signals through the animal.
in muscles is used to initiate contraction.

The Resting Potential

All cells (not just excitable cells) have a resting potential: an electrical charge
across the plasma membrane, with the interior of the cell negative with respect to
the exterior. The size of the resting potential varies, but in excitable cells runs
about 70 millivolts (mv).
The resting potential arises from two activities:
The sodium/potassium ATPase. This pump pushes only two potassium ions
(K+) into the cell for every three sodium ions (Na+) it pumps out of the cell
so its activity results in a net loss of positive charges within the cell.
2. Some potassium channels in the plasma membrane are "leaky" allowing a slow
facilitated diffusion of K+ out of the cell (red arrow).

Ionic Relations in the Cell

The sodium/potassium ATPase produces
A concentration of Na+ outside the cell that is some 10 times greater than that
inside the cell
A concentration of K+ inside the cell some 20 times greater than that outside
the cell.
The concentrations of chloride ions (Cl) and calcium ions (Ca2+) are also
maintained at greater levels outside the cell EXCEPT that some intracellular
membrane-bounded compartments may also have high concentrations of Ca2+
(green oval) .

Depolarization
Certain external stimuli reduce the charge across the plasma membrane.
Mechanical stimuli (e.g., stretching, sound waves) activate mechanically-gated
sodium channels
Certain neurotransmitters (e.g., acetylcholine) open ligand-gated sodium
channels.

In each case, the facilitated diffusion of sodium into the cell reduces the resting
potential at that spot on the cell creating an excitatory postsynaptic potential
orEPSP.
If the potential is reduced to the threshold voltage (about 50 mv in mammalian
neurons), an action potential is generated in the cell.

Action Potentials
If depolarization at a spot on the cell reaches the threshold voltage, the reduced
voltage now opens up hundreds of voltage-gated sodium channels in that portion of
the plasma membrane. During the millisecond that the channels remain open, some
7000 Na+ rush into the cell. The sudden complete depolarization of the membrane
opens up more of the voltage-gated sodium channels in adjacent portions of the
membrane. In this way, a wave of depolarization sweeps along the cell. This is the
action potential (In neurons, the action potential is also called the nerve impulse.)

The refractory period

A second stimulus applied to a neuron (or muscle fiber) less than 0.001 second after
the first will not trigger another impulse. The membrane is depolarized (position B
above), and the neuron is in its refractory period. Not until the 70 mv polarity is
reestablished (position C above) will the neuron be ready to fire again.
Repolarization is first established by the facilitated diffusion of potassium ions out of
the cell. Only when the neuron is finally rested are the sodium ions that came in at
each impulse actively transported back out of the cell.

In some human neurons, the refractory period lasts only 0.0010.002 seconds.
This means that the neuron can transmit 5001000 impulses per second.

The action potential is all-or-none

The strength of the action potential is an intrinsic property of the cell. So long as
they can reach the threshold of the cell, strong stimuli produce no stronger action
potentials than weak ones. However, the strength of the stimulus is encoded in the
frequency of the action potentials that it generates.

SD curve (strength-duration curve)

The ability to capture the myocardium can be defined by a strengthduration curve .This is a plot of the pulse amplitude verses pulse duration
at threshold .As the pulse duration is prograssively decreased,the pulse
amplitude increases in order to maintain capture. At extremely narrow

pulse durations, stimulus will be ineffective no matter how high the pulse
amplitude. The pulse amplitude required to effectively stimulate the heart
decreases as the pulse duration increases .At pulse width above 1.5 to 2.0
ms, however further increase in pulse duration usually will not result in a
concomitant decreases in pulse amplitude. The voltage level at which a
further increase in pulse duration does not result in a continued fall in
pulse amplitude is termed the RHEOBASE .The pulse duration
threshold at twice the rheobase is termed as CHRONAXIE POINT.

Stimulation threshold
Pulse amplitude
(volts)

Chronaxie point

Rheobase

Pulse duration
(ms)

A schematic strength-duration curve is shown below. A pacemaker pulse which

falls to the left of the curve will be ineffective while one in which a portion of the
pulse falls to the right to the curve will be effective.

Functional organization of the peripheral nervous

system
The reflex arc
The spinal nervous system is functionally organized on the basis of what is
commonly called the reflex arc . The components of this arc are as follows:
1. A sense organ,

consisting of many individual sense receptors that respond preferentially to an

environmental stimulus of a particular kind, such as pressure, temperature
touch, or pain.
2. A sensory nerve,
containing many individual nerve fibers that perform the task of transmitting
information (encoded in the form of action potential frequency) from a
peripheral sense receptor to other cells lying within the central system (brain and
spinal cord)
3. The CNS,
which in this case serves as a central integrating station. Here information is
evaluated, and, if warranted, a "motor" decision is implemented.
ie, action potentials are initiated in motor-nerve fibers associated with the
motor-nerve trunk.
4. A motor nerve,
sewing as a communication link between the CNS and peripheral muscle.
5. The effector organ,
which consists, in this case, of skeletal muscle fibers that contract (shorten) in
response to the driving stimuli (action potentials) conducted by motor-nerve
fibers.

The simplest example of the behavior of the reflex arc is the knee-jerk reflex,
in which the patellar tendon below the knee is given a slight tap that stretches
specialized length receptors, called muscle spindles, within the muscle and
subsequently excites them. This excitation results in action potentials that
propagate along the sensory nerve that enters the spinal cord and communicates
with CNS cells, specifically motor neurons. The resultant motor activity reflexly
brings about contraction of the muscle that was initially stimulated, and the

shortening muscle jerks the limb, producing the well-known knee-jerk response.
Note that the initial stimulus to the muscle was a stretch, whereas the response was
a contraction of the muscle. This simple reflex arc has many of the features of a
negative-feedback loop, in which the control variable is muscle length . The CNS
acts as the controller, the muscle spindle as a feedback length sensor, and the
muscle-limb system as the process to be controlled.

Junctional Transmission
Within the reflex arc there are intercommunicating links between neurons(neuroneuro junctions) called synapse., as well as communicating links between neurons
and muscle fibers called neuromuscular junctions. These occur at small,specialized
regions of the muscle fiber referred to as an end-plate regions. The junctional
transmission process in each of these cases is electrochemical in nature. There is a
prejunctional fiber involved in the neuromuscular junction that, when depolarized,
releases a neurotransmitter substance acetylcholine (ACh). Which diffuses across a
very small fluid-filled gap region approximately 20 nm in thickness. The fluid
filling the gap is assumed to be ordinary interstitial body fluid. Once ACh reaches
the postjunctional membrane, it combines with a membrane receptor complex that
activates an ion channel, which leads to a relatively brief transient depolarization
of the postjunctional membrane and subsequently to the initiation of an action
potential that propagates away from the junctional region. The electrochemical
transmission process at the junction involves a time delay on the order of 0.5 to
1.0ms. More detailed descriptions of interneuronal and neuromuscular transmission
are available in general physiology texts (e.g.,Levitan and Kaczmarek. 2002).Another
time delay associated with the neuromuscular system is the delay between electrical
activation of the musculature and the onset of mechanical contraction. This delay,
which is referred to as excitation-contraction time.is a property of the muscle itself.
when the muscle is repeatedly stimulated, the mechanical response summates. At
high stimulation rates, the mechanical responses fuse into one continuous contraction
called a tetanus (or tetanic contraction).

Electrocardiogram
The heart
Distribution of specialized conductive tissues in the atria and ventricles, showing the
impulse-forming and conduction system of the heart. The rhythmic cardiac impulse
originates in pacemaking cells in the sinoatrial (SA) node, located at the junction of
the superior vena cava and the right atrium. Note the three specialized pathways
(anterior, middle, and posterior intermodal tracts) between the SA and atrioventricular
(AV) nodes. Bachmann's bundle (interatrial tract) comes off the anterior internodal
tract leading to the left atrium. The impulse passes from the SA node in an organized

manner through specialized conducting tracts in the atria to activate first the right
and then the left atrium. Passage of the impulse is delayed at the AV node before it
continues into the bundle of His, the right bundle branch, the common left bundle
branch, the anterior and posterior divisions of the left bundle branch, and the
Purkinje network.

ECG requirement
The ECG machine must deals with extremely weak electric signals, and the noise
from everywhere will intensively affect the acquisition of ECG signal, there are some
particular requirements for ECG instrumentation. The Committee on
Electrocardiography of the American Heart Association and lots of other organization
have made recommendations for the standardization of the ECG requirement. Some of
these recommendations for the ECG instrument design used in this thesis are as
follows.
1.
2.

The instrument should have capability to sense low amplitude signals should
be in the range of 0.05 10mV, as the normal ECG amplitude is 2 mV.
The input impedance between an electrode terminal and ground should not
less than 5 M at 10 Hz, as the ECG signal has high source impedance.

3.
4.
5.
6.

The instruments frequency response should has a band width from 0.1Hz to
150Hz.
The instrument should not allow currents (leakage currents) greater than 10
A to flow through the patient.
The isolation methods should be used to keep the patient from being part of
the AC circuit in the case of a patient-to-power-line fault.
The instrument is recommended to have a high common-mode rejection
ratio (CMRR) on the preamplifier stage.

Block diagram of ECG

CRO

Electro
de

Instrument
ation
amplifier

Low
pass
filter

Ampr

Micro
controll
er
LCD
Display

A. Electrode:
It converts physical signals into electrical voltage. The voltage is in the range of 1 mV
~ 5 mV. The sensor pair is stuck on the right arm (RA), left arm (LA) and right leg (RL)
of the subject
Wilson Electrode System: This system uses the right leg of the patient as driven right
leg lead. This involves a summing network to obtain the sum of the voltages from all
other electrodes and driving amplifier, the output of which is connected to the right leg
of the patient. This arrangement is known as Wilson electrode system. The effect of this
arrangement is to force the reference connection at the right leg of the patient to assume
a voltage level equal to the sum of the voltages at the other leads. This arrangement
increases the common mode rejection ratio of the overall system and reduces noise
interference. It also has the effect of reducing the current flow in to the right leg
electrode
B. Instrumentation Amplifier:
Many industrial and medical applications use instrumentation amplifiers (INAs) to
condition small signals in the presence of large common-mode voltages and DC
potentials so we choose Analog instrumentation amplifier to amplify the ECG voltage

from electrodes, which is in the range of 1mV to 5mV.we have designed the
instrumentation amplifier using op-amp 741, with a gain of 1000 and power supply is
+12V to -12V.
C. Low pass filter:
This block is used to remove the unwanted signals like noise, the frequency range of
ECG is 0.04HZ to 150 Hz, and so the low pass filter is designed with the cut off
frequency of 150HZ.
D. Amplifier:
It consists of a simple non inverting amplifier which is designed to saturate the
ECG signals, and the output of amplifier is fed to the microcontroller to count the
heart rate.
E. Microcontroller:
Microcontroller for counting of the pulses. It takes the conditioned square pulses from
hardware system as an input and counts it for one minute, which is the required heart
rate count.
F. LCD:
It is used to displaying the result on a text based LCD (Normal, Low, High).

Driven-Right-Leg Circuit
In many modern electrocardiographic systems, people are using a driven-right-leg
system. The patient is not grounded at all. Instead, the right leg electrode is
connected (as show in Figure ) to the output of an auxiliary op amp. The commonmode voltage on the body is sensed by the two averaging resistors Ra, inverted,
amplified and fed back to the right leg. Such a negative feed back drives the
common-mode voltage to a low level. It can also provide some electric safety,
because the auxiliary op amp will saturate when an abnormally high voltage
appears between the patient and ground.

Fig . Driven-right-leg circuit for minimizing common-mode interference

Note
This negative feedback drives the common mode voltage to a low level.
The body's displacement current flows not to ground but rather to the op-amp
output circuit. This reduces the pickup as far as the ECG amplifier is concerned
and effectively grounds the patient.
This circuit can also provide some electrical safety.
If abnormal high voltage should appear between the patient and ground due to
electrical leakage or other means, the auxiliary op-amp saturates (figure 2-11).
This effectively ungrounds the patient because amplifier can no longer drive the
right leg. Now the parallel resistances Rf and Ro are between the patient and
ground. They can be in several mega ohms in value---large enough to limit the
current.
These resistances do not protect the patient, however, because 120v on the patient
would break down the op-amp transistors of the ECG amplifier, and large currents
would flow to ground.

Lead system
The standard 12 lead electrocardiogram is a representation of the hearts electrical
activity recorded from electrodes on body surface.
Bipolar limb leads ,, (frontal plane)

Augmented unipolar limb leads aVR,aVL,aVF (frontal plane)

Addition to the three bipolar limb leads described above , there are three
augmented unipolar limb leads, these are termed as unipolar because there is a
single positive electrodes that is refrenced against the combination of other limb
electrodes. The positive electrodes for these augmented leads are located on the left
arm (aVL) t5he right arm(aVR) and the left leg (aVF). In practice ,these are the
same electrodes used for leads 1,2,3 (the ECG machine does the actual switching
and rearranging of the electrode designation) .
The three augmented unipolar leads ,coupled with the three bipolar
leads,constitute the six limb leads of the ECG these leads record electrical activity
along single plane ,termed the frontal plane relative to the heart.Using axial
refrence system and these six leads,it is simple to define the direction of an
electrical vector at any given in time

Unipolar chest lead V1,V2,V3,V4,V5,V6 (horizontal plane)

In addition to three standard limb leads and the three augmented limb
leads that view the electrical activity of heart from the frontal plane,there
are six precordial,unipolar chest lead.this configuration places six positive
electrodes on the surface of the chest over different regions of the heart in

order to record electrical activity in a plane perpendicular to the frontal

plane. These six leads are named V1 to V6.
The ECG signal

P wave:

Electroencephalogram (EEG)
The EEG is a recording of the brains electrical activity, in most cases made from
electrodes over the surface of the scalp. It may also be made from electrodes placed
directly over the surface of the brain or from needle electrodes inserted into the brain.The
recordings are the summation of volume conductor fields produced by millions of
interconnecting neurones. The neurone components producing the currents are the
dendrites, axons and cell bodies. The architecture of the brain is not uniform but varies
with different locations. Thus the EEG can vary depending on the location of
the recording electrodes. Sensory information is transmitted to the brain by frequency
modulated trains of action potentials which cause neurone activity in particular regions of
the brain depending on the type of sensory information and the site of stimulus in the
body. Similarly the decision to initiate a movement, in response to sensory information,
arises in various parts of the brain, depending on the type of movement and its location in
the body, and gives rise to electrical activity at the corresponding sites.
When analysing the EEG it is convenient to think of the brain as three sections.
cerebrum, cerebellum and brain stem. The brain stem is the oldest part in evolutionary
terms, and its structure, size and function have changed little in the evolution of the
vertebrates. It is an extension of the spinal chord and has three main functions.
1. Connecting link between the cerebral cortex, cerebellum and spinal chord,
2. Control centre for basic body functions such as respiration, heart and blood
flow regulation,
3. Integration centre for complex reflexes, such as maintenance of body
position and posture.
The cerebellum coordinates voluntary muscle movements and maintains balance.
Thecerebrum is the dominant part of the central nervous system and has centres for
conscious appreciation of sensation, initiation of movement, complex analysis and

expressions of emotions and behaviour .