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EC2021-Medical Electronics Notes For All Five Units
EC2021-Medical Electronics Notes For All Five Units
UNIT I
ELECTRO-PHYSIOLOGY AND BIO-POTENTIAL RECORDING
UNIT I PART A
1.1)Define
a) Resting Potential
b) Action Potential
May/June 2009, Nov/Dec 2008
1.2)Define Conduction Velocity Apr/May 2008, Nov/Dec 2008, May/June 2007
1.3)State all or none law in respect of cell bio potential.
Apr/May 2008
1.4)Name the electrodes used for recording EMG and ECG. Nov/Dec 2012
1.5)List the lead systems used in ECG recording.
Apr/May 2010
1.6)What is PCG?
May/June- 2012, Nov/Dec 2012
1.7)Compare the signal characteristics of ECG and PCG. Nov/Dec 2011
1.8)What is EOG?
Nov/Dec 2011
1.9)Draw typical ECG waveform. Nov/Dec 2009, May/June 2007
1.10What are the peak amplitude and frequency response for ECG, EEG and EMG.
1.11) Write down the Nernst equation ? (Nov/Dec 07 )
1.12) What is Phonocardiogram ? (Nov/Dec 07 )
UNIT I-PART B
1.1) Discuss in detail the origin of bioelectric potentials with necessary diagrams. (Nov/Dec 07 )
amplitudes and
1.3)With neat diagrams explain the 12 lead system in ECG measurement (Nov/Dec 07 )
1.4). Draw the waveform of the ACTION POTENTIAL and explain :
(i) Depolarization
(ii) Repolarization
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1.5) Draw the waveform of the ACTION POTENTIAL and describe Resting Potential ,
Depolarization, Repolarization, action potential, Absolute Refractory period and Relative
Refractory Period (APR/MAY 2005)
1.6)Write down Goldman Equation and write the constants indicate. (APR/MAY 2005)
1.7)Draw a typical single channel ECG machine and give justification for the inclusion of each circuit
block of the machine. ( Nov.Dec.2003)
1.8)Write about standard lead system for ECG recording. Also draw a typical ECG waveform and mark
the various complexes of ECG and give their durations. ( April /May 2004)
1.9)Write briefly about the recording devices for EMG.
1.10) Draw the equivalent circuit of a pair of electrodes in electrolytic contact with a human being to
measure bio-potential. Name the components.
(4)
1.11).Draw a typical 8 channel EEG machine and discuss about its function. (12)
Resting potential is defined as the electrical potential of an excitable cell relative to its
surroundings when not stimulated or involved in passage of an impulse. It ranges from -60mV to
-100mV
Action potential is defined as the change in electrical potential associated with the passage of an
impulse along the membrane of a cell.
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Conduction velocity is defined as the rate at which an action potential moves down a fiber or is
propagated from cell to cell. It is also called as Nerve conduction rate.
3. Write down the Nernst equation of action potential.
An equation relating the potential across the membrane and the two concentrations of the ion is
called Nernst equation.
RT
C1 f1
ln
E
Where,
nF
C 2 f2
R
gas constant(8.315 x 107 ergs/mole/degree Kelvin)
T
absolute Temperature, degrees Kelvin
n
valence of the ion (the number of electrons added or removed to ionize the atom)
F
Faraday constant (96,500 coulombs)
C1, C2 two concentrations of the ion on the two sides of the membrane
f1, f2 respective activity coefficients of the ion on the two sides of the membrane
4. What is meant by sodium pump?
Sodium pump is an active process in which sodium ions are quickly transported to the outside of
the cell and the cell again becomes polarized and assumes its resting potential.
Apr/May 2008
Regardless of the method by which a cell is excited or the intensity of the stimulus, the action
potential is always the same for any given cell.
6. List the types of bioelectric potentials.
Bio electric potential related to
Heart
ElectroCardioGram (ECG)
Brain
ElectroEncephaloGram (EEG)
Muscle
ElectroMyoGram (EMG)
Eye (Retina)
ElectroRetinoGram (ERG)
Eye (Cornea - Retina)
ElectroOculoGram (EOG)
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Nov/Dec-2012
BIOLOGICAL AMPLIFIERS
Apr/May 2010
Bio signals such as ECG, EMG, EEG, EOG have low amplitude and low frequency. So,
amplifier is used to boost the amplitude level of bio signals.
12. What are the requirements for bio-amplifiers?
Bio amplifiers must have
a) High input impedance
b) Isolation and protection circuit
c) High voltage gain
d) Constant gain throughout required bandwidth
e) Low output impedance
f) High CMRR
ECG, EEG, EMG, PCG, EOG LEAD SYSTEMS AND RECORDING METHODS, TYPICAL
WAVEFORMS AND SIGNAL CHARACTERISTICS.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
Page 4
Apr/May 2010
Page 5
Nov/Dec 2008
Latency is defined as the elapsed time between the stimulating impulse and the muscle action
potential. In other words it is the time delay between stimulus and response
Wave
P
R
T
QRS Complex
Amplitude (mV)
0.25
1.06
0.1 0.5
-
Duration (sec)
0.12 0.22 (P R interval)
0.07 0.1
0.05 0.15 (S T segment)
0.09
22. What are the important bands of frequencies in EEG and state their importance.
Nov/Dec 2004
Waves
Frequency (Hz)
Observation
Delta()
0.5 4
Theta()
48
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8 13
Beta( )
13- 22
23. What are the peak amplitude and frequency response for ECG, EEG and EMG.
Bioelectric potential
ElectroCardioGram
(ECG)
Function
Records
electrical
activity of heart
Peak
amplitude
0.1 to 4mV
ElectroEncephaloGram Records
(EEG)
electrical
activity of
brain
2 to 200V
ElectroMyoGram
(EMG)
50V to
1mV
Records
muscle
potential
Frequency
Observation
response
0.05 to
Used to measure
120 Hz
heart rate,
arrhythmia and
abnormalities
0.1 to 100 Used to analysis
Hz
evoked potential,
certain patterns,
frequency
response
5 to 2000
Used as indicator
Hz
of muscle action
for measuring
fatigue
UNIT II
2.1) What are the typical values of blood pressure and pulse rate of an adult? (Nov/Dec.2012)
2.2) What are systolic and diastolic pressures?
( Nov/Dec 2011)
2.3) What is the reason for decrease of cardiac output?
2.4) Define Cardiac Output.
2.5) State the principle behind the indicator dilution method.
2.6)What is residual volume?
( May /June 2007)
2.7) What is electrophoresis?
(April / May 2010)
2.8) What are the applications of flame photometer?
( Nov/Dec2009)
2.9) How is auto analyzer useful in medical field?
( April /May 2010)
2.10)What are korotkoff sounds?
( Nov/Dec 2008)
2.11) Name the four physical principles based on which blood flow meters are constructed?
(Nov/Dec 07 )
2.12) Define Mean Arterial Pressure ? (Nov/Dec 07)
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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2.11)Explain :
(i) ultrasonic Blood flow meter (Doppler type) (May/ June 2006)
(ii) Plethysmograph. (May/ June 2006)
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3.1) With respect to the Defibrillator draw the following waveform :(Nov/Dec 07 )
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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(Nov/Dec 07 )
3.3)What is Bio Telemetry ? Explain the working of single channel ECG telemetry system.
(Nov/Dec 07 )
3.4) W.r.t. DEFIBRILLATOR draw the following waveforms : (May/ June 2006)
(1) DC fibrillator discharge waveform
(2) Dual peak monophasic defibrillator discharge waveform
(3) Truncated defibrillator discharge waveform
(4) Write the technical properties of Electrodes used in Defibrillator.
3.5) (i) What are the basic requirements to be taken care for any implantable circuit ?
(ii) W.r.t Dialyser Perforamance what are CLEARANCE, PRIMING
VOLUME, RESIDUAL BLOOD VOLUME , ULTRAFILTRATION RATE ?.
(May/ June 2006)
3.6 i) Draw the basic circuit diagram of a capacitive discharge type of cardiac defibrillator and explain
the working principle. (APR/MAY 2005)
ii) List out the advantages of Rectangular Wave Defibrillators. (APR/MAY 2005)
3.7) Explain in detail about Pacing modes and pulse generators. (APR/MAY 2005)
3.8) What is Fibrillation ? With a neat diagram, discuss about the equipment used to correct this. What are
the precautions to be followed when such an equipment is used in the hospital? ( Nov.Dec.2003)
3.9) What is a Triggred type pacemaker ? Expalin .Also discuss about its merits and demerits compared to
other types of pacemakers. ( Nov.Dec.2003)
3.10). Write briefly about the power sources used for implantable tykpe of pacemaker . ( Nov.Dec.2003)
3.11).What is meant by Demand Pacemaker ? How is it different from other types of pacemakers ? State
the merits and demerits of this pacemaker.. ( April /May 2004)
3.12). How is atrial defibrillation arrested? Explain with neat diagrams of the setup used.
( April /May 2004)
3.13)What is meant by Demand Pacemaker ? How is it different from other types of pacemakers ? State
the merits and demerits of this pacemaker.. ( April /May 2004)
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Give two important factors that demand internal pace makers usage. [A/M2005]
The two important factors that demand internal pace makers usage are
(i). Type and nature of the electrode used
(ii). Nature of the cardiac problems.
(iii). Mode of operation of the pacemaker system.
Internal Pacemakers
External Pacemakers
It requires open chest minor surgery It does not require open chest surgery
to place the pacemaker
It is used
regularity
There is no safety for the pacemaker, There is 100% safety for circuit from
particularly in case of child carrying the external disturbances.
the pacemaker
for
temporary
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What are the three types of exchangers used in HEMODIALYSIS system? [M/J
2005]
The three types of exchangers used in HEMODIALYSIS systems are
i)Parallel Flow dialyzer,
(ii).Coil Hemodialyser,
(iii). Hollow Fiber Hemodialyser
Draw the defibrillator output waveform and indicate the output energy level. [M/J
2012]
FREQUENCY SELECTION AND BIO-TELEMETRY
10 What is the modulation techniques used for biotelemetry? Mention the reason for
adopting that modulation scheme.[N/D 2004]
The two different modulation techniques used for biotelemetry are
i)Double Modulation
ii)Pulse Width Modulation
The reason for adopting such a scheme
i)Double modulation gives
a) better
The purpose behind this double modulation, it gives better interference free
performance in transmission, and this enables the reception of low frequency biological
signals. The sub modulators can be a FM (frequency modulation) system, or a PWM
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Biological
signal(ECG,EEG)
Transducer
Amplifier &
Filter(Conditioner)
Transmisssion
channel
12 What are the advantages of biotelemetry system? [M/J 2007] [M/J 2009]
recorder
Output unit
The advantages of biotelemetry systems are (Video
Tape recorder,
(i). It is used to record the biosignals over long
periods and while the
C.R.O)
Patient is engaged in his normal activities.
(ii). The medical attendant or computer can easily diagonise the nature of
Disease by seeing the telemeter biosignals without attending patient
Room
(iii). Patient is not disturbed during recording.
(iv). For recording on animals, particularly for research, the biotelemetry is
greatly used.
13 Specify the frequencies used for biotelemetry.[N/D 2012]
Wireless telemetry system uses modulating systems for transmitting biomedical
signals. Two modulators are used here. A lower frequency sub-carrier is employed in
addition to very- high frequency (VHF). This transmits the signal from the transmitter.
RADIO-PILL AND TELE-STIMULATION
14 What is a radio-pill? [N/D 2009][A/M 2010][M/J 2012]
The radio pill is capable of measuring various parameters that are available in the
tract. With the help of radio pill type devices, it is possible for us to measure or sense
temperature, pH, enzyme activity, and oxygen tesion values. These measurements can be
made in associated with transducers. Pressure can be sensed by using variable inductance,
temperature can be measured by using temperature-sensitive transducer.
15 What is principle of telestimulation? [A/M 2008]
Telestimulation is the measurement of biological signals over long distance.
UNIT IV
RADIOLOGICAL EQUIPMENTS
UNIT IV- PART A
4.1)State different types of radiation generated from radio isotopes.
May/June 2012
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4.3)In what way X-ray equipments are useful for diagnostic purpose?
4.4)Distinguish between hard X-ray and soft X-ray.
4.5)What is angiography?
Apr/May 2010
Nov/Dec 2009
Nov/Dec 2008
4.6)State few radio isotopes used for diagnostic purpose. Apr/May 2010, May/June 2009, Nov/Dec 2011
4.7)Differentiate between radiography and fluoroscopy. May/June 2007, Nov/Dec 2008
4.8)List out safety precaution to be taken while handling radio isotopes.
Nov/Dec 2009, Apr/May 2008
4.9)Name two equipments used in radiation therapy.
4.10)What is radiation therapy?
May/June 2007
Apr/May 2008
4.18) What is the principle of Cryogenic technique? Give any two medical applications of the same.
( April /May 2004)
4.19)Mention the scheme of modulation techniques used for biotelemetry. Also mention the reason for
such scheme ( Nov.Dec.2003)
4.20)What is the frequency of operation of ultrasound diathermy ?What is the reason for this frequency
selection ? ( Nov.Dec.2003)
UNIT IV- PART B
4.1) Explain in detail an X-ray Image Intensifier with appropriate diagram (Nov/Dec 07 )
4.2)Discuss in detail the Scintillation detectors for gamma radiations with necessary diagrams
(Nov/Dec 07 )
4.3)With a neat block diagram explain the instrumentation system for radioisotope procedures.
(Nov/Dec 07 )
4.4)Write short notes on Fluroscopy. (Nov/Dec 07 )
4.5) Write down the salient features of Frequency Selection with respect to Biotelemetry.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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( Nov.Dec.2003)
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May/June 2007
UNIT V
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5.6) Explain the basic concepts (including the modulation types )of radio transmission used in
Bio-telemetry.
5.7)With reference to Electrical safety explain : (APR/MAY 2005)
i) Physiological effects of electricity.
ii) Ventricular fibrillation
iii) Isolated power systems
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Introduction
Introduction:
The human body is the most deeply studied and frequently portrayed object in the
history. Despite its familiarity, it is instinctively absorbing and eternally fascinating.
The number of humans in the world is racing towards seven billion. More than 5
babies are born every minute, while 150,000 people die daily. With the population increasing by
almost three humans per second. Each of these people lives, thinks, worries, and day dreams
with and within the most complex and marvelous of possessions- a human body. An enduring
feature of this body and its behavior is self-curiosity. We continually look inside ourselves in
enormous and ever-increasing detail in order to comprehend the action within.
Levels of organization:
The body is viewed to be a series of integrated systems. Each system carries out one
major role or task. In the cardiovascular system, for example the heart pumps blood through
vessels, to supply every body part with essential oxygen and nutrients. The systems are in turn
composed of main parts known as organs. The stomach, intestines and liver are the organs of
digestive system. Moving through further levels in the hierarchy the organs consist of tissues and
tissues made up of cells.
Cells are often called the microscopic building blocks of the body. However they are
active and dynamic, they continually grow and specialize function die and replenish themselves
by the millions every second. The whole body contains 200 different kinds. Science in
increasingly able to deliver deeper than cells to the organelles within them and onwards and
inwards to the ultimate components of ordinary matter molecules and atoms.
Anatomy:
The study of the bodys structure and how it cells, tissues and organs are assembled is
known as human anatomy. In reality, the inside of the body is a crowded place. Tissues and
organs push and press against one another. There is no free space, and no stillness either. Body
parts shift continually in relation to each other. We move about, breathe, pump blood shift
digestive matter and eat. For example, swallowed food does not simply fall down inside the
gullet {oesophagus}. The gullet is normally pressed flat by internal chest pressure so that food
must be forced down into the stomach by waves of muscular contraction.
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Body Cell:
Everyone is made up of Billions of cells, which are the basic structural units of the body.
Bones, muscles, nerves, skin, blood and all other tissues are formed from different types of cells.
Each cell has a specific function but works with other types of cells. Each cell has a specific
function but works with other types of cells to perform the enormous number of tasks needed to
sustain life. Most body cells have a similar basic structure. Each cell has an outer layer (called
cell membrane) and contains a fluid material (cytoplasm). Within the cytoplasm are many
specialized structures(organelles). The most important organelle is the nucleus which contains
vital generic material and acts as the cells control centre.
The structure of DNAs is like spiral ladder DNA contains all the vital generic
information and instruction codes necessary for the maintenance and continuation of life.
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Skeleton:
The skeleton is a mobile frame work made up of 201 bones, approximately half of which
are in the hands and feet. Although individual bones are rigid, the skeleton as a whole is
remarkably flexible and allows the human body a huge range of movement. The Skelton serves
as an anchorage for the skeletal muscles and as protective cage for the bodys internal organs.
Female bones are usually smaller and higher than male bones, and the female pelvis is shallower
and has wider cavity.
Head:
In a new born body, the head accounts for one quarter of total body length, by adulthood,
the proportion has reduced to one eighth contained in the head are the bodys main sense organs,
eyes, ears, olfactory nerves that defect smells, and the taste buds of the tongue. Signal from these
organs pass to the bodys great coordination centre. The brain housed in the protective bony
dome of the skull. Hair on the head insulates against heat loss, and adult males also grow thick
facial hair. The face has three important openings two nostrils through which air passes and the
mouth which takes in the nourishment and helps from speech. Although all heads are basically
similar, differences in the size, shape and color of features produce an infinite variety of
appearances.
Body organs:
All the body organs except for the brain are enclosed within the trunk or torso(the body
apart from the head and limbs). The trunk also contains two large cavities separated by a
muscular sheet called the diaphragm. The upper cavity contains the stomach, intestines, liver and
pancreas which all play a role in digesting the food. Also within the trunk are the kidneys and
bleeder, which are part of the urinary system, and the reproductive organism which hold the
seeds of new human life. Modern imaging techniques such as contrast X-rays and different types
of scans make it possible to see and study body organs without eh need to cut through their
protective covering of skin, fat, muscle and bone
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Muscles:
There are three main types of muscles skeletal muscle (also called voluntary muscle
because it can be consciously controlled); smooth muscle (also called involuntary muscle
because it is not under voluntary control) and specialized muscle tissue of the heart. Humans
have more than 600 skeletal muscles which differ in size and shape according to the jobs they do.
Skeletal muscles are attached directly or indirectly (via tendons) to bones and work in opposing
pairs (one muscle in the pair contracts while the other relaxes) to produce body movements as
diverse as making threading a needle and an array of facial expression. Smooth muscles occur in
the wall of internal body organs and perform actions such as forcing food through the intestines,
contracting the uterus (womb) In child birth and pumping blood through blood vessels some
other muscle in the body.
Iris:
The muscle fibers contract and dilate (expand) to alter pupil size.
Tongue:
Interacting layer of muscle allow great mobility
Ileum:
Opposing muscle layers transport semi-digested food.
Muscles 2:
Muscles of facial expression:
A single expression is the result of movement of many muscles.
Hands:
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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The human hand is an extremely versatile root, capable of delicate manipulation as well
as powerful gripping actions. The arrangement of its 27 small bones, moved by 37 skeletal
muscles that are connected to the bones by tendons, allows a wide range of movements. Out
ability to bring the tips of out thumbs and fingers together combined with the extra ordinary
sensitivity of our fingertips due to their rich supply of nerve endings, makes out hands uniquely
dextrous.
Feet:
The feet and toes are essential elements in body movement. They bear and propel the
weight of the body during walking and running and also help to maintain balance during changes
of body position. Each foot has 26 bones, more than 100 ligaments and 33 muscles some of
which are attached to the lower leg. The heel pad and the arch of the foot act as shock absorbers,
providing and cushion against the joints that occur with every step.
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Physiological system
2.1.Information Processing
The human body is alive with information. Being a complex, dynamic mechanism, its interacting
and interdependent parts require control and co-ordination. This is done by passing information
between them. Two body systems are responsible for command-control and data management
The nervous and the endocrine systems.
Information processing involves inputs evaluation and decision making followed by
outputs. The body has inputs from the various senses such as sight and hearing. Its brain is CPU
(Central Processing Unit) whose outputs control the physical action of muscles and chemical
responses of glands. Both nerves and hormones are involved in data management.
The language of the nervous system is tiny electrical impulses. They are small and fast each
just one-tenth of a volt in strength and lasting hardly one-thousandth of a second and numerous.
Every second millions pass through the networks of long pale, string like pathways called
nerves. Informations from the senses flow to the brain as electrical impulse. Here it is shifted,
analyzed and evaluated causing millions more signals to pass around and within the brain
between numerous, complex areas. Decisions are reached and command messages are produced
in the form of electrical impulses. The brains electrical output travels along motor nerves to the
muscles to stimulate and co-ordinate their contraction for movements. Different information
carriers-hormones-instruct the endocrine glands on the timing and quantity of secretion required
for the desired effect. More than 50 hormones circulate in the blood stream. The specific
molecular structure of each hormone stimulates only cells with suitable receptors on their
surface, instructing the cells to carry out certain procedures. In general nerves work fast within
fraction of a second. Most hormones function over longer times within minutes, days or even
months. Long-lasting effects as in growth of hormones are continuously secreted over many
years, as individual dose would last only few days.
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2.3.1.Types of Neurons
The shapes and sizes of the bodies of neuron cells vary greatly as do the type, number
and length of their projections. Neurons are classified according to the number of process that
extends from the cell body. Bipolar neurons are the original neuronal design in the embryo, but
adulthood, they are found in only a few locations, such as the eyes retina and the olfactory nerve
in the nose. Most neurons in the brain and spinal cord are multipolar, unipolar neurons are
present mainly in the sensory nerves of the peripheral nervous system.
Unipolar Neuron: - A single short process, an axon extends from the cell body and splits into
tow.
Bipolar Neuron: - The cell body is located between two processes-an axon and a dendrite.
Multipolar Neuron: -These have three or more processes several dendrites and one axon.
2.4.ORIGIN OF BIOPOTENTIALS:
Nerve cells or neurons are excitable. When stimulated, they undergo chemical changes
that produce tiny traveling waves of electricity.- nerve signals or impulses. These pass to other
neurons, eliciting similar response from them.
Throughout the nervous system, information is conveyed as tiny electrical signals called
nerve impulses or action potentials. These impulses are the same all over the body about 100
milli volts in strength and lasting just 1 millisecond. The information carried depends on their
position in the nervous system, and their frequency from one impulse every few seconds to
several hundreds per second. Typically when a neuron receives enough pulses from other
neurons it fires one of its own as wavelike movements of ions (electrically changed particles)
impulses jump from one neuron to another at junctions known as synapses.
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2.4.5.Repolarization
Positively charged potassium ions flow in the opposite direction, restoring the charge membrane
and the next and so on. The impulse moves along the membrane as a wave of depolarization and
repolarization.
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2.5.Respiratory system
Respiratory system a pneumatic systeman air pump (diaphragm ) alternately creates negative and positive pressures in a sealed
chamber (thoriac cavity) and causes air to be sucked into and forced out of a pair of
elastic bags (lungs).
The respiratory system supplies the oxygen needed by the body cells and carries off their
carbon dioxide waste.
Inhaled air passes via the trachea (windpipe) through two narrower tubes, the bronchi to
the lungs.
chambers called alveoli
Each lung comprises many fine, branching tubes called bronchioles that end in tiny
clustered
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Lungs -outside environment through a passage way comprising nasal cavities, pharynx,
larynx, trachea, bronchi, and bronchioles.
Oxygen is taken into the blood from the incoming air and carbon dioxide is transferred
from the blood to the air
Thus, the blood circulation forms link in the supply of oxygen to the tissues and in the
removal of gaseous waste products of metabolism.
Gases cross the thin alveolar walls to and from a network of tiny blood vessels.
Intrercostal (rib) muscles and the muscular diaphragm below the lungs operate the lungs
like bellows, drawing air in and forcing it out at regular intervals.
2.6.Urinary system
The urinary system filters waste products from the blood and removes them from the
body via a system of tubes.
Blood is filtered in the two kidneys which are fist-sized. Bean-shaped organs.
The renal arteries carry blood to the kidneys.
The renal veins remove blood after filtering
Each kidney contains about one million tiny units called nephrons.
Each nephron is made up of tubule and a filtering unit called glomerulus, which consists
of a collection of tiny blood vessels surrounded by the hollow Bowmans capsule.
The filtering process produces a watery fluid that leaves the kidney as urine.
The urine is carried via two tubes called ureters to the bladder where it is stored until its
release from the body through another tube called urethra.
2.7.Nervous system
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2.8.Endocrine system
The endocrine system works by using harmones which are carried through circulatory
system.
The harmones are generated in the endocrine glands.
The principal endocrine gland is PITUTIARY which governs several other endocrine
glands.
The pitutiary is controlled by hypothalamus.
The thyroid gland secretes thyroxin which increases the metabolism in the body.
The deficiency of thyroid gland secretes thyroxin which increases the metabolism of
the body.
The adrenal gland secretes corticoids and they regulates the metabolism of glucose.
A deficiency of insulin results in increase glucose in the blood which leads the
condition called diabetes.
2.9.Ear
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The inner ear consist of the spiral-shaped cochlea and also the semicircular canals and the
vestibule which are the organs of balance.
Sound waves entering the ear travel through the auditory canal to the tympanic
membrane (ear drum) where they are converted to vibrations that are transmitted via the
ossicles to the cochlea.
Here the vibrations are converted by millions of microscopic hairs into electrical nerve
signal to be interpreted by the brain.
2.10.Eye
2.11.Body cells
Every one is made up of billions of cellsWhich are the structural units of the body.bones,
muscles, nerves, skin blood, and all other body tissues are formed from different types of
cells.Each cell has an outer layer (cell membrane) and contains fluid
material(cytoplasm)Within the cytoplasm many specialized structures called
organelles.The most important is the nucleus which contains vital genetic material.The
structure of DNA is like a spiral ladder.DNA contains genetic information and instruction
codes necessary for maintenance and continuation of life.In DNA we have four basic
materials.
They are - adenine, guanine, thymine and cytocine.Nucleus is centrally located.It is
separated from surrounding fluids by cell membrane.Protoplasm is present in the
cell.This protoplasm is composed by water, electrolytes, protein, lipids and
carbohydrates.
The principal fluid medium of the cell is water.Its concentration is about 70-85
percent.Water serves as solvent for various chemicals to produce chemical reactions.The
inorganic chemicals for chemical reactions are provided by electrolytes.In the electrolytes
we have sodium ions, potassium ions, phosphate ions, sulphate ions, bicarbonate ions and
a small quantity of proteins.Proteins- structural proteins, globular proteins.Lipids are
composed of different types of phospho lipids and cholesterol.Carbohydrates play a
major role in the nutrition of the cell. They are stored in the cells in the form of glycogen
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which supplies energy needs for the cells. Ribosomes are also present in the
cystol.Lysosomes are vesicular organelles.
They provide an intracellular digestive system that allows the cell to digest and thereby
remove unwanted substances and damaged foreign structures such as bacteria. The
mitochondria organelles are called power house of the cell. The cell extract significant
amounts of energy from the nutrients and oxygen by means of mitochondria. Nucleolus is
present inside the nucleus. The size of the cell is in the range of 5-10 micrometer.
Fluid is present inside the cell and outside the cell. This fluid is called intracellular fluid
and extra cellular fluid respectively. The extra cellular fluids contain large amount of
sodium ions and small amount of potassium ions. But in the intra cellular fluid it is vice
versa.
The concentration of phosphates and proteins are more in intracellular fluid.
Concentration of chloride ions are more in extra cellular fluid. a lipid bilayer is present in
the cell membrane. This consists of large number of protein molecules are present in the
cell membrane.
The cell membrane constitutes a barrier for the movement of the water soluble substances
between the extra cellular and intracellular fluid organs. With the help of diffusion
process transport of substances take place. This type of transport is called passive
transport. Ions like sodium potassium, calcium, chloride and most amino acids are
actively transported through cell membrane..
The active transport can be subdivided into two types according to the source of energy used to
cause the transport. They are primary active transport and secondary active transport.
3.2.Fluid Compartments
The bodys different fluids can be grouped into physiological categories that are known
as compartments. There are two major fluid compartments intracellular and extra cellular.
Intracellular fluid (also known as cytoplasm) is found within the bodys cells. Extracellular fluid
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3.3.Function of fluids
Water is excellent solvent. Thousands of substances that are dissolved in it are used in the
bodys biochemical reactions. These reactions are the very basis of life. Water is also an
effective transport system. It moves around the body distributing nutrients and collecting and
delivering waste materials. Fluids spread heat from active parts of the body, such as exercising
muscles, to cooler areas and in doing so they aid I thermoregulation. The body uses fluid as
shock absorbers to cushion sensitive areas such as brains, the eyes and the spinal cord. Fluid also
works as lubricants within the body, so that tissues and organs slip past each other with minimal
friction. Small amount of specific fluids that specialize in this role include the pleural fluid
around the lungs, the pericardial fluid around the heart and the synovial fluids inside joints.
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Blood plasma
and lymph
cycle:Blood plasma
leaks out from
capillaries to
become
interstitial fluid.
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3.6.2.What is Blood?
Blood forms about 1/10th of the body weight of an adult amounting to 5 liters in volume.
Roughly 50-55% of blood plasma consists of the liquid-only portion in which cellular
components are distributed. Plasma is 90% water containing dissolved substances such as
glucose (blood sugar) hormones, enzymes and also waste products such as urea and lactic acid.
Plasma also contains proteins such as albumins, fibrinogens (important in blood clotting) and
globular proteins or globulins. Alpha and beta globulins help to transport lipids, which are fatty
substances such as cholesterol. Gamma globulins are mostly the disease fighting substances
known as antibodies. The remaining 45-50% of blood is made up of three types of specialized
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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3.6.3.Parts of Blood
Blood is made up of liquid portion (plasma) red blood cells, a small band of platelets and white
blood cells.
Red Blood Cell Structure:
A biconcave disc with no nucleus or discrete nibble inner structure, each red blood cell
contains 300 millions hemoglobin molecules.
Role of Hemoglobin:
Hemoglobin is composed of hem, an iron-rich pigment and globins, ribbon-like protein
chains. Oxygen in the lungs latches onto hem to make oxyhemoglobin. In this conjoined form,
oxygen travels through the blood stream to all parts of the body.
3.7.Blood Groups
Every individual belongs to one of four blood groups which are determined by markers or
red blood cells known as antigens (agglutinogens). The antigens may be either A, B, both (AB)
or neither (O) and blood groups are named correspondingly. Plasma contains different antibodies
(isohemoagglustinins). For example, a person with blood group A has plasma containing B
antibodies. If mixed with type B blood with A antibodies in its plasma) A antibodies clump
(agglutinate) with A antigens. This is the reason why blood types must be matched to transfuse
blood safely from donor to recipient.
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Blood Group A
A Antigen; B - Antibody
Blood Group B
A - Antibody; B - Antigen
Blood Group AB
A & B Antigen with neither
A or B in Plasma
Blood Group O
Lack of A & B antigen but plasma
contains both A & B antibodies.
3.7.1Arteries
Arteries carry blood away from the heart towards organs and tissues. Apart from the
pulmonary arteries, all arteries carry oxygenated blood. Their thick walls and muscular and
elastic layers can withstand the high pressure that occurs when the heart contracts. An artery
narrows when the heart relaxes, helping to push blood onwards. The largest artery is aorta.
3.7.2.Veins
A vein is more flexible than an artery and its walls are considerably thinner. The blood
inside a vein is under relatively low pressure and as a result, it flows slowly and smoothly. Many
larger veins particularly the long veins in the legs contain valves that are formed from pouch
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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3.7.4.Capillaries
The smallest and most numerous of the blood vessels capillaries convey blood between arteries
and veins. Many capillaries enter tissue to form a capillary bed, the area where oxygen and other
nutrients are released. Capillary bed connects small arteries (arterioles) to veins (venules).
3.8.Cellular Respiration
Glucose (blood sugar) is the bodys main energy source. Cellular respiration occurs in
every body cell when oxygen reacts with glucose to free its energy in chemical form. The end
products are carbon dioxide and water, which is known as metabolic water and amounts to about
300ml daily throughout the body. The whole process is called aerobic (oxygen requiring) cellular
or internal respiration.
3.8.Respiration Reaction
Cells take up oxygen to drive the key respiration reaction that release energy from glucose.
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Bright red, oxygenated blood leaves heart along the aorta (the bodys main artery) and
circulates through a network of arteries to the bodys tissues.
Step6:
Oxygenated blood is carried through the tissues in capillaries thinner than hair.
Step7:
Arriving red blood cells are rich in oxygen, which is bound to hemoglobin in the body of
each cell.
Step8:
Oxygen leaves the hemoglobin within the red blood cells, diffuses across the blood
capillary walls and into tissue cells.
Step9:
Carbon dioxide diffuses out of tissue cell, across wall of blood capillary and into blood
plasma.
3.9.Blood Pressure
The heart is a dynamic, untiring, precisely adjustable double-pump that forces blood around the
bodys immense network of blood vessels, perhaps more than three billion times during lifetime.
The hearts power comes from its two lower chambers (ventricles) which have thick muscular
walls. That contact to squeeze blood out into the arteries. The upper chamber (arterial) have
thinner walls and function partly as passive reservoirs for blood oozing in from the main veins.
Each heartbeat has two phases. In the first phase (diastole) the heart relaxes and refills with
blood; during the second stage (systole) it contracts, forcing the blood out. The whole cycle takes
on average less than second. During vigorous activity or stress, both beating rate and the volume
of blood pumped out of the heart increases greatly.
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Electrical Impulses
Electrical impulses spread over surface of both atria, stimulating them to contract.
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The red blood cells have a much higher electrical resistivity than the blood plasma in
which they are suspended and so the resistivity of the blood shows a high correlation with
the hematocrit.
Manual blood cell counts are performed by using microscope. For this, the blood is first
diluted 1 :100 or 1:200 for counting of red blood cells (RBC) and 1:10 or 1:20 for white
blood cell count (WBC). For counting WBC, a diluents is used that dissolves the RBCs,
whereas for counting RBCs, an isotonic diluent preserves these cells. The diluted blood is
then brought into a counting chamber of 0.1mm deep, which is divided by marking lines
into a number of squares, when magnified about 500 times, the cells in a certain number
of squares can be counted.
Today simple RBC and WBC counts are normally performed by automatic or
semiautomatic blood cell counters. The most commonly used devices of this kind are
based on the conductivity(coulter) method, which makes use of the fact that blood cells
have a much lower electrical conductivity than the solution in which they are suspended.
Such a counter contains a beaker with the diluted blood. A closed glass tube that contains
a very small orifice is placed inside the diluted blood. The conductance between the
solution in the glass tube and the solution in the beaker is measured with two electrodes.
The result is a pulse at the output of the conductance meter, the amplitude of which is
proportional to the volume of the cell.
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1. First Contact
2. Second Contact
3. Suction Pump
4. Electrodes
( Platinum)
4
Conductivity
meter
Threshold unit
2
1
Pulse gate
BLOCK gives
start stop signal to
counter
counter
A threshold circuit lets only those pulses pass that exceed a certain amplitude
gate. The first contact and closes when it reaches the second contact. Thus counting the
number of cells contained in a given volume, of the solution passing through the orifice.
A count is completed in less than 20 seconds. With counts of upto 100,000 the result is
statistically accurate. Care must be taken to keep the aperture from clogging. From these
measurements, the mean cell volume, the mean cell hematocrit and mean cell hematocrit
concentration are calculated and the corresponding results are taken out on a preprinted
report form.
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4.2.4.1.Gas Chromatograph:
The quantities of various gases in the expired air can also be determined by means of a
gas chromatograph, an instrument in which the gases are separated as the air passes through a
column containing various substances that interact with the gases. The reactions cause different
gases to pass through the column at different times. The quantity of each gas is measured as it
emerges. To identify the gases in the expired air other than oxygen nitrogen or CO 2, a mass
spectrometer is used in conjunction with the gas chromatograph. The mass spectrometer
identifies the ions according to their mass/charge ratio.
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With the help of this analyzer, it is possible to measure O 2,CO2,pH and bicarbonate in
arterial blood. If we try to measure the diffusion of oxygen from the aleovli, into the blood, it is
usually assumed that all alveoli have an equal concentration of oxygen. Actually this condition
does not exist because of the unequal distribution of ventilation in the lung, hence the terms
diffusing capacity or transfer factor (rather than diffusion) is used to describe the transfer of
oxygen from the alveoli into the pulmonary capillary blood.
Carbon mono oxide (CO) resembles oxygen in its solubility and molecular weight and
also combines with hemoglobin reversibly. Its affinity for hemoglobin is about 200 to 300 times
that of oxygen. Carbonmonooxide can thus be used as a tracer gas in measuring the diffusion
capacity of the lung. It passes from the alveolar gas into the alveolar walls, then into the plasma
from which it enters the red blood cells where it combines with hemoglobin
1 / TF = 1/ Dm + 1/Vc
Where TF = diffusing capacity for the lung for CO.
Dm = diffusing capacity for alveolar membrane
Vc = volume of blood in the capillaries.
= reaction rate of CO with oxyhemoglobin.
TF, the diffusing capacity for the whole lung in normal adults ranges from 20 to 38 ml/min/mm
HG during exercise, and decreases with anemia or low hemoglobin.
In the single-breath method, the last 75 to 100 ml of the expired air is collected so that
enough end-tidal air containing CO is available for the measurement. CO in the blood is
negligible, for it combines with the hemoglobin I the red blood cells and exerts no significant
back pressure. The commonly used carbon mono oxide analyzer utilizes an infrared energy
source, a beam chopper, sample and reference cells, plus a detector and amplifier. A milli
ammeter or a digital meter may be used for display. Two infrared beams are each measured by a
differential infrared detector. The output signal is proportional to the amount of monitored gas in
the sample cell. The signal is amplified and presented to the output display meter or to a
recorder.
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4.3.1.Parts of Lung :
Nasal cavity:
Main route for air to and from the lungs, lined with a sticky mucus covered membrane
that traps dust particles and germs; divided into two by central plate of cartilage (nasal septum)
fuzzy looking patches (olfactory epithelia)in roof of cavity are the sensory organs of smell.
Nose hairs:
Situated inside entrance of nostrils help in filter large particles of dust and debries.
Epiglotis:
Cartilage flap that tilts over entrance to larynx when swabling to prevent food and drink
and saliva entering trachea.
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Pleural membrane:
Sac composed of two thin membrane layer encloses each lung; fluid secreted by one of
the membranes allows them to slide smoothly over each other during breathing.
Diaphragm:
Dome-shaped muscle that divides chest and abdomen and together with inter costal
muscles from bodys main breathing muscle; during contraction it flattens and increases size of
chest cavity.
Nasopharynx:
Allows the passage of air only.
Oropharynx:
Permits passage of foods and fluids.
Pulmonary artery:
Thick-walled vessel that transports deoxygenated blood lungs from right side of heart.
Pulmonary vein:
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Primary bronchus:
One of the five branches of the primay bronchus each one supplies a defined segment of
the lung, bronchus further divides into air ways of diminishing diameter called tertiary bronchi.
Lobes of Left lung:
Has only two lobes, to make room for heart (right lung is tri-lobed)
Bronchioles:
Miniscule terminals of the bronchi; gas exchange occurs in tiny sacs (alveoli) at their
ends.
Heart :
Nested in the pericardial cavity.
Pericardial cavity:
Formed mainly by a scoop like shape in the left lung.
Alveoli:
The lungs microscopic air sacs, alveoli are elastic thin walled structures arranged in
clumps at the ends of respiratory bronchioles. They resemble bunches of grapes, although the
alveoli are partly merged with each other. White blood cells known as macrophages are always
present on their surfaces, where they in digest and destroy air borne irritants such as bacteria,
chemicals and dust.
Around the alveoli are networks of capillaries. Oxygen passes from the air in the alveoli
into the blood by diffusion through the alveolar and capillary walls. Carbon di oxide diffuses
from blood into the alveoli. There are more than 00 million alveoli in both lungs.
4.3.2.Breathing:
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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4.3.2.1.Diaphragm movement:
The abdominal contents are flattened by the diaphragm muscle during inhalation and then
rise up during exhalation.
4.3.2.2 Inhalation:
The chief muscles used in respiration at rest are the diaphragm at the base of the chest
and the external intercostal between the ribs. For forceful inhalation, additional muscles assist in
moving the ribs and sternum to expand the chest further and stretch the lungs even more.
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Positive pressure:
As lung volume diminishes, when exhaling, the air is compressed, raising its pressure
within the lungs. So the air is pushed back along the airways and out of the mouth.
Respiratory Reflexes:
The two important respiratory reflexes are coughing and sneezing. Both aim to blow
out excess mucus, dust irritants and obstructions- coughing from lower pharynx, larynx, trachea
and lung air ways and sneezing from nasal chambers and naso-pharynx. In both cases, a deep
inhalation is followed by sudden contraction of the muscles involved in forceful exhalation. For
a cough, the lower pharynx, epiglottis and larynx close so that air pressure builds up in the lungs
and is released explosively, rattling the vocal cords. In a sneeze, the tongue closes off the mouth
to force air up and out through the nose.
4.4.Spirometry:
Flow-Volume loop showing successful FVC maneuver. Positive Values represent
expiration, negative values represent inspiration. The trace moves clockwise for expiration
followed by inspiration. (Note the FEV1, FEV1/2 and FEV3 values are arbitrary in this graph
and just shown for illustrative purposes, they must be recorded as part of the experiment).
Spirometry (meaning the measuring of breath) is the most common of the Pulmonary
Function Tests (PFTs), measuring lung function, specifically the measurement of the amount
(volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is an important
tool used for generating pneumotachograph to assessing conditions such as asthma, pulmonary
fibrosis, and COPD.
4.4.1.Spirometry testing
The spirometry test is performed using a device called a spirometer, which comes in several
different varieties. Most spirometers display the following graphs:
a volume-time curve, showing volume (liters) along the Y-axis and time (seconds) along the Xaxis
a flow-volume loop, which graphically depicts the rate of airflow on the Y-axis and the total
volume inspired or expired on the X-axis
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Note that functional residual capacity (FRC) cannot be measured via spirometry, but it can be
measured with a plethysmograph.
Results are usually given in both raw data (liters, liters per second) and percent predicted - the
test result as a percent of the "predicted values" for the patients of similar characteristics (height,
age, sex, and sometimes race and weight). The interpretation of the results can vary depending
on the physician and the source of the predicted values. Generally speaking, results nearest to
100% predicted are the most normal, and results over 80% are often considered normal.
However, review by a doctor is necessary for accurate diagnosis of any individual situation.
4.5.Temperature Measurements:
Body temperature is one of the oldest known indicators of the general well being of a
person. Techniques and instruments for the measurement of temperature have been common
place in home. Two basic types of temperature measurements can be obtained from the human
body. Systematic and skin surface measurements. Both provides valuable diagnostic information
although the systematic temperature measurement is much more commonly used.
4.5.1.Temperature Regulation:
One of the skins functions is to contribute to thermo regulation maintenance of a
constant body temperature. It does this in three main ways: Widening and narrowing of blood
vessels, sweating and hair adjustments, if the body becomes hot, blood vessels in the dermis
widen (vasodilate) to allow extra blood flow so more warmth can be lost from the surface. The
skin may look flushed, and sweat oozes from sweat glands and evaporates , drawing away body
heat. If the body is cold, the peripheral blood vessels (vasoconstrict) to minimize heat loss and
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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4.6.Systematic Temperature:
It is the temperature of the internal regions of the body. This temperature is maintained through a
carefully controlled balace between the heat generated by the active tissues of the body mainly
the muscles and the liver and the heat lost by the body to the environment. Measurement of
systemic temperature is accomplished by temperature sensing devices placed in the mouth, under
the arm pits or in the rectum. The normal oral (mouth) temperature of a healthy person is about
31 C . The under arm temperature is about 1 degree lower, whereas the rectal temperature is
about 1 degree higher than the oral reading.
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4.7.Measurement of pulse:
When the heart muscles contracts, blood is ejected from the ventricles and a pulse of
pressured is transmitted through the circulatory system. A vessel-wall displacement is caused by
vessels when the pressure pulse is traveling. The pulse can be measured at various points of the
peripheral circulatory system. We can analyze the pulse rate if we keep the finger tip over the
radial artery in the wrist or some other location where an artery seems just below the skin. The
timing and wave shape of the pressure pulse are diagnostically important because they provide
correct information.
The pulse gives the measure of pulse wave velocity and can be reduced and compared
with the ECG signal. The pulse wave travels at 5 to 15 m/s depending on the size and rigidity of
the arterial walls, the larger and more rigid the artery walls, the greater the velocity. The velocity
is 10-15 times faster than blood flow and is relatively independent of it.
The methods used for the detection of volume(pulse) changes due to blood flow are:
(i)
optical changes (changes in density)
(ii)
Electrical impedence changes
(iii)
Strain gauge or microphone (mechanical)
The most common used method to measure plusatile blood volume changes is by the
photoelectric method . Two methods are common : Reflectance method and transmittance
method.
In the transmittance method, a light emitting diode (LED) and photoresistor are mounted
in an enclosure that fits over the tip of the patients finger. Light is transmitted through the finger
tips of the subjects finger and the resistance of the photoresistor is determined by the amount of
light reaching it. With each contraction of the heat, blood is forced to the extremities and the
amount of blood in the finger increases. This alters the optical density with the result that the
light transmissions through the finger reduce and the resistance of the photo resistor increases
accordingly. The photo resistor is connected as part of the voltage divider circuit and produces a
voltage that varies with the amount of blood in the finger. This voltage that closely follows the
pressure pulse and its waveshape can be displayed on an oscilloscope or recorded on a strip
chart.
An electric impedance method measures the impedance change between two electrodes
caused by the changes in blood volume between them. The change in impedance (0.1 ohm) may
be small as compared to the total impedance (several hundred ohms) . An alternating current is
applied between electrodes that are attached to the body. With this set the impedance can be
measured. An alternating signal (10- 100khz) is used (rather than dc) in order to polarization of
the electrodes.
The mechanical method involves the use of a strain gauge connected to a rubber-band
placed around a limb or finger. Expansion in the band due to change in blood volume causes a
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4.8.Cardiac output:
The blood flow at any point in the circulatory system is the volume of blood that passes
that point during a unit of time. It is normally measured in millimeters per minute or liters per
minute. Blood flow is highest in the pulmonary artery and the aorta, where these blood vessels
leave the heart. The flow at these points called cardiac output is between 3.5 and 5 litres/min in a
normal adult at rest. On the other hand in the capillaries blood flow can be slow , that the travel
of individual blood cells can be observed under a microscope.
With the help of cardiac output or the blood flow in a given vessel, it is possible for us to
calculate so many other variables. The cardiac output divided by the number of heart beats per
minute gives the amount of blood that is ejected during each heart beat, it is known as stroke
volume. If the total amount of blood circulation is known and this stroke volume is divided by
the cardiac output, the mean circulation time is obtained. From the blood flow through a vessel ,
divided by the cross sectional area of the vessel, the mean velocity of the blood at the point of
measurement can be calculated.
In the arteries, blood flow is pulsatile. In fact, in some blood vessels, a reversal of the
flow can occur during certain parts of the heart beat cycle. Because of the elasticity of their walls
the blood vessels tend to smooth out the pulsations of blood flow and blood pressure. Both
pressure and flow are greatest in the aorta where the blood serves the heart.
Blood flow is a function of the blood pressure and flow resistance of the blood vessels in
the same way as electrical current flow depends on voltage and resistance. The flow resistance of
the capillary bed can vary ever a wide range. The body reduces the blood flow through the skin
by means of vasoconstriction (narrowing) of the capillaries . This symptoms occur whenever a
body is exposed to low temperatures or under the influence of certain drugs (eg: nicotine)
Vasodilation (widening) of the capillaries occur when heat excitement or local
inflammation among other things, this increases the blood flow locally. Wide variations that are
possible in the flow resistance, the determination of blood pressure along is not sufficient to
access the status of the circulatory system.
The velocity of blood flowing through a vessel is not constant throughout the cross
section of the vessel but is a function of the distances from the wall surface. A thin layer of blood
actually adheres to the wall, resulting in zero velocity at this place, whereas the highest velocity
occurs at the centre of the vessel. Some blood flow meters do not actually measure the blood
flow but measures the mean velocity of the blood.
The laminar flow of blood has been changed to turbulent flow pattern , when the local
blood velocity exceeds a certain limit, it is difficult to determine the flow rate.
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4.10.Colorimeter
Colorimeter :
Introduction:
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Filters
Changeable optics filters are used in the colorimeter to select the wavelength of light which the
solute absorbs the most, in order to maximize accuracy. The usual wavelength range is from 400
to 700 nanometres (nm). If it is necessary to operate in the ultraviolet range (below 400 nm)
then some modifications to the colorimeter are needed. In modern colorimeters the filament
lamp and filters may be replaced by several light-emitting diodes of different colors.
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Flame photometer:
A flame photometer is used to analyze urine or blood in order to determine the
concentration of potassium (K) sodium (Na) calcium(Ca) lithium (Li). Sometimes lithium is used
as a calibration substance in the analysis of the other three substances. A known amount of
lithium is added to the sample and the emitted light intensity of the sample under analysis is
measured relative to that of the lithium. By this way, any error due to varying flame temperature
is eliminated.
The sample whose concentration is to be analyzed is taken in a beaker. This sample is
sprayed into fine droplets using an atomizer. This fine droplets are passed through oxygen or air
past opening in it.
4.11.Electrophoresis
Electroporesis Introduction:
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Electrophoresis occurs because particles dispersed in a fluid almost always carry an electric
surface charge. An electric field exerts electrostatic Coulomb force on the particles through
these charges.
Another force is electrostatic as well. It is known from double layer theory that all surface
charges in fluids are screened with a diffuse layer. This diffuse layer has the same absolute
charge value, but with opposite sign from the surface charge. The electric field induces force on
the diffuse layer, as well as on the surface charge. The total value of this force equals to the
first mentioned force, but it is oppositely directed. However, only part of this force is applied to
the particle. It is actually applied to the ions in the diffuse layer. These ions are at some distance
from the particle surface. They transfer part of this electrostatic force to the particle surface
through viscous stress. This part of the force that is applied to the particle body is called
electrophoretic retardation force.
Basic Principles:
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4.12. pCO2 (Partial Pressure of Carbon Dioxide) reflects the amount of carbon
dioxide gas dissolved in the blood.
Indirectly, the pCO2 reflects the exchange of this gas through the lungs to the outside
air. Two factors each have a significant impact on the pCO2. The first is how rapidly
and deeply the individual is breathing:
Someone who is hyperventilating will "blow off" more CO2, leading to lower
pCO2 levels
Someone who is holding their breath will retain CO2, leading to increased
pCO2 levels
The second is the lungs capacity for freely exchanging CO2 across the alveolar
membrane:
With pulmonary edema, there is an extra layer of fluid in the alveoli that
interferes with the lungs' ability to get rid of CO2. This leads to a rise in pCO2.
With an acute asthmatic attack, even though the alveoli are functioning
normally, there may be enough upper and middle airway obstruction to block
alveolar ventilation, leading to CO2 retention.
Pulmonary edema
Obstructive lung disease
Hyperventilation
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Hypoxia
Anxiety
Pregnancy
Pulmonary Embolism (This leads to hyperventilation, a more important
consideration than the embolized/infarcted areas of the lung that do not
function properly. In cases of massive pulmonary embolism, the infarcted or
non-functioning areas of the lung assume greater significance and the pCO2
may increase.)
4.12.1.Measurement of PCO2
The measurement of PCO2 is based on the fact that the relationship between log PCO 2 and pH is
linear over the range of 10 to 90 mm Hg which includes essentially all the values of clinical
interest. This result can be established by examining some fundamental chemical relationships
among H+, H2CO3, and PCO2. The first three quantities are related by the equilibrium equation
H2O + CO2
H2CO3
H+ + HCO3- ------------
In addition, the relationship between PCO2 and the concentration of the CO2 dissolved in the
blood, [CO2] is given by
[CO2] = a(PCO2) ------------------------------------------(2)
Where a = 0.0301 mmol/liter per mm Hg PCO2. The mass relationship corresponding to eq(1)
k' =
---------------------------------------------------------(3)
Next we use the fact that [H2CO3] is proportional to [CO2] to obtain the result
k=
--------------------------------------------------------------(4)
where k represents the combined values of k' and the proportionality constant between [H2CO3]
and [CO2] using eq(2) we obtain the following result
k=
----------------------------------------------------------------(5)
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H+ +
HCO
HCO3- +
H+ +
H2CO3
For blood
Or calibrating
gas
Entrance
Glass
AgCl Ag0
H2CO3
k
CO2
Voltmeter
V
k
CO2
(Dissolve
d
Sample Chamber
Buffer
Reference
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Glass
Cathode
e-
Voltmeter
V
For blood
Or calibrating
gas
Entrance
Anode
O2
O2
AgCl Ag0
(Dissolve
d
Sample Chamber
Reference
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Lactic Acidosis
Ketoacidosis
Ingestion of acids
Cardiopulmonary collapse
Shock
Page 81
Due to the difference in permeability the concentration of sodium ions inside the cell becomes
much lower than the outside the cell. Since the sodium ions are positive, the outside of the cell is
more positive than inside. The concentration of potassium and chloride ions is negative on the
inside and positive on the outside.
An equation relating the potential across the membrane and the two concentrations of the ion is
called Nernst equation.
RT
C1 f1
ln
E
Where,
nF
C 2 f2
R
gas constant(8.315 x 107 ergs/mole/degree Kelvin)
T
absolute Temperature, degrees Kelvin
n
valence of the ion (the number of electrons added or removed to ionize the atom)
F
Faraday constant (96,500 coulombs)
C1, C2 two concentrations of the ion on the two sides of the membrane
f1, f2 respective activity coefficients of the ion on the two sides of the membrane
The approximate value of the resting potential for living cell is 70mV. The resting potential
ranges from -60 to -100nV.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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ElectroCardioGram (ECG)
ElectroEncephaloGram (EEG)
ElectroMyoGram (EMG)
ElectroRetinoGram (ERG)
ElectroOculoGram (EOG)
Function
Frequency Observation
response
ElectroCardioGram
Records
0.05 to
Used to measure
(ECG)
electrical
120 Hz
heart
rate,
activity of heart
arrhythmia
and
abnormalities
ElectroEncephaloGram Records
2 to 200V 0.1 to 100 Used to analysis
(EEG)
electrical
Hz
evoked potential,
activity
of
certain patterns,
brain
frequency
response
ElectroMyoGram
Records
50V
to 5 to 2000 Used as indicator
(EMG)
muscle
1mV
Hz
of muscle action
potential
for
measuring
fatigue
Peak
amplitude
0.1 to 4mV
Page 83
4.14. Pacemaker
Inroduction
Pacemaker is an electrical pulse generator for starting /maintaining the normal heart beat.
The output of the pacemaker is either externally to the chest or internally to the heart
muscle. In the case of cardiac stand still, the use of the pacemaker is temporary just
long enough to start a normal heart rhythm. In the cases requiring long term pacing, the
pacemaker is surgically implanted in the body and its electrodes are in direct contact with
the heart. The contraction of heart (cardiac) muscle in all animals with hearts is initiated
by electrical impulses. The rate at which these impulses fire controls the heart rate. The
cells that create these rhythmical impulses are called pacemaker cells, and they directly
control the heart rate. The normal heart rate is 60-100 beats per minute.
A higher rate than this ( above 100 beats per minute) is called Tachycardia. slower
rate(Below 60 beats per minute) than this is called Bradycardia .
Definition of Pacemaker
A small battery powered device, implanted into a patient Paces the heart when normal
rhythm is slow, when there is a heart block not allowing the ventricles to contract when the SA
node fires, or any arrhythmia causing a slow rate.
Determining Pacemaker Types
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The sinoatrial node (SA node) is a group of cells positioned on the wall of the right atrium,
near the entrance of the superior venacava. These cells are modified cardiomyocyte. They
possess rudimentary contractile filaments, but contract relatively weakly.
Primary Pacemaker
Cells in the SA node spontaneously depolarize, resulting in contraction, approximately 100 times
per minute. This native rate is constantly modified by the activity of sympathetic
and parasympathetic nerve fibers, so that the average resting cardiac rate in adult humans is
about 70 beats per minute. Because the sinoatrial node is responsible for the rest of the heart's
electrical activity, it is sometimes called the primary pacemaker.
Secondary Pacemaker
If the SA node does not function, a group of cells further down the heart will become the ectopic
pacemaker of the heart. These cells form the atrioventricular node(or AV node), which is an area
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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In a healthy sinoatrial node (SAN, a complex tissue within the right atrium containing pacemaker
cells that normally determine the intrinsic firing rate for the entire heart), the pacemaker potential
is the main determinant of the heart rate. Because the pacemaker potential represents the noncontracting time between heart beats ( diastole), it is also called the diastolic depolarization. The
amount of net inward current required to move the cell membrane potential during the
pacemaker phase is extremely small, in the order of few pAs, but this net flux arises from time to
time changing contribution of several currents that flow with different voltage and time
dependence
Artificial Cardiac Pacemaker
A pacemaker (or artificial pacemaker, so as not to be confused with the heart's natural
pacemaker) is a medical device that uses electrical impulses, delivered by electrodes contracting
the heart muscles, to regulate the beating of the heart. The primary purpose of a pacemaker is to
maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough,
or there is a block in the heart electrical conduction system. Modern pacemakers are externally
programmable and allow the cardiologist to select the optimum pacing modes for individual
patients. Some combine a pacemaker and defibrillator in a single implantable device. Others
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Pacemaker Pulses
These Pulses should have the pulse to space ratio 1:10000.
The pulse voltage is made variable to allow adjustments in the energy delivered by the
pacemaker to the heart during each pulse.
Methods of stimulation
External stimulation
Internal stimulation
External stimulation is employed to restart the normal rhythm of the heart in the case of cardiac
standstill. Internal stimulation is employed in cases requiring long term pacing because of
permanent damage that prevents normal self triggering of the heart.
External Stimulation
It is employed to restart the normal rhythm of the heart in the case of cardiac stand still.
Stand still can occur during openheart surgery or whenever there is a sudden physical shock or
accident.
Internal Stimulation
Internal stimulation is employed in cases requiring long term pacing because of permanent
damage that prevents normal self triggering of the heart.
Comparision between external pacemaker and internal pacemaker.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Internal pacemaker
The pacemaker is surgically implanted
beneath
The skin near the chest or abdomen with its It requires open chest minor surgery to
output leads are connected directly to he place the circuit
heart muscle
These are used for temporary heart These are used for permanent heart
irregularities. There is no safety or damages. There is cent percent safety for
pacemaker.
circuit from external disturbances
Electrodes for Stimulation
Bipolar and unipolar electrodes are used.
In the bipolar electrode, there are stimulating electrode and contact electrode which
serves as a return path for current to the pacemaker.
In the unipolar electrode, there is only stimulating electrode.
The return path for current to the pacemaker is made through the body fluids.
Advantages:
To arrest the ventricular fibrillation, this circuit can be used.
If the R wave occurs with its normal value in amplitude and frequency, then it would not
work. Therefore the power consumption is reduced, and there is no chance of getting side
effects due to competition between natural and artificial pacemaker pulses.
Disadvantages:
Prepared by A.Devasena., Asso. Prof., Dept/ECE
Page 88
Page 89
The sensing electrode pickup R wave. The refractory circuit provides a period of time following
an output pulse or a signals. The sensing circuit detects the R wave and resets the oscillator. The
reversion circuit allows the amplifier to detect the R- wave in low level signal to noise ratio. In
the absence of R wave, it allows the oscillator in the timing circuit to deliver pulses at its preset
rate. The timing circuit consists of an RC network, a reference voltage source and a comparator
which determines the basic pulse rate of the pulse generator. The output of the timing circuit is
fed into pulse delivered to the heart. Then the output of the pulse width circuit is fed into the rate
limiting circuit which limits the racing rate to a maximum of 120 pulses per minute.
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Page 91
Heart
5.1.Electrical conduction system of the heart
The normal electrical conduction in the heart allows the impulse that is generated by the
Sinoatrial node (SA node) of the Heart to be propagated to (and stimulate) the
myocardium (muscle of the heart).
After myocardium is stimulated, it contracts.
It is the ordered stimulation of the myocardium that allows efficient contraction of the
heart, thereby allowing blood to be pumped throughout the body.
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5.2.1P wave
Under normal conditions, electrical activity is spontaneously generated by the SA node,
the physiological pacemaker.
This electrical impulse is propagated throughout the right and left atria, stimulating the
myocardium of the atria to contract.
The conduction of the electrical impulse throughout the atria is seen on the ECG as the P
wave.
5.2.2.INTERNODAL TRACTS,
As the electrical activity is spreading throughout the atria,
it travels via specialized pathways, known as internodal tracts,
from the SA node to the AVnode.
The P wave is the electrical signature of the current that causes atrial depolarization.
Both the left and right atria contract simultaneously. Its relationship to QRS complexes
determines the presence of a heart block.
Irregular or absent P waves may indicate arrhythmia.
The shape of the P waves may indicate atrial problems.
5.3.Bundle of His
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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The two bundle branches taper out to produce numerous Purkinjie fibers,
which stimulate individual groups of myocardial cells to contract.
The spread of electrical activity through the ventricular myocardium produces the QRS
Complex on the ECG.
The QRS complex corresponds to the current that causes contraction of the left and right
ventricles,
which is much more forceful than that of the atria and involves more muscle mass,
thus resulting in a greater ECG deflection.
The Q wave, when present,
represents the small horizontal (left to right) current as the action potential travels
through the interventricular septum.
Very wide and deep Q waves do not have a septal origin, but indicate myocardial
infraction that involves the full depth of the myocardium and has left a scar.
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The R and S waves indicate the spread of the action potential along the ventricular
myocardium itself.
5.6.ST Segment
An impulse (action potential) that originates from the SA node at a rate of 60 - 100
beats/minute (bpm) is known as normal sinus rhythm.
If SA nodal impulses occur at a rate less than 60 bpm, the heart rhythm is known as sinus
bradycardia.
If SA nodal impulse occur at a rate exceeding 100 bpm, the consequent rapid heart rate is
sinus tachycardia.
These conditions are not necessarily bad symptoms, however.
Trained athletes, for example, usually show heart rates slower than 60bpm when not
exercising
Page 95
5.10.Normal ECG
Surface electrodes are used with jelly as electrolyte between skin and electrodes.
The potentials generated in the heart are conducted to the body surface.
The potential distribution changes in a regular and complex manner during each cardiac
cycle.
To record electrocardiograms standard electrode positions must be selected.
four types of electrode systems are there. They are:
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In standard leads the potentials are tapped from four locations of our body.
They are
Right arm
Left arm
Right leg
Left leg.
Usually right leg electrode is acting as ground reference electrode.
Electrode from
LA
Output VI
Electrode from RA
Ground electrode RL
Page 97
Einthoven triangle.
Lead I
Right arm
+
Left arm Cardiac vector
Lead III
Lead II
+
Left leg
In case of unipolar chest leads, the exploratory electrode is obtained from one of the chest
electrodes.The chest electrodes are placed are placed on the six different points on the
chest closed to the heart.
Page 98
The ECG potentials are measured with color coded leads according to the convention:
White right arm
Black left arm.
Green right leg.
Red left leg.
Brown - chest
The corrected orthogonal leads system (or ) frank lead system is used in vector
cardiography. Here we can get informations from above said 12 leads.
If QRS complex is widened I.e. QRS interval extended from the normal condition means
Result : Bundle block.
If train of pulses occurs instead of PQRST waves means Result : Ventricular fibrillation
which may lead to death if it is not properly corrected by defibrillator.
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Atrial fibrillation: Due to fast beating rate (300-500 beats/minute) of the atrium. Here
ventricles beat very slowly.s
Ventricular fibrillation: due to fast beating rate of the ventricles. No pumping of the
blood to different parts of the body.
5.13.Heart Transplantation
5.13.1.allo graft
Heart transplantation or cardiac transplantation, is a surgical transplant procedure
performed on patients with end-stage heart failure or severe coronary artery disease.
The most common procedure is to take a working heart from a recently deceased organ
donor (allo graft) and implant it into the patient.
The patient's own heart may either be removed (orthotopic procedure) or, less commonly,
left in to support the donor heart (heterotopic procedure).
5.13.2.xenograft
It is also possible to take a heart from another species (xenograft), or implant a manmade artificial one,
although the success of these two procedures has been less successful in comparison to
the far more commonly performed allograft
5.13.3.Indications
In order for a patient to be recommended for a heart transplant they will generally have
advanced, irreversible heart failure with a severely limited life expectancy.
Other possible treatments, including medication, for their condition should have been
considered or attempted prior to recommendation.
Page 100
Cardiomyopathy
Congential heart disease
Coronary artery disease
Heart valve disease
Life-threatening arrhythmias.
Page 101
5.15.7.POWER SWITCH:
The power switch of the recorder has three positions. In the on position the powet to the
amplifier is turned on; but the paper drive is not running. In order to start the paper drive the
switch must be placed in the RUN position. In the off position, the ECG unit is in switched off
condition.
Page 102
An echocardiogram. Image shows that the human heart has four chambers. Apical view - left
side of the heart to the right. Right side-up - heart's apex at bottom. The trace in the lower left
shows the cardiac cycle and the red mark the time in the cardiac cycle that the image was
captured.
An abnormal echocardiogram. Image shows a mid-muscular ventricular septal defect. The trace
in the lower left shows the cardiac cycle and the red mark the time in the cardiac cycle that the
image was captured. Colours are used to represent the velocity of the blood.
The echocardiogram is an ultrasound of the heart. Using standard ultrasound techniques, twodimensional slices of the heart can be imaged. The latest ultrasound systems now employ 3D
real-time imaging.
In addition to creating two-dimensional pictures of the cardiovascular system, the
echocardiogram can also produce accurate assessment of the velocity of blood and cardiac tissue
at any arbitrary point using Pulsed or Continuous wave Doppler ultrasound. This allows
assessment of cardiac valve areas and function, any abnormal communications between the left
and right side of the heart, any leaking of blood through the valves (valvular regurgitation), and
calculation of the cardiac output as well as the ejection fraction.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
Page 103
5.16.1.Transthoracic echocardiogram
The standard echocardiogram is also known as a transthoracic echocardiogram, or TTE.
In this case, the echocardiography transducer (or probe) is placed on the chest wall (or thorax) of
the subject, and images are taken through the chest wall. This is a non-invasive, highly accurate
and quick assessment of the overall health of the heart. A cardiologist can quickly assess a
patient's heart valves and degree of heart muscle contraction (an indicator of the ejection
fraction).
The TTE is commonly used to help diagnose endocarditis. Diagnostic findings by the
Echocardiogram include definitive evidence of vegetation or thrombus on valves or other
endocardiac structures, abscesses, or disruption of a prosthetic heart valve.
The TTE is highly accurate for identifying vegetations, but the accuracy can be reduced in up to
20% of adults because of obesity, chronic obstructive pulmonary disease, chest-wall deformities,
or otherwise technically difficult patients. Transesophageal echocardiography, if available, may
be more accurate than TTE because it excludes the variables previously mentioned and allows
closer visualization of common sites for vegetations and other abnormalities. Transesophageal
echocardiography also affords better visualization of prosthetic heart valves.
Transesophageal echocardiogram
Another way to perform an echocardiogram is to insert a specialised scope containing an
echocardiography transducer (TEE probe) into the patient's esophagus, and record pictures from
there. This is known as a transesophageal echocardiogram, or TEE (TOE in the United
Kingdom). The advantages of TEE over TTE are usually clearer images. The transducer is closer
to the heart and doesn't have the ribs and lungs to deflect the ultrasound beam. Some structures
are better imaged with the TEE. These structures include the aorta, the pulmonary artery, the
valves of the heart, and the left and right atria. While TTE can be performed easily and without
pain for the patient, TEE may require light sedation and a local anesthetic lubricant for the
esophagus. Children are anesthetized. Unlike the TTE, the TEE is considered an invasive
procedure.
In some centers, sedation is used to ease the discomfort to the individual. The use of local
anesthetic agents and sedation can decrease the gag reflex, making the ultrasound probe easier to
pass into the esophagus. The transducer and cable are then coated in a lubricant, placed in the
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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6.2.ElectroEncephaloGraphy (EEG)
Page 106
6.2.1.Brain Waves:
Wide variation among individuals and the lack of repeatability in a given person
from one person to another make the establishment of specific relationships. But some
characteristics EEG waveforms can be related to epileptic seizures and sleep. The EEG
waveforms obtained with the help of intensity and patterns of this electrical activity due to
overall level of excitation of the brain. This includes various activities of a person when in
alert condition, sleepy condition, tension condition etc.
Normally the brain waves are irregular, no general patterns can be discerned in the
EEG. But during abnormal conditions we can obtain the specific wave form.
The normal Brain waves that occur in the human being can be classified into Alpha,
Beta, delta and theta waves.
Brain waves
Delta wave
Theta wave
Alpha wave
Beta wave
Frequency
below 3 hz
from 3 hz to about 8hz .
from about 8hz to about 13hz .
above 13hz .
Activity types
Page 107
Delta is the frequency range up to 4 Hz and is often associated with the very young and
certain encephalopathies and underlying lesions. It is seen in stage 3 and 4 sleep.
Delta waves.
Theta waves.
Alpha waves.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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sensorimotor rhythm (SMR) is a middle frequency (about 1216 Hz) associated with
physical stillness and body presence.
Beta is the frequency range above 12 Hz. Low amplitude beta with multiple and varying
frequencies is often associated with active, busy or anxious thinking and active
concentration. Rhythmic beta with a dominant set of frequencies is associated with
various pathologies and drug effects, especially benzodiazepines.
Beta waves.
Gamma is the frequency range approximately 26100 Hz. Gamma rhythms appear to be
involved in higher mental activity, including perception, problem solving, fear, and
consciousness.
Gamma waves.
Rhythmic slow activity in wakefulness is common in young children, but is abnormal in
adults. In addition to the above types of rhythmic activity, individual transient waveforms such
as sharp waves, spikes, spike-and-wave complexes occur in epilepsy, and other types of
transients occur during sleep.
In the transition from wakefulness, through Stage I sleep (drowsiness), Stage II (light) sleep, to
Stage III and IV (deep) sleep, first the alpha becomes intermittent and attenuated, then
disappears. Stage II sleep is marked by brief bursts of highly rhythmic beta activity (sleep
spindles) and K complexes (transient slow waves associated with spindles, often triggered by an
auditory stimulus). Stage III and IV are characterized by slow wave activity. After a period of
deep sleep, the sleeper cycles back to stage II sleep and/or rapid eye movement (REM) sleep,
associated with dreaming. These cycles may occur many times during the night.
EEG under general anesthesia depends on the type of anesthetic employed. With halogenated
anesthetics and intravenous agents such as propofol, a rapid (alpha or low beta), nonreactive
EEG pattern is seen over most of the scalp, especially anteriorly; in some older terminology this
was known as a WAR (widespread anterior rapid) pattern, contrasted with a WAIS (widespread
slow) pattern associated with high doses of opiates. Anesthetic effects on EEG signals are
beginning to be understood at the level of drug actions on different kinds of synapses and the
circuits that allow synchronized neuronal activity
Prepared by A.Devasena., Asso. Prof., Dept/ECE
Page 109
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6.5.ELECTROMYOGRAPHY:
Electromyography is the science of recording and interpreting the electrical activity of the
muscles action potentials. Meanwhile the recording of the peripheral nerves action potentials is
called electroneurography. The electrical activity of the under lying muscle can be measured by
placing surface electrodes on the skin. To determine whether the muscle is contracting or not, or
displaying on the CRO and loud speaker the action potentials spontaneously present in a muscle
or induced by voluntary contraction as a means of detecting the nature and location of the motor
unit lesions. So to record the action potentials of individual motor units, the needle electrode is
inserted into the muscle. The EMG indicates the amount of activity of a given muscle or a group
of muscles and not an individual nerve fiber.
The action potentials occur both positive and negative polarities at a given pair of
electrodes, so they may add or cancel each other. Thus EMG appears, very much like a random
noise waveform. The contraction of a muscle produces action potentials. Where there is
stimulation to a nerve fiber, all the muscle fiber contract simultaneously developing action
potentials. In a relaxed muscle, there is no action potential. EMG is usually recorded by using
surface electrodes or more often needle electrodes inserted directly into the muscle. The surface
electrodes pick-up the potentials produced by the contracting muscle fibers. The signal can then
Prepared by A.Devasena., Asso. Prof., Dept/ECE
Page 111
Oscilloscope
Tape recorder
Input
EMG
amplifier
Speaker
A.F.Amplifier
The surface electrodes or needle electrodes pickup the potentials produced by the
contracting muscle fibers. The surface electrodes are from Ag-Agcl and are in disc shape. The
surface of the skin is cleaned and electrode paste is applied. The electrodes are kept in place by
means of elastic bands. By that way, the contact impedance is reduced below 10kiloohms. There
are two types of conventional electrodes: bipolar and unipolar type electrodes. In the case of
bipolar electrode, the potential difference between two surface electrodes resting on the skin is
measured. In case of unipolar electrode, the reference surface electrode is placed on the skin and
the needle electrode which acts as active electrode, is inserted into the muscle. Because of small
contact area, these unipolar electrodes have high impedances ranging from 0.5 to 100mega ohms.
With needle electrodes, it is possible to pickup action potentials from the selected nerves or
muscles and individual motor units. In the case of coaxial electrode which consists of an
insulated wire threaded through a hyperdermic needle with a oblique tip for easy penetration, the
surrounding steel jacket acts as reference and the metallic wire acts as exploring electrode. The
needle is inserted into the muscle further to record the action potentials for a single nerve
microelectrodes are used.
The amplitude of the EMG signals depends upon the type and placement of
electrodes used and the degree of muscular exertions. That is the surface electrode pick up many
Prepared by A.Devasena., Asso. Prof., Dept/ECE
Page 112
6.6.ELECTRORETINOGRAPHY:
The recording and interpreting the electrical activity of eye is called electroretinography.
All sense organs are connected to the brain but the eye has a special relationship as the retina is
an extension of the cerebral cortex. Potentials within the eye may be recorded relatively easily
because of its exposed position. The cornea is about 20mv positive relative to the fundus of the
eye. The fundus is the back of the interior of the eye ball. If the illumination of the retina is
changed, the potential changes slightly in a complex manner. The recording of these changes is
called retinogram. A silver- silver chloride electrode on a contact lens and a distinct electrode on
the cheek are used to record the eye potential changes.
Electrode placement:
The bipolar recording technique is used. The exploring electrode is placed on a saline
filed contact lens. The contact lens is placed on a saline filled contact lens. The contact lens is
tightly attached to the eye. During eye movement there is no slip of contact lens by using
negative pressure (between the corneal cavity and the cornea) attachment techniques. The
common contact lenses used for corrections or cosmetic purposes ride on a tear film over the
cornea, do not follow eye movements well and are unsuitable for recording purposes. Therefore
specially made contact lenses used to record the action potentials of eye during flash of light
incident on eye.
Page 113
1 Sec
1 mV
Light on
Time
Figure shows the typical eletroretinogram. Before the flash of light is incident on eye, there is a
constant d.c. horizontal line in the recorder. In response to a 2 seconds flash of light, a
retinogram is developed. Probably the curve originates from the pigment layer beyond photo
receptors (extra retinal).
The first part A of the response to a brief flash of light is due to the early receptor
potential (ERP) generated by the incident light which induces changes in the photo pigment
molecules. The second component part B with a delay of 1 to 5 milliseconds is due to later
receptor potential (LRP) produced by syruptic ending of the photoreceptors. This is the
maximum output of the receptors. The part C wave recorded with the off response of ERP and
LRP.
In the earlier recording of the eye potentials, the corneal electrodes were not used. Instead
the rotation of the contact lens was measure by means of a mirror (on contact lens) which reflects
the incident light on a moving photographic film or photo cell. After developing the
photographic film, we can see the image and from that we can get some informations about the
eye potentials. In the case of photocells, the output from the photocell was amplified and then
given to the recorder. There was also a nonoptical method for measuring contact lens rotation.
Two sets of magnetic coils, normal in the space and oscillating in phase quadrature at 4.8kHz
create crossed magnetic fields which excite two small search coils embedded in the contact lens.
Rotations of the eye cause induced voltages of few millivolts, which can give information about
the eye potential.
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TELEMEDICINE
7.1 Introduction :
7.1.1 Wireless telemetry:
Wireless telemetry gives analysis of the physiological data of man or animal under
normal conditions and in natural surroundings without any discomfort or obstruction to the
person or animal
Biotelemetry is the branch of biomedical instrumentation that deals with the measuring
physiological variables to a method of transmission of resulting data. Telemetry is most
convenient during transportation within the hospital area as well for the continuous monitoring
of patients sent to other wards or clinics for check-up or therapy.
Biotelemetry is the measurement of biological parameters over a distance. The means of
transmitting the data from the point of generation to the point of reception can take many forms.
Measurements can be applied to two categories.
Biological variables such as EEG, ECG and EMG.
Physiological variables that require transducers such as
gastrointestinal pressure, blood flow and temperatures.
blood
pressure,
In first category, a signal is obtained directly in electrical form, whereas the second category
requires a type of excitation. The physiological parameters are eventually measured as variations
of resistance, inductance or capacitance. The differential signals obtained from these variations
can be calibrated to represent pressure, flow, temperature and so on.
The analog signal that is obtained from the electrodes (the signal may be in the form of
voltage, current etc) is converted into a form or code capable of being transmitted at the
transmitter end with the help of transmitter set up.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Page 116
Direct
biopotential
Amplifier
Subject
Processor
Transducer
Modulator
Exciter
Carrier
Page 117
Tuner
Demodulator
Chart Recorder
or Oscilloscope
Tape Recorder
Page 118
In the above diagram, the tuned oscillator serves as a frequency modulator. The diode used here
is a varactor diode. The varactor diode is operating in a reverse biased mode, because of this;
the varactor diode gives a depletion layer capacitance to the tank circuit.
This capacitance is a function of the reverse biased voltage across the diode and therefore
produces an FM wave with modulating signal applied.
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Page 120
The transmitter:
The commonly used FM transmitter is shown below. This circuit can be used for medical
telemetry also. The circuit comprises of a transistor, feedback circuit, and a tank circuit. The
transisytor used here is a grounded base colpitts R.F. oscillator with L1, C1, C2 as the tank circuit.
Transmitter circuit diagram:
Inductor
A capacitive divider circuit is plced in the collector circuit, that is formed with the
help of C1 and C2. inductor L1 functions both as a tuning coil and a transmitting antenna.
With the help of this set up, a positive feedback is provided to the amplifier circuit. We can able
to set the transmission frequency to a precise level. This can be done by adjusting the trim
capacitor C2. with this set up, we can able to set the frequencyrange of 88 to 188 MHz.
Frequency modulation can be achieved by variation in the operating point of the transistor,
which in turn varies its collector capacitance, thus changing the resonant frequency of the
tranistor circuit. The operating point can be changed by the sub-carrier input. Thus the
transmitter,s output consists of an RF signal, tuned in the FM broad cast band and frequency
modulated by the sub-carrier oscillator (SCO), which in turn is frequency modulated by the
physiological signals of interest.
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7.3.Radio Pill
The earliest biotelemetry units was the endoradiosonde, developed by Mackay and
Jacobson. The pressure sensing electrode is a radio pill less than 1 cm3.in volume. This radio pill
can be swallowed by the patient. Radio pill now travels through the gasterointestinal tract on the
way of passing into the gastrointentinal tract, the radio pill is capable of measuring various
parameters that are available in the tract. With the help of radio pill type devices, it is possible
for us to measure or sense temperature, pH, enzyme activity, and oxygen tesion values. These
measurements can be made in associated with transducers. Pressure can be sensed by using
variable inductance, temperature can be measured by using temperature-sensitive transducer.
7.4.1.STIMULATION OF NERVES:
There is normally a potential difference of about 100mv across a nerve membrane. if this
potential is reversed for more than about 20 milliseconds, the nerves will be stimulated and an
action potential will be propagated along the nerve fiber.
the nervous system is the body's internal, electrochemical, communication network. its
main poarts are the brain and spinal cord from the central nervous system (CNS) the body's chief
controlling and coordinating centres. Billions of long neurons, many grouped as nerves, make up
the peripheral nervous system, transmitting nerve impulses between the CNS and other regions
of the body. Each neurons has threee parts: a cell body, branching dendrites that receive
chemical signals from other neurons, and a tube -like axon that conveys these signals as
electrical impulses.
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7.4.2.ACCUPUNCTURE:
Accu-means needle, puncture- means making a highly concentrated presssure over the
skin, in order to relief the pain over the partiular area of the skin. This kind of treatment is
popular in CHINA from 2600B.C. onwards. in accupuncture, care should be taken for the
patient, not for the diseases. iin our body electric energy is there. It is possible for us to adjust the
electric energy in proper way. 12 paths are there in our body. in these 12 paths 900 needle points
are there. in these points, with the help of stainless steel needle we are puncturing our body. by
doing like this we can increase or decrease the electric energy in our body. In olden days people
had used this acupuncture in place of anasthesia. With the help of these acupunctre we can stop
the poain information, which passes to our brain. In our heart there are no nerves. so if we are
acupuncturing our heart means, we dont feel no pain. With the help of this accupunctur , we can
stimulate our nerves. nowadays with the help of electric current these nerves are stimulated.
7.4.3.DIFFERENT
TYPES
OPF
STIMULATOR(ELECTROTHERAPY)
WAVEFORMS
USED
IN
Various types of waveforms are used for stimulation of nerves and muscles to carry out
treatment of various diseases.
(i) Galvanic current:
galvanic current is a constant or direct current. the maximum amount of current passed
through the body is about 0.3 to 0.5 mA/cm2 of electrode surface. the duration of the passage of
current is about 10 to 20 minutes. The passage of current creates the movement of ions. it is used
for the preliminary treatment of atonic paralysis and for the disturbance of blood flow in the
arteries.
(ii) Interrupted galvanic current:
Interrupted galvanic current pulses are a series of negative going rectangular pulses. the
pulse duration is about 100 milliseconds with a repetition rate is between 12 per minute and 70
per minute. A silghtly different form of interrupted galvanic pulses is the triangular wavepulses.
fig shows the unidirectional interrupted galvanic pulses which create ionization of the skin of the
patient and produce discomfort and inflammation. it is overcome by the application of a positive
current in between the negative pulses proportional to the time interval.
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Radiation therapy
Radiation therapy:
Radiation therapy (also called radiotherapy, x-ray therapy, or irradiation) is the
use of a certain type of energy (called ionizing radiation) to kill cancer cells and shrink
tumors. Radiation therapy injures or destroys cells in the area being treated (the target
tissue) by damaging their genetic material, making it impossible for these cells to
continue to grow and divide. Although radiation damages both cancer cells and normal
cells, most normal cells can recover from the effects of radiation and function properly.
The goal of radiation therapy is to damage as many cancer cells as possible, while
limiting harm to nearby healthy tissue.
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Cancer patients receiving radiation therapy are often concerned that the treatment will
make them radioactive. The answer to this question depends on the type of radiation
therapy being given.
External radiation therapy will not make the patient radioactive. Patients do not need to
avoid being around other people because of the treatment.
Internal radiation therapy (interstitial, intracavitary, or intraluminal) that involves sealed
implants emits radioactivity, so a stay in the hospital may be needed. Certain precautions
are taken to protect hospital staff and visitors. The sealed sources deliver most of their
radiation mainly around the area of the implant, so while the area around the implant is
radioactive, the patients whole body is not radioactive.
Systemic radiation therapy uses unsealed radioactive materials that travel throughout the
body. Some of this radioactive material will leave the body through saliva, sweat, and
urine before the radioactivity decays, making these fluids radioactive. Therefore, certain
precautions are sometimes used for people who come in close contact with the patient.
The patients doctor or nurse will provide information if these special precautions are
needed.
Dosage of radiation:
The amount of radiation absorbed by the tissues is called the radiation dose (or
dosage). Before 1985, dose was measured in a unit called a rad (radiation absorbed
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rays and gamma rays, some particle beams can penetrate only a short
distance into tissue. Therefore, they are often used to treat cancers located
on the surface of or just below the skin.
Proton beam therapy is a type of particle beam radiation therapy.
Protons deposit their energy over a very small area, which is called the Bragg
peak. The Bragg peak can be used to target high doses of proton beam therapy
to a tumor while doing less damage to normal tissues in front of and behind the
tumor. Proton beam therapy is available at only a few facilities in the United
States. Its use is generally reserved for cancers that are difficult or dangerous to
treat with surgery (such as a chondrosarcoma at the base of the skull), or it is
combined with other types of radiation. Proton beam therapy is also being used
in clinical trials for intraocular melanoma (melanoma that begins in the eye),
retinoblastoma (an eye cancer that most often occurs in children under age 5),
rhabdomyosarcoma (a tumor of the muscle tissue), some cancers of the head
and neck, and cancers of the prostate, brain, and lung.
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THERMOGRAPH:
Need for the Thermography:
Thermograph has a number of distinct advantages over other imaging systems. It is
completely non- invasive, there is no contact between the patient and system as with echography,
and there is no radiation hazard as with x-rays. A thermograph is a real-time system, changes can
be followed as fast as at a rate if one study per second.
Classification of thermography:
Based on detection of the thermal radiation from the skin sreas, we can classify the
thermograph into three methods. They are
Infrared thermograph
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Microwave themograph.
Thermo gram:
Thermo gram is a record of the infrared heat waves that are emitted by the body. it gives a visual
display of the hot and cold areas of the whole body. The technique of obtaining a thermo gram is
known as thermograph.
Thermographic equipment:
Thermographic equipment incorporate scanning systems which enable the infrared radiation
emitted from the surface of the skin with in the field of view to be focused on to an infrared
detector. The equipment used in the thermography basically consists of two units. A special
infrared camera that scans the object and a display unit for displaying the thermal picture on the
screen.
NETD:
NETD is nothing but Noise Equivalent Temperature Difference (NETD). It is the figure
of merit for the thermographic imaging system. This is usually called minimum resolution.
Resolution of the thermographic system:
The thermal and spatial resolution of a thermographic system is determined by the optical
parameters, detector performance. Preamplifiers noise, the signal processing system, the picture
presentation and evaluation systems. Thermo gram:
Problem of medical thermography:
For comparing the results of successive thermo graphic examinations, it is essential that
the results are standardized and quantified. In the earlier thermographic equipment the
thermograph was recorded on a photographic film from which it was limited by the long
scanning time. a practical solution to this problem is the use of isotherms. Differences between
the various gray tones are determined accurately by means of a thermal band or isotherm. In
modern thermographic equipment, temperature measurement is improved by providing two
simultaneous isotherm functions.
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Lasers
Laser
The light emitted from an ordinary light source is incoherent, because the
radiation emitted from different atoms do not have definite phase relationship with each other.
For interference of light coherent sources are required. Two independent sources cannot act as
coherent sources. For experimental purposes, from a single source, two coherent sources are
obtained. In recent years certain highly coherent sources were developed namely LASER. The
word LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. The
difference between ordinary light and LASER beam is pictorially depicted as follows:
Characteristics of LASER:
The LASER beam is
1. Monochromatic
2. Highly coherent with waves exactly in phase with each other.
3. Doesnt diverge.
4. Extremely intense.
Spontaneous and Stimulated radiation:
An atom may undergo transition between two energy states E 1 and E2 if it emits or
absorbs a photon of the appropriate energy E1-E2 =h .
In a system of thermal equilibrium the number of atoms in the ground state(N 1) is
greater than the number of atoms in the excited state(N 2).This is called Normal population.
Consider a sample of free atoms, some of which are in the ground state with energy E1 and some
in the excited state with energy E 2. If the photons of energy E1-E2 =h are incident on the sample,
the photons can interact with the atoms in the ground state and are taken to excited state. This is
called Stimulated or Induced absorption. The process by which the atoms in the ground state are
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Absorption
of
energy:
An atom absorbs energy in the form of heat, light, or
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Ruby LASER:
The Ruby laser was first developed by T.Maiman in 1960. It consists of a single
crystal of ruby rod of dimensions 10cm and 0.8cm. A ruby is a crystal of aluminium oxide Al 2O3
in which some of aluminium ions (Al3+) are replaced by chromium ions (Cr3+). The opposite
ends of the ruby rod are made flat and parallel, one end is fully silvered and the other end is
partially silvered. The ruby rod is surrounded by a helical Xenon flash tube which provides the
pumping light to raise the chromium ions to upper energy level. In the Xenon flash tube each
flash lasts several milliseconds and in each flash a few thousand joules of energy is consumed.
In normal state most of the chromium ions are in the ground state E 1. When the ruby rod is
irradiated by a flash of light 5500 radiation (green colour) photons are absorbed by the
chromium ions which are pumped to the excited state E 3. The excited ion gives up part of its
energy to the crystal lattice and decay without giving any radiation to the metastable state E 2.
Since the state E2 has a much longer lifetime (10 -3 seconds) the number of ions on this state goes
on increasing. Thus population inversion is achieved between the states
E2 and E1. When the excited ion from the metastable state E 2 drops down spontaneously to the
ground state E1 it emits a photon of wavelength 6943.
This photon travels through the ruby rod and is reflected back and forth by the silvered ends until
it stimulates other excited ion and causes it to emit a fresh photon in phase with stimulating
photon. Thus the reflections will amount to the additional stimulated emission, the so-called
Amplification by Stimulated emission. This stimulated emission is the LASER transition. Finally
a pulse of red light of wavelength 6943 emerges through the partially silvered end of the
crystal.
Ruby Lasers
A ruby laser consists of a flash tube (like you would have on a camera), a ruby rod and two
mirrors (one half-silvered). The ruby rod is the lasing medium and the flash tube pumps it.
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2. The flash tube fires and injects light into the ruby rod.
The light excites atoms in the ruby.
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He-Ne laser system consists of a quartz discharge tube containing helium and
neon in the ratio of 1:4 at a total pressure about 1mm of Hg. One end of the tube is fitted with a
perfectly reflecting mirror and the other end with partially reflecting mirror. A powerful radio
frequency generator is used to produce discharge in the gas, so that the helium atoms are excited
to a higher energy level.
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The light released is monochromatic. It contains one specific wavelength of light (one
specific color). The wavelength of light is determined by the amount of energy released
when the electron drops to a lower orbit.
The light released is coherent. It is organized -- each photon moves in step with the
others. This means that all of the photons have wave fronts that launch in unison.
The light is very directional. A laser light has a very tight beam and is very strong and
concentrated. A flashlight, on the other hand, releases light in many directions, and the
light is very weak and diffuse.
To make these three properties occur takes something called stimulated emission. This does not
occur in your ordinary flashlight -- in a flashlight, all of the atoms release their photons
randomly. In stimulated emission, photon emission is organized.
The photon that any atom releases has a certain wavelength that is dependent on the energy
difference between the excited state and the ground state. If this photon (possessing a certain
energy and phase) should encounter another atom that has an electron in the same excited state,
stimulated emission can occur. The first photon can stimulate or induce atomic emission such
that the subsequent emitted photon (from the second atom) vibrates with the same frequency and
direction as the incoming photon.
The other key to a laser is a pair of mirrors, one at each end of the lasing medium. Photons, with
a very specific wavelength and phase, reflect off the mirrors to travel back and forth through the
lasing medium. In the process, they stimulate other electrons to make the downward energy jump
and can cause the emission of more photons of the same wavelength and phase. A cascade effect
occurs, and soon we have propagated many, many photons of the same wavelength and phase.
The mirror at one end of the laser is "half-silvered," meaning it reflects some light and lets some
light through. The light that makes it through is the laser light.
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Types of Lasers
There are many different types of lasers. The laser medium can be a solid, gas, liquid or
semiconductor. Lasers are commonly designated by the type of lasing material employed:
Solid-state lasers have lasing material distributed in a solid matrix (such as the ruby or
neodymium:yttrium-aluminum garnet "Yag" lasers). The neodymium-Yag laser emits
infrared light at 1,064 nanometers (nm). A nanometer is 1x10 -9 meters.
Gas lasers (helium and helium-neon, HeNe, are the most common gas lasers) have a
primary output of visible red light. CO2 lasers emit energy in the far-infrared, and are
used for cutting hard materials.
Excimer lasers (the name is derived from the terms excited and dimers) use reactive
gases, such as chlorine and fluorine, mixed with inert gases such as argon, krypton or
xenon. When electrically stimulated, a pseudo molecule (dimer) is produced. When lased,
the dimer produces light in the ultraviolet range.
Dye lasers use complex organic dyes, such as rhodamine 6G, in liquid solution or
suspension as lasing media. They are tunable over a broad range of wavelengths.
Semiconductor lasers, sometimes called diode lasers, are not solid-state lasers. These
electronic devices are generally very small and use low power. They may be built into
larger arrays, such as the writing source in some laser printers or CD players.
A ruby laser (depicted earlier) is a solid-state laser and emits at a wavelength of 694 nm. Other
lasing mediums can be selected based on the desired emission wavelength (see table below),
power needed, and pulse duration. Some lasers are very powerful, such as the CO2 laser, which
can cut through steel. The reason that the CO2 laser is so dangerous is because it emits laser light
in the infrared and microwave region of the spectrum. Infrared radiation is heat, and this laser
basically melts through whatever it is focused upon.
Other lasers, such as diode lasers, are very weak and are used in todays pocket laser pointers.
These lasers typically emit a red beam of light that has a wavelength between 630 nm and 680
nm. Lasers are utilized in industry and research to do many things, including using intense laser
light to excite other molecules to observe what happens to them.
Here are some typical lasers and their emission wavelengths:
Laser Type
Wavelength (nm)
193
248
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308
Nitrogen (UV)
337
Argon (blue)
488
Argon (green)
514
543
633
570-650
694
Nd:Yag (NIR)
1064
10600
Examples include the use of a laser scalpel in otherwise conventional surgery, and soft
tissue laser surgery, in which the laser beam vaporizes soft tissues with high water
content. Laser resurfacing is a technique in which molecular bonds of a material are
dissolved by a laser. Laser surgery is commonly used on the eye. Techniques used
include LASIK, which is used to correct near and far-sightedness in vision, and
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Laproscopic surgery
Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery,
or keyhole surgery, is a modern surgical technique in which operations in
the abdomen are performed through small incisions (usually 0.51.5 cm) as opposed to
the larger incisions needed in laparotomy.Keyhole surgery makes use of images
displayed on TV monitors to magnify the surgical elements. Laparoscopic surgery
includes operations within the abdominal or pelvic cavities, whereas keyhole surgery
performed on the thoracic or chest cavity is called thoracoscopic surgery. Laparoscopic
and thoracoscopic surgery belong to the broader field of endoscopy. The key element in
laparoscopic surgery is the use of a laparoscope. There are two types: (1) a telescopic
rod lens system, that is usually connected to a video camera (single chip or three chip), or
(2) a digital laparoscope where the charge coupled device is placed at the end of the
laparoscope, eliminating the rod lens system.
DIATHERMY:
Diathermy therapy is generally contra-indicated for pacemaker patients.the operation of a
pulse generator subject to the intense fields of energy involved in diathermy cannot be predicted;
reversion to fixed rate pacing is likely, to copmplete inhibition is possible. Although damage to
either pulse generator circuitry or cardiac tissue is highly improbable, it cannot be positively
ruled out. If diathermy therapy must be used, it should be applied away from the immediate
vicinity of the pulse generator/ lead system.
INTRODUCTION:
Operation theatre equipment are very useful both diagnostically and therapeutically. they
are mainly useful for monitoring and treatment purposes. during operation or intensive care or
intensive treatment, the patient's condition is followed carefully by repeated measurement of
many variables, like blood flow velocvity, cardiac output, blood pressure. PH value and so
on.The above variables are also measured and monitored by operation theatre equipment.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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Surgical diathermy machines depend for their action, the heating effect of electric
current. When high frequency current flows through the sharp edge of a wire loop or point of a
needle into the tissue. There is a high contraction of current at this point. The tissue is heated to
such an extent that cells immediately under the electrode are torn apart by the boiling of the cell
fluid. The indifferent electrode establishes a large area contact with the patient and the RF
current is therefore dispersed so that very little cheat is developed at this electrode. This type of
tissue separation forms the basis of electrosurgical cutting.
Honig (1975) worked out detailed derivation of the significant parameters affecting the
distribution of electro surgical RF power in tissue. He analyzed how electrosurgical RF power is
localized in the vicinity of the cutting electrode. It was shown that the combination of fine wire
electrodes high RF voltage and high cutting speeds are necessary for the confinement of tissue
destruction in electro surgery. These parameters are of great value in micro surgery since
localization of electrosurgical effects would also be accompanied by coagulation and
homeostasis. His analysis supported the supposition that evolving steam bubbles in the tissues at
the surgical tip continuously rupture the tissue and are responsible for cutting mechanism.
Coagulation:
Electrosurgical coagulation of the tissue is caused by the high frequency current flowing
through the tissue and heating it locally so that it coagulates from inside. The coagulation process
is accompanied by a grayish-white discoloration of the tissue that the edge of the electrode. In
contrast to a thermocauter, better coagulation can be achieved by high frequency currents
because it does not cause superficial burning.
Fulguration:
The term fulguration refers to a superficial tissue destruction without affecting deep-seated
tissues. This is obtained by passing sparks from the needle or ball electrode of small diameter to
the tissue. When electrode is held near the tissue without toughing it, spark is produced. This
spark is capable of burning the unwanted portions.
Prepared by A.Devasena., Asso. Prof., Dept/ECE
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8.1 Introduction:
Electric shock is a traumatic state caused by the passage of electric current can flow
through the human body either accidentally or intentionally. The kind and amount of damage
depends on the intensity, type and duration of the current, the point where the electricity first
touched the body and the path it took through the body. Burns may be superficial or very deep
with widespread tissue death. Severe shock may cause muscle contractions, respiratory paralysis,
unconsciousness and cardiac arrest. A high voltage electric shock may cause sudden muscle
spasm that may through the victim away from the power source with extreme force, resulting in
further injuries, such as fracture. Lightening causes injuries similar to those sustained from a
high voltage electric shock. Electrical currents are administered intentionally in the following
case.
For measurement of respiration rate by impedance method, a small current at high
frequency is made to flow between the electrodes applied on the surface of the body.
High currents are also passed through the body for therapeutic and surgical purposes.
When recording signals like ECG, and EEG, the amplifiers used in the preamplifier stage
may deliver small currents themselves to the patient. These are due to bias currents.
Accidental transmission of electrical current takes place because of defect in the
equipment; excessive leakage and simultaneous use of other equipment on the patient
which may produce potentials on the patient circuit.
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A patient may not be usually able to react in the normal way. He/she is either ill,
unconscious anaesthetized or strapped on the operating table. He/she may not be able to
withdraw him/herself from the electrified object, when feeling tingling in his/her skin,
before any danger of electrocution occurs.
The patient or the operator may not realize that a potential hazard exists. This is because
potential differences are small and high frequency and ionizing radiations are not directly
indicated.
Considerable neutral protection and barrier to electric current is provided by human skin.
In certain applications of electro medical equipment, the natural resistance of the skin
may be passed. Such situations arise when the tests are carried out on the subject with a
catheter in his/her heart or an large blood vessels.
Electro medical equipment, example : pacemakers may be used either temporarily or
permanently to support or replace functions of some organs of the human body. The
interruption in the power supply or failure of the permanent injuries or even prove fatal
for the patient.
Medical instruments are quite often used in conjunction with several other instruments
and equipment. These combinations of high power equipment and extremely sensitive
low signal equipment. Each of these devices may be safe in itself, but can become
dangerous when used in conjunction with others.
Environmental conditions in the hospitals particularly in the operating theatres cause
explosion or fire hazards due to the presence of anesthetic agents, humidity and cleaning
agents etc.
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8.4.2 Microshock:
A physiological response to a current applied to a surface of the heart that results in
unwanted stimulation like muscle contractions or tissue injury is called microshock. Micro
shock is most often caused when currents in excess of 10 microamperes, flow through an
insulated catheter to the heart. The catheter may be an insulated, conductive-fluid filled tube, or a
solid wire pacemaker cable. The micro shock results because the current density at the heart
become high in the situation depicted there, in which the catheter touches the heart.
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