DTE LAB MANUAL - 2017 Regulation

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VEL TECH MULTI TECH DR.RANGARAJAN

DR.SAKUNTHALA ENGINEERING COLLEGE AVADI
DEPARTMENT OF BIOMEDICAL ENGINEERING
ACADEMIC YEAR 2020-2021

(Even semester)
BM8611 DIAGNOSTIC AND THERAPEUTIC EQUIPMENT

LABORATORY
(2017 regulation)
SEM : VI
YEAR: III YEAR
BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

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SYLLABUS
BM8611 DIAGNOSTICANDTHERAPEUTICEQUIPMENTLABORATOR L T PC
0042
OBJECTIVES:
 To demonstrate recording and analysis of different Bio potentials

 To examine different therapeutic modalities.
LIST OF EXPERIMENTS:
1. Measurement of visually evoked potential

2. Galvanic skin resistance (GSR) measurement
3. Study of shortwave and ultrasonic diathermy
4. Measurement of various physiological signals using biotelemetry
5. Study of hemodialysis model
6. Electrical safety measurements
7. Measurement of Respiratory parameters using spirometry.
8. Study of medical stimulator
9. Analyze the working of ESU – cutting and coagulation modes
10. Recording of Audiogram
11. Study the working of Defibrillator and pacemakers
12. Analysis of ECG, EEG and EMG signals
13. Study of ventilators
14. Study of Ultrasound Scanners
15. Study of heart lung machine model
TOTAL: 60 PERIODS
OUTCOMES:
At the end of the lab, the student should be able to:
Measure different bioelectrical signals using various methods
Assess different non-electrical parameters using various methodologies
Illustrate various diagnostic and therapeutic techniques
Examine the electrical safety measurements
Analyze the different bio signals using suitable tools.

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B. E. Bio-Medical Engineering (R 2017)
BM 8611 - Diagnostic & Therapeutic Equipment Laboratory

(Requirement for a batch of 30 students)
Quantity
S.No Description of Equipment
Required
1 Visually evoked potential setup 1
GSR setup
2 1
3 2
Multi-output power supply (+15v, -15v, +30V variable, +5V, 2A)
4 Short wave Diathermy 1

Ultrasound diathermy
5 1
6 Multiparameter biotelemetry system 1
7 Electrical Safety Analyser 1
8 Spirometry with associated analysis system: 1

ECG Simulator
9 1
Medical stimulator
10 1
11 Surgical diathermy with analyzer 1
12 Audiometer 1
13 Pacemaker and Defibrillator 1
14 Hemodialysis model and Heart lung Model 1
15 Ventilator 1
16 Ultrasound Scanner 1
17 Software to Analyze ECG,EEG and EMG 1

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LIST OF EXPERIMENTS
S.No Name of theExperiment Page No

Measurement of visually evoked potential
1
Galvanic skin resistance (GSR) measurement

2
Study of shortwave and ultrasonic diathermy

3
Measurement of various physiological signals using biotelemetry

4
5 Study of hemodialysis model
Electrical safety measurements

6
Measurement of Respiratory parameters using spirometry.

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Study of medical stimulator

8
Analyze the working of ESU – cutting and coagulation modes

9
10 Recording of Audiogram
11 Study the working of Defibrillator and pacemakers
12 Analysis of ECG, EEG and EMG signals
13 Study of ventilators
14 Study of Ultrasound Scanners
15 Study of heart lung machine model

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ADDITIONAL EXPERIMENTS
VIRTUAL VALUE LABORATORY
S.No. Name of theExperiment Page No

1 To simulate Biopotential Amplifier
2 To simulate Missing Pulse Detector

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Ex. No: 1
MEASUREMENT OF VISUALLY EVOKED POTENTIAL
Date:
Aim
To analyze the nature of visually evoked potential using EEG recorder.
Equipment and Accessories Required
S.No Name of the Equipment Quantity

1 EEG Recorder 1
2 Flash Light 1
3 Montages 1
4 PC with EEG software 1
Theory :
Electrical potentials that occur in the cortex after stimulation of a sense organ which can be
recorded by surface electrodes are known as Evoked Potential. Example: SEP, ABR and VEP.
Evoked potentials test and record how quickly and completely the nerve signals reach the
brain. Evoked potentials are used because they can indicate problems along nerve pathways that
are too subtle to show up during a neurologic examination or to be noticed by the patient. The
disruption may not even be visible on MRI exam. These tests can be helpful in making the
diagnosis of multiple sclerosis (MS) and other neurological disorders. Evoked potential amplitudes
tend to be low, ranging from less than a microvolt to several microvolt’s, compared to tens of
micro volts for EEG, mill volts for EMG, and often close to a volt for ECG. Signals can be
recorded from cerebral cortex, brain stem, spinal cord and peripheral nerves. Usually the term
"evoked potential" is reserved for responses involving either recording from, or stimulation of,
central nervous system structures.
Types:
Visual Evoked Potentials (VEP)
Auditory Evoked Potentials (AEP)
Sensory Evoked Potentials (SEP)

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OPTICAL SYSTEM
Visually evoked potential

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VISUAL EVOKED RESPONSE (VEP):
The VEP tests the function of the visual pathway from the retina to the occipital cortex. It
assesses the integrity of the visual pathways from the optic nerve, optic chiasm, and optic
radiations to the occipital cortex. Visual evoked potential (VEP) tests evaluate how the visual
system responds to light. VEP tests used to evaluate optic neuritis, optic tumors, retinal disorders,
and demyelenating diseases such as multiple sclerosis.
An evoked potential or evoked response is an electrical potential recorded from the nervous
system of a human or other animal following presentation of a stimulus. The recording of electrical
activity associated with the functioning of brain activity is known as electroencephalogram. The
10- 20 electrode system is used for placing the electrodes on the scalp. The electrodes are place at
the specific points after applying gel to reduce the contact impedance.
The terms visually evoked potential (VEP), visually evoked response (VER) and visually
evoked cortical potential (VECP) are equivalent. They refer to electrical potentials, initiated by
brief visual stimuli, which are recorded from the scalp overlying visual cortex, VEP waveforms are
extracted from the electro-encephalogram (EEG) by signal averaging. VEPs are used primarily to
measure the functional integrity of the visual pathways from retina via the optic nerves to the
visual cortex of the brain
Procedure
1. The montages are connected by 10-20 electrode system on the scalp.
2. Using DAC system connects the output of the recorder to the PC.
3. The flashes of light are exposed to the subject.
4. The EEG signals are observed and are stored.
5. The digital data is exported and analyzed using EEG software.
6. The Delta (δ), Theta ( φ ), Alpha (α ), Beta ( β ), Gamma( γ ) waveforms are identified.
RESULT:
Thus the natures of visually evoked potential were identified in the EEG waveform.

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CIRCUIT DIAGRAM:

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Ex. No: 2
GALVANIC SKIN RESISTANCE (GSR) MEASUREMENT
Date:
Aim
To study the measurement of skin conductivity and the operation of galvanic skin response
system

1 Galvanic skin resistance measurement 1
monitor
2 Surface electrodes 1
3 Gel 1
Theory
Electro-dermal activity is measured in two ways. They are:
• Basal Skin Response (BSR)
• Galvanic Skin Response (GSR)
Galvanic skin resistance (GSR) refers to the recorded electrical resistance between two
electrodes when a very weak current is steadily passed between them. The electrodes are normally
placed about an inch apart, and the resistance recorded varies in accordance with the emotional
state of the subject. This resistance is normally in the range of 100,000 to 1,000,000 ohms.
Galvanic skin potential(GSP) refers to the voltage measured between two electrodes
without any externally applied current. This is conducted by connecting the electrodes to a voltage
amplifier. This potential may range as high as 50mv. Similarly, this voltage varies with the
emotional state of

the subject. The combined changes between galvanic skin resistance and galvanic skin potenti 1a6l
make up the galvanic skin response.GSR is measured readily at the palms of hands, fingers, and
soles of feet that display different bio-electrical phenomena.
An active electrode, positioned at the centre of the palm, can be used together with a neutral
electrode, either at the wrist or at the back of the hand. In order to increase the stability of the
measurement, non-polarizing electrodes, such as silver-silver chloride surface electrodes are used
with an electrode jelly.
Standard placement: affix the electrodes on the surface of the distal phalanges of the left hand
Alternative placement: affix the electrodes on the thenar and hypothenar eminences of the
left hand.
LEAD PLACEMENT:
TABULATION:
S. No Mode Conductance Resistance External

Value value Stimulus
1. Dry Skin 62 93 nil
2. Wet Skin 2.85 362 nil

reactions such as fear. External factors such as temperature and humidity affect GSR
measuremen1ts8,
AUDIO AMPLIFIER:It amplifies the input signal without any changes in the input signal.
Audio Feedback Features:
•Each audio feedback option can be switched on and off using a button.
•Tone and midi: feedback via pitch
•Auto-recalibrate feature: when pitch drifts out of range, it automatically resets to the
middle of the pitch range
•Threshold-based feedback: a reward or warning repeatedly sounds when the rate of change
falls out of range for a sustained period.
OSCILLOSCOPE:
Design features are:
•Dual screen designs (therapist and client) included
•Automatic calculation of baseline (average over first 30 seconds)
•Button option to reset baseline (to average over the last 30 seconds)
•Calculation of gain over baseline
A skin conductance meter is a device that measures the electrical conductance between 2
points, and is essentially a type of ohmmeter. Active measuring involves sending a small amount
of current through the body.
The galvanic skin response is combined with the recording of heart rate, respiratory rate,
and blood pressure because they are all autonomic dependent variables, meaning they cannot be
consciously changed.
Many biofeedback therapy devices utilize skin conductance to measure and present an
individual’s stress response with the goal of helping the user to control their anxiety.
Skin conductance measurement is also becoming popular in hypnotherapy and
psychotherapy practice where it can be used as a method of detecting depth of hypnotic trance
prior to suggestion therapy commencing. It is also used in behaviour therapy to measure
physiological
which can lead to inconsistent results. Internal factors such as medications can also change GSR
measurements. Responses have been shown to show inconsistency even when given the same
stimulus level.
GSR is also known as psychogalvanic reflex (PGR), or skin conductance level (SCL).

reactions such as fear. External factors such as temperature and humidity affect GSR
measuremen1ts8,
MODEL GRAPH:
Amplitude (V)
Time (ms)

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BLOCK DIAGRAM DESCRIPTION:
CHARGER AND BATTERY: Measurement is made using the dc current source.
R-F CONVERTER: A resistance-to-frequency converter consisting of a Wheatstone bridge
followed by an integrator and a comparator is described. In concept the circuit represents a
relaxation oscillator whose frequency changes linearly with a resistance change detected by
the bridge. Analyses show that a resolution better than 0.05% is possible with the simple
configuration and an excellent linearity is maintained over the wide resistance change by using a
simple compensation method. The converter is therefore suited as a signal conditioner of a
resistive sensor.
GSR SENSOR: The electrodes are typically attached to the subject's fingers or toes using
electrode cuffs (as shown on the left electrode in the diagram) or to any part of the body using a
silver-Chloride electrode patch such as that shown on the EMG.
F-V CONVERTER: There are two methods to make a F-V converter. They are:
•The input frequency triggers the monostable of a charge-balance VFC that has a resistor in
parallel with its integration capacitor; or
•The input frequency can be applied to the phase/frequency comparator of a phase-locked
loop (PLL), which uses a VFC (of either type) as its oscillator.
In F-V converter the output voltage is proportional to its input frequency.
Result: Thus GSR was measured for both dry and wet skin.

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Ex. No: 3 STUDY OF SHORTWAVE AND
Date: ULTRASOUND DIATHERMY
Aim
To study the working of shortwave diathermy and ultrasound diathermy for various
power settings.

1 Diathermy Unit 1
2 Electrode Pads 1
3 Connecting Cables As required
4 Ultrasonic therapy Unit 1
5 Ultrasonic transducer 2
6 DSO or PC with Data 1
Acquisition Unit
Theory
Short Wave Diathermy
The term ‘diathermy’ means ‘through heating’ or producing deep heating directly in the
tissues of the body. Externally applied sources of heat like hot towels, infrared lamps and electric
heating pads often produce discomfort and skin burns long before adequate heat has penetrated to
the deeper tissues. But with the diathermy technique, the subject’s body becomes a part of the
electrical circuit and the heat is produced within the body and not transferred through the skin.
Another advantage of diathermy is that the treatment can be controlled precisely. Careful
placement of electrodes permits localization of the heat to the region that has to be treated. The
amount of heat can be closely adjusted by means of circuit parameters. The heating of the tissues is
carried out by high frequency alternating current which generally has a frequency of 27.12 MHz
and a wavelength of 11m. The current being altering, it is possible to pass current through the
tissues of a much greater intensity to produce direct heating in the tissues similar to any other
electrical conductor.

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Principle of Shortwave Diathermy
Electrodes
Joints to be
treated
Circuit Diagram

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Circuit Description
The short wave diathermy machine consists of two main circuits: an oscillating circuit,
which produces a high frequency current and a patient circuit, which is connected to the oscillating
circuit and through which the electrical energy is transferred to the patient.
Transformer T1, the primary of which can be energized from the mains supply, is a step-up
transformer for providing EHT for the anode of the triode valve. A second winding can provide
heating current for the cathode of the triode valve. The tank (resonance) circuit is formed by the
coil AB in parallel with the condenser C1. The positive feedback is generated by coil CD. There is
another coil EF and a variable condenser C2 which form the patient’s resonator circuit due to its
coupling with the oscillator coil AB.
The anode supply of such a circuit is around 4000 V. The conduction in the triode takes
place during the positive half cycle and the high frequency is generated only during this period.
More usually, the supply voltage is rectified before supplying to the anode of the oscillator valve.
In such case, the oscillations produced are continuous and more power thus becomes available. In
order to ensure that the oscillator circuit and the patient’s resonator circuit are tuned with each
other, and ammeter is placed in series with the circuit. The variable condenser C2 is adjusted to
achieve a maximum reading on the meter, the needle swinging back on either side of the tuned
position. The maximum power delivered by these machines is 500 W.
A thermal delay is normally incorporated in the anode supply which prevents the passage
of current through this circuit until the filament of the valve attains adequate temperature. The
patient circuit is then switched on followed by a steady increase of current through the patient. A
mains filter is incorporated in the primary circuit to suppress interference produced by the
diathermy unit itself.
There are several ways of regulating the intensity of current supplied to the patient from a
short-wave diathermy machine. This can be done by either (i) controlling the anode voltage, or (ii)
controlling the filament current, or (iii) adjusting the grid bias by change of grid leak resistance R 1,
the best way of finely regulating the current is by adjusting the grid bias, by putting a variable
resistance as the grid leak resistance.
Procedure
 The two condenser pads is connected to the output socket. The two electrodes are
placed around the patient’s body where treatment is to be given.
 Connect the mains cable is connected & the unit is switched ON. Power ON switch
must glow.
 Timer is set for desired period.
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Tabulation
Power
Max. Applied Distance Between the Deflection at the Time of Patient
S.No Control
Current Electrode Pads Treatment Time (Sec)
Position

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 Power control is set to the desired position; generally in position 2 or 3 of power control
is sufficient.
 The capacitor knob is tuned at a position corresponding to maximum current indication
in the meter.
 Readings are taken for power control position 2 and3.
 The above procedure is repeated by changing the distance between pads.
Ultrasound Diathermy
The heating effect is produced because of the ultrasonic energy absorption property of the
tissues. The effect of ultrasonic on the tissues is thus a high speed vibration of micro massage.
Massage as a modality in physical medicine has been used in the treatment of soft tissue lesions for
centuries. Ultrasonic energy enables this massage to be carried out, firstly to a greater depth than is
possible manually and secondly at times (in acute injuries) when pressure cannot be exerted by
hand because of intolerable pain caused to the patient. The thermal effects of ultrasound are
dependent on the amount of energy absorbed, the length of time of the ultrasound application and
the frequency of the ultrasound generator.
Ultrasonic generators are constructed on the piezo-electric effect. A high frequency
alternating current (e.g., 0.75-3.0 MHz) is applied to a crystal whose acoustic vibration causes the
mechanical vibration of the transducer head, which itself is located directly in front of the crystal.
These mechanical vibrations then pass through a metal cap and into the body tissue through a
coupling medium. The therapeutic ultrasonic intensity varies from 0.5 to 3.0 W / cm 2. Applicators
range from 70 to 130 mm in diameter.
Circuit Description
The equipment required for ultrasonic therapy is electronically very simple. The heart of
the system is a timed oscillator which produces the electrical oscillations of the required frequency.
The oscillator output is given to a power amplifier which drives the piezo electric crystal to
generate ultrasound waves. Power amplification is achieved by replacing the transistor in typical
LC tuned Colpitt oscillator by four power transistors placed in a bridge configuration.
The delivery of ultrasound power to the patient is to be done for a given time. This is
controlled by incorporating a timer to switch on the circuit. The timer can be a mechanical spring –
loaded type or an electronic one, allowing time settings from 0 to 30 minutes.

Block Diagram of Ultrasonic Therapy Unit
Ultrasonic Transducer Structure
Tabulation
S.No Power Control Position Graphical Output from DSO

The output of the oscillator can be controlled by either of the following methods:
1. Using a transformer with a primary winding having multi-tapped windings and
switching the same as per requirement.
2. Controlling the firing angle of a TRIAC placed in the primary circuit of the transformer
and thereby varying the output of the transformer.
The machine can be operated in either continuous or pulsed mode. A full-wave rectifier
comes in the circuit for continuous operation. The mains supply is given to the oscillator without
any filtering. The supply voltage is therefore at 100Hz. In pulsed mode, the oscillator supply is
provided by the half-wave rectifier and the oscillator gets the supply only for a half cycle. Thus the
output 1 MHz is produced only for one half of the cycle and is pulsed.
The transducer may be barium titan ate or lead zircon ate titan ate crystal, having 5-6 cm 2
effective radiating area. In front end of the crystal lies a metal face plate which is made to vibrate
by the oscillations of the crystal. Ultrasonic waves are emitted from this plate. The crystal has a
metal electrode pressed against its back surface by a coiled spring. Voltage is applied to the crystal
via this electrode. The front diaphragm is grounded and provides a return path for the excitation
voltage.
Dosage Control
The dosage can be controlled by varying any one of the following variables.
 Frequency of ultrasound
 Intensity of ultrasound
 Duration of the exposure
The output power of an ultrasonic therapy unit can be varied continuously between 0 and 3 W/cm2
Procedure
 The ultrasonic transducer is connected to the power unit. The ultrasonic transducer
is placed on the patient’s body where treatment is to be given.
 Switch ON the unitby connecting to the mains cable &. Power ON switch must glow.
 Ultrasound selector switch is set for desired mode of operation (continuous or pulsed).
 Power control is set to the desired position, generally 1 w/cm2 or 2w/cm2 is sufficient.
 The treatment time is set.
Result
The working of shortwave and ultrasound diathermy are thus studied at various power settings.

BLOCK DIAGRAM OF A BIOTELEMETRY TRANSMITTER
Battery
ECG Low Pass FM FM

Amplifier Filter Modulator Transmitter
Electrode
BLOCK DIAGRAM OF RECEIVER- STORAGE AND DISPLAY UNITS
FM FM Low Pass DSO

Receiver Demodulator Filter
Battery

Ex. No: 4
MEASUREMENT OF VARIOUS
Date: PHYSIOLOGICALSIGNALS USING BIOTELEMETRY
Aim
To transmit and receive the ECG signal through Biotelemetry system.

1 ECG Lead 3 No’s
2 Telemetry transmitter 1
3 Telemetry receiver 1
Theory
Wireless telemetry permits the examination of the physiological data of man or animal
under normal conditions and in the natural surroundings without any discomfort or obstruction
to the person or animal under investigation. The stage of a typical biotelemetry system is divided
into two functional blocks, the transmitter and receiver. In the transmitter unit the physiological
signals are obtained from the subjects by means of appropriate transducers. The signal is then
passed through a stage of amplification and processing circuits that include generation of a
subcarrier and a modulation stage for transmission. A radiofrequency (RF) carrier is a high-
frequency sinusoidal signal which when applied an appropriate transmitting antenna, is propagated
in the form of electromagnetic waves. The range of the biotelemetry system is the distance
travelled by the transmitted signal. Information to be transmitted is impressed upon the carrier by
a process known as modulation. The circuitry which generates the carrier and modulates it
constitute the transmitter. The receiver consists of a tuner to select the transmitting frequency, a
demodulator to separate the signal from the carrier wave and a mean of displaying or recording the
signal. By tuning the receiver to the frequency of the desired RF carrier, that the signal can be
selected while others are rejected.The two basic system of modulation are Amplitude Modulation
(AM) and Frequency Modulation (FM). In amplitude – modulated system, the amplitude of the
carrier is caused to vary with the information being transmitted. Amplitude modulated system are
susceptible to nature and manmade interference, since the interference generally appear as
variations in the amplitude of the
received signal. In Frequency Modulation system, the frequency
TABULATION:
S.NO SU BJECT TRANSMITTED ECG
FREQUENCY (Hz) WAVEFORM

from its modulated radio carrier wave. Here the modulated ECG signal is demodulated at a
frequency of around 100 Hz and the original of the carrier is caused to vary with the modulated
signal. The transmitted heart rate is obtained by finding the interval between the two successive
RR intervals.
BLOCK DIAGRAM DESCRIPTION
ECG Amplifier::ECG has amplitude of 1 mV. Hence an amplifier with a gain of 1000 and
CMRR of more than 80 dB is used to amplify the signal obtained from the subject.
Low Pass Filter::A low pass filter allows low-frequency signals but attenuates signals with
frequencies higher than the cut off frequency. When the ECG is amplified, the noise is amplified
too, and often swamps the ECG signal. The noise is usually of a higher frequency than the ECG.
So the noise can be reduced by low pass filtering.
FM Modulator::Modulation is used to embed a message on to a carrier wave for
transmission. A band limited range of frequencies that comprise the message is translated to a
higher range of frequencies. The band limited message is preserved, i.e. every frequency in that
message is scaled by a constant value. The incoming ECG signal is modulated at around 110 MHz.
the modulated ECG signal is given to the FM Transmitter.
FM Transmitter:FM Transmitter sends a signal ( typically 4-20 mA ) from a process
location to a central location for control and monitoring. Here FM Transmitter transmits the
modulated ECG signal.
FM Receiver: A receiver receives its input through an antenna. It receives the modulated
signal from the transmitter. The receiver then passes on the information to the FM Demodulator
where the ECG signal is demodulated to obtain the original ECG signal.
FM Demodulator: Demodulation, in ratio is the technique of separating a transmitted
audio frequency signal from its modulated radio carrier wave. Here the modulated ECG signal is
demodulated at a frequency of around 100 Hz and the original ECG signal is recovered.
Procedure:
1. The modules are connected as per the block diagram.
2. The battery power supply is switch on.
3. The Electrodes from the subject is connected to the ECG amplifier.
4. The ECG from the output of ECG Amplifier is observed on the DSO.
5. The ECG signal on the receiver side from the output of FM Demodulator is
observed on the DSO.
RESULT:
Thus the ECG signal was transmitted and received through single channel Biotelemetry.

Ex. No: 5
STUDY OF HEMODIALYSIS MODEL
Date:
Aim
To study the working of a hemodialysis machine.

1 Hemodialysis Kit 1
2 Dialyzer 1
3 Connecting Cables As Required
Theory
Hemodialysis is a treatment to filter wastes and water from the blood, as kidneys did when
they were healthy. Hemodialysis helps control blood pressure and balance important minerals,
such as potassium, sodium, and calcium, in the blood.
Hemodialysis can help the patient feel better and live longer, but it’s not a cure for kidney
failure.
During hemodialysis, blood that is drawn out of the body goes through a filter, called a dialyzer,
outside the body. A dialyzer is sometimes called an “artificial kidney.”
Hemodialysis works on two principles:
 osmosis
 diffusion
Osmosis is the ability of water to pass through the wall of a cell. This wall is called a semi-
permeable membrane and acts like a filter.
Diffusion is the natural movement of particles from an area with lots of particles to an area
with fewer particles.
In hemodialysis, the dialyzer (mechanical kidney) acts as the semi-permeable membrane.
 Blood flows along one side of the membrane and a special dialysis solution called dialysate
flows on the other side.
 The waste products removed from your child's body diffuse, or spread, from the blood (an
area with lots of waste products) into the dialysate (an area with no waste products).
 The substances that the body needs cannot pass through the semi-permeable membrane. These
stay in the blood that is returned to the body.
Hemodialysis process
Process in Dialyzer

Dialyzer
A dialyzer is often referred to as an “artificial kidney.” Its function is to remove the excess
wastes and fluid from the blood, when the patient’s kidneys can no longer perform that task.
Dialyzers are made of a thin, fibrous material. The fibers form a semipermeable membrane,
which allows smaller particles and liquids to pass through. The dialyzer is encased in a sealed
plastic cylinder about a foot long and approximately two to three inches in diameter with openings
at the top and bottom. During treatment dialysate (dialysis solution) and your blood flow through
the dialyzer (but they never touch). Fresh dialysate from the machine enters your dialyzer through
one opening and blood enters through the other. Wastes are filtered out of your blood into the
dialysate. Dialysate containing waste products leaves the dialyzer and is washed down the drain,
while the cleaned blood goes back into your body.
There are different sizes of dialyzers. These sizes are related to the blood volume that will
go through them, which depends on the patient's size and weight. Your kidney doctor will
prescribe the right-sized dialyzer for you.
Drawing blood out of the body for Dialysis:
 Fistula (also known as arteriovenous fistula or A-V fistula): An artery and vein are joined
together under the skin in the arm. An A-V fistula needs 6 weeks or longer to heal before it can
be used for hemodialysis. Then, it can be used for many years.
 Graft (arteriovenous graft or A-V graft): A plastic tube is used to join an artery and vein under
the skin.
 Catheter (central venous catheter): A flexible tube (catheter) is put into a vein in the neck,
below your collarbone, or next to your groin. It’s only meant to be used for a short time.
Procedure
Measurement of Maximum & Minimum speed of peristaltic pump with and without load
1. Connect all accessories

2. Switch on the mains switch. Speed switch at OFF position. Heater switch at OFF position
3. Remove red blood pipe from peristaltic pump (without load)
4. Measure minimum and maximum speed without load.
5. Connect red blood pipe in peristaltic pump and insert water.
6. Measure minimum and maximum speed with load.
Measurement of Dialysate Temperature


Measurement of Maximum & Minimum speed of peristaltic pump with and without load
S. No Speed Knob Speed

ON
Speed without load
1. Knob at zero position –
………………….BPM
minimum speed
ON
Knob at maximum Speed without load
2.
position – maximum ………………….BPM
speed
ON
Speed with load
3. Knob at zero position –
………………….BPM
minimum speed
ON
Knob at maximum Speed with load
4.
position – maximum ………………….BPM
speed
Measurement of Time taken for transfer of 1 liter water for different pump speeds
S. No Speed Time
1. 60
2. 90
3. 100

3. Fill the Dialysate beaker with water
4. Switch ON the Dialysate pump
5. Switch ON the heater and adjust temperature by 27˚C
6. Put the thermometer in Dialysate beaker.
7. Measure the temperature
Measurement of Time taken for transfer of 1 liter water for different pump speeds

3. Fill the 1 liter beaker with water. Adjust the speed at 60 RPM
4. Switch on the timer and measure the time.
5. Fill water if water level is low.
6. Repeat for speeds 90 and 100 RPM.
Result
Thus the working of hemodialysis machine is studied.
Ex. No: 6
ELECTRICAL SAFETY MEASUREMENTS
Date:
Aim
To measure the leakage currents, insulation break using electrical safety analyzer.

1 Electrical Safety Analyzer Kit 1
2 Transformer, Wires 1
3 Connecting Cables As Required
Theory
Electrical safety is very important in hospitals as patients may be undergoing a diagnostic

or treatment procedure where the protective effect of dry skin is reduced. Also patients may be
unattended, unconscious or anaesthetized and may not respond normally to and electric current.
Further, electrically conductive solutions, such as blood and saline, are often present in patient
treatment areas and may drip or spill on electrical equipment.
Electrical current:
Injuries received from electric current are dependent on the magnitude of current, the
pathway that it takes through the body and the time for which it flow.
Leakage current:
Electrical components and systems are encased in non-conducting insulation, to ensure that
the electric current is contained and follows the intended pathways. If the insulation cracks or
deteriorates current will leak through the insulation barrier and either flow to earth through the
protective earth conductor or through the operator.
Medical equipment and clinical areas are fitted with a number of protective devices to
protect the patient and operator from harmful leakage currents.
Test method
Normally the high voltage is applied between the two parts across the insulation being
tested, such as the primary circuit and metal enclosure of the equipment under test.

34
Tabulation
S.No Condition Voltage in Volts
Input voltage:
Line and neutral

1.
Line and ground
Neutral and ground
Output voltage:
Line and neutral

2.
Line and ground
Neutral and ground
Open neutral loop output:
Line and neutral

3.
Line and ground
Neutral and ground
Reverse Polarity:
Line and neutral

4.
Line and ground
Neutral and ground

35
If the insulation between the two is adequate, then the application of a large voltage
difference between the two conductors separated by the insulator would result in the flow
of a very small current. Although this small current is acceptable, no breakdown of either the air
insulation or the solid insulation should take place. Therefore, the current of interest is the current
that is the result of a partial discharge or breakdown, rather than the current due to capacitive
coupling.
Another example would be to test the insulation between the primary and secondary
circuits of a power supply. Here, all the outputs are shorted together. The ground probe from the
tester is placed in contact with this cable bunch, and the high voltage probe is placed in contact
with L and N connectors, which are shorted together. The equipment under test does not run during
the test. It must also be noted that when applying the high voltage during the type test, the ideal
situation would require that not more than half of the prescribed voltage be applied, and then
raised gradually over a period of 10 seconds to the full value and maintained for 1 minute. Most
test equipment, however, either turns on directly to the full voltage or has an electronically
controlled ramp.
Test voltage:
The majority of safety standards allow the use of either ac or dc voltage for the test. When
using ac test voltage, the insulation in question is being stressed most when the voltage is at its
peak, i.e., either at the positive or negative peak of the sine wave. Therefore, if one decides to use
dc test voltage, one must ensure that the dc test voltage is √2 (or 1.414) times the ac test voltage, so
the value of the dc voltage is equal to the ac voltage peaks. For example, for a 15-V-ac voltage, the
equivalent dc voltage to produce the same amount of stress on the insulation would be 15 x 1.414
or
21.21 V dc.
Insulation
Resistance:
The insulation resistance test is also known as a Megger test. Its objective is to measure the
total resistance between any two points separated by insulation. The test, therefore, determines
how effective the insulation is in resisting the flow of electrical current. The voltage is typically
around 500 – 1000 V dc; hence, the current is very low. Because the current is so low, this test is
useful for checking the quality of the insulation not only when a product is first manufactured, but
also over time as the product is used.

36
Test procedure
The equipment under test is connected to the measuring instrument, and the voltage is
ramped up from zero to the final value, which in most cases is 500 V dc. Once the voltage reaches
the selected value, it is kept at that value for a brief period (typically up to 5 seconds) before the
resistance test is measured. The measured value should be very high (typically in the meg ohm
region).
Earth leakage current
This refers to the electric current through a human body or through an animal body when it
touches one or more accessible parts of installation or equipment. There is also another concept
known as “protective conductor current” and this refers to the current that flows in a protective
conductor. A protective conductor current, therefore, can never be the source of an electric shock
because, by definition, the protective conductor is connected to earth.
If touch current is excessive, and operator could receive an electric shock, which could
result in a serious injury, depending on a person’s body weight. Typically, current of more than 1.0
mA can cause and electric shock to an operator. The shock may or may not be serious, depending
on the amount of the current and the body weight.
Result
The leakage current, insulation for the given items are measured using Electrical Safety
Analyzer.

37
Ex. No: 7
MEASUREMENT OF RESPIRATORY PARAMETERS USING
Date: SPIROMETRY
Aim
To measure the respiratory rate using displacement transducer

1 Pneumotachometer 1
2 PC with Analyzer 1
3 Data Cable 1
Theory
Pulmonary function analyzers provide the means for automated clinical procedures and
analysis techniques for carrying out a complete evaluation of the lung function or the respiratory
process. The respiratory activity ensures supply of oxygen to and removal of carbon dioxide from
the tissues. This is performed by using a device called spirometer that measures the volume
displacement and amount of gas moved in a specific time. Usually this requires the patient to take
a deep breath and then exhale as rapidly and completely as possible called the forced vital
capacity, this gives an indication of how much air can be moved by the lungs and how freely this
air flows.
Spirometer
A spirometer is an apparatus for measuring the volume of air inspired and expired by the
lungs. It is a precision differential pressure transducer for the measurements of respiration flow
rates. The spirometer records the amount of air and the rate of air that is breathed in and out over a
specified time. The spirometer and attached flow head function together as a Pneumotachometer,
with an output signal proportional to airflow. The output produced by a spirometer is called a
kymograph trace. From this, vital capacity, tidal volume, breathing rate and ventilation rate (tidal
volume × breathing rate) can be measured. From the overall decline on the graph, the oxygen
uptake can also be measured.

38
Block Diagram of Pulmonary Function Analyze
Spirometery

39
Pneumotachometer
Pneumotachometer is a turbine transducer that converts the flow of air, breathed by the
patient, against a frictionless rotating vane into an electrical signal which is used to produce the
relevant plots. The arrow on the surface of the transducer indicates the direction in which it is to be
pushed inside the transducer slot in the head piece.
Respiratory
Volumes Tidal
Volume
The volume of gas inspired or expired (exchange with each breath) during normal quiet
breathing is known as tidal volume.
Minute Volume (MV)

The volume of gas exchanged per minute during quiet breathing. It is equal to the tidal
volume multiplied by the breathing rate.
Alveolar Ventilation (AV)

The volume of fresh air entering the alveoli with each breath.
Alveolar Ventilation = (Breathing rate × (Tidal volume – Dead space)
Inspiratory Reserve Volume (IRV)
The volume of gas, which can be inspired from a normal end tidal volume.
IRV = VC – (TV + FRC)
Expiratory Reserve Volume (ERV)
The volume of gas remaining after a normal expiration less the volume remaining after a
forced expiration.
ERV = FRC – RV
Residual Volume (RV)
The volume of gas remaining in the lungs after a forced expiration.

40
Lung Volumes and Lung Capacities
Tabulation
Lung Functions
S.No. Subject Name
Volume Capacity

41
Respiratory Capacities
Functional Residual Capacity (FRC)
The volume of gas remaining in the lungs after normal expiration.
Total Lung Capacity (TLC)
The volume of gas in the lungs at the point of maximal inspiration.
TLC = VC + RV
Vital Capacity (VC)
The greatest volume of gas that can be inspired by voluntary effort after maximum
expiration, irrespective of time.
Inspiratory Capacity (IC)
The maximum volume that can be inspired from the resting end expiratory position.
Dead Space (DS)
Dead space is the functional volume of the lung that does not participate in gas exchange.
Procedure
 Fix the transducer into the transducer assembly. The transducer has an arrow on the surface.
Insert the transducer in the direction indicated by the arrow. The transducer will click into
position when correctly connected.
 Fix the mouth piece (disposable or reusable) to the transducer assembly. The mouthpiece
will click into position when correctly connected. Connect the transducer assembly to the
computer using the USB cable.
 Train thepatientin testperformance. The patient’s collaboration is essential to carry out the
maneuvers correctly. Use a nose clip to allow air to flow only through the patient’s mouth.
 The patient must sit upright holding the hand piece to their mouth and throughout the
maneuver the patient should try to keep their back straight as much as possible.
 The patient should hold transducer hand unit in such a way that the air passage is completely
unobstructed. Ensure the patient’s hands, fingers or clothing, etc., are not obstructing the air
flow. The area in front of the patient should also be kept clear to avoid back draft of air
entering the turbine and affecting the readouts.

42
Performing the PVC Test

 Explain the general procedure to the patient.
 Load patient details to the database. Click FVC. The FVC test screen is displayed.
 Ask the patient to begin with relaxed tidal breathing through the mouth piece fixed over
the transducer and then to take a deep breathe in.
 Simultaneously click the Start button. Make the appropriate choice of the test
(Pre medication or Post Medication)
 Immediately after this the patient should blow out as hard and fast as possible and
continue blowing until no more air can be exhaled.
 Then the patient should take another deep breath back in, with the mouthpiece still in
his mouth, until the lungs are full.
 When finished the effort is complete.
 Repeat the test as required until adequate test data has been acquired, or until a
maximum of eight acceptable maneuvers have been performed.
Performing the SVC Test
 Explain the general procedure to the patient.

 Load patient details form to the database. Click SVC. The SVC test screen is displayed.
 Ask the patient to begin relaxed tidal breathing through the mouth piece fixed over
the transducer.
 Click the Start button. Make the appropriate choice of the test.( Pre Medication or
Post Medication)
 The patient should next take a deep breath followed by a deep exhalation. Both
inhalation and exhalation should be performed to the maximum extent but slowly.
 After this the patient should take a few gentle and normal breaths.
 Click stop button from the Tool Bar.
 Repeat the test until adequate test data has been acquired, or until a maximum of
eight acceptable maneuvers have been performed.
 Show all maneuvers option is not available in the SVC maneuver.
Result
The respiratory rate is measured using displacement transducer and the spirogram is
recorded.

43
Ex. No: 8
STUDY OF MEDICAL STIMULATOR
Date:
Aim
To study the medical stimulator for different types of waveforms and intensity

1 Medical Stimulator 1
2 DSO 1
3 Connecting cables 1
Theory
Electrotherapy is applying low-volt, low-frequency impulse current in the physiotherapy
department for therapeutic management of many diseases affecting muscles and nerves. This
technique is used treatment of paralysis with totally or partially degenerated muscles, for treatment
of pain, muscular spasm and peripheral circulatory disturbances.
Different types of waveforms are used for carrying out specific treatments. The most
commonly used pulse waveforms are
Galvanic current: When a steady a steady current of direct current is passed through a tissue, its
effect is primarily chemical. It causes the movement of ions and their collection at the skin lying
immediately beneath the electrodes. The effect is manifested most clearly in a bright red coloration
which is an expression of hyperemia (increased blood flow).Galvanic current is used for the
preliminary treatment of atonic paralysis and for treatment of disturbance in blood flow. It is also
used for iontophoresis, for introduction of drugs into the body through the skin by electrolytic
means. Faradic current: Faradic current is a sequence of pulses with a defined shape and current
intensity. The pulse duration is about 1 minute with a triangular waveform and an interval duration
about 20 minutes. Faradic current acts upon muscle tissue and upon the motor nerves to produce
muscle contraction. There is no ion transfer and consequently no chemical effect. Used for the
treatment of muscle weakness after lengthy immobilization and of disuse atrophy.
Surging current: If the peak current intensity applied to the patient increases and decreases
rhythmically with slow rate resulting in a shape called surging current. The main field of
application of the Faradic surge current is in the treatment of functional paralysis. The surge rate is
usually from

44
Block Diagram of Medical Stimulator
TNS
Modulating Circuit Intensity/

DSO
Surged Faradic Duration
IG
Types of Current Waveforms

45
surges per minute in most instruments. The ratio of the interval to the duration of the
surging is also adjustable so that graded exercise can be administered. This type of current
is required for the treatment of spasm and pain.
Exponentially Progressive Current: This type of current is useful for the treatment of severe
paralysis. The main advantage of this method lies in the possibility of providing selective
stimulation for the treatment of the paralyzed muscles. This means the surrounding health tissues
even in the immediate neighborhood of the diseased muscles are not stimulated.
Biphasic Stimulation: The all recovery from the effect of a stimulus can be hastened by the
passage of a lower intensity current of opposing polarity over a longer period so that the net
quantity of electricity is zero. Biphasic current is the most versatile of the stimulation therapy
waveforms. It can be used for several different purposes. The use of biphasic current for the
treating pain, strengthening muscles, re-educating muscles, increasing circulation and decreasing
swelling.
TENS:Transcutaneous electrical nerve stimulation (TENS or TNS) is the use of electric

current produced by a device to stimulate the nerves for therapeutic purposes. The unit is usually
connected to the skin using two or more electrodes. A typical battery-operated TENS unit is able to
modulate pulse width, frequency and intensity. Generally TENS is applied at high frequency (>50
Hz) with an intensity below motor contraction (sensory intensity) or low frequency (<10 Hz) with
an intensity that produces motor contraction. The small electrical currents of TENS are adjusted to
send stimulating pulses over the surface of the skin and into nerve endings. Those pulses help to
decrease pain by blocking pain signals from reaching the brain. They also help stimulate
production of endorphins, the body's natural painkillers. Common uses for TENS: back and neck
syndromes, RSD (or "complex regional pain syndrome"), arthritis, shoulder syndromes,
neuropathies, and other acute and chronic pain.
Procedure
1. Connect the output from Surged current to DSO
2. Switch on the equipment and draw the output waveform for Faradic and Surged
Faradic for different intensity and duration
3. Change the connection to TENS mode
4. Draw the output waveform for TNS and IG for different intensity and duration
Result
The waveform for the therapeutic application are studied using medical stimulator.

46
Ex. No: 9
STUDY OF ESU – CUTTING AND
Date: COAGULATION MODES
Aim
To study and analyze the functioning and safety aspects of surgical diathermy.

1 Electrosurgical machine with mains cord 1
2 Patient plate with cable 1
3 Foot switch with cable 1
4 Bicoag forceps with cable 1
5 Active electrode with cable 1
6 Electrode set 1
Theory
Surgical diathermy machine uses high frequency currents for surgical purposes involving
cutting and coagulation. They depend on the heating effect of electric current. When a high
frequency current flows through the sharp edge of wire loop or band loop or the point of a needle
into the tissue as shown in the figure, there is a high concentration of current at this point. The
tissue is heated to such an extent that the cells which are 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 heat is developed at this
electrode. This type of tissue separation forms the basis of electro-surgical cutting. Electro-surgical
coagulation of tissue is caused by the high frequency current flowing through the tissue and
heating it locally so that it coagulates from inside.
Operation
Surgical diathermy machine consists of a high frequency power oscillator. Two electrodes
are connected to the RF power generator. One electrode is active and has a very small cross
sectional area (100 cm2) with respect to the other electrode. The current flowing into the patient
cable is same as the current flowing into the active electrode. The current density is in amperes.
The current density is difference between the two electrodes. The tissue beneath the patient plate
heats up slightly, while the tissue underneath the active electrode is heated to destruction. In
bipolar mode electrode does

47

48
Principle of Electro Surgical Diathermy
Block Diagram of Surgical Diathermy
Tabulatio
n

49
Ammeter (A) Voltmeter (V)

S.No Electrode Type Soap
Soft Hard Soft Hard
Cut
1 Unipolar
Coagulation
2 Bipolar Coagulation

not require a patient plate. In the unipolar systems the two electrodes are active electrode and
patient plate. The principle of electro surgery is as follows. The total current through the body is
determined by the voltage (set on electrosurgical unit) and the total impedance between the
electrodes.
The generation of heat per unit volume of tissue, P/V (W/m3) is given by
P/V = ρi2,
Where ρ is the resistivity (Ωm) including the dielectric losses, and i is the current density
(A/m2).
As a means of incising tissue, electro surgery has the advantage that bleeding is diminished due to
the coagulation of the vessels. In addition some microorganisms are killed by heat.
Procedure
 Connect the instrument to the mains.

 Connect the foot switch, active electrode, bipolar electrode and patient cable to
the instrument.
 Put all the knobs at zero position and then switch on the machine.
 Press the foot switch in cut and coagulation mode so as to get the different audio
with indication.
 For lab purpose soap is used as subject.
 Remove active and patient cable when operating in bipolar mode. Operate bipolar only
in coagulation mode.
 The knife electrode is used for cutting and ball electrode is used for coagulation,
whereas needle electrode can be used for microsurgery as well as fine points to be
coagulated.
Safety Aspects
The risk associated with electro surgery fall into four main categories. They are burns,
electrical interference with the heart muscles (ventricular fibrillation), the danger of explosions
caused by the sparks and electrical interference with the pacemaker and other electronic
equipment. Burns may occur due to inadequate electrode contact, presence of moisture, abnormal
power setting. High frequency current hazards may occur due to possible electrocution of the
patient from faulty mains operated equipment. Explosive hazards can occur through the use of
cleansing agents such as ether and alcohol and by using explosive anesthetic gas or mixtures with
oxygen.
Result
The functioning of surgical diathermy is analyzed with various safety aspects.
Ex. No: 10
RECORDING OF AUDIOGRAM
Date:
Aim
To measure the pure tone air conduction and to study bone conduction thresholds of
hearing using audiometer

1 Audiometer 1
2 Headphones 1
Theory
Acuity of hearing can be measured with the help of audiometer. The human ear responds to
vibrations ranging from 20-20000 Hz. Hearing is affected by anything which interferes with the
conduction of sound waves to the cochlea, such as perforated tympanic membrane ( ear drum),
disease of middle ear or disease of cochlea itself or its connection in the central nervous system.
Audiometer is divided into two main groups

1. Pure tone audiometer.
2. Speech audiometer.
Pure tone audiometer is used to obtain air and bone conduction thresholds of hearing.Air
conduction is the transmission of sound through the external and middle ear to theinternal ear.
Bone conduction on the other hand refers to transmission of sound to the internal ear mediated by
the mechanical vibrations of the cranial bones and soft tissues. The sound intensity in an earphone
is gradually increased until the sound is perceived by thesubject. The hearing in the other ear
during this measurement is often masked by presenting a neutral stimulus (white noise) to this ear.
The threshold of hearing is determined at anumber of frequencies. The frequency varies from 125-
8000KHz. Signal intensity varies from -10dB to 100dB. They are helpful in diagnosis of hearing
loss. Speech audiometers are normally used to determine speech reception thresholds for
diagnostic purposes and to assess and evaluate the performance of hearing aids.
Air and Bone Conduction
Block Diagram of Audiometer Audiogram
Tabulation
Pure tone Audiometry for Air Conduction
Hearing Level in dB
Frequency in Hz
Left Ear Right Ear
Procedure
Pure Tone Audiometer for Air Conduction
 The head phones should be plugged into the jack socket on the side panel.
 Switch on the audiometer.
 The mode which can be turned to either ‘RIGHT’ or ‘LEFT’ depending upon the ear to
be tested.
 The frequency dial is then adjusted to the test frequency from 1000Hz to 8000Hz step
by step.
 The frequency and intensity is set so that patient hears the sound.
 It is then diminished by adjusting the dB’s and note the dB
 Repeat the test to verify the reliability of the patient’s response.
 Then do the test below 1000Hz.
 While testing each frequency, the tone should first be presented at a higher level to make
thepatient aware of the tone he is going to hear and then gradually the intensity is reduced
to histhreshold.
Pure tone Bone conduction Audiometry is conducted only for patients and the procedure is
as follows
 The jack of the bone conduction vibrator is plugged into the socket on the side panel of
the audiometer.
 The bone switch is positioned to BC.
 Bone conduction up to 4000Hz only can be tested.
 The testing procedure is the same as for air conduction.
Resul
t
The hearing of acuity is checked with audiometer and an audiogram is drawn for measured
readings.
Ex. No: 11
STUDY THE WORKING OF DEFIBRILLATOR AND
Date: PACEMAKERS
Aim
To study the working of defibrillator and pacemaker..

1 Defibrillator 1
2 Pacemaker 1
3 Pacemaker leads 2
4 Conductivity gel 1
Theory
Ventricular fibrillation is serious cardiac emergency resulting from asynchronous

contraction of heart muscle.This uncoordinated movement of ventricle walls of the heart may
result from electric shock or from abnormalities of body chemistry Main problem
of fibrillation is continuously stimulation of adjacent cells of heart muscle fibers.so there is no
synchronized succession of events that follow heart action. This Fibrillation leads
to loss of cardiac output and irreversible brain damage or death if not reversed within 5 minutes of
onset.
Ventricular fibrillation can be converted into more efficient rhythm (fig.1) by applying a
high energy shock to the heart. This sudden surge across the heart cause all muscle fibers to
contract simultaneously ,possibly the fibers nay then respond to normal physiological intrinsic
pulse. Restoration of normal rhythm in fibrillating heart by direct current shock. The horizontal
line after the shock shows that cardiograph was blocked or disconnected for its protection during
the period of shock.
Defibrillator
The instrument for administering the shock is called a defibrillator. So
it is used to reverse fibrillation of the heart. Electric shock by defibrillator is used to reestablish
normal activity.
Ventricular fibrillation and with electric shock
Types of waveform
Basic circuit diagram of DC Defibrillator and the typical discharge pulse of defibrillator
The shock can be delivered to the heart by means of electrode placed on chest of the
patient(External defibrillation) or the electrode may be held directly against the heart when the
chest is open(internal defibrillation). Higher voltage is required for external defibrillation than for
internal defibrillation
A Variable auto transformer forms the primary of a high voltage transformer. The output
voltage transformer is rectified by a diode rectifier and is connected to vacuum type high voltage
change over switch. In position 1, the switch is connected to one end of an oil filled micro farad
capacitor. In this position, the capacitor charge to a voltage set by the positioning of the auto
transformer. When the shock is delivered to the patient, a foot switch or a push button mounted on
the handle of the electrode is operated. The high voltage switch change over to position 2 and the
capacitor is discharged across the heart through the electrode.
The inductor in the circuit slows down the discharge from capacitor by induced counter
voltage. This gives the output pulse a physiologically favorable shape. The disadvantage of using
inductor is that any practical inductor will have its own resistance and dissipates part of the energy
during the discharge process. The shape of waveform that appears across electrodes will depend
upon the value of the capacitor and inductor used in the circuit. The discharge resistance which the
patient represent for defibrillating pulse may be regarded as purely ohmic resistance of 50-100 Ω
approximately for typical electrode size of 80 cm2. The typical discharge pulse of defibrillator is
shown in fig.
Monophasic pulse width is typically programmable from 3.0 to 12.0 msec. Biphasic
positive pulse width is typically programmable from 3.0 to 10.0 msec, while the negative pulse is
from 1.0 to 10.0 msec Studies suggest that biphasic pulses yield increased defibrillation efficacy
with respect to Monophasic pulses
Procedure
1. DC Defibrillator is switched ON by connecting the power cord main supply .

2. Also DC defibrillator simulator is switched ON.
3. The output of the defibrillator simulator is connected to the front panel of the DC defibrillator, where ECG
input is marked and ECG output is connected to channel 1 of DSO.
4. If ‘A-fib ‘ or ‘Normal’ waveform from DC Defibrillator simulator is selected, the manual/synch switch
should be on synch position. And when ‘V-fib’ is selected then manual/synch switch should be in manual
position.
5. First press the switch which marked ‘Normal’ on simulator front panel.
6. ECG signal is observed on DSO & connect the Synch output to channel 2 of DSO.
TABULATION
WAVEFORM
S.NO HEART NATURE MODE OF
BEFORE AFTER
RATE OF DEFIBRILLATION
DEFIBRILLATION DEFIBRILLATION
RHYTHM
1. The Rising edge of the synch pulse is observed coinciding with the rising edge of the QRS complex.
2. The switch marked ‘A-fib’ is pressed to adjust the threshold on the back panel of the simulator.
3. The waveform is observed on DSO which is not a atrial fibrillation and has changed to normal.
4. The charge switch is now pressed and charges up to some energy level (for e.g :300 j)
5. The value appears on the front panel display in relative units.
6. The output marked ‘patient ‘of DC defibrillator is connected to simulator top panel.
7. With the mode switch in synch position, energy is discharged & corrected ECG waveform is observed, if not,
the defibrillator is charged to a higher energy level & the procedure is repeated.
8. Now create ‘V-fib’ switch on the simulator front panel. With the mode switch in manual mode and the above
procedure is repeated.
Pacemaker
A pacemaker is an electronic device that provides an electrical signal to make the heart
beat when its own, built-in pacemakers fail. The anatomical, built-in pacemakers provide what’s
called the “intrinsic” rhythm, and they can be disrupted by various conditions – ischemia for
example, or by an MI.
Cardiac arrhythmia
Abnormality in cardiac normal rhythm is called cardiac arrhythmia.There are various
types of cardiac disorder. Some of them are Bradycardia and tachycardia. In bradycardia heart
rate goes down from normal rate(i.e. below 60) and in tachycardia heart rate is higher than
normal rate.
There are several reasons for cardiac arrhythmia. One of the reason for arrhythmia is blockage in
conduction path. Heart block can occur anywhere in the specialized conduction system beginning with
the sino-atrial connections, the AV junction, the bundle branches and their fascicles, and ending in the
distal ventricular Purkinje fibers. Disorders of conduction may manifest as slowed conduction
Pacemaker classification
Pacemaker can classified in two category
1. External pacemaker
2. Implantable pacemaker

Block Diagram of Pacemaker
Charger Battery Oscillator Refra Pulse Width Amplitude Paced Patient

Gen Control Control output Simulator
ECG Amp
pacemaker
Sync Gen Refra Gen QRS QRS

Detector filter
TABULATION
S.NO MODE WAVEFORM FREQUENCY AFTER SIMULATION
FREQUENCY WAVEFORM
1. NORMAL
2. TACHYCARDIA
3. BRADYCARDIA
4. AV BLOCK

Based on cardiac disorder physician decide which pacemaker to be used. If pacemaker requires
temporary to correct cardiac rhythm then external pacemaker is used but if pacemaker require
permanent than implantable pacemaker is used.
Asynchronous pacemaker
Asynchronous device is free-running–Produces uniform stimulation regardless of cardiac activity

(i.e. fixed heart-rate). This type of pacemaker is intended for patients having permanent heart
blocks. The rate is preset. It can be varied externally within the range of 60 PPM to 180 PPM.
Since this pacemaker functions regardless of the patient’s natural heart rhythm it poses a potential
danger because of competition between the patient’s rhythm and that of the pacemaker.
Synchronous pacemaker
In patients who have normal heart function most of the time, asynchronous pacing can be
extremely dangerous, working against their own physiological pacemaker with the danger of
stimulating in the vulnerable period of the T wave, a condition that can result in fibrillation. The
demand pacemaker consists of an ECG amplifier and a conventional pacemaker output pulse
circuit that has been modified to allow output from the ECG amplifier to inhibit the pulse
generator. This pacemaker senses R-waves and its timing and logic circuits count out an elapsed
time interval following an R- wave or previously induced pulse. If the intrinsic R-wave does not
appear before the elapsed time interval, the ventricle is stimulated. If an R-wave is received, the
counter is reset again. This type of pacemaker is used for patients with bradycardia, and it ensures
a heartbeat no slower than its set rate.

Pulse Waveform

65
Output circuit produces the electrical stimuli to be applied to the heart
 Stimulus generation is triggered by the timing circuit
 Constant-voltage pulses
o Typically rated at 5.0 to 5.5V for 500 to 600μs
 Constant-current pulses
o Typically rated at 8 to 10mA for 1.0 to 1.2ms
 Asynchronous pacing rates –70 to 90 beats per min
 Realistic depiction of waveform appearing across heart emitted from capacitor
discharge output circuit.
Procedure
1. The pacemaker patient simulator is connected to 230 V AC supply.

2. Pacing electrode cable is connected from back panel of pacemaker patient simulator to paced output of
pacemaker.
3. The pulse width potentiometer and voltage pot is adjusted to maximum.
4. Pacemaker patient simulator is switched on and the rate of ECG is adjusted for 60 bpm with rate
potentiometer. Now observe that the RED LED’s which are indicating normal ECG conduction are glowing.
5. Pacemaker setup is the switched on and the rate is adjusted to 72 bpm.
6. Now decrease the rate of ECG from patient simulator and make sure that the pacemaker has captured the
heart, indicated by glowing YELLOW LED.
7. Now slowly decrease the voltage by voltage pot from pulse amplitude control.
8. Observe the top panel of patient simulator.
9. As soon as the RED LED’s start glowing, the heart has lost the capture.
10. Again increase the voltage slightly to regain the capture. The pacing pulse amplitude at this point is the
threshold.
11. Now decrease the width approximately by 10%, using pulse width pot and repeat the above procedure.
12. Observe and plot all the waveform provided on the top panel, both in pacing and sensing mode on same time
axis.
Result
The working of pacemaker and defibrillator were studied using simulators.

66
Ex. No: 12
ANALYSIS OF ECG, EEG AND EMG SIGNALS
Date:
Aim
To analyze ECG, EEG and EMG signals.

1 ECG, EMG, EEG recording setup 1
2 PC or CRO for Analysis 1
3 Connecting leads As required
4 Conductivity Gel 1
Theory
Electrocardiograph (ECG)
Electrocardiograph (ECG) is an instrument used to record electrical activity of the heart over a
period of time, as detected by electrodes attached to the surface of the skin and recorded by a
device external to the body. The recording produced by this noninvasive procedure is
termed an electrocardiogram. An ECG is used to measure the rate and regularity of heartbeats, as
well as the size and position of the chambers, the presence of any damage to the heart, and the
effects of drugs or devices used to regulate the heart, such as a pacemaker. The conducting system
of the electrical pulses in heart is shown above. ECG provides a wide range of cardiac disorders
such as the presence of an inactive part (infarct) or an enlargement (hypertrophy) of heart muscle.
The ECG device detects and amplifies the tiny electrical changes on the skin that are caused when
the heart muscle depolarizes during each heartbeat.
The diagnostically useful frequency range is usually 0.05 to 150Hz. The interference of non-
biological noises can be handled by using modern differential amplifiers, which are capable of
providing excellent rejection capabilities. Common Mode Rejection Ratio of the order of 100-
120db with 5KΩ unbalance in the leads is a desirable feature of ECG machines. It is necessary to
use a notch filter tuned to 50Hz to reject hum due to power mains.

67
Normal ECG Wave
Amplitude: Time period:

P wave – 0.25 mV PR interval – 0.12 – 0.22 sec
Q wave – 0.4 mV QT interval – 0.35 – 0.44 sec
R wave – 1.6 mV ST segment – 0.05 – 0.15 sec
T wave – 0.1 – 0.5 mV P wave interval – 0.11 sec
U wave - <0.1 mV QRS duration – 0.06 – 0.1 sec

21
EFFECT OF ARTIFACTS ON ECG RECORDING:
Abnormal patterns of ECG recording may be due to pathological states or on occasion they may be
due to artifacts.
INTERFERENCE FROM POWRERLINE:
Power line interference is easily recognizable since the interfering voltage in ECG would have a
frequency of 50Hz. This interference may be due to the stray interference of the alternating current
on the patient or because of alternating current fields due to loops in the patient cable. Other causes
of interference are loose contacts on the patient cable as well as dirty electrodes. When the
machines or the patient is not properly grounded, power line may even completely obscure the
ECG waveform.The most common cause of 50Hz interference is the disconnected electrode
resulting in a very strong disturbing signal. It is often strong enough to damage the stylus of an
unprotected direct writing recorder, and therefore needs a quick action.
SHIFTING OF BASELINE:
A wandering baseline but otherwise normal ECG trace is usually due to the movement of the
patient or electrode, the baseline shift is eliminated by ensuring that the patient lies relaxed and the
electrodes are properly attached. Baseline wander is usually observed immediately after the
application of electrodes.
MUSCLE TREMOR:
Irregular trembling of ECG trace, without wandering of the baseline occurs when the patient is not
relaxed or is cold. It is generally formed in the case of older patients. Muscle tremor signals are
especially bothersome on limb leads. When a patient moves or the muscles are stretched. For
normal ECG recording, the patient must be advised to get warm and to relax so that muscle tremor
from shivering or tension is dominated. The most critical component of the ECG recorder is the
patient cable. They should be made of silicon-rubber, which provides better elasticity over long
period.
Normal Rhythms
Normal sinus rhythm - heart rhythm controlled by sinus node at a rate of 60-100 beats/min, each
P wave followed by QRS and each QRS preceded by a P wave.

22

CALCULATION OF HEART BEAT 23
Count the distance between successive ‘R’ waves. By using the formula the heart rate can be
calculated
1500
Heart Rate (H.R) =------------------------beats/min
RR Interval
METHOD 1: When the rhythm is regular, the heart rate is 300 divided by the number of
large squares between the QRS complexes.
For example, if there are 4 large squares between regular QRS complexes, the heart rate is
75bpm (300/4=75).
300*0.2(time of 1 large box)=60sec.
METHOD 2: The second method can be used with an irregular rhythm to estimate the rate.
Count the number of R waves in a 6 second strip and multiply by 10.
For example, if there are 7 R waves in a 6 second strip, the heart rate is 70bpm (7x10=70).
METHOD 3: When the rhythm is regular, the heart rate is 1500 divided by the number of
small squares between the QRS complexes.
For example, if there are 22 small squares between regular QRS complexes, the heart rate is
68bpm (1500/22=68).
1 small square – 0.04sec. For 60 sec the numbers of small boxes are 1500.
(1500*0.04=60sec.)
METHOD 4:
60 divided by [(number of small squares between the QRS complexes) *(0.04 sec)]
Abnormal Rhythms
Sinus bradycardia - low sinus rate <60 beats/min.
Sinus tachycardia - high sinus rate of 100-180 beats/min as occurs during exercise or other
conditions that lead to increased SA nodal firing rate.
Atrial flutter - sinus rate of 250-350 beats/min.
Atrial fibrillation - uncoordinated atrial depolarization
Ventricular fibrillation - uncoordinated ventricular depolarization, leads to death if not quickly
converted to a normal rhythm or at least a rhythm compatible with life.
AV nodal blocks - a conduction block within the AV node (or occasionally in the bundle of His)
that impairs impulse conduction from the atria to the ventricles.
First-degree AV nodal block - the conduction velocity is slowed so that the P-R interval is

24
Normal EEG Waveform

increased to greater than 0.2 seconds. Can be caused by enhanced vagal tone, digitalis, beta- 25
blockers, calcium channel blockers, or ischemic damage.
Second-degree AV nodal block - the conduction velocity is slowed to the point where some
impulses from the atria cannot pass through the AV node. This can result in P waves that are not
followed by QRS complexes. When the QRS follows the P wave, the P-R interval is increased. In
this type of block, the ventricular rhythm will be less than the sinus rhythm. Third-degree
AV nodal block - conduction through the AV node is completely blocked so that no impulses are
able to be transmitted from the atria to the ventricles. QRS complexes will still occur (escape
rhythm), but they will originate from within the AV node, bundle of His, or other ventricular
regions. Therefore, QRS complexes will not be preceded by P waves. Furthermore, there will be
complete asynchrony between the P wave and QRS complexes. Atrial rhythm may be completely
normal, but ventricular rhythm will be greatly reduced depending upon the location of the site
generating the ventricular impulse. Ventricular rate typically range from 30 to 40 beats/min.
Electro Encephalography (EEG)

An electroencephalogram (EEG) is a test that detects electrical activity in your brain using
small, metal discs (electrodes) attached to your scalp. Your brain cells communicate via electrical
impulses and are active all the time, even when you're asleep. This activity shows up as wavy lines
on an EEG recording. An EEG is one of the main diagnostic tests for epilepsy. An EEG can also
play a role in diagnosing other brain disorders.
An EEG can determine changes in brain activity that might be useful in diagnosing brain
disorders, especially epilepsy or another seizure disorder. An EEG might also be helpful for
diagnosing or treating the following disorders:
 Brain tumor
 Brain damage from head injury
 Brain dysfunction that can have a variety of causes (encephalopathy)
 Inflammation of the brain (encephalitis)
 Stroke
 Sleep disorders
EEG amplitude and frequency bands

EEG Signals are mainly classified on the basis of frequency. Frequency information is particularly
significant since the basic frequency of the EEG varies greatly with different behavioral states. To
assist in the EEG analysis, the normal frequency range of the EEG (0.5Hz to 30Hz ) has been
divided into five bands.

Normal and Abnormal EMG Waveform 26

27
Theta ( φ ) 4 - 8 Hz
Alpha (α ) 8 - 12 Hz
Beta ( β ) 12 - 22 Hz
Gamma ( γ ) 22 - 30 Hz
The EEG signal is closely related to the level of consciousness of the person. As the activity
increases, the EEG shifts to higher dominating frequency and lower amplitude. When the eyes are
closed, the alpha waves begin to dominate the EEG. When the person falls asleep, the dominant
EEG frequency decreases. In a certain phase of sleep, rapid eye movement called (REM) sleep, the
person dreams and has active movements of the eyes, which can be seen as a characteristic EEG
signal. In deep sleep, the EEG has large and slow deflections called delta waves. No cerebral
activity can be detected from a patient with complete cerebral death.
Electromyogram (EMG)
Generation of EMG
The EMG is generated when a motor neuron action potential from the spinal cord arrives at a
motor end plate. Its arrival causes a release of ACh (Acetylcholine) at the synaptic cleft which
causes a depolarization (Action Potential). This action potential electrically travels downward from
the surface in a transverse tubule. This in turn causes a release of Ca++, causing cross-bridge
binding and the sarcomere of the muscle to contract .
An Electromyography (EMG) is a measurement of the electrical activity in muscles as a by
product of contraction. An EMG is the summation of action potentials from the muscle fibers
under the electrodes placed on the skin. The more muscles that fire, the greater the amount of
action potentials recorded and the greater the EMG reading. The test is used to help detect
neuromuscular abnormalities. During the test, one or more small needles electrodes are inserted
through the skin into the muscle.
The contraction of the skeletal muscle results in the generation of action potentials in the
individual muscle fibres, a record of which is known as electromyogram. In this case skeletal
muscle repolarization takes place more rapidly, the action potential lasting only a few
milliseconds. Since most of EMG measurements are made to obtain an indication of the amount of
activity of a given muscle, or a group of muscles rather than an individual muscle fibre, the EMG
pattern is usually a summation of the individual action potentials from the fibres constituting the
muscles or muscles being studied. In voluntary contraction of the skeletal muscle, the muscle
potentials range from 50 µV to 5 mV and the duration from 2 to 15 ms. The values vary with the
anatomical position of the muscle and the size and location of electrode.

28
Result
Thus normal and abnormal ECG, EEG and EMG signals has been analyzed.

29
Ex. No: 13
STUDY OF VENTILATORS
Date:
Aim
To study the working of ventilators.

1 Ventilator setup 1
2 Patient tubing 1
3 Power cord 1
4 Test Lung 1
Theory
For reduced breathing or respiratory failure (insufficiency), mechanical devices or respirators

are used in hospitals. These devices provide artificial ventilation, supply enough oxygen and
eliminate the right amount of carbon dioxide, maintain the desired arterial partial pressure of
carbon dioxide (PaCO2) and desired arterial oxygen tension (PaO2). Mechanical aids for manual
artificial ventilation consist of a mask, breathing valve and self filling bag .The mask, which is of
soft rubber or plastic, is held firmly over the patient’s mouth and nose so that it fits tightly. The
breathing valve serves to guide the air so that fresh air or air enriched with oxygen is supplied to
the patient and expired air is conducted away. The bag is squeezed with one hand and functions as
a pump. It is self-expanding and fills automatically with fresh air or oxygen when the patient
breathes out.
The main function of a respirator is to ventilate the lungs in a manner as close to natural
respiration as possible. Since natural inspiration is a result of negative pressure in the pleural cavity
generated by the movement of the diaphragm, ventilators were initially designed to create the same
effect. These ventilators are called negative-pressure ventilators. Positive-pressure ventilators
generate the inspiratory flow by applying a positive pressure— greater than the atmospheric
pressure—to the airways.
Lung Compliance: The compliance of the patient’s lungs is the ratio of volume delivered to the
pressure rise during the inspiratory phase in the lungs. This includes the compliance of the airways.

30
Breathing setup for artificial ventilation

Compliance is usually expressed as litres/cm H2O. Lung compliance is the ability of the alveoli 33
and lung tissue to expand on inspiration. The lungs are passive, but they should stretch easily to
ensure the sufficient intake of the air. A ventilator and other parts of the breathing circuit also have
compliance and some of the delivered volume is used to compress gas or expand gas in these parts.
The compliance of a patient’s lungs is the ratio of pressure drop across the airway to the resulting
flow rate through it. It is also expressed as cm H2O/litres (pressure drop/flow rate). Airway
Resistance: Airway resistance relates to the ease with which air flows through the tubular
respiratory structures. Higher resistances occur in smaller tubes such as the bronchioles and alveoli
that have not emptied properly.
Mean Airway Pressure (MAP): An integral taken over one complete cycle expresses the mean
airway pressure.
Inspiratory Pause Time: When the pressure in the patient circuit and alveoli is equal, there is a
period of no flow. This period is called inspiratory pause time.
Inspiratory Flow: Inspiratory flow is represented as a positive flow above the zero line.
Expiratory Flow: Expiratory flow is a negative flow below the zero line.
Tidal Volume: Tidal volume is the depth of breathing or the volume of gas inspired or expired
during each respiratory cycle. It can be calculated by multiplying the flow rate (l/sec) setting by the
set inspiratory time (seconds). Calibrated tidal volume settings range from 0.010 litre to 4.8 litres.
If the flow is set at 0.6 l/s and inspiratory time is set at 1 sec, the tidal volume is = 0.6 litres.
Minute Volume: This refers to volume of gas exchanged per minute during quiet breathing.
Minute volume is obtained by multiplying the tidal volume by the breathing rate.
Respiration Rate: This is the number of breaths per second. It represents total respiratory rate of
the patient. In the assist-control mode and SIMV (Synchronized Intermittent Mandatory
Ventilation) mode, the ventilator measures the previous four breaths and shows the average total
rate, which is prescribed rate plus the additional breaths taken by the patient. Conventional
Mechanical Ventilation (CMV): This provides the force which determines the tidal volume (VT)
at a respiratory frequency (f) to achieve the desired minute ventilation (VE) VE = VT ¥ f
Intermittent Mandatory Ventilation (IMV): This allows the insertion of a variable time delay
between each breath. Inspiratory Expiratory Phase Time Ratio (I : E Ratio): This signifies the ratio
of inspiratory interval to expiratory interval of a mandatory breath. This ratio is normally limited to
1:1, i.e. the inspiratory time should not exceed 50% of the total ventilator cycle time as set by the
breath/minute control. Inverse I:E ratio is prevented.
Synchronized Intermittent Mandatory Ventilation (SIMV): It represents a combination of
machine ventilation and spontaneous breathing. SIMV enables the patient to breathe spontaneously
in regular prescribed cycles, with the mechanical mandatory ventilation strokes providing a
minimum ventilation during the remaining cycles.

34

Sigh Volume: One sigh breath is 150% of the set tidal volume. Patient Circuit: This includes a
se t5
of3tools collecting the patient airway to the outlet of a ventilator.
Oxygen Percentage (F1O2): In all ventilatory modes, oxygen is delivered during the inspiratory
phase and the percentage (F1O2) is adjustable from 21 to 91%.
Peak Airway Pressure: It is the highest level of pressure reached over several breaths.
Spontaneous Ventilation: This is a ventilation mode in which the patient initiates and breathes
from the ventilator at will.
Bias Flow: In bias flow, mixed gas from the mixer is directed through the patient circuit in-
between mechanical breaths. Bias flow stabilizes baseline pressure for spontaneously breathing
patients and decreases the response time of the demand valve.
Sensitivity: It is used to detect spontaneous effort by the patient, in order to trigger mandatory
ventilation with the set Respiration rate.
Mandatory Minutes Volume Ventilation (MMV): This operating mode applies mandatory
ventilation only if spontaneous breathing is not yet sufficient and has fallen below a pre-selected
minimum ventilation. Unlike SIMV, the mandatory strokes are not applied regularly but only in
cases of insufficient ventilation.
Controlled Mandatory Ventilation: This term refers to mandatory ventilation of patients who are
not able to initiate or respire on their own.
Assisted Spontaneous Breathing (ASB): It refers to the pressure support of insufficient
spontaneous breathing.
Positive End Expiratory Pressure (PEEP): PEEP is a therapist-selected pressure level for the
patient airway at the end of expiration in either mandatory or spontaneous breathing. PEEP is used
to increase the end-expiratory lung volume (EELV) or prolong expiration with a potentially similar
effect on the EELV.
Procedure
1. Connect the flexible tubing to the air outlet on the side of the device.
2. Connect the tubing to the mask.
3. Plug the socket of the power cord into the power supply. Switch on the machine.
4. Press the wheel to highlight on/off icon and switch on the device.
5. Verify that the device beeps and the alarm and ramp LEDs light up each time therapy is started.
6. Make sure there is no leak from the mask . Adjust the mask and connect it to the test lung
or patient.
7. Observe and record the pressure readings in various therapy modes.
8. Press and hold the wheel for approximately 2 seconds to turn off therapy.

36
Tidal Pressure
S. No Mode of Respiratory Leak
volume (cmH2O)
ventilation rate (bpm) (lpm)
(ml)
Result
Thus the working of ventilator was studied.

37
Ex. No: 14
STUDY OF ULTRASOUND SCANNERS
Date:
Aim
To study the working of ultrasound scanners.

1 Ultrasound scanner 1
2 Power cable 1
3 Ultrasound coupling gel 1
4 Linear and convex probe 1
Theory
Ultrasound has become increasingly important in medicine and has taken its place along with X-
ray and nuclear medicine as a diagnostic tool. Its main attraction as an imaging modality lies in its non-
invasive character and ability to distinguish interfaces between soft tissues. In contrast, X-rays only
respond to atomic weight differences and often require the injection of a more dense contrast medium
for visualization of non-bony tissues. Similarly, nuclear medicine techniques measure the selective
uptake of radioactive isotopes in specific organs to produce information concerning organ function.
Radioactive isotopes and X-rays are, thus, clearly invasive. Ultrasound is not only non-invasive,
externally applied and non-traumatic but also apparently safe at the acoustical intensities and duty
cycles presently used in diagnostic equipment. Diagnostic ultrasound is applied for obtaining images
of almost the entire range of internal organs in the abdomen. These include the kidney, liver, spleen,
pancreas, bladder, major blood vessels and of course, the foetus during pregnancy. It has also been
usefully employed to present pictures of the thyroid gland, the eyes, the breasts and a variety of other
superficial structures. In a number of medically meaningful cases, ultrasonic diagnostics has made
possible the detection of cysts, tumours or cancer in these organs. This is possible in structures where
other diagnostic methods by themselves were found to be either inapplicable, insufficient or
unacceptably hazardous. Ultrasonic studies which do not involve image formation have also been
extensively developed to allow the dynamics of blood flow in the cardiovascular system to be
investigated with a precision not previously possible. The main limitation of ultrasound, however, is

38
Bloc Diagram of Ultrasound Scanner

39
that it is almost completely reflected at boundaries with gas and is a serious restriction in investigation
of and through gas-containing structures.
Sound Pulse
A sound wave is typically produced by a piezoelectric transducer encased in a plastic housing.
Strong, short electrical pulses from the ultrasound machine drive the transducer at the desired
frequency. The frequencies can be anywhere between 1 and 18 MHz, though frequencies up to 50–
100 megahertz have been used experimentally in a technique known as biomicroscopy in special
regions, such as the anterior chamber of the eye. Older technology transducers focused their beam
with physical lenses. Newer technology transducers use phased array techniques to enable the
ultrasound machine to change the direction and depth of focus. The sound is focused either by the
shape of the transducer, a lens in front of the transducer, or a complex set of control pulses from the
ultrasound scanner, in the (beamforming) technique. This focusing produces an arc-shaped sound
wave from the face of the transducer. The wave travels into the body and comes into focus at a desired
depth.
Materials on the face of the transducer enable the sound to be transmitted efficiently into the body
(often a rubbery coating, a form of impedance matching). In addition, a water-based gel is placed
between the patient's skin and the probe.
The sound wave is partially reflected from the layers between different tissues or scattered
from smaller structures. Specifically, sound is reflected anywhere where there are acoustic impedance
changes in the body: e.g. blood cells in blood plasma, small structures in organs, etc. Some of the
reflections return to the transducer.
Receiving the echoes
The return of the sound wave to the transducer results in the same process as sending the sound
wave, except in reverse. The returned sound wave vibrates the transducer and the transducer turns the
vibrations into electrical pulses that travel to the ultrasonic scanner where they are processed and
transformed into a digital image.
Forming the image
To make an image, the ultrasound scanner must determine two things from each received echo:
 How long it took the echo to be received from when the sound was transmitted.
 How strong the echo was.
Once the ultrasonic scanner determines these two things, it can locate which pixel in the image to light
up and to what intensity.
Transforming the received signal into a digital image may be explained by using a blank spreadsheet
as an analogy. First picture a long, flat transducer at the top of the sheet. Send pulses down the
'columns' of the spreadsheet (A, B, C, etc.). Listen at each column for any return echoes. When an
echo is heard, note how long it took for the echo to return. The longer the wait, the deeper the row
40
(1,2,3, etc.). The strength of the echo determines the brightness setting for that cell (white for a strong
echo,

41
Types of USG Probes

42
black for a weak echo, and varying shades of grey for everything in between.) When all the echoes are
recorded on the sheet, we have a greyscale image.
Displaying the image
Images from the ultrasound scanner are transferred and displayed using the DICOM standard.
Normally, very little post processing is applied to ultrasound images.
Linear array transducer
Ultrasonography (sonography) uses a probe containing multiple acoustic transducers to send pulses of
sound into a material. Whenever a sound wave encounters a material with a different density
(acoustical impedance), part of the sound wave is reflected back to the probe and is detected as an
echo. The time it takes for the echo to travel back to the probe is measured and used to calculate the
depth of the tissue interface causing the echo. The greater the difference between acoustic impedances,
the larger the echo is. If the pulse hits gases or solids, the density difference is so great that most of the
acoustic energy is reflected and it becomes impossible to see deeper.
The frequencies used for medical imaging are generally in the range of 1 to 18 MHz. Higher
frequencies have a correspondingly smaller wavelength, and can be used to make sonograms with
smaller details. However, the attenuation of the sound wave is increased at higher frequencies, so in
order to have better penetration of deeper tissues, a lower frequency (3–5 MHz) is used.
Seeing deep into the body with sonography is very difficult. Some acoustic energy is lost every time
an echo is formed, but most of it is lost from acoustic absorption. The speed of sound varies as it
travels through different materials, and is dependent on the acoustical impedance of the material.
However, the sonographic instrument assumes that the acoustic velocity is constant at 1540 m/s. An
effect of this assumption is that in a real body with non-uniform tissues, the beam becomes somewhat
de-focused and image resolution is reduced.
To generate a 2-D image, the ultrasonic beam is swept. A transducer may be swept mechanically by
rotating or swinging. Or a 1-D phased array transducer may be used to sweep the beam electronically.
The received data is processed and used to construct the image. The image is then a 2-D representation
of the slice into the body.
3.D images can be generated by acquiring a series of adjacent 2-D images. Commonly a specialized
probe that mechanically scans a conventional 2-D image transducer is used. However, since the
mechanical scanning is slow, it is difficult to make 3D images of moving tissues. Recently, 2-D phased
array transducers that can sweep the beam in 3-D have been developed. These can image faster and
can even be used to make live 3-D images of a beating heart.
Doppler ultrasonography is used to study blood flow and muscle motion. The different detected
speeds are represented in color for ease of interpretation, for example leaky heart valves: the leak
shows up as a flash of unique color. Colors may alternatively be used to represent the amplitudes of the
received echoes.
43
Procedure
1. Connect the system to Mains and connect the required probe in the socket.
2. Turn on the power switch on control panel and the indicator light will be on.
3. Adjust GAIN, NEAR and FAR controls ( Overall Gain: 68, Near Gain: -18, Far Gain: 2.8)
4. Apply sufficient amount of ultrasound coupling gel to both the examined region and the
probe surface.
5. Place the probe on the examination region. An image will immediately appear on the screen.
6. When a desired image is acquired on the screen, press Freeze key.
7. Measure the distance between two points, area, circumference, volume, etc using the Meas
or Dis key.
8. Exit by pressing Esc or Freeze to return to the ultrasound interface after talking
necessary measurements.
Result
Thus the working of ultrasound scanner is studied.

44
Ex. No: 15
STUDY OF HEART LUNG MACHINE MODEL
Date:
Aim
To study the working of heart lung machine.

1 Heart lung machine model 1
2 Connecting cables and power cords As required
3 Effluent pump 1
4 Blood pump 1
Theory
The heart-lung machine (HLM) is a device used to provide blood circulation and oxygenation
while the heart is stopped. It is a means of keeping a patient alive while his/her heart is stopped or even
removed from the body. Usually called the heart-lung machine, the device also is referred to as
cardiopulmonary bypass, indicating its function as a means to substitute for the normal functions of the
heart (cardio) and lungs (pulmonary).
It is the function of the heart to provide circulation of blood at all times. It pushes blood out
into the body and through the lungs. It must function every minute of every day of life to maintain the
health of the tissues throughout the body.
To function, the heart-lung machine must be connected to the patient in a way that allows blood
to be removed, processed, and returned to the body. Therefore, it requires two hook-ups. One is to a
large artery where fresh blood can be pumped back into the body. The other is to a major vein where
used blood can be removed from the body and passed through the machine.
In fact, connections are made on the right side of the heart to the inferior and superior vena
cavae .These vessels collect blood drained from the body and head and empty into the right atrium.
They carry blood that has been circulated through the body and is in need of oxygenation. Another
connection is made by shunting into the aorta, the main artery leading from the heart to the body, or
the femoral artery, a large artery in the upper leg. Blood is removed from the vena cavae, passed into
the heart-lung machine where it is cooled to lower the patient’s body temperature, which reduces the
tissues’ need for blood. The blood receives oxygen which forces out the carbon dioxide and it is

45
Schematic Diagram of Heartlung Machine

46
filtered to remove any detritus that should not be in the circulation such as small clots. The processed
blood then goes back into the patient in the aorta or femoral artery.
During surgery the technician monitoring the heart-lung machine carefully watches the
temperature of the blood, the pressure at which it is being pumped, its oxygen content, and other
measurements. When the surgeon nears the end of the procedure the technician will increase the
temperature of the heat exchanger in the machine to allow the blood to warm. This will restore the
normal body heat to the patient before he is taken off the machine.
The main components of a heart–lung machine are a pump (to provide the driving force to the
blood in the arterial system), an oxygenator (for exchange of oxygen and carbon dioxide), and a heat
exchanger (to allow control of temperature of the body). The connecting tubing and filter are other
components of the heart–lung bypass circuit.
Venous blood is siphoned from the body via a tube in the right atrium of the heart, or via two
tubes in the major veins which converge on the heart. It is pumped through the oxygenator and heat
exchanger, and returned via a plastic tube into the arterial system of the body — usually at the upper
portion of the ascending aorta. The design of pump which is in most common use today is the roller
pump — a simple rotating arm carrying rollers which compress a loop of polymeric tubing against a
solid surface. Speed of rotation of the roller-bearing arm is controlled to allow a pumping rate similar
to that of the normal heart at rest (about 2.4 litres/min/m 2 body surface — or typically about 5
litres/min in an adult).
There are two main types of oxygenator in use at present. ‘Bubble oxygenators’ expose the
passing blood to a stream of gaseous bubbles composed of 95% oxygen and 5% carbon dioxide. Gas
exchange with the blood occurs on the surface of the bubbles and results in reasonably normal levels of
oxygenation of the blood and maintains carbon dioxide in the normal physiological range. The bubble
oxygenator has a sponge-like filter and reservoir to enable gaseous bubbles to be removed from the
oxygenated blood before it is pumped back to the body.
Membrane oxygenators consist of a series of fine tubes which allow diffusion of oxygen and
carbon dioxide between the blood flowing through them and the ventilating gas surrounding them (or
vice versa). The oxygenator also combines with a heat exchanger — a system of tubes through which
the blood passes, surrounded by circulating water at controlled temperature. This allows the blood
temperature to be maintained (counteracting the heat loss during the passage of blood through the
heart–lung machine). It also allows deliberate cooling and subsequent rewarming of the blood, giving
the surgeon the option of reducing, or even stopping, the circulation of the blood around the body for a
period of time with safety, because the oxygen requirement of the body is reduced by hypothermia.

47
Procedure
1. Connect the tubings as per the circuit diagram

2. Connect the effluent pump and blood pump to the circuit.
3. Fill effluent and blood compartments with water.
4. Prime the tubings and look for any water bubbles or leak in the tubing.
5. Set blood pump at low speed. Set temperature
at Max :40 degrees
Min: 30 degrees
6. Switch on the heater and power the modules.
7. Observe how blood is circulated and oxygenated in the heart lung model.
Result
Thus the working of heart lung machine is studied with a working model.

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2

VEL TECH MULTI TECH DR.RANGARAJAN

DEPARTMENT OF BIOMEDICAL ENGINEERING

ACADEMIC YEAR 2020-2021

BM8611 DIAGNOSTIC AND THERAPEUTIC EQUIPMENT

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

 To demonstrate recording and analysis of different Bio potentials

1. Measurement of visually evoked potential

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

B. E. Bio-Medical Engineering (R 2017)

BM 8611 - Diagnostic & Therapeutic Equipment Laboratory

1 Visually evoked potential setup 1

4 Short wave Diathermy 1

7 Electrical Safety Analyser 1

8 Spirometry with associated analysis system: 1

11 Surgical diathermy with analyzer 1

13 Pacemaker and Defibrillator 1

14 Hemodialysis model and Heart lung Model 1

17 Software to Analyze ECG,EEG and EMG 1

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

S.No Name of theExperiment Page No

Galvanic skin resistance (GSR) measurement

Study of shortwave and ultrasonic diathermy

Measurement of various physiological signals using biotelemetry

5 Study of hemodialysis model

Electrical safety measurements

Measurement of Respiratory parameters using spirometry.

Study of medical stimulator

Analyze the working of ESU – cutting and coagulation modes

11 Study the working of Defibrillator and pacemakers

12 Analysis of ECG, EEG and EMG signals

14 Study of Ultrasound Scanners

15 Study of heart lung machine model

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

VIRTUAL VALUE LABORATORY

S.No. Name of theExperiment Page No

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

To analyze the nature of visually evoked potential using EEG recorder.

Equipment and Accessories Required

S.No Name of the Equipment Quantity

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

Visually evoked potential

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

VISUAL EVOKED RESPONSE (VEP):

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

S.No Name of the Equipment Quantity

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

S. No Mode Conductance Resistance External

1. Dry Skin 62 93 nil

2. Wet Skin 2.85 362 nil

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

BM8611 Diagnostic and Therapeutic Equipment Laboratory Department of BME

Equipment and Accessories Required

S.No Name of the Equipment Quantity