TEMB 2203: Biomedical

Instrumentation I (The General

Instrumentation System)

Department of Biomedical &

Mechatronics Engineering

Kyambogo University, Uganda.

 Blood Pressure
• An Individuals blood pressure is a standard clinical
measurement

• Is considered a good indicator of the status of the

cardiovascular system.

• Blood pressure values in the various chambers of the heart

and in the peripheral vascular system help the physician
determine the functional integrity of the cardio vascular
system.

Blood Pressure inside the heart chambers

Major Arteries & Veins of the Body
Cardiovascular system-typical Values

Blood Pressure Measurement

Direct (invasive)
1. Extravascular Method
• The vascular pressure is coupled to an external sensor element
via a liquid filled catheter. [Catheter — is a long tube introduced into the
heart or a major vessel by way of a superficial vein or artery].

2. Intravascular- -A sensor is placed into the tip of a catheter that is

placed in the vascular system,

Indirect (non invasive)

• Sphygmomanometer

Consists of an inflatable pressure cuff and a manometer to

measure the pressure in the cuff.

Direct BP Measurement
Sensing
port
 Disposable blood-pressure sensor with integral flush device

To patient

Electrical cable
 Extra Vascular
• The extra vascular sensor system is made up of a
catheter.

• The catheter is connected to a three-way

stopcock and then to a pressure sensor

• It is filled with a saline-heparin solution.

• It must be flushed with solution every few

minutes to prevent blood clotting at the tip.
 Extra Vascular contd...
Physician inserts the catheter
• Either by means of a surgical cut-down, which exposes the artery
or vein.

• or by means of percutaneous insertion which involves the use of

a special needle or guide-wire technique.

• Blood pressure is transmitted via the catheter column to

the sensor and finally to the diaphragm which is
deflected.
• The displacement of the diaphragm is sensed
electronically.

Disadvantages

• The frequency response of the catheter-sensor system is

limited by the hydraulic properties of the system.

• Creates time delay in detection of pressures when a

pressure pulse is transmitted.
 Direct BP Measurement -Intravascular
• The sensor is placed at the tip of the catheter.

• Enables the physician to obtain a high frequency

response in detection of pressures at the tip of the
catheter.

• Types of sensors

1. Strain-gage systems bonded onto a flexible

diaphragm at the catheter tip.

2. Fibre-optic device
• Measures the displacement of the diaphragm optically by
varying reflection of light from the back of the deflecting
diaphragm
Bonded Strain Gage pressure transducer
• Consists of strain-sensitive gages which are firmly
bonded with an adhesive to the membrane or
diaphragm whose movement is to be recorded,

Made by taking a length of a very thin wire or foil

which is formed into a grid pattern and bonded to a
backing material.
Wire
Is then attached to the diaphragm.

Deflection of the diaphragm causes corresponding

strain in the wire gage.

Causes a corresponding change in the resistance

which is proportional to the pressure.
 Fiber optic type pressure transducer
• Measures the displacement of the diaphragm
optically by the varying reflection of light from the
back of the deflecting diaphragm.
• Inherently safer electrically
Indirect Blood pressure Measurement
-Sphygmomanometer.
(a) Oscillations in cuff pressure
• The pressure cuff on the upper arm is first
inflated to a pressure well above the systolic
pressure.

• At this point no sound can be heard through

the stethoscope, which is placed over the
brachial artery, for that artery has been
collapsed by the pressure of the cuff.

• The pressure in the cuff is then gradually

reduced.
 Sphygmomanometry.,.

• When the systolic peaks are higher than the

occlusive pressure, the blood spurts under
that cuff and causes a palpable pulse in the
wrist (Riva-Rocci Method)

• Audible sounds (Korotkoff (named after Dr.

Nikolai Korotkoff) sounds) generated by the
flow of blood and vibrations of the vessel
under the cuff are heard through the
stethoscope.
 Sphygmomanometry

• The pressure of the cuff that is indicated on

the manometer when the first Korotkoff
sound is heard is recorded as the systolic
blood pressure.

• As the pressure in the cuff is continues to

drop, the Korotkoff sounds continue until the
cuff pressure is no longer sufficient to
occlude the vessel during any part of the
cycle. Below this pressure the Korotkoff
 sounds disappear, marking the value of the
diastolic pressure.
• Auscultatory (based on the Korotkoff sounds)
technique is simpler and requires a minimum
of equipment.
• Cannot be used in noisy environments.

• Palpation (based on pulse on the blood

vessel) technique doesn't require a noise free
environment.
• Normal respiration and vasomotor waves
modulate the normal blood-pressure levels.
Automated Indirect Blood Pressure
measurement techniques

• Involves an automatic sphygmomanometer

that inflates and deflates an occlusive cuff at a
predetermined rate.

• A sensitive detector is used to measure the

distal pulse or cuff pressure.
 Automated Auscultatory device

• Microphone replaces the stethoscope for

sensing the Korotkoff sounds.

• The process begins with a rapid (20-30mm

Hg/s) inflation of the occlusive cuff to a pre-set
pressure about 30mm Hg higher that the
suspected systolic pressure.
• The flow of blood beneath the cuff is stopped
by the collapse of the vessel.
• Cuff pressure is then reduced slowly (2-3 mm
Hg/s).

• The first Korotkoff sound is detected by the

microphone, at which time the level of the cuff
pressure is stored.
• The muffling and silent period of the
Korotkoff sound is detected, and the value of
the diastolic pressure is also stored.

• After a few minutes the instrument displays

the systolic and diastolic pressure and recycles
the operation.
 Ultrasonic Based Blood Pressure Measurement

• Employs a transcutaneous Doppler sensor

that detects the motion of the blood-vessel
walls in the various states of occlusion.

• The Doppler ultrasonic transducer is focused

on the vessel wall and the blood.
• The reflected signal (shifted in frequency) is
detected by the receiving crystal and decoded.
• The difference in frequency, in the range of
40 to 500 Hz, between the transmitted and
received signals is proportional to the
velocity of the wall motion and the blood
velocity.
• As the applied pressure is further increased,
the time between the opening and closing
decreases until they coincide. The reading at
this point is the systolic pressure.

• When the pressure is cuff is reduced, the

time between the opening and closing
increases until the closing signal from one
pulse coincides with opening signal from the
 next. The reading at this point is the diastolic
pressure.
Advantages:
• Doesn't require a noise free environment.

Disadvantage:
Movement of the subject's body cause
changes in ultrasonic path between the
sensor and the blood vessel.
~END~