Bioinstrumentation

Hospital operating rooms, emergency rooms, and doctors’ offices each contain an array
of instruments used to measure and record a patient’s vital signs such as temperature,
blood pressure, pulse, and oxygen saturation. Many of the most popular instruments
enable non-invasive monitoring of vital signs of patient health: The stethoscope allows
doctors to listen reliably to the beating heart, the sphygmomanometer allows them to
estimate pressure within vessels deep in the body and the ophthalmoscope allows them
to see structures on the retina. It is impossible to estimate the number of lives that have
been lengthened or improved by these devices
Most instrumentation systems contain common elements, which are present regardless
of the parameter being measured. A typical system measures a parameter of interest
(labeled as INPUT and creates a reading (or OUTPUT) that the user can
comprehend. There are many types of inputs that might be measured in patient care,
such as temperature, oxygen saturation, blood pressure, electrical potentials, pH, or
glucose concentration. Sometimes the instrument is used to detect an input, such as
light absorbance or fluorescence, which is coupled to, or related to, the actual parameter
of interest. The part of the instrument that detects the input is called a sensor. The
sensor converts the input parameter into a signal, usually an electrical voltage,
which varies in a predictable and reliable way with changes in the input
parameter.
Electrical circuit analysis is an essential skill for biomedical engineers who design
or use medical devices and instruments. Input signals, which arise from a variety of
sources, are converted to electrical signals that can be processed, amplified, and
displayed. A familiar mechanical system is analogous to a simple electrical resistance
circuit. Blood flow rate (Q) through a cylindrical vessel is proportional to the pressure
drop.

where ∆p is the pressure drop across the vessel, and R is the resistance to flow. The
analogous expression for an electrical system is known as Ohm’s law, which defines the
current (i) as

For a circuit consisting of a single resistor and a voltage source, Ohm’s law can be
applied directly to calculate the unknown current, voltage, or resistance. Ohm’s law can
also be applied to each individual resistor in a circuit, if the voltage drop or current
across the resistor is known.
Example of sensors used in biomedical instruments
Different types of sensors
1. Thermal sensors
Control of body temperature is critical to life processes; therefore, the body has
multiple mechanisms for maintaining an appropriate internal temperature that, for most
people, is near 37 ºC(98.6◦F). Deviation of body temperature from this normal value is
frequently used as an indicator of disease. One of the most commonly used
temperature-sensing elements is a thermocouple. A thermocouple is formed by fusing
two dissimilar metals to produce two junctions, as shown below-

Example of a thermocouple formed by fusion of two metals: copper and alumel (an
alloy containing 5% nickel, 2% manganese, 2% aluminium, and 1% silicon).
If a complete circuit is formed from the two metals and one of the junctions is
maintained at a lower temperature, a current will flow through the metals. This flow of
current produced by a temperature difference is known as Seebeck effect.

When the circuit is broken, a voltage difference known as Seebeck voltage can be
measured which depends in a predictable way on the temperature of remaining
junctions.

Thermocouples are used widely in manufacturing and other engineering applications

because they are inexpensive and reliable and can be used over a wide temperature
range, with some capable of measuring temperatures as low as−200 ºC and others as
high as 1,250 ºC.
Thermistors are homogeneous composites of dissimilar metals that form thermally
sensitive resistors. They are distinct from thermocouples, which are heterogeneous
combinations of different metals. For any particular thermistor, the relationship
between the resistance and temperature is exponential

where T is temperature in degree Kelvin (K), RT is the

measured electrical resistance, R 0 is the resistance at
reference temperature (T0 = 298 K), and β is a
coefficient that is characteristic of the material.

Resistivity-Temperature characteristics
for a common thermistor. The resistance
varies exponentially with temperature
Mechanical sensors measure force and, therefore, can be used to measure pressure.
These sensors often consist of materials, such as metal wires or films, which exhibit a
change in resistance in response to a change in shape.

certain kinds of shape deformations can be reported as changes in strain, ε. For

example, a material that becomes elongated in the presence of an applied force exhibits
strain that can be measured as the fractional change in length (ε = L/L).

An instrument that measures strain is called a strain gauge.

In biomedical applications, a strain gauges typically measure strains in the range 10 −6 to

10−3. Mechanical strain can be measured using sensing elements composed of
piezoelectric materials. Piezo literally means pressure and derives from the Greek word
piezein, which means “to squeeze.” When a piezoelectric element, such as quartz, is
placed under pressure, polarized ions within the crystal are deformed, leading to
generation of an electric charge. The converse is also true: Application of an electric
field to a piezoelectric material will create strain (or deformation) in the material.
Piezoelectric materials are used in various applications including pressure transducers
and acoustic transducers. Acoustic transducers convert strains that occur because of
sound waves into electric charge, or vice versa, and are commonly found in telephones,
microphones, electric guitars, and automated blood pressure machines at the local
drugstore.
Electrical sensors or electrodes are used in both research and clinical settings. In
biological applications, electrodes are often used to detect the electric potential
generated by cellular ionic currents. The electrodes that accomplish this can range in
size from micro-sized probes to larger adhesive pads. All cells have a resting membrane
potential caused by the difference in ion concentrations across a cell membrane that is
permeable to these ions electrodes are useful for measuring these potentials

Patch-clamp techniques permit the measurement of currents through individual ion channels.
Researchers have learned how to collect patches of membranes using different techniques,
allowing the measurement of a variety of ion channel properties. A. Overview of pipette and cell.
B. Tight contact is created between the pipette and the plasma membrane. C. The pulled
membrane breaks away from the cell and allows access to the cytoplasmic domain of the ion
channel.
In excitable cells such as neurons and muscle cells, certain movements of ions into or
out of the cell can trigger action potentials, which can also be detected using electrodes.
The electrocardiograph, or ECG, indirectly measures the electrical activity of cardiac
muscle cells using surface electrodes attached to the skin. Similarly, the electrical
activity of the brain is sometimes measured using electrodes placed on the surface of
the skull, often by using specially designed, electrode-loaded caps.

Electrophysiology is the study of the behavior of electrically excitable cells and

membranes. Cells and tissues are studied by inserting probes or electrodes into the cell
or tissue, in such a way that the biological function of the system is not altered, and
measuring its electrical behavior. The probes that are used for these measurements can
be electrical wires or needles, thin glass cylinders (called micropipettes) that are filled
with conductive electrolyte solutions, or other devices. Often, the probe is so small that
it can be inserted into a cell without changing the cell’s behavior significantly.
 Measurement of membrane potential. The membrane potential of a cell can be
measured directly by inserting an electrode through the membrane (left) or indirectly,
by first loading the cell with fluorescent dyes that are sensitive to local electrical
potential and then observing the cell using fluorescence microscopy (right).
In a voltage clamp technique, the potential (or voltage) drop across a membrane is held
constant so that the resulting current can be measured. In a current clamp, a known
current is introduced through the electrode, and the resulting change in potential is
measured.
Chemical sensors are designed to measure the presence—and sometimes the
concentration—of specific chemicals. Because of the great diversity of chemical
species( i.e., ions, gases, chemical or biochemical agents)—and the need to create
sensors that detect only one or a small number of related species—there are many types
of chemical sensors. Ion analyzers or detectors are used broadly for monitoring the
quality of air, water, food, and consumer and pharmaceutical products; they are also
used in both clinical and biomedical research laboratories. This section focuses on one
type of chemical sensor, which uses an ion selective electrode (ISE) to detect ions.

Another type of chemical sensor is an amperometric sensor, in which the current is

proportional to the concentration of the species generating the current. An example of
an amperometric sensor is the Clark electrode, which is used for oxygen measurement.
Operation of an amperometric sensor generates a current flow, which requires the use
of a polarizing voltage source
Optical sensors are able to detect light in the visible, infrared (IR), or ultraviolet
(UV)regions of the electromagnetic spectrum. This range of the electromagnetic
spectrum spans a wide range of wavelengths, from 10 nm up to 1 mm (for a review of
the electromagnetic spectrum.

Light can be detected by either photodiode arrays or photomultiplier tubes; both of

these devices convert light energy into an electrical signal. Photodiodes are made of
semiconductor materials such as silicon (Si) or gallium arsenide (GaAs).

When a photon of light strikes this material, a current is generated. The resulting
voltage is proportional to the intensity of the incoming light. Photodiodes are used in
many biomedical devices, including the finger pulse oximeter,

(Structure of a photodiode)
Different bioinstruments
Measurement of body temperature
Measurement of an elevated body temperature is often the first indication of an
abnormal condition; for example, parents measure the temperature of their children as
an early sign of illness. The normal body temperature is 98.6◦F (or 37◦C), although
normal temperature varies somewhat from person to person. Usually, a temperature
above99.5 F(or37.5 ºC) is a sign of an underlying illness or infection (or a child who
needs to stay home from school).
Several different types of instruments are
used to measure temperature, including
glass thermometers, electronic
thermometers, and IR thermometers. All of
these instruments rely on a temperature
sensitive sensor.

A glass thermometer is a familiar method for

measurement of body temperature. Thermometers can be
placed under the tongue, under the arm, or in the rectum
to estimate internal body temperature. This photo shows
the mercury reservoir and capillary of a classic glass
thermometer.
Glass thermometers, because they are inexpensive and reliable, are still used in the
laboratory and in meteorology for measuring the outdoor ambient temperature.
However, their use in medicine is becoming increasingly rare. Mercury is highly toxic
to the nervous system, and many countries ban their use in medical applications;
manufacturers have replaced mercury with liquid alloys of gallium, indium, and
galinstan.

Electronic thermometers use thermocouples or thermistors as the sensing element; the

sensing element is placed in direct contact with the body surface. Ear thermometers,
now often used at home, measure body temperature through a non-contact probe that
senses IR radiation emitted from the tympanic membrane. The emitted IR radiation is
measured with a pyroelectric crystal. Pyroelectricity is a property of certain materials;
these materials respond to heat by the generation of an electrical potential.
Blood pressure is critically important in the operation of the cardiovascular system and
human health. Measurement of blood pressure provides rapid information about the
health status of the cardiovascular system.
Blood pressure is often reported as systolic pressure over diastolic pressure.

Systolic pressure is the maximum pressure exerted on the arterial walls during
contraction of the ventricles of the heart, whereas diastolic pressure occurs during the
relaxation of the ventricles.

In an average adult, the systolic/diastolic blood pressure is 120/80 mmHg.

Individuals who are diagnosed with hypertension typically have blood pressure of
140/90 mmHg or higher.
The most common method of measuring blood pressure is based on the detection of
Korotkoff sounds, also known as the auscultatory method. Auscultation refers to
listening to sounds within the body. During a blood pressure measurement, an air-filled
sphygmomanometer cuff is wrapped around the patient’s upper arm. The nurse or
physician places a stethoscope under the cuff and inflates the cuff to a pressure above
the systolic pressure; a fully inflated cuff completely stops the blood flow by
compression of superficial arteries in the arm. As the cuff pressure is slowly decreased,
the operator listens for the appearance (the start of systole) and disappearance (the start
of diastole) of Korotkoff sounds
These sounds correspond to the turbulent flow of blood as it spurts through the
occluded artery during cuff deflation.

A disadvantage of the auscultatory method is clinician bias: Different operators have

different levels of skill in hearing and interpreting the Korotkoff sounds.

Some automated machines use microphones to detect the sounds, but even those
machines cannot overcome the difficulty of measuring blood pressure in cases where
the late Korotkoff sounds are barely audible, such as in patients who have hypotension.

Another method to measure blood pressure non-invasively involves analyzing

variations in arterial blood pressure as the cuff is deflated. This technique is called the
oscillometric method.
Measurement of oxygen saturation in the blood
Proper blood O2 and CO2 levels are critical for maintenance of pH and healthy function
of cells. Lung diseases including asthma, emphysema, severe pneumonia, and
pulmonary edema (fluid in the lungs) can cause low oxygen levels in the blood, a
condition known as hypoxemia. Blood oxygen is monitored for all patients during
surgery and often for patients during recovery in the hospital. One way to measure
oxygen content in blood (which is usually expressed as the percentage of O2 saturation;
%SpO2) is by taking an arterial blood sample: This procedure is more difficult than is
collection of a venous blood sample because the arteries in the arm are deeper, and the
muscular arterial wall is more difficult to puncture with a needle.

As an alternative, O2 saturation can be measured by a pulse oximeter. The pulse

oximeter also monitors the heart rate, or pulse; in fact, measurement of the pulsations
of blood in the tissue is essential for its operation. The oximeter device, which consists
of a light emitter probe coupled with a photodiode, is attached to a finger tip or earlobe
(or leg of a neonate)
 The pulse oximeter measures the difference in light
absorbance at two wavelengths: one in the red portion of the
visible region and another in the IR region. These
measurements provide information on the ratio of
oxyhemoglobin (hemoglobin [Hb] bound to oxygen) to
deoxyhemoglobin (Hb without oxygen) in the tissue. Red
light is not absorbed well by oxygenated blood, but IR light
is absorbed. By using photodiodes to produce small light
beams at these two wavelengths, and detectors to measure
the fraction of each light beam that passes through the tissue,
the device calculates the ratio of red to IR absorbance.
Pulse Oximeter

Measurement of oxygen saturation in tissue. The pulse

oximeter measurement uses light absorbance at two
different wavelengths: 660 nm (in the red portion of the
visible region) and 910 nm (in the infrared region).
Oxyhemoglobin (HbO2) and deoxyhemoglobin (Hb) have
different absorbance characteristics at these two
wavelengths.