1 BASIC CONCEPTS OF MEDICAL INSTRUMENTATION&walter H.Olson 1
1.1 Terminology of Medicine and Medical Devices 4
1.2 Generalized Medical Instrumentation System 5
1.3 Alternative Operational Modes 7
1.4 Medical Measurement Constraints 9
1.5 Classifications of Biomedical Instruments 12
1.6 Interfering and Modifying Inputs 12
1.7 Compensation Techniques 13
1.8 Biostatistics 16
1.9 Generalized Static Characteristics 19
1.10 Generalized Dynamic Characteristics 25
1.11 Design Criteria 35
1.12 Commercial Medical Instrumentation Development Process 35
1.13 Regulation of Medical Devices 38
Problems 39
References 42
2 BASIC SENSORS AND PRINCIPLES&Robert A.Peura and John G.Webster 44
2.1 Displacement Measurements 44
2.2 Resistive Sensors 45
2.3 Bridge Circuits 51
2.4 Inductive Sensors 53
2.5 Capacitive Sensors 55
2.6 Piezoelectric Sensors 57
2.7 Temperature Measurements 61
2.8 Thermocouples 62
2.9 Thermistors 64
2.10 Radiation Thermometry 67
2.11 Fiber-Optic Temperature Sensors 72
2.12 Optical Measurements 72
2.13 Radiation Sources 73
2.14 Geometrical and Fiber Optics 78
2.15 Optical Filters 80
2.16 Radiation Sensors 81
2.17 Optical Combinations 84
Problems 85
References 87
3 AMPLIFIERS AND SIGNAL PROCESSING&John G.Webster 89
3.1 Ideal Op Amps 89
3.2 Inverting Amplifiers 91
3.3 Noninverting Amplifiers 94
3.4 Differential Amplifiers 95
3.5 Comparators 98
3.6 Rectifiers 100
3.7 Logarithmic Amplifiers 101
3.8 Integrators 102
3.9 Differentiators 105
3.10 Active Filters 106
3.11 Frequency Response 108
3.12 Offset Voltage 110
3.13 Bias Current 111
3.14 Input and Output Resistance 113
3.15 Phase-Sensitive Demodulators 115
3.16 Microcomputers in Medical Instrumentation 118
Problems 118
References 120
4 THE ORIGIN OF BIOPOTENTIALS&John W.Clark, Jr 121
4.1 Electrical Activity of Excitable Cells 121
4.2 Volume Conductor Fields 129
4.3 Functional Organization of the Peripheral Nervous System 132
4.4 The Electroneurogram (ENG) 134
4.5 The Electromyogram (EMG) 138
4.6 The Electrocardiogram (ECG) 139
4.7 The Electroretinogram (ERG) 151
4.8 The Electroencephalogram (EEG) 156
4.9 The Magnetoencephalogram (MEG) 175
Problems 176
References 180
5 BIOPOTENTIAL ELECTRODES&Michael R.Neuman 183
5.1 The Electrode-Electrolyte Interface 183
5.2 Polarization 186
5.3 Polarizable and Nonpolarizable Electrodes 189
5.4 Electrode Behavior and Circuit Models 194
5.5 The Electrode-Skin Interface and Motion Artifact 196
5.6 Body-Surface Recording Electrodes 200
5.7 Internal Electrodes 206
5.8 Electrode Arrays 211
5.9 Microelectrodes 213
5.10 Electrodes for Electric Stimulation of Tissue 222
5.11 Practical Hints in Using Electrodes 225
Problems 226
References 230
6 BIOPOTENTIAL AMPLIFIERS&Michael R.Neuman 233
6.1 Basic Requirements 233
6.2 The Electrocardiograph 235
6.3 Problems Frequently Encountered 245
6.4 Transient Protection 253
6.5 Common-Mode and Other Interference-Reduction Circuits 255
6.6 Amplifiers for Other Biopotential Signals 258
6.7 Example of a Biopotential Preamplifier 262
6.8 Other Biopotential Signal Processors 264
6.9 Cardiac Monitors 273
6.10 Biotelemetry 277
Problems 281
References 285
7 BLOOD PRESSURE AND SOUND&Robert A.Peura 287
7.1 Direct Measurements 289
7.2 Harmonic Analysis of Blood-Pressure Waveforms 294
7.3 Dynamic Properties of Pressure-Measurement Systems 295
7.4 Measurement of System Response 302
7.5 Effects of System Parameters on Response 303
7.6 Bandwidth Requirements for Measuring Blood Pressure 305
7.7 Typical Pressure-Waveform Distortion 305
7.8 Systems for Measuring Venous Pressure 307
7.9 Heart Sounds 308
7.10 Phonocardiography 312
7.11 Cardiac Catheterization 312
7.12 Effects of Potential and Kinetic Energy on Pressure Measurements 316
7.13 Indirect Measurements of Blood Pressure 317
7.14 Tonometry 324
Problems 328
References 329
8 MEASUREMENT OF FLOW AND VOLUME OF BLOOD&John G.Webster 332
8.1 Indicator-Dilution Method That Uses Continuous Infusion 332
8.2 Indicator-Dilution Method That Uses Rapid Injection 335
8.3 Electromagnetic Flowmeters 338
8.4 Ultrasonic Flowmeters 344
8.5 Thermal-Convection Velocity Sensors 355
8.6 Chamber Plethysmography 357
8.7 Electric-Impedance Plethysmography 359
8.8 Photoplethysmography 366
Problems 368
References 369
9 MEASUREMENTS OF THERESPIRATORY SYSTEM&Frank P.Primiano, Jr 372
9.1 Modeling the Respiratory System 373
9.2 Measurement of Pressure 380
9.3 Measurement of Gas-Flow Rate 382
9.4 Lung Volume 390
9.5 Respiratory Plethysmography 399
9.6 Some Tests of Respiratory Mechanics 406
9.7 Measurement of Gas Concentration 417
9.8 Some Tests of Gas Transport 427
Problems 434
References 437
10 CHEMICAL BIOSENSORS&Robert A.Peura 440
10.1 Blood-Gas and Acid-Base Physiology 442
10.2 Electrochemical Sensors 444
10.3 Chemical Fibrosensors 450
10.4 Ion-Selective Field-Effect Transistor (ISFET) 466
10.5 Immunologically Sensitive Field-Effect Transistor (IMFET) 468
10.6 Noninvasive Blood-Gas Monitoring 469
10.7 Blood-Glucose Sensors 477
10.8 Summary 482
Problems 482
References 483
11 CLINICAL LABORATORY INSTRUMENTATION&Lawrence A.Wheeler 486
11.1 Spectrophotometry 487
11.2 Automated Chemical Analyzers 495
11.3 Chromatology 502
11.4 Electrophoresis 505
11.5 Hematology 507
Problems 515
References 516
12 MEDICAL IMAGING SYSTEMS&Melvin P.Siedband 518
12.1 Information Content of an Image 518
12.2 Modulation Transfer Function 525
12.3 Noise-Equivalent Bandwidth 527
12.4 Photography 527
12.5 Television Systems 530
12.6 Radiography 532
12.7 Computed Radiography 540
12.8 Computed Tomography 543
12.9 Magnetic Resonance Imaging 551
12.10 Nuclear Medicine 555
12.11 Single-Photon Emission Computed Tomography 561
12.12 Positron Emission Tomography 562
12.13 Ultrasonography 565
Problems 573
References 576
13 THERAPEUTIC AND PROSTHETIC DEVICES&Michael R.Neuman 577
13.1 Cardiac Pacemakers and Other Electric Stimulators 577
13.2 Defibrillators and Cardioverters 591
13.3 Mechanical Cardiovascular Orthotic and Prosthetic Devices 597
13.4 Hemodialysis 600
13.5 Lithotripsy 602
13.6 Ventilators 604
13.7 Infant Incubators 607
13.8 Drug Delivery Devices 609
13.9 Surgical Instruments 613
13.10 Therapeutic Applications of the Laser 617
Problems 618
References 620
14 ELECTRICAL SAFETY&waiter H.Oison 623
14.1 Physiological Effects of Electricity 624
14.2 Important Susceptibility Parameters 626
14.3 Distribution of Electric Power 630
14.4 Macroshock Hazards 634
14.5 Microshock Hazards 636
14.6 Electrical-Safety Codes and Standards 640
14.7 Basic Approaches to Protection Against Shock 642
14.8 Protection: Power Distribution 643
14.9 Protection: Equipment Design 646
14.10 Electrical-Safety Analyzers 649
14.11 Testing the Electric System 650
14.12 Tests of Electric Appliances 654
Problems 656
References 658
APPENDIX 659
A.1 Physical Constants 659
A.2 SI Prefixes 659
A.3 SI Units 660
Reference 660
A.4 Abbreviations 661
A.5 Chemical Elements 664
INDEX 667