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Medical Instrumentation: Application and Design, 4th Edition

John G. Webster (Editor)

ISBN: 978-0-471-67600-3 February 2009 736 Pages

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This contributed book provides the premiere reference on medical instrumentation as well as a comprehensive overview of the basic concepts of medical instrumentation illustrating the interdisciplinary nature of bioinstrumentation. This revised edition features new material on infant apnea monitors, impedance pneumography, the design of cardiac pacemakers, and disposable defibrillator electrodes and their standards.

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Preface v

List of Symbols ix

1 BASIC CONCEPTS OF MEDICAL INSTRUMENTATION 1
Walter H. Olson

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 37

1.13 Regulation of Medical Devices 39

Problems 42

References 43

2 BASIC SENSORS AND PRINCIPLES 45
Robert A. Peura and John G. Webster

2.1 Displacement Measurements 45

2.2 Resistive Sensors 46

2.3 Bridge Circuits 53

2.4 Inductive Sensors 53

2.5 Capacitive Sensors 56

2.6 Piezoelectric Sensors 58

2.7 Temperature Measurements 62

2.8 Thermocouples 63

2.9 Thermistors 66

2.10 Radiation Thermometry 69

2.11 Fiber-Optic Temperature Sensors 74

2.12 Optical Measurements 74

2.13 Radiation Sources 75

2.14 Geometrical and Fiber Optics 79

2.15 Optical Filters 82

2.16 Radiation Sensors 83

2.17 Optical Combinations 86

Problems 87

References 88

3 AMPLIFIERS AND SIGNAL PROCESSING 91
John G. Webster

3.1 Ideal Op Amps 91

3.2 Inverting Amplifiers 93

3.3 Noninverting Amplifiers 96

3.4 Differential Amplifiers 97

3.5 Comparators 100

3.6 Rectifiers 102

3.7 Logarithmic Amplifiers 103

3.8 Integrators 104

3.9 Differentiators 107

3.10 Active Filters 108

3.11 Frequency Response 110

3.12 Offset Voltage 112

3.13 Bias Current 114

3.14 Input and Output Resistance 115

3.15 Phase-Sensitive Demodulators 117

3.16 Timers 120

3.17 Microcomputers in Medical Instrumentation 122

Problems 123

References 125

4 THE ORIGIN OF BIOPOTENTIALS 126
John W. Clark, Jr.

4.1 Electrical Activity of Excitable Cells 126

4.2 Volume-Conductor Fields 135

4.3 Functional Organization of the Peripheral Nervous System 138

4.4 The Electroneurogram 140

4.5 The Electromyogram 144

4.6 The Electrocardiogram 147

4.7 The Electroretinogram 158

4.8 The Electroencephalogram 163

4.9 The Magnetoencephalogram 181

Problems 182

References 186

5 BIOPOTENTIAL ELECTRODES 189
Michael R. Neuman

5.1 The Electrode–Electrolyte Interface 189

5.2 Polarization 192

5.3 Polarizable and Nonpolarizable Electrodes 196

5.4 Electrode Behavior and Circuit Models 202

5.5 The Electrode—Skin Interface and Motion Artifact 205

5.6 Body-Surface Recording Electrodes 209

5.7 Internal Electrodes 215

5.8 Electrode Arrays 220

5.9 Microelectrodes 222

5.10 Electrodes for Electric Stimulation of Tissue 231

5.11 Practical Hints in Using Electrodes 233

Problems 235

References 239

6 BIOPOTENTIAL AMPLIFIERS 241
Michael R. Neuman

6.1 Basic Requirements 241

6.2 The Electrocardiograph 243

6.3 Problems Frequently Encountered 254

6.4 Transient Protection 264

6.5 Common-Mode and Other Interference-Reduction Circuits 266

6.6 Amplifiers for Other Biopotential Signals 269

6.7 Example of a Biopotential Preamplifier 274

6.8 Other Biopotential Signal Processors 275

6.9 Cardiac Monitors 282

6.10 Biotelemetry 287

Problems 288

References 291

7 BLOOD PRESSURE AND SOUND 293
Robert A. Peura

7.1 Direct Measurements 295

7.2 Harmonic Analysis of Blood-Pressure Waveforms 300

7.3 Dynamic Properties of Pressure-Measurement Systems 301

7.4 Measurement of System Response 308

7.5 Effects of System Parameters on Response 310

7.6 Bandwidth Requirements for Measuring Blood Pressure 311

7.7 Typical Pressure-Waveform Distortion 311

7.8 Systems for Measuring Venous Pressure 313

7.9 Heart Sounds 314

7.10 Phonocardiography 318

7.11 Cardiac Catheterization 318

7.12 Effects of Potential and Kinetic Energy on Pressure Measurements 323

7.13 Indirect Measurements of Blood Pressure 325

7.14 Tonometry 330

Problems 335

References 336

8 MEASUREMENT OF FLOW AND VOLUME OF BLOOD 338
John G. Webster

8.1 Indicator-Dilution Method That Uses Continuous Infusion 338

8.2 Indicator-Dilution Method That Uses Rapid Injection 341

8.3 Electromagnetic Flowmeters 344

8.4 Ultrasonic Flowmeters 350

8.5 Thermal-Convection Velocity Sensors 361

8.6 Chamber Plethysmography 364

8.7 Electrical-Impedance Plethysmography 366

8.8 Photoplethysmography 372

Problems 374

References 375

9 MEASUREMENTS OF THE RESPIRATORY SYSTEM 377
Frank P. Primiano, Jr.

9.1 Modeling the Respiratory System 378

9.2 Measurement of Pressure 385

9.3 Measurement of Gas-Flow 388

9.4 Lung Volume 396

9.5 Respiratory Plethysmography 404

9.6 Some Tests of Respiratory Mechanics 411

9.7 Measurement of Gas Concentration 425

9.8 Some Tests of Gas Transport 436

Problems 443

References 446

10 CHEMICAL BIOSENSORS 449
Robert A. Peura

10.1 Blood-Gas and Acid-Base Physiology 451

10.2 Electrochemical Sensors 453

10.3 Chemical Fibrosensors 461

10.4 Ion-Selective Field-Effect Transistor 475

10.5 Immunologically Sensitive Field-Effect Transistor 478

10.6 Noninvasive Blood-Gas Monitoring 479

10.7 Blood-Glucose Sensors 486

10.8 Electronic Noses 492

10.9 Lab-on-a-Chip 493

10.10 Summary 494

Problems 495

References 495

11 CLINICAL LABORATORY INSTRUMENTATION 498
Lawrence A. Wheeler

11.1 Spectrophotometry 499

11.2 Automated Chemical Analyzers 508

11.3 Chromatology 512

11.4 Electrophoresis 515

11.5 Hematology 517

Problems 526

References 527

12 MEDICAL IMAGING SYSTEMS 528
Melvin P. Siedband

12.1 Information Content of an Image 528

12.2 Modulation Transfer Function 535

12.3 Noise-Equivalent Bandwidth 536

12.4 Television Systems 537

12.5 Radiography 540

12.6 Computed Radiography 549

12.7 Computed Tomography 553

12.8 Magnetic Resonance Imaging 561

12.9 Nuclear Medicine 566

12.10 Single-Photon Emission Computed Tomography 572

12.11 Positron Emission Tomography 573

12.12 Ultrasonography 576

12.13 Contrast Agents 585

Problems 587

References 589

13 THERAPEUTIC AND PROSTHETIC DEVICES 590
Michael R. Neuman

13.1 Cardiac Pacemakers and Other Electric Stimulators 590

13.2 Defibrillators and Cardioverters 606

13.3 Mechanical Cardiovascular Orthotic and Prosthetic Devices 611

13.4 Hemodialysis 615

13.5 Lithotripsy 618

13.6 Ventilators 619

13.7 Infant Incubators 622

13.8 Drug Delivery Devices 624

13.9 Surgical Instruments 629

13.10 Therapeutic Applications of the Laser 632

Problems 633

References 635

14 ELECTRICAL SAFETY 638
Walter H. Olson

14.1 Physiological Effects of Electricity 639

14.2 Important Susceptibility Parameters 641

14.3 Distribution of Electric Power 646

14.4 Macroshock Hazards 650

14.5 Microshock Hazards 653

14.6 Electrical-Safety Codes and Standards 658

14.7 Basic Approaches to Protection Against Shock 659

14.8 Protection: Power Distribution 660

14.9 Protection: Equipment Design 663

14.10 Electrical-Safety Analyzers 667

14.11 Testing the Electric System 667

14.12 Tests of Electric Appliances 669

Conclusion 673

Problems 673

References 674

Appendix 676

A.1 Physical Constants 676

A.2 International System of Units (SI) Prefixes (Thompson and Taylor, 2008) 676

A.3 International System of Units (Thompson and Taylor, 2008) 677

A.4 Abbreviations 678

A.5 Chemical Elements 681

Index 683

All chapters have been revised-New material covers medical imaging and therapeutic and prosthetic devices
All chapters have been revised or shortened with most new material in medical imaging and therapeutic and prosthetic devices