Acknowledgments xiii
Preface xv
List of Symbols xviii
1 Basic Concepts of Medical Instrumentation 1
Walter H. Olson and John G. Webster
1.1 Terminology of Medicine and Medical Devices 2
1.2 Generalized Medical Instrumentation System 3
1.3 Alternative Operational Modes 5
1.4 Medical Measurement Constraints 7
1.5 Classifications of Biomedical Instruments 10
1.6 Interfering and Modifying Inputs 10
1.7 Compensation Techniques 12
1.8 Biostatistics 14
1.9 Generalized Static Characteristics 18
1.10 Generalized Dynamic Characteristics 26
1.11 Amplifiers and Signal Processing 40
1.12 Inverting Amplifiers 42
1.13 Noninverting Amplifiers 45
1.14 Differential Amplifiers 47
1.15 Comparators 53
1.16 Rectifiers 55
1.17 Logarithmic Amplifiers 60
1.18 Integrators 61
1.19 Differentiators 62
1.20 Active Filters 64
1.21 Frequency Response 68
1.22 Offset Voltage 71
1.23 Bias Current 73
1.24 Input and Output Resistance 75
1.25 Design Criteria 77
1.26 Commercial Medical Instrumentation Development Process 77
1.27 Regulation of Medical Devices 80
Problems 85
References 89
2 Basic Sensors and Principles 91
Robert A. Peura and John G. Webster
2.1 Displacement Measurements 91
2.2 Resistive Sensors 92
2.3 Bridge Circuits 102
2.4 Inductive Sensors 104
2.5 Phase-Sensitive Demodulators 107
2.6 Capacitive Sensors 110
2.7 Piezoelectric Sensors 113
2.8 Accelerometer 119
2.9 Temperature Measurements 119
2.10 Thermocouples 120
2.11 Thermistors 123
2.12 Radiation Thermometry 128
2.13 Fiber-Optic Temperature Sensors 133
2.14 Optical Measurements 133
2.15 Radiation Sources 135
2.16 Geometrical and Fiber Optics 140
2.17 Optical Filters 143
2.18 Radiation Sensors 144
2.19 Optical Combinations 148
Problems 148
References 150
3 Microcontrollers in Medical Instrumentation 153
Amit J. Nimunkar
3.1 Basics of Microcontroller 153
3.2 Embedded Medical System 154
3.3 ECG-Based Embedded Medical System Example 156
3.4 Selection of a Microcontroller 161
3.5 IoT-Based Medical Devices 188
Problems 191
References 193
4 The Origin of Biopotentials 196
John W. Clark, Jr.
4.1 Electrical Activity of Excitable Cells 197
4.2 Volume Conductor Fields 206
4.3 Functional Organization of the Peripheral Nervous System 209
4.4 The Electroneurogram 211
4.5 The Electromyogram 216
4.6 The Electrocardiogram 219
4.7 The Electroretinogram 232
4.8 The Electroencephalogram 238
4.9 The Magnetoencephalogram 259
Problems 260
References 264
5 Biopotential Electrodes 267
Michael R. Neuman
5.1 The Electrode-Electrolyte Interface 268
5.2 Polarization 271
5.3 Polarizable and Nonpolarizable Electrodes 275
5.4 Electrode Behavior and Circuit Models 282
5.5 The Electrode-Skin Interface and Motion Artifact 285
5.6 Body-Surface Recording Electrodes 289
5.7 Internal Electrodes 302
5.8 Electrode Arrays 309
5.9 Microelectrodes 311
5.10 Electrodes for Electric Stimulation of Tissue 320
5.11 Practical Hints in Using Electrodes 323
Problems 325
References 329
6 Biopotential Amplifiers 333
Michael R. Neuman
6.1 Basic Requirements 333
6.2 The Electrocardiograph 335
6.3 Problems Frequently Encountered 348
6.4 Transient Protection 358
6.5 Common-Mode and Other Interference-Reduction Circuits 361
6.6 Amplifiers for Other Biopotential Signals 365
6.7 Example of a Biopotential Preamplifier 370
6.8 Other Biopotential Signal Processors 372
6.9 Cardiac Monitors 381
6.10 Biotelemetry 389
Problems 391
References 394
7 Blood Pressure and Sound 396
Robert A. Peura
7.1 Direct Measurements 399
7.2 Harmonic Analysis of Blood Pressure Waveforms 403
7.3 Dynamic Properties of Pressure-Measurement Systems 405
7.4 Measurement of System Response 414
7.5 Effects of System Parameters on Response 418
7.6 Bandwidth Requirements for Measuring Blood Pressure 419
7.7 Typical Pressure-Waveform Distortion 420
7.8 Systems for Measuring Venous Pressure 422
7.9 Heart Sounds 422
7.10 Phonocardiography 428
7.11 Cardiac Catheterization 428
7.12 Effects of Potential and Kinetic Energy on Pressure Measurements 433
7.13 Indirect Measurements of Blood Pressure 435
7.14 Tonometry 442
Problems 448
References 450
8 Measurement of Flow and Volume of Blood 452
John G. Webster
8.1 Indicator-Dilution Method that Uses Continuous Infusion 453
8.2 Indicator-Dilution Method that Uses Rapid Injection 455
8.3 Electromagnetic Flowmeters 459
8.4 Ultrasonic Flowmeters 467
8.5 Thermal-Convection Velocity Sensors 481
8.6 Chamber Plethysmography 484
8.7 Electrical-Impedance Plethysmography 486
8.8 Photoplethysmography 493
Problems 495
References 497
9 Measurements of the Respiratory System 499
Frank P. Primiano, Jr.
9.1 Modeling the Respiratory System 501
9.2 Measurement of Pressure 508
9.3 Measurement of Gas Flow 511
9.4 Lung Volume 520
9.5 Respiratory Plethysmography 528
9.6 Some Tests of Respiratory Mechanics 535
9.7 Measurement of Gas Concentration 548
9.8 Some Tests of Gas Transport 560
Problems 568
References 571
10 Chemical Biosensors 574
Robert A. Peura
10.1 Blood-Gas and Acid-Base Physiology 576
10.2 Electrochemical Sensors 580
10.3 Chemical Fibrosensors 589
10.4 Ion-Sensitive Field-Effect Transistor (ISFET) 606
10.5 Immunologically Sensitive Field-Effect Transistor (IMFET) 609
10.6 Noninvasive Blood-Gas Monitoring 610
10.7 Blood-Glucose Sensors 620
10.8 Electronic Noses 630
10.9 Lab-on-a-chip 631
10.10 Summary 632
Problems 633
References 633
11 Clinical Laboratory Instrumentation 637
Lawrence A. Wheeler
11.1 Spectrophotometry 638
11.2 Automated Chemical Analyzers 649
11.3 Chromatology 653
11.4 Electrophoresis 656
11.5 Hematology 659
Problems 671
References 671
12 Medical Imaging Systems 673
Melvin P. Siedband
12.1 Information Content of an Image 674
12.2 Modulation Transfer Function 678
12.3 Noise-Equivalent Bandwidth 680
12.4 Image Processing 681
12.5 Radiography 682
12.6 Computed Radiography 690
12.7 Computed Tomography 697
12.8 Magnetic Resonance Imaging 707
12.9 Nuclear Medicine 714
12.10 Single-Photon Emission Computed Tomography 722
12.11 Positron Emission Tomography 723
12.12 Ultrasonography 728
12.13 Contrast Agents 740
Problems 742
References 744
13 Therapeutic and Prosthetic Devices 746
Michael R. Neuman
13.1 Cardiac Pacemakers and Other Electric Stimulators 746
13.2 Defibrillators and Cardioverters 764
13.3 Mechanical Cardiovascular Orthotic and Prosthetic Devices 771
13.4 Hemodialysis 775
13.5 Lithotripsy 778
13.6 Ventilators 780
13.7 Infant Incubators 784
13.8 Drug Delivery Devices 786
13.9 Surgical Instruments 793
13.10 Therapeutic Applications of the Laser 797
Problems 798
References 800
14 Electrical Safety 803
Walter H. Olson
14.1 Physiological Effects of Electricity 804
14.2 Important Susceptibility Parameters 807
14.3 Distribution of Electric Power 813
14.4 Macroshock Hazards 818
14.5 Microshock Hazards 822
14.6 Electrical-Safety Codes and Standards 827
14.7 Basic Approaches to Protection Against Shock 829
14.8 Protection: Power Distribution 830
14.9 Protection: Equipment Design 833
14.10 Electrical-Safety Analyzers 838
14.11 Testing the Electric System 838
14.12 Tests of Electric Appliances 840
14.13 Conclusion 843
Problems 844
References 846
Appendix 848
A.1 Physical Constants 848
A.2 International System of Units (SI) Prefixes 848
A.3 International System of Units 849
A.4 Abbreviations 850
A.5 Chemical Elements 853
Index 855
