EB3100 Praktikum Teknik Biomedis 2

1. Introduction to Instrumentation and

Measurement Systems
 Medical devices
• Medical devices can be grouped according to the
three areas of medicine:
• Diagnosis
– diagnostic devices
• Therapy
– therapeutic devices
– application of energy
• Rehabilitation
– Application of Assisting orthotic-prosthetic devices
Diagnostic devices
• Types of diagnostic devices
– recording and monitoring devices
– measurement and analysis devices
– imaging devices
• importance of diagnostic devices
– enhance and extend the five human senses to improve to
collect data from the patient for diagnosis
– the perception of the physician can be improved by
diagnostic instrumentation in many ways:
• amplify human senses
• place the observer's senses in inaccessible environments
• provide new senses
Therapeutic devices

• Objective of therapeutic devices:

– deliver physical substances to the body to treat disease
• Physical substances:
– Voltage, current
– Pressure
– Flow
– Force
– Ultrasound
– Electromagnetic radiation
– Heat
• Therapeutic device categories:
– devices used to treat disorders
– devices to assist or control the physiological functions
Assistive or rehabilitative devices
• Objective of rehabilitative devices
– to assist individuals with a disability
• The disability can be connected to the troubles to
– perform activities of daily living
– limitations in mobility
– communications disorders and
– sensory disabilities
• Types of rehabilitative devices
– Orthopedic devices
• An orthopedic device is an appliance that aids an existing function
– Prosthetic devices
• A prosthesis provides a substitute
 Medical Procedure

Biomedical Instrumentation (BMI) aims to assist clinician

in performing objective medical procedure:
1 Collection of data - qualitative and/or
quantitative
2 Analysis of data
3 Decision making
4 Treatment planning based on the decision
 The scientific method…
• In the scientific method, a hypothesis is tested
by experiment to determine its validity.

Problem Review State Perform

statement prior work hypothesis experiments

Design further Analyze Final

experiments data conclusions
More
Problem
experiments
solved
necessary
 …The scientific method
• In the scientific method, a hypothesis is tested by
experiment to determine its validity.
– For example, we might hypothesize that exercise
reduces high blood pressure yet experimentation and
analysis are needed to support or refuse the
hypothesis.
• Experiments are normally performed multiple times. Then
the results can be analyzed statistically to determine the
probability that the results might have been produced by
chance.
• Results are reported in scientific journals with enough detail
so that others can replicate the experiment to confirm them.
 Clinical diagnoses
• Physicians often need instrumentation to obtain data as part
of the scientific method.
– For example, a physician obtaining the history of a patient
with a complaint of poor vision would list diabetes as one
possibility on a differential diagnosis.
List the Treatment
Chief Obtain Examination
differential and
complaint history and tests
diagnosis evaluation

Use data
Select further Final
to narrow the
tests diagnosis
diagnosis
More than Only one
one likely likely
 Feedback in measurement systems…
• Figure shows that the measurand is measured by a
sensor converting the variable to an electrical signal,
which can undergo signal processing. Sometimes the
measurement system provides feedback through an
effector to the subject.
Outputs

Signal Signal Data

Sensor
Measurand conditioning processing displays

Feedback
Data Data
Effector
storage communication
 …Feedback in measurement systems
• Figure (a) shows that a patient reading an instrument usually lacks
sufficient knowledge to achieve the correct diagnosis.
• Figure (b) shows that by adding the clinician to form an effective
feedback system, the correct diagnosis and treatment result.

Patient
Instrument

Patient Clinician
Instrument

(a) (b)
 …Feedback in measurement systems
• In certain circumstances, proper training of the patient and a
well-designed instrument can lead to self-monitoring and self-
control (one of the goals of bioinstrumentation).
– An example of such a situation is the day-to-day monitoring of glucose
by people suffering from diabetes. Such an individual will contact a
clinician if there is an alert from the monitoring instrument.

Abnormal
Clinician readings Patient Instrument
 Some characteristics of BMI
• Deals with biological tissues, organs and organ systems and their
properties and functions
• Always consider the underlying physiological mechanism in
measurement interpretation
• Bio-phenomena:
– bioelectricity, biochemistry, biomechanics

• Accessibility of data is limited

• Interface between tissue and instrumentation is needed
• Consider invasiveness of procedures: non-invasive, minimally
invasive, invasive
 Common bio-phenomena measured
• Dimensional parameters:
– size, weight, density
• Bioelectricity:
– bio-potentials: electro- cardio/encephalo/myo -gram
– bio-impedance
• Biochemical parameters:
– molecule concentrations
– oxygen saturation
– pH and other ionic concentrations
• Biomechanical parameters:
– pressure, flow, volumes
– temperature
– displacement (velocity, acceleration, force)
 Common measurement range of biosignals
Measurement Range Frequency, Hz Method
Blood flow 1 to 300 mL/s 0 to 20 Electromagnetic or ultrasonic
Blood pressure 0 to 400 mmHg 0 to 50 Cuff or strain gage
Cardiac output 4 to 25 L/min 0 to 20 Fick, dye dilution
Electrocardiography 0.5 to 4 mV 0.05 to 150 Skin electrodes
Electroencephalography 5 to 300  V 0.5 to 150 Scalp electrodes
Electromyography 0.1 to 5 mV 0 to 10000 Needle electrodes
Electroretinography 0 to 900  V 0 to 50 Contact lens electrodes
pH 3 to 13 pH units 0 to 1 pH electrode
pCO2 40 to 100 mmHg 0 to 2 pCO2 electrode
pO2 30 to 100 mmHg 0 to 2 pO2 electrode
Pneumotachography 0 to 600 L/min 0 to 40 Pneumotachometer
2 to 50
Respiratory rate 0.1 to 10 Impedance
breaths/min
Temperature 32 to 40 °C 0 to 0.1 Thermistor
 Data (“biosignal”) Accessibility in BMI

• Many crucial variables in living systems are not directly accessible:

– Surface measurement: measure from the outside (ExG)
– Proxy measurement: measure something which indicates
something else (biomechanical/ biochemical indicators)
• Variables measured are seldom deterministic (mostly stochastic).
• Operation of instruments in the medical environment imposes
important additional constraints.
– Radiation limits
– Length of period under anesthetics/ conditioning drugs
 Tissue Interface in BMI
• Bio-compatibility is needed:
– Material compatibility in implanted components
– Impedance matching in bioelectricity and bioacoustics surface
transducer
• Patient bio-safety; measurement should perform none to minimal
damage to the tissue:
– Energy limitation to maintain tissue integrity -- bioelectricity:
current, voltage; biomechanics: pressure, flow, force
– Bioelectricity: patient electrical isolation
• Environmental bio-safety: measurement should yield none to minimal
risk of disease transmission:
– Sterilization procedures before and after use
– Protection gears: gloves, etc.
Generalized Medical Instrumentation System…

Actuator
Computation Unit
Variable
Conversion
Element

Electrical
Interface
 Components of BM Instrumentation System…

• A sensor
Converts a physical measurand (biochemical, bioelectrical, or
biophysical parameter) to an electrical output
– (Ideally) should respond only to the targeted form of energy
present in the measurand
– Should be minimally invasive (ideally noninvasive)
– Provides a safe interface with biological materials

• An actuator
– Delivers external agents via direct or indirect contact
– Controls biochemical, bioelectrical, or biophysical parameters
– Provides a safe interface with biologic materials
 Sensor/Actuator Technical Specification:
example (1)
• Bioinstrumentation should be designed with a specific signal in mind.
– Table shows a few specifications for an electrocardiograph
– The values of the specifications, which have been agreed upon by a committee,
are drawn from research, hospitals, industry, and government.

Specification Value
Input signal dynamic range ±5 mV
Dc offset voltage ±300 mV
Slew rate 320 mV/s
Frequency response 0.05 to 150 Hz
Input impedance at 10 Hz 2.5 M
Dc lead current 0.1 A
Return time after lead switch 1s
Overload voltage without damage 5000 V
Risk current at 120 V 10 A
 Sensor/Actuator Technical Specification:
example (2)
• The specifications for a typical blood pressure sensor.
– Sensor specifications for blood pressure sensors are
determined by a committee composed of individuals from
academia, industry, hospitals, and government

Specification Value
Pressure range –30 to +300 mmHg
Overpressure without damage –400 to +4000 mmHg
Maximum unbalance ±75 mmHg
Linearity and hysteresis ± 2% of reading or ± 1 mmHg
Risk current at 120 V 10 A
Defibrillator withstand 360 J into 50 
 Sensor/Actuator Technical Specification:
compare with the biosignal range!
Measurement Range Frequency, Hz Method
Blood flow 1 to 300 mL/s 0 to 20 Electromagnetic or ultrasonic
Blood pressure 0 to 400 mmHg 0 to 50 Cuff or strain gage
Cardiac output 4 to 25 L/min 0 to 20 Fick, dye dilution
Electrocardiography 0.5 to 4 mV 0.05 to 150 Skin electrodes
Electroencephalography 5 to 300  V 0.5 to 150 Scalp electrodes
Electromyography 0.1 to 5 mV 0 to 10000 Needle electrodes
Electroretinography 0 to 900  V 0 to 50 Contact lens electrodes
pH 3 to 13 pH units 0 to 1 pH electrode
pCO2 40 to 100 mmHg 0 to 2 pCO2 electrode
pO2 30 to 100 mmHg 0 to 2 pO2 electrode
Pneumotachography 0 to 600 L/min 0 to 40 Pneumotachometer
2 to 50
Respiratory rate 0.1 to 10 Impedance
breaths/min
Temperature 32 to 40 °C 0 to 0.1 Thermistor
…Components of BM Instrumentation System…

• The electronics interface

– Matches electrical characteristics of the
sensor/actuator with computation unit
– Preserves signal to noise ratio of sensor
– Preserves efficiency of actuator
– Preserves bandwidth (i.e., time response) of
sensor/actuator
– Provides a safe interface with the sensor/actuator
– Provides a safe interface with the computation unit
– Provides secondary signal processing functions for the
system
 …Components of BM Instrumentation System

• The computation unit

– provides primary user interface
– provides primary control for the overall system
– provides data storage for the system
– provides primary signal processing functions for
the system
– maintains safe operation of the overall system
 Biomedical Sensing

• Sensing hysteresis loop: Sensor

– The output curve obtained signal

when increasing the

measurand is different
from the output obtained Measurand
when decreasing the
measurand.
 Biomedical Sensing

• (a) A low-sensitivity sensor has low gain. (b) A

high sensitivity sensor has high gain.

Sensor Sensor
signal signal

Measurand Measurand

(a) (b)
 Biomedical Sensing
• Most sensors are analog and provide a continuous range of
amplitude values for output (a).
• Other sensors yield the digital output (b).
– Digital output has poorer resolution, but does not require conversion
before being input to digital computers and is more immune to
interference
Amplitude

Amplitude
Time Time

(a) (b)
 Biomedical Sensing

(a) An input signal which exceeds the dynamic range.

(b) The resulting amplified signal is saturated at 1 V.
Amplitude

5 mV

(a) Dynamic
Time Range

-5 mV

Amplitude

1V
(b)
Time

-1 V
 Biomedical Sensing
• DC offset voltage is the amount a signal may be moved from
its baseline and still be amplified properly by the system.
Figure shows an input signal without (a) and with (b) offset.
Amplitude

(a) Time

Amplitude

(b) Dc offset
Time
 Biomedical Sensing
• The frequency response of a device is the range of
frequencies of a measurand that it can handle.
• Frequency response is usually plotted as gain versus
frequency.
• Figure shows Frequency response of the electrocardiograph.

1.0

Amplitude

0.1
0.05 Hz 150 Hz
Frequency
 Biomedical Sensing

• Linearity is highly desirable for simplifying signal processing

(a) A linear system fits the equation y = mx + b.
(b) A nonlinear system does not fit a straight line.

Output Output

Input Input

(a) (b)
 Biomedical Sensing

• All bioinstrumentation observes the measurand either continuously or

periodically. However, computer-based systems require periodic
measurements since by their nature, computers can only accept discrete
numbers at discrete intervals of time.
(a) Continuous signals have values at every instant of time.
(b) Discrete-time signals are sampled periodically and do not provide
values between these sampling times.
Amplitude

Amplitude

Time Time

(a) (b)
 Biomedical Sensing

• Signal conditioning
– Amplify, filter, match the impedance of the sensor
to the display
– Convert analog signal to digital
– Process the signal
 Clinical Biosignal Measurement

Panels and series:

• Certain groups of measurements are often
ordered together because they are very
commonly used or because they are related.
• This may occur even if the measurements are
based on different principles or are taken with
different sensors.
• Table in next slide is an example of one of these
groups of measurements, which are called panels
or series.
 Clinical Biosignal Measurement

• Complete blood count for a male subject.

Laboratory test Typical value
Hemoglobin 13.5 to 18 g/dL
Hematocrit 40 to 54%
Erythrocyte count 4.6 to 6.2  106/ L
Leukocyte count 4500 to 11000/ L
Neutrophil 35 to 71%
Band 0 to 6%
Lymphocyte 1 to 10%
Differential count
Monocyte 1 to 10%
Eosinophil 0 to 4%
Basophil 0 to 2%
 Clinical Biosignal Measurement

• Hemoglobin is the protein which caries oxygen in the

bloodstream.
• Hematocrit is the percent of solid material in a given
volume of blood after it has been centrifuged.
• An erythrocyte is a red blood cell.
• A leukocyte is a white blood cell.
– The differential count tells how many of each type of white
blood cell there are in one microliter of blood.
– Unusual values for different leukocytes can be indicative of
the immune system fighting off foreign bodies.
 Errors in measurements…
LIHAT KULIAH EB3205 Pengukuran dan Instrumentasi Biosinyal
 Electronics Review
• Amplifier
– Ideal op-amp
– Inverting & non-inverting configurations
– Summing, comparator, logarithmic amplifiers
– Integrator & differentiator
– Rectifier (half and full-wave)
– Differential, instrumentation, isolation amplifiers
• Filter
– Active & passive filter (characteristics & differences
– Magnitude & phase response
– Critical frequencies: cut-off, resonance
– Frequency selective filter (LPF, BPF, HPF)