Medical Instruments II (Third class)

Prepared by

Dr. Saad Mutashar Abbas

2024-2025
Fundamentals of medical Instrumentation

Lecture 1

Dr. Saad Mutashar Abbas

2024-2025
Fundamentals of medical Instrumentation

Introduction
Biomedical Instrumentation deals with the measurement and analysis
of current or voltage signals from different parts of the body.
The human body generates a variety of voltages which are usually very
small. Biomedical instrumentation helps medical personnel or
physicians to make a better diagnose of the problem in a patient and
provide the appropriate treatment.
The Basic Features of a Biomedical Instrumentation System
Certain characteristics, which are common in most instrumentation
systems are also applied in Biomedical Instrumentation Systems. Any
medical instrumentation system would be made up of the following
key components:
1. Measured
2. Transducer or sensor
3. Signal Conditioner
4. Display system
BASIC MEDICAL INSTRUMENTATION SYSTEM
Biomedical Signals Recorders and
Monitors

Dr. Saad Mutashar Abbas

2024-2025
 Measured
This is the physical quantity or condition that the instrumentation system measures. The source of the
Measurand is the human body which generates a variety of signals. The Measurand for example can be on the
surface of the body (electrocardiogram potential) or may be blood pressure in the chambers of the heart.
 Transducer/Sensor
A transducer is a device that converts one form of energy to another. A transducer converts a physical signal
into an electrical output. The primary function of the transducer is to provide a usable output in a response to
the Measurand. Sometimes another term, ‘’sensor’’ maybe used in medical instrumentation systems. When used
here it does the same function of converting the physical Measurand to an electrical signal.
 Signal Conditioner
The signal conditioner converts the output of the transducer into an electrical quantity that is suitable for
operation of the display or recording system. Signal conditioning usually include functions such as
amplifications, filtering, analog-to-digital conversions, digital-to-analog conversions etc. This component of the
medical instrumentation system helps in increasing the sensitivity of instruments by amplification of the
original signal (which is usually extremely small) or its transduced form.
 Display System
This provides a visible representation of the quantity as a displacement on a scale or on the chart of a recorder
the screen of CRT or in a numerical form. Besides the display unit, the processed signal after signal
conditioning maybe passed to:
 Alarm system: With upper and lower adjustable thresholds to indicate when
the measured physical variable goes beyond the preset limits.
 Data Storage: To keep data for future reference, this may be a hard copy on a
paper or on magnetic or semiconductor memories.
 Data Transmission: Using standard interface connections so that information
obtained may be carried to other parts of an integrated system or transmits it
from one location to another.

Sources of Biomedical Signals

Biomedical signals/physiological signals are those signals (phenomenon that
conveys information) which are used primarily for extracting information on a
biological system under investigation. Our body produces various physiological
signals. The accessibility to these signals is important because these signals:
• Can be internal (Blood pressure)
• May emanate from the body (infrared radiation)
• Maybe derived from tissue sample (Blood or tissue biopsy)
All physiological signals can grouped as:
• Bio potential
• Pressure
• Flow
• Dimensions (imaging)
• Displacement (velocity, force, acceleration)
• Impendence
• Temperature
• Chemical concentration and composition
A transducer converts a physical signal into an electrical output. A transducer
should only respond to the targeted form of energy existing in the physiological
signal and it must exclude all other energies. It should also interface with the living
system in such a way that it extracts minimum energy and it should not be invasive.
How are Physiological Signals generated
Physiological signals are generated by the body during the functioning of various physiological systems. Hence,
physiological signals hold information which can be extracted from these signals to find out the state of the functioning of
these physiological systems. The process of extracting information can be either a simple as feeling the pulse to find the
state of heart beats or it can be complex as analyzing the structure of internal soft issues by an ultrasound. (link to
ultrasound article) Biomedical signals/Physiological signals are classified according to where they originate from within
the body.
Biomedical signals are classified as follows:
 1. Bioelectric signals: These signals are generated by the nerve and muscle cells. Their basic
source is the cell membrane which under certain conditions maybe excited to generate an
action potential. The electric field generated by the action of many cells constitutes the
bioelectric signal. The most common examples of bioelectric signals are the ECG
(Electrocardiographic) and EEG (Electroencephalographic) signals. (Link to amazon products
for ECG and EEG)
 2. Biomechanical signals: These signals are generated due to some mechanical function of a
physiological system. They include all types of motion and displacement signals, pressure,
flow signals etc. in the physiological system. The respiratory physiological system performs
its function by the chest movement. This movement can be measure and analyzed.
 3. Biocoustic signals: These signals are created by the physiological system in which either
flow of blood or air takes place. The flow of the blood in the heart as well as inspiration and
expiration of the lungs takes place accompanied with unique acoustic signals.
 4. Bio-impedance signals: The impedance of the skin depends upon; the composition of the
skin, blood distribution and blood volume through the skin. The measurement of impedance
helps in finding the state of skin and functioning of various physiological systems. The
voltage drop due to the tissue impedance is a bio-impedance signal.
 5. Biochemical signal: The signals which are obtained as a result of chemical
measurements from the living tissue or from samples analyzed in the laboratory.
The examples of these include; measurement of partial pressure of carbon-
dioxide (pCO2), partial pressure of oxygen (pO2) and concentration of various
ions in the blood.
 6. Bio-optical signals: These signals are produced by the optical variation by
the functioning of the physiological system. The blood oxygenation can be
determined by measuring transmitted and reflected light occurring from the
blood vessel.
 7. Biomagnetic signals: Extremely weak magnetic fields are produced by
various organs such as the brain, heart and lungs. The measurement of these
signals provides information which is not available in other types of bio-signals
such as bioelectric signals. A typical example is the Magnetoencephalography
which is obtained by recording the biomagnetic signals from the brain
Key Points to Note when using a Biomedical Instrumentation System
In most of the medical instrumentation systems, some calibration is necessary at regular intervals during their
operation. The calibration signal is applied to the sensor input or as early in the signal processing chain as
possible. In many measurement applications in the medical field, some form of stimulus or energy is given to
the patient and the effect it has on the patient is measured. This stimulus can be visual in the form of flash or
light or stimulation of some part of the nervous system. In some situations, automatic control of the transducer,
stimulus or signal conditioning part of the system may be required. This is achieved by using a feedback loop
in which part of the output from the signal conditioning or a display device is fed back to the input stage. Note,
the control and feedback may be automatic or manual.
Key Factors to Consider when Designing Biomedical Instruments
Some of the important factors that are considered when designing a medical measuring instrument include:
1. Patient safety considerations –Since medical instruments have to be physically connected to the patient,
there is the possibility of an electric shock hazard in cases where there is electric or electronic equipment
unless adequate measures have been taken in the design of the medical equipment to prevent such kind of
hazards. All safety measures need to be ensured during the operation of the medical instrument.
2. Transducer interface problems –All instrumentation systems are affected in some way by the presence of
the measuring transducer. This problem may get compounded while making measurement on the living system
where the physical presence of the transducer may change the reading significantly. Besides, the presence of a
transducer in one system can affect response in other system. Therefore, adequate care needs to be taken while
designing a medical measuring system to ensure that the loading effect of the transducer is minimal on the
source of the measured variable.
3. Measurement range –Generally, physiological signals measurement ranges are quite low to
other parameters outside the medical field. The biomedical signals are usually very small in the
microvolt range. Therefore, it is important to consider this when designing any medical
instrument.
4. Frequency range –Most of the physiological signals are in the audio-frequency range or below.
Also, many signals contain dc and very low frequency components.
5. The high possibility of artifacts –An artifact is undesirable signal that is extraneous to the
physiological variable under measurement. This may come from electrical interference, cross talk
or noise generated within the measurement system. Designers of biomedical instruments, put in
ways to remove/filter or avoid these kinds of artifacts.
6. Reliability –In cases of life saving instrument like the defibrillators, their failure to operate or
provide the desired output can cause a potential life threat to the patient. Hence, the biomedical
equipment must be reliable, easy to operate and able to withstand physical stress like
transportation within the hospital or in the ambulance and or exposure to corrosive chemicals.
7. Safe levels of applied energy –Biomedical instruments require some form of energy to be
applied to the living tissue e.g. CT scan requires X-rays (a form of electromagnetic waves energy).
Safe levels of some of these energies have been established by scientific researchers; designers can
use this information when they are designing the medical equipment.
Bio-amplifiers used in Biomedical Measurement
Applications

Dr. Saad Mutashar Abbas

2024-2025
Types of Amplifiers used in Biomedical Measurement Applications
Signal amplification is essential part of any biomedical measurement. Bioelectric
measurements are usually low-level i.e. microvolt level measurements, therefore
amplification is required to boost the level of the input signal to match the requirements
of recording/display systems or to match the range of the analog-to-digital convertor, thus
increasing the resolution and sensitivity of the measurement.
Carrier Amplifiers
The carrier amplifiers are used with transducers which require an external source of
excitation. They are characterized by high gain, negligible drift, extremely low noise
and the ability to operate with resistive, inductive or capacitive transducers. A carrier
amplifier is made up of a carrier oscillator, a bridge balance, with a calibration
circuit, a high gain ac amplifier, a phase-sensitive detector, and a dc output amplifier.
Chopper Amplifiers
The chopper amplifier is used to amplify very small dc signals of the order of microvolts. To avoid the drift
problem that is characterized by the direct coupled amplifier, the chopper amplifier is used. The amplifier uses
a chopping device that converts a slowly varying direct current to an alternating voltage (the dc is chopped into
a square wave with a chopper modulator). The resulting alternating voltage has amplitude that is proportional to
the input direct current and with phase dependent on the polarity of the original signal. The resulting ac square
wave is amplified with an ac amplifier and then demodulated to get an amplified dc. Chopper amplifiers are
available in both single-ended as well as differential input configurations. Chopper amplifiers are used in
medicine in amplification of small dc signals of a few microvolts. They are used with transducers such as
temperature sensors (thermistors, thermocouples), strain gauge, etc.
Isolation Amplifiers
Isolation amplifiers are used to provide protection against leakage currents. They break the ohmic continuity of
electric signals between the input and output of the amplifier. We have 3 methods of isolation that can be used:
1. Optical isolation
2. Transformer isolation
3. Capacitive isolation

1. Optical Isolation
From the above diagram, as the input signal varies, the light intensity of the LED shown in the last stage of
amplification also varies. An optocoupler is used to couple this light to the phototransistor. This light falls on a
phototransistor. The collector current of the phototransistor is proportional to the light intensity. For stabilization
purposes, a feedback from the output may be provided. Electrical isolation is used to ensure patient protection
against electrical hazards. Biomedical instruments such as pacemakers, electrocardiographs, pressure monitors,
pressure transducers, etc. are designed to electrically separate the portion of the circuit to which the patient is
connected from the portion of the circuit connected to the ac power line and ground.
2. Transformer isolation
A transformer-isolated amplifier relies on transformer coupling of a high-frequency carrier signal
between input and output. Some models also include a transformer-isolated power supply, that may also
be used to power external signal processing devices on the isolated side of the system.

3. Capacitive isolation
Is a mature solution developed over the past decade to replace optocouplers in signal isolators, isolated
gate drivers, isolated transceivers, and other applications
Differential Amplifiers
 Biomedical amplifiers employed in the input stage of a biomedical measurement system are mostly of the
differential type. Differential amplifier has three input terminals out of which one is arranged at the reference
potential and the other two are live terminals. The differential amplifier is used when it is necessary to measure
the voltage difference between two points, both of them varying in amplitude at different rates and in different
patterns. Heart-generated voltages that are picked up by means of Bioelectrodes on the arms and legs and
brain-generated voltages picked up by the Bioelectrodes on the scalp are typical examples of signals whose
measurements needs the use of differential amplifier.
Reasons why Differential amplifier is preferred over other electronic amplifiers
1- Its ability to reject common-mode interferences which are invariably picked up by electrodes from
the body along with the useful bioelectric signals. 2- As a direct coupled amplifier, it has good stability
and versatility. 3- High stability is achieved because it can be insensitive to temperature changes which
is often the source of excessive drift in other configurations It is versatile in that it may be adapted for
many applications e.g. applications requiring floating inputs and outputs or applications where
grounded inputs and or outputs are desirable. 4- The ability of the differential amplifier to reject
common voltages on its two input leads is known as Common-mode rejection and is specified as the
ratio of common-mode input to differential input to derive the same response. It is abbreviated as
CMRR (Common-mode rejection ratio). CMRR is an important specification with regard to
differential amplifiers and is usually expressed in decibels. CMRR for the input stage of biomedical
instrumentation systems should be as high as possible so that only the wanted signals find a way
through the amplifier and all unwanted signals get rejected in the preamplifier stage. A high rejection
ratio is normally achieved by the use of a matched pair of transistors in the input stage of the
preamplifier and a large ‘’tail’’ resistance in the long-tailed pair to provide maximum negative
feedback for in phase signals. In order to minimize effects of changes occurring in the electrodes
impedances, it is necessary, to use an input stage amplifier or preamplifier with a high input
impedance. It has been established that a low value of input impedance give rise to a considerable
distortions of the data recordings. High gain integrated dc amplifiers, with differential input
connections and a provision for external feedback are termed to as operation amplifiers because of
their ability to perform mathematical operations. They come in integrated circuit form.
The common-mode rejection for most op-amps is typically between 60 dB and 90 dB. This may not
be enough to reject common-mode noise that is usually encountered in biomedical measurements. In
addition, the input impedance is not very high to handle signals from high impedance sources. One
way to increase the input impedance of the op-amp is to use Field effect transistors (FET) in the input
differential stage. Alternatively, the best solution is to use an Instrumentation amplifier in the
preamplifier stage.
Limitations of Differential amplifiers
Although the differential amplifier is well suited for most of the applications in biomedical
measurements, it has the following limitations:
 • The amplifier has limited input impedance and therefore, draws some current from the source
and loads them to some extent.
 • The common-mode rejection ratio (CMMR) of the amplifier may not exceed 60 dB in most of
the cases, which is inadequate in modern medical measurement systems. The Instrumentation
amplifier, which is an improved version of a differential amplifier, overcomes the limitations of
the differential amplifier. In fact connecting a buffered amplifier to a basic differential amplifier
makes an instrumentation amplifier!
Instrumentation Amplifiers
Instrumentation amplifier is a differential voltage gain device optimized for operation in an environment that is
hostile to precision measurements. It is consists of 3 op-amps and 7 resistors. The instrumentation amplifier is
made up of 2 parts: a buffered amplifier (OP1, OP2) and a basic differential OP3.

The differential amplifier part is essential for biomedical sensors; this is because a sensor produces a signal
between its terminals however, in some applications neither terminal may be connected to the same ground as
your measuring circuit hence the terminals may be biased at a high potential or might be riding on a noise
voltage. The differential amplifier fixes this problem by directly measuring the difference between the sensors
terminals. The buffered amplifier OP1 and OP2 provides gain and also prevents the sensor resistance from
affecting the resistors in the op amp circuit.
Key Characteristics of Instrumentation Amplifiers
1. Voltage gain from differential input (V1-V2) to single ended output is set by one resistor
(RG).
2. The input resistance of both inputs is very high and does not change as the gain is varied.
3. Vo does not depend on common-mode voltage but only on their difference i.e. output voltage
is proportional to the difference between the two input voltages.

Reasons why Instrumentation Amplifiers are Preferred in Biomedical Applications

1. They have high input impedance • They have high common mode rejection ratio (CMRR)
2. Low bias and offset currents
3. Low power consumption
4. High slew rate
5. Less performance deterioration if source impedance changes
6. Possibility of independent reference levels for source and amplifier.
The Essential Requirements of Biopotential Amplifiers for Medical applications
Biopotential amplifiers are also termed to as Bioamplifiers. Bioelectric measurements are normally
low-level voltages with high source impedances therefore signal amplification is essential part of
biomedical measurement systems. The signal amplification is needed to boost or increase the
strength of the input signal to match the requirements of recording/display systems. We have
specialized amplifiers designed to do signal amplification in biomedical measurement applications
and are known as biopotential amplifiers. Biopotential amplifiers are usually in the form of voltage
amplifiers because they are capable of increasing the voltage levels of a signal. However, voltage
amplifiers also serve to increase power levels so they can be considered power amplifiers too. In
some circumstances biopotential amplifiers are employed in isolating the load from the source. In
this case, the amplifiers provide only current gain, leaving the voltage levels principally unchanged.
Examples of biopotential amplifiers include Chopper amplifier, Differential amplifier,
Instrumentation amplifier, etc. These examples and more are covered in details in the Types of
Amplifiers used in Biomedical Measurement Applications.
Biomedical Signals Recorders and Monitors

Lecture 2

Dr. Saad Mutashar Abbas

2024-2025
 A Basic Biomedical Recording System
Recorders provide permanent visual trace or record of an applied electrical signal. The most
basic electronic recording system consists of 3 important components.
1. Electrodes/Transducer
2. Signal conditioner
3. Writing system
The electrode picks up the bioelectric potentials whereas the transducer converts the physiological
signal to be measured into a usable electrical output
The signal conditioner converts the output of the electrode/transducer into an electrical quantity
suitable for operating the writing system
The writing system provides a visible graphic representation of the quantity of the physiological
variable of interest.
In medical recorders, the signal conditioner usually consists of a preamplifier and the main amplifier.

Both of these amplifiers must satisfy specific operation requirements such as input impedance, gain

and frequency response characteristics for an effective reproduction of the input signal. To make the

signal from any transducer compatible with the input signal required for the driver amplifier of the

display or recording system, it is usual to arrange to normalize the electrical signals produced by each

transducer. This is done in the signal conditioner which adjusts its output to a common signal level

e.g. one volt. The necessary adjustments of gain and frequency response are provided by the signal

conditioners. This means that, it is possible to interchange the signal conditions to record any one of

the physical or bioelectric events on the same writing channel. The writing systems which are

available in many forms constitute the key portion of the recording instrument. Examples of

commonly used writing system include: The Inkjet recorder, Galvanometer type pen recorder,

Potentiometric recorder, etc

Electrode-Tissue Interface:
The most commonly used electrodes in patient monitoring and related studies are surface electrodes. The
notable examples are when they are used for recording ECG, EEG and respiratory activity by impedance
pneumography. In order to avoid movement artefacts and to obtain a clearly established contact (low contact
impedance) an electrolyte or electrode paste is usually employed as an interface between the electrode and the
surface of the source of the event. Figure below represent the electrode-tissue interface. The characteristic of a
surface electrode composed of a metal electrode and attached to the surface of the body through an electrolyte
(electrode jelly) are dependent upon the conditions at the metal-electrolyte interface, the electrolyte-skin
interface and the quality of the electrolyte.