Asst. Prof. Dr.

Esra SAATI
Biomedical Instrumentation
A Historical Perspective
About this course
Prerequisites:
Electronic Circuits
Signals & Systems.
Recommended Books and Notes:
J.G. Webster, Medical Instrumentation Application and Design, John Wiley
& Sons, 2010
J. Aston, Principles of Biomedical Instrumentation and Measurement, Merrill
Publishing Company, 1990.
J.D. Enderle, S.M. Blanchard, J.D.Bronzino, Introduction to Biomedical
Engineering, Wiley, 2008.
Lecture Notes
Tentative Grading:
10%
Homework Midterm I Midterm II Final
20% 20% 50%
About this course
Tentative Course Outline:
A Historical Perspective
Anatomy and Physiology
The Origin of Biopotentials
The Electrocardiography and Electroencephalography
Biomedical Sensors
Biopotential Electrodes and Amplifiers
Blood Pressure and blood flow measurements
Measurements of the Respiratory System
Therapeutic and Prosthetic Devices
Defibrillator and Pacemakers
Clinical Laboratory Equipment
Electrical Safety
Biomedical Engineering
Since technology has had a dramatic impact on medical care, engineering
professionals have become intimately involved in many medical ventures.
As a result, the discipline of Biomedical Engineering has emerged as an
integrating medium for two dynamic professionals, medicine and engineering.
Biomedical Engineering assists in the struggle against illness and disease by
providing tools that can be utilized for research, diagnosis, and treatment by
health care professionals.
Evolution of the Modern
Health Care System
Prehistoric Ages
Primitive humans considered diseases to be visitations, invasion of evil
spirits, supernatural forces. Witch doctor, medicine man, and medicine
woman were early practitioners. Their practise were based on primitive
science based on empirical laws. They passed their experiences to other
generations.
Certain plants and grains were good to eat and could be cultivated.
Early surgical operations were based on the magic and religious beliefs: skulls
with holes to access to the brain.
From these beginnings, the practice of medicine has become integral to all
human societies and cultures.
Evolution of the Modern
Health Care System
Ancient Egyptians (~ 3000 BC)
Egyptian mythology emphasized the interrelationships between the
supernatural and ones health.
Imhotep (the god of healing): early physician, recorded on the papyri
hundreds of remedies.
Papyrus outline proper diagnoses, prognoses and treatment in a series of
surgical cases.
1st to keep accurate written health records
Ancient Egyptians practiced: blood letting, making prosthetic devices,
embalming
Evolution of the Modern
Health Care System
Ancient India (~ 3300 BC)
Detected diabetes by smelling & tasting urine (for sweetness).
Ancient Indian practiced: hernia repairs, amputations, C-sections, cosmetic
surgery to nose, earlobes, & harelips,
Evolution of the Modern
Health Care System
Ancient China (~ 1500 BC)
Illness still seen as violation of a good.
Male doctors didnt directly examine women, used ivory dolls.
Also used acupuncture to treat ailments, Idea behind acupuncture -
stimulating energy points with needles/pressure relieved obstructions
enabling body to heal.
Ancient Chinese used variety herbs to treat diseases.
Evolution of the Modern
Health Care System
Ancient Greece (~ 776 BC)
1st to study cause of disease, looked for natural explanations not just divine
ones,
Hippocrates, most famous of all ancient Greek physicians, he viewed the
physician as a scientist instead of priest. Hippocratic Oath.
Balance theory for fours: Theory that four elements (earth, air, fire &
water) and the four seasons (summer, autumn, winter & spring) were all
linked to the four humors (blood, phlegm, yellow bile & black bile) in
human body. Believed that imbalance in any of these humors, elements or
seasons caused illness.
bloodletting
scalpels
Evolution of the Modern
Health Care System
Romans (~ 900 BC)
Developed sanitation system of aqueducts to bring clean water to cities.
Built sewers to carry off waste.
Built public baths with filtering systems.
1st to consider public health & sanitation.
Gelen, greatest physician in the history of Rome. Wrote more than 300
books of anatomical observations which than become both the bible and
the law in the Dark Ages.
Evolution of the Modern
Health Care System
The Renaissance (1350 - 1650 AD)
Building of universities & medical schools: eg. Oxford.
Search for new ideas.
Acceptance of dissection for study.
Development of printing press & publishing books.
Michelangelo, Raphael, Durer and Leonardo Da Vinci viewed the human
body as it really was, not simply as a text passage from Galen.
Thermometer
Galileo (1603): closed glass of tube inserted in a container of water could be
arranged so that the height of water sucked into the tube by a partial vacuum
varied with the temperature.
Santorio Santonio (1605): measured the human body temperature by similar
device.
Ferdinand II de Medici (1654): sealed the water in a closed vessel to eliminate the
atmospheric pressure effects.
Gabrial D. Fahrenheit (1724): replaced the water with the mercury and improved
the instruments accuracy.
People of Importance
Galileo: encouraged the use of experimentation and exact measurement as
scientific tools. Inventions: the thermoscope, the pendulum and telescopic lens.
Sanctorius: made comparative studies of the human temperature and pulse.
Anton van Leeuwenhoek: Invented microscope in 1673 & discovered
animalcules . Leeuwenhoeks microscope was a lens mounted in a tiny hole of a
brass plate.
Andreas Vesalius: Officially the world's first modern anatomist. He corrected
many of the mistakes that Galen had made on human anatomy.
William Harvey: discovered the circulation of the blood. He carried out many
experiments and eventually proved the idea when he realized that the amount of
blood leaving the heart every second was far too high to have been produced by
the body.
Evolution of the Modern
Health Care System
18th and 19th Centuries
Edward Jenner (1796) found vaccination against smallpox. The word
vaccination," made up by Jenner for his treatment (comes from Latin vacca, a
cow). Word later adopted by Pasteur for immunization against any disease.
James Blundell (1818) performed 1st successful human blood transfusion.
Florence Nightingale (1854); beginnings of modern nursing
Pasteur (1864); germ theory. Discovered that microorganisms were
everywhere. Proved that microbes caused disease.
William Morton (1850) dentist who developed anaesthesia techniques that
made surgery painless.
Stethoscope
From the Greeks, physicians have used their hearings for diagnosis.
T.H. Laennec (1819) invented cylinder stethoscope. First made from paper and
then wood designed to amplify the sound. Hailed as Father of Thoracic
Medicine.
G.P.Cammann (1851) improve the binaural stethoscope. His stethoscope had an
assortment of flanges or tapers that could be used in different areas of the body
because acoustic impedance varies among patients and among sites of the body.
Ophthalmoscope
Earliest example of instruments that present images of internal organs,
forerunner of x-ray.
Hermann von Helmholtz invented in the mid-19th century.
They enables the examiner to look into body cavities, such as the ear, eye, and
nose noninvasively.
X-Rays
Wilhelm Roentgen Discovered x-rays in 1895
Initially used for the diagnosis of bone fractures
Technology has evolved today to visual all organ systems (with the use of
radio-opaque materials)
Experimenting with cathode rays, Roentgen noticed that paper saturated
with barium platinocyanide began to glow even though it was well out of
range of the cathode rays.
Experiments showed that denser materials placed against paper cast a
shadow on the paper.
Evolution of the Modern
Health Care System
20th Century
It was an era of intense interdisciplinary cross-fertilization
1901 blood groups were discovered
1906 M.Cremer introduced pH electrode for quantifying acid/base
content of the biological solutions. This device measured the membrane
potential changes resulting from changes in ionic content and activity. Its
invention led to measuring the blood gasses and partial pressure of oxygen
and carbon dioxide.
1920 separating the plasma from the rest of the blood so that blood could
be stored effectively and given to patients who needed it after operations.
1921 insulin was discovered.
Early ECG
In 1906 Willem Einthoven developed the electrocardiogram (ECG) (Nobel
prize in 1924)
pattern of electrical charges in the heart during contraction ,diagnostic tool
that is still used today
Capillary galvanoscope used by
Einthoven (slightly different
configuration). Mercury droplet in the
horizontal tube moves under the
influence of an electric field applied to
the two electrodes
Early ECG
Evolution of the Modern
Health Care System
20th Century
1924 Hans Berger invented electroencephalograph (EEG). He used a
galvanometer to measure currents from metal strips attached to the scalp
and found that these current resulted from brain activity. His systematic
investigations laid the foundation for studies of the correlation between
brain waves, sleep, and epilepsy.
1928 Alexander Fleming discovered that penicillium mould could fight
bacteria when some landed on a petri-dish in his laboratory
Evolution of the Modern
Health Care System
20th Century
1928 W.T. Bovie and Harvey Cushing introduced spark gap transmitters
for radio communication provided the components for the clinically useful
electrosurgical unit (ESU). Radio frequency energy vaporized the cells when
applied by a metal electrode, and it tended to cauterize blood vessels to
reduce bleeding. Widespread use of the ESU was encouraged by the
introduction of non-flammable anaesthetics in the 1950s.
Early Respirator
In 1929 Drinkler invented the first
mechanical respirator (a.k.a. iron lung)
First widely used mechanical device capable
of artificial respiration to treat victims of
respiratory paralysis. The patients entire
body, excluding the head, was placed in a
sealed tank. Tank pressure was increased and
decreased to move air into and out of the
lungs to simulate normal respiration.
Evolution of the Modern
Health Care System
20th Century
1935 Gibson developed heart-lung machine; artificial device for shunting
blood flow outside of the patient by bypass the heart and lungs to allowing
for more effective heart surgery (i.e. heart could be stopped).
1931 Rusca developed the electron microscope; providing the first real
ability to visualize sub-cellular structures.
Evolution of the Modern
Health Care System
20th Century
1936 J.Lawrence produced radionuclides in a cyclotron and used them in
the treatment of leukemia, thus beginning the field of nuclear medicine.
1941 Cournand developed angiography; first local visualization of arteries
and veins using a catheter and radio-opaque dyes in a living subject.
1953 Watson and Crick discovered DNA
1954 DeBakey used first artificial tissue replacements, synthetic artery
grafts (Dacron polyester)
Evolution of the Modern
Health Care System
20th Century
1954 Salk invented polio vaccine
1956 P.M.Zoll led a group of investigators who succeeded in reversing a
hearth fibrillation by application of ac currents through the chest wall. The
reliability of the defibrillator was significantly improved when B.Lown
introduced the dc defibrillator (discharging capacitor) in 1962.
1957 C.Walton Lillehei paced a hearth during a surgery by attaching wires
to it and applying pulses of current spaced at a normal heart rate. This
external pacemaker could be applied only during surgery. William Chardack
and Wilson Greatbatch developed the implantable pacemaker in 1960.
Evolution of the Modern
Health Care System
20th Century
1954 Artificial tubes for replacing sections of arteries was introduced and it
led to the artificial kidney. Although hemodialysis, a process for removing
impurities from blood was first achieved in 1944, a clinically useful device
was developed in 1960 by B.H.Scribner. This device is called artificial kidney.
Evolution of the Modern
Health Care System
20th Century
1957 O.H.Houry and W.R.Bliss first used
World War II sonar for the clinical application as
a ultrasonic imaging device. This instrument
measures sonar-type reflections from internal
organs in order to construct an image of
structures.
Evolution of the Modern
Health Care System
20th Century
1970 Allan Cormack and Geoffrey Hounsfield invented computer
tomography (CT) scanner by computing the amount of x-ray absorbed at the
intersections of columns and rows of a matrix of regions. By this technique
they were able to produce an image of a slice through the body. The
development of minicomputer in the 1970s made it feasible to perform
necessary computations.
Evolution of the Modern
Health Care System
20th Century
1970 Harold J.Swan and William Ganz introduced a balloon-tipped catheter
for measuring the blood pressure, temperature, and flow rate in the heart and
lungs. The catheter is threaded through the veins or arteries into the heart;
the balloon on the tip is then inflated. This action assists the heart-pumping
action. A balloon inflatable catheter used for opening blocked blood vessels.
Evolution of the Modern
Health Care System
20th Century
1982 Magnetic Resonance Imaging (MRI) was introduced for the imaging of
the internal organs especially the soft tissue. This device measures the
frequency and duration of a nuclear magnetic resonance of protons. To get the
image, the patient is placed in a strong magnetic field and radiated with pulse
of radio frequency (RF) energy. The frequency and duration of the ringing of
the proton after the RF field is shut off provides the data from which the image
is computed.
Biomedical Engineering
Many different titles have been used for engineers working in the
medical/biological industry:
Biomedical Engineering
Biological Engineering
Clinical Engineering
Bioengineering
Biomedical Engineering
Bioengineering:
is usually defined as a basic-research-oriented activity closely related to
biotechnology and genetic engineering, that is, the modification of animal
or plant cells or parts of cells to improve plants or animals or to develop
new microorganisms for beneficial ends.
Biomedical Engineering
Bioengineering:
Development of improved species of plants and animals for food production
Invention of new medical diagnostic tests for diseases
Production of synthetic vaccines from clone cells
Bioenvironmental engineering to protect human, animal, and plant life from
toxicants and pollutants
Study of protein-surface interactions
Modelling of the growth kinetics of yeast and hybridoma cells
Research in immobilized enzyme technology
Development of therapeutic proteins and monoclonal antibodies
Biomedical Engineering
Biomedical Engineering:
The term biomedical engineering appears to have the most comprehensive
meaning.
Biomedical engineers apply electrical, chemical, optical, mechanical, and other
engineering principles to understand, modify, or control biological (i.e.,
human and animal) systems.
Biomedical Engineering
Biomedical Engineering:
Application of engineering system analysis (physiologic modelling, simulation,
and control) to biological problems
Detection, measurement, and monitoring of physiologic signals (i.e.,
biosensors and biomedical instrumentation)
Diagnostic interpretation via signal-processing techniques of bioelectric data
Therapeutic and rehabilitation procedures and devices (rehabilitation
engineering)
Biomedical Engineering
Biomedical Engineering:
Devices for replacement or augmentation of bodily functions (artificial organs)
Computer analysis of patient-related data and clinical decision making (i.e.,
medical informatics and artificial intelligence)
Medical imaging; that is, the graphical display of anatomic detail or physiologic
function.
The creation of new biologic products (i.e., biotechnology and tissue
engineering)
Biomedical Engineering
Typical pursuits of biomedical engineers include
Research in new materials for implanted artificial organs
Development of new diagnostic instruments
Writing software for analysis of medical data
Analysis of medical device hazards for safety and efficacy
Development of new diagnostic imaging systems
Design of telemetry systems for patient monitoring
Design of biomedical sensors
Biomedical Engineering
Development of expert systems for diagnosis and treatment of diseases
Design of closed-loop control systems for drug administration
Modeling of the physiologic systems of the human body
Design of instrumentation for sports medicine
Development of new dental materials
Design of communication aids for individuals with disabilities
Study of pulmonary fluid dynamics
Study of biomechanics of the human body
Development of material to be used as replacement for human skin
Biomedical Engineering
Clinical Engineering:
Biomedical engineers working within a hospital or clinic are more properly
called clinical engineers,
Clinical engineers are essentially responsible for all the high-technology
instruments and systems used in hospitals today; for the training of medical
personnel in equipment safety; and for the design, selection, and use of
technology to deliver safe and effective health care.
It is born when the hospital safety became paramount due to the electric
equipment failures.
Biomedical Engineering
Clinical Engineering:
Became actively involved in developing cost-effective approaches for using
medical technology
Provided advice to hospital administrators regarding the purchase of medical
equipment based on its ability to meet specific technical specifications
Started utilizing modern scientific methods and working with standards-
writing organizations
Became involved in the training of health care personnel regarding the safe
and efficient use of medical equipment
Biomedical Engineering
Professional licensing for Biomedical Engineers falls under the
Accreditation Board for Engineering and Technology (ABET)
Professional Societies
American Institute for Medical and Biological Engineering (AIMBE)
IEEE Engineering in Medicine and Biology Society (EMBS)
Biomedical Engineering Society (BMES)
ABET Engineering Curricula
Four year engineering programs approved by The Accreditation Board
for Engineering and Technology (ABET) includes a broad range of
courses.
Intro Engr
6%
Comm
8%
Socio/Hum
13%
Science
13%
Engr. Science
16%
Specialty
26%
General
3%
Math
15%
Why do I care about ABET
accreditation?
l ABET audits engineering programs on a regular
basis to assure that the program maintains high
standards.
l Having an engineering degree from a four-year
accredited engineering program is required to
become a registered professional engineer.
l K Electronic Engineering Program being
improved toward to the ABET accrediation
ABET Goals
a. Apply knowledge of mathematics, science, and
engineering
b. Design and conduct experiments, as well as to
analyze and interpret data
c. Design a system, component, or process to
meet desired needs
d. Function on multi-disciplinary teams
ABET Goals
e. Identify, formulate, and solve engineering
problems
f. Understand professional and ethical
responsibilities
g. Communicate effectively
h. Understand the impact of engineering solutions
in a global and societal context
ABET Goals
i. Recognize the need for, and engage in life-long
learning
j. Understand contemporary engineering issues
k. Use the techniques, skills, and modern
engineering tools necessary for engineering
practice
BIOMEDICAL INSTRUMENTATION
LEARNING OUTCOMES:
On successful completion of Biomedical Instrumentation
course, students
Will be able to define commonly used terms from Medicine
and Biomedical Engineering.
Will be able to describe common mechanical, electrical
(biopotentials) and chemical signals that emanate from the
body.
Will be able to describe the engineering principles of
commonly used medical devices.
BIOMEDICAL INSTRUMENTATION
LEARNING OUTCOMES:
Will be able to distinguish basic structural and functional
components of medical devices.
Will be able to discuss the clinical issues of patient and
operator electrical safety of biomedical instrumentation.
EE951 BIOMEDICAL
INSTRUMENTATION
a b c d e f g h i j k
Will be able to define commonly used terms fromMedicine and
Biomedical Engineering,
2 3
Will be able to describe common mechanical, electrical
(biopotentials) and chemical signals that emanate fromthe body,
3 3 1 3
Will be able to describe the engineering principles of commonly
used medical devices,
3 3 2 2 3 3
Will be able to distinguish basic structural and functional
components of medical devices,
3 3 3 3
Will be able to discuss the clinical issues of patient and operator
electrical safety of biomedical instrumentation,
3 3 2 2 3