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EC8073 MEDICAL ELECTRONICS L T P C

3 0 0 3
OBJECTIVES:
The student should be made:
 To gain knowledge about the various physiological parameters both electrical and non-
electrical and the methods of recording and also the method of transmitting these parameters
 To study about the various assist devices used in the hospitals
 To gain knowledge about equipment used for physical medicine and the various recently
developed diagnostic and therapeutic techniques.

UNIT I ELECTRO-PHYSIOLOGY AND BIO-POTENTIAL RECORDING 9

Sources of bio medical signals, Bio-potentials, Bio potential electrodes, biological
amplifiers, ECG, EEG, EMG, PCG, typical waveforms and signal characteristics
UNIT II BIO-CHEMICAL & NON ELECTRICAL PARAMETER MEASUREMENT 9

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pH, PO2, PCO2, Colorimeter, Blood flow meter, Cardiac output, respiratory, blood
pressure, temperature and pulse measurement, Blood Cell Counters.

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UNIT III ASSIST DEVICES

.Ea 9

Imaging Systems, Ultrasonic Imaging Systems.

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Cardiac pacemakers, DC Defibrillator, Dialyser, Ventilators, Magnetic Resonance

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UNIT IV PHYSICAL MEDICINE AND BIOTELEMETRY 9
Diathermies- Shortwave, ultrasonic and microwave type and their applications, Surgical
Diathermy, Biotelemetry.

UNIT V

on a chip.
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RECENT TRENDS IN MEDICAL INSTRUMENTATION 9
Telemedicine, Insulin Pumps, Radio pill, Endomicroscopy, Brain machine interface, Lab

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TOTAL: 45 PERIODS
OUTCOMES:

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On successful completion of this course, the student should be able to: g
 Know the human body electro- physiological parameters and recording of bio-potentials .ne
t
 Comprehend the non-electrical physiological parameters and their measurement – body temperature,
blood pressure, pulse, blood cell count, blood flow meter etc.
 Interpret the various assist devices used in the hospitals viz. pacemakers, defibrillators, dialyzers and
ventilators
 Comprehend physical medicine m`ethods eg. ultrasonic, shortwave, microwave surgical diathermies ,
and bio-telemetry principles and methods
 Know about recent trends in medical instrumentation

TEXT BOOK:
1. Leslie Cromwell, “Biomedical Instrumentation and Measurement”, Prentice Hall of India, New
Delhi, 2007. (UNIT I – V)

REFERENCES:
1. Khandpur, R.S., “Handbook of Biomedical Instrumentation”, TATA Mc Graw-Hill, New Delhi, 2003.
2. John G.Webster, “Medical Instrumentation Application and Design”, 3rd Edition, Wiley India
Edition, 2007
3. Joseph J.Carr and John M.Brown, “Introduction to Biomedical Equipment Technology”, John Wiley
and Sons, New York, 2004.

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UNIT- I
ELECTRO- PHYSIOLOGY AND BIO-POTENTIAL RECORDING

The origin of Bio–potentials, Biopotential Electrodes,

Biological Amplifiers, ECG, EEG, EMG, PCG, EOG, lead system, and
Recording Methods, Typical Wave forms and signal characteristics.

SOURCES OF BIOELECTRIC POTENTIAL

The body generates their own monitoring signals which

convey useful information about the function they represent. These
signals are the bioelectric potential. Bioelectric potential are actually ionic
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voltage produced as a result of electrochemical activity of certain
special type of cells.

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Resting and Action Potential

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The concentration of sodium ions inside the cell becomes much

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lower than outside. Since the sodium ions are positive, the outside of
the cell is more positive than inside.

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To balance the electric charge, potassium ions which are
positive enters the cell causing a higher concentration of potassium on

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inside than on outside.

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Fig 1.1: Polarized cell with its resting potential
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

This charge cannot be achieved. However Equilibrium is

reached with a potential difference across the membrane, negative on inside
and positive on outside. This membrane potential is called the resting
potential of the cell.

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Characteristics of Resulting Potential

The resting potential is maintained as a constant until some kind of
disturbance upsets the equilibrium. It is strongly depending on temperature.
It is given as negative and various from 60 to 100mA. The resting potential
‗V‘of a cell can be written as

Where k – Boltzmann‘s constant

T- Absolute Temperature of cell q- Change of electron

ww Pk, PNa, PCl- Permeability of K, Na, & Cl ions

+ -

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[K ], [Na+], [Cl ] –Concentration of K, Na & Cl ions

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Fig 1.2: Depolarized cell with action potential
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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When the passage of sodium ions is stopped, there is no ionic

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current and hence the membrane reverts back to the original condition. By
an active process called a sodium pump, sodium ions are quickly
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transported to the outside of cell and the cell is in its resting potential.
This is called repolarization.

Fig 1.3: waveform of the action potential

[Source: Leslie Cromwell - Biomedical instrumentation and measurement],

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DESIGN OF MEDICAL INSTRUMENT

To design any medical instrument, the factors to be considered are

1. Accuracy: ccuracy is the closeness with which an instrument reading
approaches the true value of variable being measured.
2. Frequency Response: It is the response of the instrument for various
frequency components present in a physiological signal.
3. Hysteresis: Hysteresis error occurs due to mechanical friction.

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4. Isolation: Electrical isolation is made for electrical safety and to avoid

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any interference between different instruments.

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5. Linearity: It is defined as the degree to which variations in the output
of an instrument follow input variations

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small change that is taking place in the input.

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6. Sensitivity: It is the ability of an instrument to detect even a very

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7. Signal to Noise (S/N) ratio: It should be high to get reliable
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information about input.
8. Simplicity: It is an essential one to eliminate the human errors

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for a given input.
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9. Stability: It is the ability of the instrument to produce constant output
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10. Precision: It is the measure of the reproducibility of the measurements.

COMPONENTS OF BIO- MEDICAL INSTRUMENT SYSTEM:

The clinical laboratory instrument is used to investigate the

pH value and concentration of various radicals present in the body
fluids and to count blood cells in the blood sample. Each switch
position connects an instrument for measurement, for monitoring,
diagnosis, therapy or surgery with signal processor.

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Transducer transforms the physiological signal like temperature,

pressure or bio-potential into an electrical form.

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PHYSIOLOGICAL SIGNAL AMPLIFIERS
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Fig 1.4: Block Diagram of a Generalized Bio-Medical Instrument System
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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The biomedical pre- amplifier should satisfy the following condition

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1. The voltage gain should be more than 100 db to amplify
the biosignal properly to drive the recorder.
2. It should have low frequency response.
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3. The gain and frequency response should be uniform
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throughout the required bandwidth.
4. There is no drift in the amplifier.
The biosignal amplifiers are designed with operational amplifiers as
the basic unit.
Isolation Amplifier
Isolation amplifiers are used to increase the input impedance
et
of the monitoring system in order to isolate the patient from
biomedical instrument. They are called pre- amplifier isolation
circuits. High quality isolation amplifiers are required so that any
electrical faults cannot result in electrical shock to the patient.
Darlington pair: It is an isolation amplifier which provides high
input impedance with high current gain. θ1 and θ2 are connected in

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0
common emitter mode. The input impedance is given by Zi = β Z
; β - Current amplification factor . The emitter of θ1 is connected to
base of θ2 and both collectors share a common lead PL. This results
in high input impedance. RB is chosen so that both stages operate in
active region X, Y, and Z are the external terminals.

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Fig 1.5: Darlington Pair [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]

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Bootstrapping circuit: is also used as isolation amplifier to get very
high input impedance. A feedback network is connected between the

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is used to limit the current flowing through θ 2.
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emitter of θ2 and collector of θ1. The feedback voltage increases the

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signal level at input which in turn increases the input impedance. R

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ECG Isolation Amplifier Circuit
The signals from the different leads are given to LPF. This
filtering reduces the interference caused by electron surgery and radio
frequency emission. The filter circuit is following by high voltage and
over voltage protection circuit so that amplifier can withstand large
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voltage. Now the signals are fed into lead selected switch and then the
output is given to a d.c amplifier.

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S Amplifier Circuit
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Fig1.6: Block Diagram of Transformer Coupled ECG Isolation
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[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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Medical Preamplifier Design. (Instrumentation Amplifier):
It has very high input impedance. It consists of op-amps.
First two are working at non-inverting mode but their inverting
terminals are not grounded. The third op-amp will act as a differential
amplifier.
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By this configuration we can get high stability high fidelity
high CMRP and high input impedance. By virtual ground concept,
inverting terminal of op-amp 1 is fed by a voltage V2 through R2 and
inverting terminal of op-amp 2 is fed by a voltage V1 through R1.
The common mode signal at input will lead to zero voltage drop

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across variable resistor R1. The common mode voltage gain is unity.
Thus most of common mode signals will be rejected by third op-
1 11
amp. Vo is the output of first op-amp and V0 is the output of
second op-amp.
Gain calculation
l
V0 = (1 + aR1/R1) V1 – (aR1 /R1) V2
ll
V 0 = (1+aR1 / R1) V2 – (aR1 / R1) V
ll l
1 Vout = ( V0 – V0 ) bR2 /R2
ww Vout= (1+ 2a) (V2 –V1)

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b Net gain is (1+2a) b

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Fig1.7: Medical Preamplifier Bridge amplifiers:
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[Source: Leslie Cromwell- Biomedical instrumentation and
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They are used to measure the magnitude of biosignal
parameters in terms of current or voltage. They are also measured in
terms of frequency.
et

Fig 1.8: Bridge Amplifier for Voltage Readout

[Source: Leslie Cromwell - Biomedical instrumentation and measurement]
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ww Fig1.9: Bridge Amplifier for Current Readout

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[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

w.E In both bridge, the unbalance is measured by measuring the

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unbalance voltage or unbalance current. It is a measure of fractional

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change ‗α‘in resistance of transducer Rα. Using op-amp, the

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unbalance voltage or current can be amplified.

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Chopper Amplifier:
The chopper is used to convert low frequency signal into a

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high frequency signal. The modulated high frequency signal is
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amplified and finally the amplified signal is demodulated and filtered

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to get low frequency signal. Chopper amplifier has no drift. Chopper
amplifiers are available in the form in the form of mechanical and

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non-mechanical chopper.
i) Mechanical Chopper Amplifier: et

Fig 1.10: Chopper amplifier using a mechanical switch

[Source: Leslie Cromwell - Biomedical instrumentation and measurement]
Chopper S1 is an electromagnetically operated switch or
relay. S1 connect the input terminal of amplifier ‗A‘to reference

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terminal ‗Q‘which is connected to ground. When the amplifier input

terminal is connected with Q, it is short circuited and the input
voltage is zero. When S1 is open, the amplifier receives the signal
voltage from P.
ii) Non mechanical Chopper Amplifier:

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Fig 1.11: Non Mechanical Photoconductive Chopper Amplifier
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

Photoconductors or photodiodes are used as non mechanical

chopper for modulation and demodulation. When there is no incident
et
light on photoconductor, its resistance is high and hence it is in RB
and no current flows through it. When there is incident light on
photoconductor, its resistance is very low and hence it is in FB and
current flows through it. Thus it can act as a switch by means of
incident light.

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ELECTRODES
Electrodes are used to pick up the electrical signals of the
body. They transfer the bioelectric event to the amplifier. The type
of electrode to be used depends upon the bioelectric generator.
Half Cell Potential (or) Electrode Potential:
The voltage development at an electrode – electrolyte
interface is designated as the half cell potential. In metal solution
interface, an electrode potential results from two processes.
1. The passage of ions from metal into solution
2. The combination of metallic ions in solution with
electrons in metal to from atoms of metal.
ww
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The net result is the creation of charge gradient, the spatial

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arrangement of which is called the electrical double layer. Electrodes in
which no net transfer of charge occurs across the metal electrolyte

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interface are called as perfectly polarized electrodes.

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Fig shows the electrical equivalent circuit of a surface
electrode when it is in contact with body surface. The electrode-
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electrolyte interface resemble a voltage source having half cell

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potential ‗Ehc‘which is developed due to charge gradient and a

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capacitor ‗Cd‘(i) parallel with a leakage resistance ‗Rd‘.

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Fig 1.12: surface electrode equivalent circuit [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]
Ehc - half – cell potential
Cd – electrode capacitance
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Rd – leakage resistance
Rs – Series electrolyte and skin resistance
The series resistance ‗Rs‘represents the series electrolyte
and skin resistance under equilibrium conditions. The impedance of
the equivalent circuit can be written as
= Rd
Z Rs
1 - j2 fC d Rd
The value of voltage and impedance depend on the

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electrode metal, its area, electrolyte, charge density and frequency of

current. The electrode potential is measured with reference to
hydrogen electrode placed in electrolyte near metallic electrode. The
half cell potential development can be expressed by Nernst equation
as
RT C f
E= ln 1. 1
hc
C f
nF 2 2
Where R – Gas Constant
T – Absolute Temperature
F – Faraday Constant
ww N – Valency of Ion

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f1, f2 E
C1, C2 – Concentration of selected ion on two sides of membrane
– Activity coefficients of ion on two sides of membrane.

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Purpose of Electrode paste:

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The outer skin of the body is highly non- conductive and will

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not establish a good electrical contact with an electrode. The skin

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should be washed and rubbed to remove some of the outer cells. The
electrode paste decreases the impedance of contact and also reduces

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the artifacts resulting from movement of electrode.
Electrode Material:
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The electrode, electrode paste and body fluids can produce
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a battery like action causing ions to accumulate on the electrodes.
This polarization of electrode can affect the signal transfer.
Types of Electrodes:
These are three types of electrodes
Micro electrodes (Intracellular Electrodes):
These are used to increase the bioelectric potential within a
et
single. It is divided into metallic and non metallic. The
microelectrodes should have smaller diameter and during insertion
of electrode into the cell, there will not be any damage to the cells.

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They are formed by electrolytically electing the tip of a fine

tungsten or stainless steel wire to a fine point. This technique is
known as electro pointing. The metal microelectrodes are coated
almost to the micro tip with a material.

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Fig 1.13: Metal Microelectrode [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]

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The impedance of microelectrode tip is inversely
proportional to the area of the tip and frequency. When the electrode
output is couple with an amplifier, the low frequency components of
the bioelectric potentials will be attenuated if the input impedance of
the amplifier is not high.
ii) Micropipet
et
It consists of a glass micropipet tips diameter is about1
micrometer. The micropipette is filled with an electrolyte usually 3M
Kcl which is compatible with the cellular fluids.
EA is the potential between metal wire and electrolyte filled in the
micropipette

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EB is the potential between the reference electrode and the

extracellular fluid.
E is variable membrane potential
ED potential existing at the tip due to different electrolytes
present in the pipet and the cell

E = EA+EB+ED

ww
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asy
C E
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S eri
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[Source: Leslie Cromwell - Biomedical instrumentation and measurement]
Depth and Needle Electrodes
These are used to measure the bioelectric potentials of the
highly localized extracellular regions in brain or bioelectric potentials
et
from specific group of muscles.
i) Depth Electrode
These are used for study the electrical activity of the
neutrons in superficial layers of the brain. Normally each electrode
consists of a bundle of Teflon insulated platinum (90%) iridium
(10%) alloy wires, bonded to a central supporting stainless steel wire
which can act as indifferent electrode by an insulating varnish.

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ii) Needle electrode

These are used to record the peripheral nerve‘s action
potentials (Electro neurography). The needle electrode resembles a
medium dropper or hypodermic needle.
Surface Electrode
Generally large area surface electrodes are used to sense
ECG potentials and smaller area surface electrodes are used to sense
EEG and EMG potentials.
i) Metal plate Electrodes
Rectangular and circular plates from German silver, nickel
silver or nickel plated steel are used as surface electrodes in the case

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of ECG measurement.

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asy
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Fig 1.15: Metal plate Electrodes [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]

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ii)Suction Cup Electrode
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It is more practical and is well suited for attachment to flat
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surfaces of the body and to regions where the underlying tissue is

n
soft. Although physically larger this electrode has a small area

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because only the rim is in contact with the skin.
et

Fig 1.16: Suction Cup electrode [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]
iii) Adhesive Tape Electrode
The pressure of the surface electrode against the skin may
square the electrode pasted. To avoid this problem, adhesive tape
electrode is used.

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Fig 1.17: Adhesive tape electrode [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]
iv) Multipoint Electrode
It is a very practical electrode for ECG measurements and it
contains nearly 1000 fine active contact points. By this a low
resistance contact is established with the subject.

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v) Floating electrode

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Here, the metal does not contact the subject directly. The

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contact is made via an electrolytic bridge. By means of this electrode,
movement artifact is eliminated. This is also called as liquid junction

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electrode.
BOIPOTENTIAL RECORDERS

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The bio – potential recorder plays an important role in the
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biomedical instrumentation. ach doctor is performing his diagnosis

gin
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based on the output from recorder.
Characteristics of Recording System:

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i) Sensitivity: The sensitivity is the magnitude of input voltage
required to produce a standard deflection in the recorded trace.

ng.
ii) Linear: a recorder is said to be linear if the pen deflection is
proportional to the amplitude of input signal.
n
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iii) Frequency Response: A recorder is said to have good frequency
response when the sensitivity is constant for all the frequencies
present in the signal.

ELECTRO CARDIO GRAPHY (ECG)

ECG deals with the study of electrical activity of heart
et
muscles. Electrocardiogram is the recorded ECG wave. ECG is also
called EKG is derived from the German Electro Kardio Gam.
i) Origin of Cardiac action potential:
Heart is divided into four chambers. The top two champers are atria
and lower two champers are ventricles.

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ww
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Fig 1.18: Cross Section of the Interior of the Heart Table

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1.1Physiological Nature of ECG Waveform

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[Source: Leslie Cromwell - Biomedical instrumentation and
measurement]

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P Wave
Origin

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Atrial depolarization or
contraction
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Repolarisation of the atrial and the
Amplitude
mV

1.60
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Duration sec

0.12 to o.22

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(P-R interval)
0.07 to 0.1

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R wave depolarization of theventricles

Ventricular repolarisation
(Relaxation of
0.1 to 0.5 0.05 to 0.15
(S-T interval)
et
myocardium)
S-T Ventricular contraction
interval
U wave Slow repolarisation of the < 0.1 0.2 (T-U interval)
intraventricular (Purkinje fibers)
system

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The complete waveform is called electrocardiogram

indicating important diagnostic features. If PR interval is more than
0.22 sec, AV (first heart attack) occurs. When QRS duration is more
than 0.1 sec, the bundle block (severe heart attack) occurs.
(ii) Lead configuration
The electrode systems are
1) Bipolar limp leads (or) standard leads.
2) Augment unipolar limp leads.
3) Chest leads (or) precordial leads.
4) Frank lead system (or) corrected orthogonal leads.

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1) Bipolar Limb leads – Standard leads I, II, and II

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In standard leads, the potential are tapped from four locations of our
body. They are i) right arm ii) Left arm iii) Right Leg and iv) Left
leg.
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Right leg electrode is acting as ground reference electrode.

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Fig.1.20 shows the standard bipolar limp lead positions and the
corresponding wave patterns.
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to right arm (RA)

right arm (RA)

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Lead I position – give voltage VI, the voltage drop from left arm (LA)

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Lead II position- gives voltage VII, voltage drop from left leg (LL) to

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Lead III position – gives voltage VIII, voltage drop from left leg (LL) to

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left arm (LA)

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Fig 1.20: Standard Bipolar Limb Leads and the Corresponding

ECG
[Source: Leslie Cromwell - Biomedical instrumentation and
measurement]

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Fig 1.21: Einthoven Triangle

[Source: Leslie Cromwell - Biomedical instrumentation and measurement]18
The closed path RA to LA to LL and back to RA is called

ww the Einthoven triangle. Along the sides of this triangle, three

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projections of ECG vector are measured.

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2) Augmented unipolar Limb leads
In this, the electrocardiogram is recorded between a

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exploratory electrode and the central terminal.
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Fig.1.22: Augmented Unipolar Limb Leads [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]
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3) Unipolar Chest Leads
In this, exploratory electrode is obtained from one of the chest
electrodes. The chest electrodes are placed on six different points on
chest closed to the heart. By connecting three equal large resistances to
LA, RA and LL a reference electrode or central terminal is obtained.
This lead system is known as Wilson system. Electrocardiogram recorded
from these 12 lead selections such that 3 standard bipolar leads, 3 augmented
unipolar leads and 6 chest leads.

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ww
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instrumentation and measurement]

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Fig.1.23: Unipolar Chest Leads [Source: Leslie Cromwell - Biomedical

The ECG potentials are measured with colour coded leads

for easy reference.

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4) Frank lead system:

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The corrected orthogonal lead system (or) Frank lead system

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is used in vector cardiography. Here one can get the information from

iii) ECG Recording setup:

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12 leads. The state of the heart is studied three dimensionally.

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i) Patient cable and Defibrillator Protection Circuit

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The patient cable connects the different leads from the limbs
and chest to the defibrillator protection circuit. It consists of buffer

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amplifiers and over voltage protection circuit. Each patient lead is
connected to one buffer amplifier.
ii) Lead selector switch et
It is used to feed the input voltage from appropriate electrode
to the preamplifier.
iii) Calibrator
A push button allows a standardization voltage of 1 mV to
the preamplifier. This enables to observe the output on display unit.
From lead selector switch, ECG signal goes to bio-amplifier.

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ww
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S Fig1.24: ECG Recording eri
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[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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Setup iv) Bio-Amplifier
The bio-amplifier consists of a preamplifier and power
amplifier. The preamplifier should have high gain and high CMRR.
It consists of two power transistor such that their emitters are
joined together and connected with RL. When VB is positive, Q1 is FB and
conducts while Q2 is RB and remains off.
et
2
Output power pout = V out / RL

Amplifier efficiency η = Pout / (pout +P loss )

To avoid the cross over distortion, an ideal non – inverting
amplifier is inserted at the output. Since Rf is so large, it raise the
gain and output voltage and thereby crossover distortion is
eliminated. The effect control is provided by R2 and gain adjustment
is provided by R s

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ww
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C E
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Fig.1.25: Push-Pull Power Amplifier with Crossover Compensation and
Offset Control
[Source: Leslie Cromwell - Biomedical instrumentation and

v) Auxiliary Amplifier gin

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measurement]

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The common mode signals can be reduced to a minimum
level by adding an auxiliary amplifier between right leg lead and ECG
unit.
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vi) Isolation Tower Supply
It is used given power to the bio amplifier and hence the
electrical safety for the patient is increased.
vii) Output Unit
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In paper chart recorder, the power amplifier or pen amplifier
supplies the required power to drive pen motor. Pen motor records
the ECG trace on the wax coated heat paper. A position control is
used to position the pen at the center on the recording paper.
viii) Power switch
The power switch of the recorder has three positions. In ON
position the power to the amplifier is turned on. But the paper drive
is not running. In RUN position, the switch makes the paper drive to
run. In OFF position, ECG unit is in switched off condition. Analysis
of Recorded ECG Signals

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Fig. shows the analysis of different ECG signals.

Normal ECG

ww
w.E
0.22second
Result: First degree AV block

asy
C E
Here the PQ segment has prolonged conduction time i.e greater than

En
gin J
Ae
Here QRS complex is widened i.e QRS interval is greater than 0.1

S eri
second
Result: Bundle block
ng.
n
M
Here ST segment is elevated
Result: Myocardial infraction
et

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Here ST segment is depressed and negative T wave is present Result:

Coronary insufficiency

wwHere the train of pulses instead of PQRST waves

w.E E
Result: Ventricular fibrillation which may lead to death if it is not
properly corrected by defibrillator.

asy
C
J
If the normal conduction system is disturbed, then the beat

En
rate will be slower than the normal rate. This state s called heart
block.

gin
Vector cardiography

S Ae eri
In electrocardiography, only the voltage generated by the

ng.
electrical activity of the heart is recorded. In vector cardiography, the
cardiac vector is displayed with its magnitude and spatial orientation.

n
M
Echocardiography
Echocardiography is a useful technique for diagnosis of
heart diseases.. By changing the position of transducer, we can get
et
reflections from the desired areas on the heart. An aqueous get is used
to couple the transducer to the skin and the beam from the transducer.
The time compensated signal amplifier is used to collect the low
amplitude signals with same signal to noise ratio. Then these
amplified signals are given to the cathode ray tube display unit.
A – Mode display
In amplitude mode or A - mode display, the echoes produce vertical
displacements of a horizontal trace on the screen. The amount of
vertical displacement is proportional to the strength of echo and the
distance along horizontal trace represents the time taken by
ultrasound to travel through tissue. Since the heart is moving,

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echoes dance up and down during cardiac cycle.

B – Mode display
In brightness mode or B – mode display, the echoes are
0
rotated through 90 towards the observer and so the echoes are
presented as dots of light. The distance between dots represents the
tissue depth. When echoes are from moving structure, dot‘s of light
move back and forth.

ww
w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M
Fig.1.26: Block diagram of Echocardiograph and the
typical Echocardiograms M – Mode display
[Source: Leslie Cromwell - Biomedical instrumentation and
et
measurement]
In time – motion mode or m – mode Display, B – mode echo
signal is recorded either by sweeping the oscilloscope screen or
photographing the oscilloscope face on moving paper. In the
conventional m – mode display time is on the x – axis distance on y
– axis and intensity of echo is on z – axis
In echocardiogram the hill and valley regions indicate the
working heart. A rapid b – mode scan of heart is known as real time

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scan which is also called cross sectional or 2- D echocardiography.

PHONOCARDIOGRAPHY (PCG):
The graphic record of the heart sounds is called
―Phonogram. Since the sound is from the heart, it is called
phonocardiogram. The instrument used to measure the heart sounds
is called phonocardiograph.
1) Heart sounds
2) Murmurs
Heart sounds have a transient character and are of short duration.
Heart murmurs have a noisy characteristic and last for a longer time.

ww
Heart sounds are due to the closing and opening of valves whereas

E
murmurs are due to turbulent flow of blood in the heart and large

w.E
vessels.
Heart sounds

C
Heart sounds are classified into four groups based on their

asy
origin. They are
1) Valve closure sounds
En
gin
3) Valve opening Sounds
4) Extra cardiac sounds
1) Valve Closure Sounds
J
2) Ventricular Filling sounds

Ae
S eri
The sounds occur at the beginning of systole (First heart

ng.
sound) and the beginning of diastole (Second heart sound). The first
heart sound is due to the closure of mitral and tricuspid valves. The

n
M
second heart sound is due to the closure of aortic and pulmonary
valves.
2) Ventricular filling sounds.
et
These sounds occur either at the period of rapid filling of the
ventricles (Third heart sounds) or during the terminal phase of
ventricular filling (ie) atrial contraction. These sounds are normally
in audible.
3) Valve opening sounds
They occur at the time of opening of atrio – ventricular
valves and semilunar valves.
4) Extra cardiac sounds

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They occur in mid (or) late systole (or) early diastole. They
are caused by thickened pericardium which limites ventricular
distensibility.

Physical characteristics of sound

Heart sounds and murmurs are characterized by three
physical properties. They are
1) Frequency
2) Amplitude
3) Quality

ww
1) Frequency: All heart sounds and murmurs are made up of
frequencies between 10 and 1000 Hz. They are divided into low,
medium and high- pitch frequencies
w.E E
i) Low range: 10 – 60 Hz. It is represented by the third and
fourth heart sounds.
asy
C
J
ii) Medium range: 60 – 150 Hz. It is represented by the first
and second heart sounds.
En
iii) High range: 150 – 1000 Hz. It is represented by snaps,
gin
Ae
clicks and diastolic murmurs of aortic and pulmonary insufficiency.
1) Amplitude: Low frequency heart sounds have the biggest

S eri
amplitude while the high frequency murmurs have small amplitudes.

ng.
2) Quality: quality depends upon the overtones (or) harmonics
accompanying the fundamental frequency and applies to tones.

n
M
Origin of the heart sounds.
There are four separate heart sounds that occur during
the sequence of one complete cardiac cycle. et
1) First heart sound: It is produced by a sudden closure of mitral
and tricuspid valves associated with myocardial contraction.
a) Timing: The low frequency vibrations occur approximately
0.05 sec after the onset of QRS complex of ECG.
b) Duration: It lasts for 0.1 to 0.12 sec.
c) Frequency : The first heart sound range from 30 – 50 Hz
d) Asculatory area: The first heart sound is best heard at the
apex of the mid pericardium.
2) Second heart sound: It is due to the closure of semi lunar valves

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(ie) the closure of aortic and pulmonary valves

a) Timing: The second heart sound start approximately 0.03 –
0.05 sec after the end of ‗T‘wave of ECG.
b) Duration : 0.08 – 0.14 sec
c) Frequency : 250 Hz
d) Asculatory Area: It is best heard in the aortic and
pulmonary areas.
3) Third heart sound: It arises as the ventricles relax and the
internal pressure drops well below the pressure in atrium.
a) Timing: It starts at 0.12 – 0.18 sec after onset of second

ww heart sound.

E
b) Duration : 0.04 – 0.08 sec

w.E c) Frequency : 10 – 100 Hz

C
d) Asculatory Area: It is best heard at the apex and left lateral

asy position after lifting the legs.

En
ginJ
4) Fourth heart sound: Also called as atrial sound. It is caused by
an accelerated flow of blood into the ventricles or due to atrial
contraction. It occurs immediately before the first heart sound.

Ae
a) Timing : it starts at 0.12-0.18 sec after the onset of p-wave
b) Duration :0.03-0.06 sec

S
c) Frequency :10-50 Hz

inaudible
eri
ng.
d) Ausculatory Area: Because of its low frequency, it is

n
M
Heart murmurs
Murmurs are sounds related to non – laminar flow of
blood in the heart and the great vessels. et
They are distinguished from heart sounds such that
1) They have noisy character.
2) They have longer duration
3) They are high frequency components upto 1000 Hz.
Typical conditions in cardiovascular system which cause turbulence
in blood flow.
1) Local obstructions to blood flow
2) Abrupt change in blood stream diameter.
3) Pathologic communication in cardiovascular system

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4) Ruptured cardiac structures.

5) Valve insufficiency.
Transduction of heart sound
The sounds and murmurs originate from the heart which
can be picked up from the chest using a stethoscope or by
transduction of sound into electrical signals. The heart sounds are
conducted from the heart to the cheat.
Recording setup:
The heart sounds are converted into electrical signals by

wwmeans of a heart microphone. The electrical signals from microphone

E
are amplified by a phonocardiographic preamplifier followed by

w.E
suitable filters and recorder.

asy
En
ginJ C
S Ae eri
ng.
Fig.1.27: Block diagram of recording setup
[Source: Leslie Cromwell Biomedical instrumentation and measurement] -

n
M
The electrodes are placed on the limbs to pickup the
electrical activity of heart and these signals are amplified and
recorded. This recorded ECG is used as a reference for PCG.
et

Fig1.28: Placement of Microphone on Different Areas of the chest for

Recording PCG Heart Sound Microphone
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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The conversion of heart sounds into electrical signals can be

done using transducers. Via condenser microphone, moving coil
microphone etc. The two main categories of microphones used in P
G are
1) The air coupled microphone
2) The contact microphone.
In the first case, the movement of chest is transferred via
on air cushion and presents low mechanical impedance to chest.
C = Q/V
The vibrations produced by chest wall change the position
of diaphragm which results in the change in voltage across

ww
electrode. The developed dc voltage is in the order of few mV.

E
Relationship between heart and function of cardiovascular system

w.E
asy
En
gin J C
Ae
Fig 1.29: Condenser Microphone along with its Circuit [Source:

S eri
Leslie Cromwell - Biomedical instrumentation and measurement]

ng.
n
M et

Fig 1.30: ECG waveform vs PCG

[Source: Leslie Cromwell - Biomedical instrumentation and
measurement] waveform Medical Applications
Rheumatic Valvular Lesions
Valvular lesions results from rheumatic fever. Rheumatic

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fever is an allergic disease in which heart valves are damaged.

This can be detected by phonocardiograph.
Fig (a) shows the normal heart sounds
The valvular lesions cause the abnormal heart sounds as
given below
1) The murmur of aortic steonosis
2) The murmur of aortic regurgitation
3) The murmur of mitral regurgitation
4) The murmur of mitral stenosis
Special applications of phonocardiogram

ww 1) Fetal phonocardiogram

E
2) Esophageal phonocardiogram

w.E 3) Tracheal phonocardiogram

asy
ELECTRO ENCEPHALO GRAPHY (EEG)

En J C
EEG deals with the recording and study of electrical activity
of brain. The brain waves can be picked up and recorded by means of

gin
Ae
electrode attached to the skill of a patient. Brain waves are the
summation of neural depolarization in the brain due to stimuli from

S eri
five sense and thought process.
1) Anatomy of brain
ng.
The brain consists of three major parts such as cerebrum,

n
M
cerebellum and the brain stem.

et

Fig 1.31: Internal structure of Human brain [Source: Leslie Cromwell -

Biomedical instrumentation and measurement]

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Cerebrum consists of two hemispheres and the hemispheres

are divided into frontal lobe, parietal lobe, occipital lobe and temporal
lobe.

ww
E
Fig 1.32: Human Brain

w.E [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]

C
2) Action Potentials of Brain:
asy
J
When the propagated action potential reaches the cell, the cell fires

En
and thus a spike wave is produced. This firing spreads throughout the
dendritic branches and causes the release of transmitter substances.

gin
Ae
Inhibitory Post Synaptic Potential ( PSP)
If the transmitter substance is inhibitory, membrane

S eri
potential of receptor neuron increases in a negative direction. It is less
likely to discharge; this induced potential charge is called an IPSP.
Excitatory Post Synaptic Potential (EPSP)
ng.
n
M
If the transmitter substance is excitatory, receptor membrane
potential increases in a positive direction.
Evoked potentials
Evoked potential are the potentials developed in the brain as
et
the responses to external stimuli like sound, light etc..
3) Brain waves
Brain waves are the recorded electrical potentials on the
surface of brain. The intensity and patterns of electrical activity are
determined by the overall level of excitation of brain.

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ww
w.E
asy
C E
En
ginJ
Ae
Fig 1.33: Brain Waves [Source: Leslie Cromwell - Biomedical

S eri
instrumentation and measurement]
Alpha waves
Frequency: 8 – 13 Hz
ng.
n
M
Occurrence: They found in normal persons when they are awake in a
quiet, state. They occur normally in occipital region. During step,
these disappear
Beta waves
et
Frequency: 13 – 30 Hz
Occurrence: These are recorded from parietal and frontal regions
of scalp two types: - Beta I – Inhibited by cerebral activity
Beta II – Excited by mental activity (tension)
Theta waves
Frequency: 4 – 8 Hz
Occurrence: These are recorded from parietal and temporal regions of
scalp of children.
Delta waves
Frequency: 0.5-4Hz
Occurrence: These occur only in every 2 or 3 sec. These occur in deep

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sleep in premature babies and in very serious brain disease.

4) Placement of electrode
In EEG, electrodes are placed in standard positions on skill
in an arrangement called 10 – 20 system. The electrodes are arranged
as follows.
1) Draw a line on the skull from the nasion, the root of nose, to the
inion, ossification center on occipital lobe.
2) Draw a similar line from the left preauricular (ear) point to the right
preauricular point.
3) Mark the intersection of two lines as Cz which is the midpoint of
distance nasion and inion.

ww
4) Mark points Fpz, Fz, Cz, Pz and Oz at 10, 20, 20, 20, and 10% of
total nasion – inion distance.
w.E
of total distance between preauricular points.

asy
C E
5) Mark points T3, C3, Cz, C4, and T4 at 10, 20, 20, 20 and 10%

6) Measure the distance between Fpz and Oz along the circle

F8, T4, T6, and O2.

En
gin J
passing through T3, and mark points as Fp1, F7, T3, T5, and O1 at
10, 20, 20, 20 and 10% of this distance.
7) Repeat this procedure on right side and mark the positions as Fp 2,

Ae
8) Measure the distance between Fp1, and O1 along the circle

intervals.

S eri
passing through C3 and mark point as F3, C3, and P3 at 25%

ng.
9) Repeat this procedure on right side and mark as F4, C4 and P4.

n
M
10) Check that F7, F3, Fz,F4 and F8 are equidistant along transverse
circle passing through F7, Fz, and F8 check that T5, P3, Pz,P4, and T6,
are equidistant along transverse circle passing through T5 , Pz , &
T
et
6
Pg1 AND Pg2 are nasopharyngeal electrodes and A1 and
A2 are ear electrodes.

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ww
w.E
asy
C E
measurement]
En
gin J
Fig 1.34: Placement of lectrodes on the Scalp for the EEG Recording
[Source: Leslie Cromwell - Biomedical instrumentation and

Ae
S eri
Pg1 AND Pg2 are nasopharyngeal electrodes and A1 and
A2 are ear electrodes. The electrode systems are used to facilitate the
ng.
location of foci, (ie) cortical areas from which abnormal waves
spread.
n
M
5) Recording Setup
In EEG recording setup, there are and drive amplifier whose
gain can be increased by cascading several stages. The patient cable
consists of 21 electrodes and is connected to the eight channel
selector. The electrodes are attached to the channel selector in groups
of eight called a montage of electrodes. The interference is reduced
et
by employing differential amplifiers as preamplifiers.

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ww
w.E
asy
C E
En
ginJ
Ae
S eri
ng.
Fig 1.35: Fig: Modern EEG Unit [Source: Leslie Cromwell -

n
M
Biomedical instrumentation and measurement]

EEG unit is covered with ferrous metal screen to reduce a,c

interference.
et
The filter bank consists of appropriate filters to select
different types of brain waves. Visual stimulus, Audio stimulus and
tactile (touch) stimulus are used to record evoked potentials from
sensory parts of brain. The time delay between stimulus and response
can be measured in the signal processing unit.
6) Analysis of EEG
EEG helps physicians to diagnose the level of

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consciousness, sleep disorders, brain death, brain tumors, epilepsy

etc.
i) Level of consciousness
EEG changes with the level of consciousness. Diminished
mental activity results in a lower frequency and large amplitude EEG
wave.
REM means Rapid Eye Movement. REM sleep coincides

ww
with the periods of dreaming. EEG displays the characteristic features

E
during the application of anaesthesia.

w.E If the tumor displays the cortex and if it is large enough, the
electrical activity will be absent since no electric potentials originate

C
in the tumor. Thus a damped EEG over the cortex can be a sign of a
asy
tumor.
iii) Epilepsy
En
gin J
Epilepsy is a symptom for brain damage. It may due to

Ae
defects in birth delivery or head injury during accident or boxing. It
may also be due to brain tumor. Epilepsy is divided into two types.

S eri
1) Grandmal
2) Peritmal
1) Grandmal
ng.
n
M
Before grandmal attack, the patient recognizes a set of
symptoms such that he sees a flash of light if grandmal arises from
visual center .He hears a noise if it arises from acoustic center. It
extends from few sec to several min
et
2) Peritmal
In peritmal attack, spike type waves are produced with a
frequency 3 Hz. It lasts for 1– 20 sec.
Application
(i) Epilepsy – EEG is very helpful to find acuteness of
epilepsy.
(ii) Anesthetic level – It is helpful to find the depth of
intensity of anesthesia
(iii) Brain injury – If there is a scar on the cerebral cortex, it
creates irrigative effect on the nearby healthy cortex. It is
identified by EEG waveform.

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(iv) Monitor during surgery – Doctor to find patient‘s

conditions.
(v) Effect of Yoga – Identified by EEG for a normal person
initially EEG in recorded.
The person has to do yoga for some time. After some period,
once again EEG recorded for same person. Then it is compared with
previous wave form different gives the effect of yoga.

ELECTRO MYO GRAPHY (EMG)

Electromyography is the science of recording and
interpreting the electrical activity of muscle‘s action potential. The
recording of peripheral nerve‘s action potentials is called
ww
E
electroneurography.

w.E
Recording Setup
The surface electrodes or needle electrodes pickup the potentials

asy
En
gin J
cleaned and electrode paste is applied.
C
produced by the contracting muscle fibers. The surface of the skin

S Ae eri
ng.
n
M et
Fig 1.36: Block Diagram for EMG Recording Setup [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]
The needle electrode picks up the action potentials from
selected nerves or muscle. Further to record the action potentials from
a signal nerve, microelectrodes are used.

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The amplitude of EMG signals depends upon the type and placement of electrodes used.
Surface electrode picks up many overlapping spikes and produces an average voltage from
various muscles.
The amplifier should have uniform frequency response, high CMRR and high input
impedance. The signal is also recorded in the tape recorder for further reference.

Determination of conduction velocities in motor nerves.

The measurement of conduction velocity is used to indicate the location and type of
nerve lesion.
The EMG electrode and stimulating electrode are placed at
two points on the skin, separated by a known distance l1.An electrical pulse is applied through the
stimulating electrode. The latency is now
measured as ‗ t 2‘seconds. The conduction velocity is
U = l1- l2 / t 1 –t2

ww
The conduction velocity in peripheral nerves is normally 50 m/s. when it is below 40 m/s, there
is some disorder in nerve conduction.

w.E
asy
C E
En
gJ
Ain
S eer
i ng.
M net
Fig 1.37: Determination of Conduction Velocity in a Motor Nerve [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]

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ELECTRO OCULO GRAPHY (EOG)

A recorder of corneal – retinal potentials associated with eye movements is called
electrooculogram. It is simpler to recorder then electroretinogram.
The electrodes are placed as shown in Fig one pair of skin electrodes on either side of
eye for recording of horizontal movement of eyes and another pair of electrodes on for head and
checks for recording for vertical movement of eyes. This electrodes position methods reduces the
cross coupling between the vertical and horizontal pair of electrodes.

ww
w.E
asyFig 1.38: EOG measurement

C E
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

En
gJ
Ain
A commonly observed artifact in EOG recording of vertical eye movements has being
attributed to the motions of upper eyelid. Some diseases which affect the steady potential the eye
can be studied using EOG.

S eer
i) The effect of certain drugs on the eye movement system can determined.
ii) The state of the semicircular canals is analysis by EOG.
iii) Diagnosis of the neurological disorders
i ng.
M
iv) The level of anesthesia can be indicated by the eye movements.

net

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UNIT II

BIO CHEMICAL NON ELECTRICAL PARAMETER

MEASUREMENT
H
P ,PO2, PCO2, PHCO3, Electrophoresis, colorimeter, photometer,
Auto analyzer, Blood flow meter, cardiac output, respiratory
measurement, temperature, pulse, Blood cell counters, Blood
pressure

ww
CHEMICALELECTRODE

E
H
P Electrode:

w.E Chemical balance of the human body in identified by the

H H

C
measurement of p content of blood and other body fluids. P is

asy +
defined as the logarithmic of reciprocal of H ion concentrations.

J
H +
P = log10 1 /[H ]

En
= - log10 [H
+]

gin
Ae
H H H
Neutral solution has a p value of 7. If p < 7, it is acidic, p >7 it
is basic.

S eri
Glass electrode advantages (over hydrogen electrode):
It is independent of oxidation – reduction potential. It is not
necessary to pass the gas through the solution i.e equilibrium
condition is reached rapidly. ng.
n
M et

H
Fig 2.1: P Electrode
:[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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The oxygen electrode is a piece of platinum wire embedded

in an insulating glass holder with the end of the wire exposed to the
electrolyte solution into which oxygen is allowed to diffuse through
the membrane
Advantages
 The oxygen electrode is also used to monitor the partial
pressure of oxygen in biological fluids.
 It is available in integrated version consisting of platinum
electrode and reference electrode in the same enclosure

ww called Clark electrode.

w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M
Fig 2.2: PO2 Electrode [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
et
PCO2 Electrode:
H
It consists of a standard glass P electrode covered with
rubber membrane permeable to CO2.Between the glass surface and
membrane there is a thin film of water. The solution under test
contains dissolved CO2 is presented to the outer surface of rubber
H
membrane. After equilibrium P of aqueous film is measured by glass
electrode and interpreted interms of PCO2.
ELECTROPHORESIS
Devices based on electrophoretic principles are used in the

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clinical laboratory to
 Measure the proteins in plasma, urine and CSF
 Separate enzymes into their component is enzymes
 Identify antibodies
 Serve in a variety of applications.
Basic Principle Definition
Electrophoresis may be defined as the movement of a solid
phase with respect to a liquid (buffer solution)
Zone Electrophoresis
In this technique, the sample is applied to the medium.
Under the effect of electric field, groups of particles that are similar

ww
in charge, size and shape migrate at similar rates.

E
(i) Magnitude of Charge

w.E The mobility of a given particle is directly related to the net

magnitude of particles charge. Mobility is defined as ―the distance

asy
En
2
Mobility = cm / (v.s)
(ii) Ionic strength of Buffer

gin
C
in cm a particle moves in unit time per unit field strength expressed
as voltage drop per centimeter‖.

J
migration of particles.

S
(iii) Temperature
Ae
The more concentrated the buffer, slower the rate of

eri
Mobility is directly related to temperature. The flow of

ng.
current through the resistance of the medium produces heat. This heat
has two important effects on electrophoresis.

n
(iv) Time:

M
The distance of migration is directly related to the time the
electrophoresis takes.
(v) Types of Support Media.
A variety of support media such as paper, cellulose acetate
starch gel, agar gel and sucrose are used in various electrophoretic
et
applications.

Cellulose Acetate Electrophoresis

It is used extensively in clinical laboratories. The cellulose
acetate strip is saturated with the buffer solution and placed in the

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membrane holder (‘bridge‘).

ww
E
Fig 2.3: Cellulose Acetate Electrophoresis [Source: Leslie Cromwell -

w.E
Biomedical instrumentation and measurement]
The current increases slightly and after 15-20 min, the

asy
densitometry.

PHOTOMETERS AND COLORIMETERSEn

gin
C
electric voltage is removed. The membrane is dried in preparation for

J
Ae
They are used to measure the transmitted and absorbed light
as it passes through a simple. The colorimeter uses light absorption

S
to determine blood proteins and iron levels.

Transmittance T =
1
eri
ng.
n
M Where I1
I0
I0
→ Transmitted light intensity
→ Incident light intensity
By measuring optical density or absorbance ‗A‘the
concentration of given substance in the sample can be determined.
When a diffraction grating or prism is used as a monochromator to
et
get different spectral components or wavelengths is the colorimeter,
and then it is called spectrophotometer. There are filter fluorometer
and spectrofluoremeters depending on whether filters or
monochromators are used to select the emission wavelength.

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Filter Photometer (Colorimeter)

It is used to measure transmittance. Light from a halogen
lamp is incident on a filter F. The divergent transmitted light is
converted into two parallel beams by an optical arrangement.

ww
w.E
asy
instrumentation and measurement]

C E
Fig 2.4: Filter Photometer [Source: Leslie Cromwell - Biomedical

En
ginJ
One beam falls on a reference selenium photoelectric cell
CR and other beam falls on a sample selenium photoelectric cell Cs

Ae
after passing through sample in the cuvette. Without the sample,
outputs from photoelectric cells are the same.

Spectrometer:

S eri
ng.
n
M et

Fig 2.5: Spectrometer [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]

Light from a halogen lamp is passed through an entrance

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slit s1 and incident on a concave reflector which focuses the light on

a diffraction grating ‗G‘to disperse light. The dispersed light is
allowed to incident on the reflector. Then the light beam is directed
to the sample through a narrow exit slit s2.
Flame Photometer:
A flame photometer is used to analyze urine or blood in
order to determine the concentration of K, Na, Ca, and Li. Lithium is
used as a calibration substance in analysis of other three substances.
A known amount of lithium is added to the sample and the emitted

ww
light intensity is measured relative to that of lithium.

w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M et
Fig 2.6: Flame Photometer [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
By this way, any error due to varying flame temperature is
eliminated. Using an atomizer, liquid sample is sprayed into fine
droplets by passing oxygen or air to it.
0 0 0
K : 4047 A , Na : 5890 A , Li : 6703 A
Separate photo detector is used for each channel. The
photodetctor circuit consists of a reverse biased diode in which
current flow increases as the intensity of light increases. Flame

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photometer has many advantages such as fast response, high accuracy

and lesser cost of equipment. But its sensitivity is smaller than
fluorometer.
Filter Fluorometer:

ww
w.E
asy
C E
En
instrumentation and measurement]
J
Fig 2.7: Filter Fluorometer [Source: Leslie Cromwell - Biomedical

gin
Ae
Flurometer is carried out by illuminating the sample with a
lower wavelength light, normally UV light and then measuring the

S eri
fluorescent light intensity which is at higher wavelength. It is used

ng.
only when the substances are available in lower concentration (eg)
certain hormones and vitamins. Light from a light source is made

n
M
parallel by a convex lens and passed through a filter F1.

Chromatography:
et
Chromatography is a technique used for separating closely
related chemical substances. It is based on differences in the
migration velocity of the substances between a stationary phase and
a mobile phase. The difference is due to a difference in solubility in
two phases. Depending upon the nature of mobile phase, there are
 Liquid chromatography which uses liquid mobile phase
 Gas chromatography which uses gas mobile phase.
Liquid chromatography is used to analyse amino
acids and composition of drugs. Gas

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Chromatography is used to anayse steroids and

aromatic acids.

ww
w.E
asy
C E
En
ginJ
Ae
S eri
ng.
n
M
Fig. 2.8: Basic Principle of Chromatography [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]
et
The sample is added with the mobile phase gas or liquid
flow. The components in the sample travel with different velocities
depending on their solubility in the stationary phase.
Radionuclide methods for evaluating the function of various
organs:
Radionuclide methods are used for the diagnosis of thyroid
gland and real function. Thyroid gland takes up a large amount of
iodine entering the body. Any disturbances of the thyroid cland

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change the iodine uptakes. This fact is used to evaluate the degree of
131
disturbance. An oral dose of I is given as sodium iodide. After 24
hours, the amount of radioactivity is measured by scintillation
131
counter. Only the radiation emitted by I is counted by using a pulse
height discriminator and counter.

ww
w.E
C E
Fig 2.9: Radionuclide Methods for Evaluating the Thyroid Gland
asy
J
Function [Source: Leslie Cromwell - Biomedical instrumentation
and measurement]
En
AUTOANALYZER (AUTOMATION OF CHEMICAL TESTS)

gin
Ae
Most chemical tests consist of simple steps like pipetting,
diluting and incubating. These are time consuming and require

S eri
skilled technicians to avoid the errors. To replace the technicians by
an automatic device, the first automatic analyse was found and still
used at most hospitals.
ng.
n
M et

Fig 2.10: Continuous Flow Analyzer

[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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BLOOD FLOW METERS

Blood flow meters are used to monitor the blood flow in
various blood vessels and to measure the cardiac output
.Electromagnetic flow meters
All blood flow meters are based on one of the following
physical principle.
(1) Electromagnetic induction
(2) Ultrasound transmission or reflection
(3) Thermal convection
(4) Radiographic principles
ww (5) Indicator (dye or thermal) dilution

w.E
Magnetic Blood Flow Meter:

asy
C E
They are based on the principle of magnetic induction. When
an electrical conductor is moved through a magnetic field, a voltage

En
gin J
is induced in the conductor proportional to the velocity of its motion.
The voltage inducted in the moving blood column is

Ae
measured with stationary electrodes located on opposite sides of
blood vessel and perpendicular to direction of magnetic field.

S eri
ng.
n
M et

Fig 2.11: Magnetic Blood Flow Meter Principle [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]
The oscillator drives the magnet and provides a control
signal for the gate, operates at a frequency between 60 & 400Hz.The
gated detector makes the polarity of output signal reverse when the

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flow direction reverses.

ww
w.E
asy
C E
Fig 2.12: Block Diagram of Magnetic Blood Flow

J
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

En
Meter Ultrasonic Blood Flow Meters:

gin
Ae
In this, a beam of ultrasonic energy is used to measure the
velocity of flowing blood. The two different ways are:

S eri
(i) Transmit time ultrasonic flow meter
(ii) Doppler type
Transmit Time Ultrasonic Flow Meter:
ng.
A pulsed beam is directed through a blood vessel at a
n
M
shallow angle and its transit time is measured.
et

Fig 2.13: Transmit Time Ultrasonic Flow Meter

[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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A piezoelectric crystal emits a pulse of ultrasound which

propagates diagonally across the blood vessel. If the flow is in same
direction as the pulse then the pulse reaches a receiving crystal
situated on the opposite side wall of the blood vessel. Electronics
circuit convert change in transits time to velocity.
D - Distance travelled by sound waves (or) Distance
between transmitter and receiver ultrasonic waves.
TD- Downstream transits time, V-velocity of blood
flow, C-ultrasound velocity Ultrasonic velocity in

ww
downstream C+V cosӨ = D/ TD

E
Ultrasonic velocity in up stream

w.E
C - V cosӨ = D/TU
Difference in transist time
∆T = TU - TD
asy 2
V = ∆T C / 2D cosӨ

En J C
Thus blood flow velocity determining difference between
upstream and downstream transit time.
gin
S Ae
Doppler type Ultrasonic Blood Flow Meter:

eri
Ultrasonic flow meters are based on the Doppler principle.

ng.
An oscillator operating at a frequency of MHZ excites a piezoelectric
transducer. This transducer is coupled to the wall of exposed blood

n
M
vessel and sends an ultrasonic beam with frequency F into flowing
blood.
et

Fig 2.14: Doppler type Ultrasonic Blood Flow Meter [Source: Leslie Cromwell
- Biomedical instrumentation and measurement]

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Flick’s Method:
This is based on the determination of cardiac output by the
analysis of gas-keeping of the organism.

I=CAQ - CVQ

ww
w.E
asy
C E
En
gin J
Ae
S Fig: 2.15 Flick’s Method
eri
ng.
[Source: Leslie Cromwell - Biomedical instrumentation and
n
M
Indicator Dilution Method:
measurement]

This is based on the principle that if we introduce an

indicator in the blood circulation and then measuring the
concentration of indicator with respect to time. We can estimate the
volume flow of blood. Let M mg of an indicator is injected into the
et
right heart.

Fig. 2.16 Dilution Curve

[Source: Leslie CromwellDownloaded
- BiomedicalFrom:
instrumentation and measurement]
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During the first circulation period, the indicator would mix

up with the blood in a small quantity. After that there is a rapid change
of concentration. This is shows by rising portion of dilution curve.
After reaching maximum, the concentration of indicator decreased
exponentially.

Thermo Dilution Method

Now-a-days thermo dilution method is adapted to measure
cardiac output.

ww
w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M
Fig. 2.17 shows the block diagram of thermo dilution system [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]
A linear relation between temperature and resistance of the
thermistor can be obtained by connected a parallel resistor with it.
et
Then the line arising amplifier works. Integrator delivers the value of
integral of blood temperature change over a given time. By feeding
data about p, s, Q and thermal indicator, the computer can deliver the
cardiac output in lit/min.

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Measurement of cardiac output by impedance change.

By the impedance method, the cardiac output can be
determined electronically. L probes method is adopted here.
The electrode pair 1 & 4 is used as current electrodes.
The electrode pair 2 & 3 is used to pick up the voltage across the
thorax

ww
w.E
asy
C E
J
Fig 2.19: Measurement of Cardiac Output by Impedance Change
En
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

gin
Ae
Advantages of Cardiac Output Measurements.

S
Indicator dilution is more useful when there is no severe
eri
heart defect. Here the diagnostic information can be obtained from
the changes in the shape of dilution curve.
ng.
n
M et

Fig. 2.20 shows the normal curve corresponding to normal circulation of blood.
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]
Fig (b) shows article output defect where blood flows internally

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from left atrium to right atrium.

Fig (c) shows ductus arterisus. Here blood flows from aorta to
pulmonary artery.

PULMONARY FUNCTION ANALYSIS (RESPIRATORY

MEASUREMENT)
They are used to evaluate the state of lungs or respiratory
process. The three basic types of measurement are ventilation,
distribution and diffusion.
Ventilation:
Ventilation deals with the determination of the ability of
ww
body to displace air volume quantitatively and the speed with which

w.E
Lung volumes and capacities

asy
C E
it moves the air. Spirometers are used in the ventilation measurement.

Pulmonary function analyzers are used to determine the lung

volumes and capacities. These parameters depend on individual’s

En
gin J
physical characteristics and condition of breathing mechanism.

Ae
S eri
ng.
n
M et

Fig 2.21 Lung Volumes and Capacities [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
IC→ Inspiratory Capacity. It is the volume of gas
remaining in the lungs at the end of expiratory level. FRC→
Functional Residual Capacity. FVC and FEV are some of the forced

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breathing tests used to assess the muscle power.

FVC → Forced Vital Capacity
FEV → Forced Expiratory Volume
FVC is the total amount of air that can forcibly be expired
as quickly as possible after taking the deepest possible breath. FEV is
the maximum amount of gas that can be expelled at the given time.
Spirometer:
It is used to measure the respiratory volume measurements. It is
used to determine all lung volumes and capacities by measuring the
gas inspired or expired during a given time involved. Fig. shows an
electrical spirometer.
ww
w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M Fig 2.22: Spirometer
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]
It consists of light weight bellows. Due to light weight, there
is no airway resistance error.
et

Pneumotachograph using strain gauge:

Pneumotachograph is an instrument to measure the patient‘s
air flow rate during respiration and vital air capacity of lung. Now-a-
days strain gauge transducer is used to sense line air flow to get better
accuracy. The airflow changes the resistance of strain gauge. Strain
gauge is attached to a Wheatstone bridge & it

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forms one arm of bridge.

ww
w.E E
Fig 2.23 Pneumotachograph using Strain [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]Gauge
Procedure:
asy
C
J
1. The volume of air exhaled by a patient is measured by first

En
closing and then opening the reset switch. This set the initial
charges on C1 to Zero and fixed Vout at Zero.

gin
Ae
2. The patient is then asked to exhale through pneumotach
mouthpiece. Hence resistance change R in strain gauge is
proportional to airflow F.

S
to‗t‘seconds.
eri
3. VF is a function of time. VF is given to the integrator and

ng.
Vout is proportional to volume of air expired from time o

n
M
4. After the patient has stopped exhaling Vout remains
constant in proportion to the total volume of air expired
until the most switches is closed.
Gas Analyzer:
Determine composition of inspired & expired gas and to
access lung function.
et
Infrared gas analyzer:
CO2 concentration can be evaluated by its infrared
absorption. One is filled with non absorbing gas such as nitrogen,
other with sample. The difference in optical absorption detected
between the 2 cells is a measure of absorption of sample at a
particular wave length. Infrared CO2 analyzer which makes use of a
non dispersive infrared analysis technique. In this technique

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selective wavelength which is highly absorbed by gas in used

accuracy of measurement.

ww
w.E
asy
C E
En
ginJ
Fig 2.24 Gas Analyzer

Ae
[Source: Leslie Cromwell - Biomedical instrumentation
and measurement]

S eri
ng.
Infrared source operates at a temperature of about 815 C
and it can deliver to a mirror. If the mirror have two beam with same

n
M
intensity. There is a high speed rotating chopping disc which includes
each beam twice per motion. The chopped lights are passing through
the reference and samples tubes.
et
PULSE RATE MEASUREMENT
Each time the heart muscle contracts blood is ejected from
ventricles and a pulse of pressure is transmitted through the
circulatory system. This pressure pulse can be felt by placing the
finger tips over the radial artery in the wrist or some other location
where an artery seems just below the skin. The timing and ware shape
of pressure pulse provide valuable diagnostic information. The pulse
pressure and waveforms are indicators for blood pressure and flow.
Instruments used to detect the artinal pulse and pulse pressure
waveforms in the extremities are called plethysmographs.
Plethysmograph techniques respond to a change in the volume of

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blood as a measure of blood pressure.

Photoelectric Method:
It is the most commonly used method to measure the
pulsatile blood volume changes. Two commonly used methods are,
i) Reflectance Method ii)
Transmittance Method
(a)Transmittance Method:
A light emitting diode (LED) and photo resistor are mounted in
an enclosure that fits over the tip of patient‘s finger. Light is
ww
transmitted through finger tip and resistance of photo resistor is
determined by the amount of light reaching it.
w.E
asy
C E
En
ginJ
Ae
S eri
Fig 2.25 Transmittance Method [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
ng.
n
M
Fig 2.26 Reflectance Method [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
et
The photoresistor is placed adjacent to exciter lamp. Part of
light rays emitted y LED is reflected and scattered from the skin &
tissues and falls on photoresistor.

TEMPERATURE MEASUREMENT:
Two types of temperature measurement can be obtained
from the body. Systematic, surface temperature.
Systematic temperature

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Temperature of the internal regions of the body. Usually

heat is generated by the active tissues of the body & heat is lost by
the body to the environment, between temperatures of body is
maintained carefully.
Systematic Body Temperature Measurement:
Mercury thermometer is used for temperature measurement.
It is inexpensive to use. When continuous temperature recording
thermocouple or thermister used.
Thermocouple:
A junction of 2 dissimilar metals produces an o/p voltage,
which is proportional to temperature at that junction.

ww
Thermistor:

E
It is a temperature sensing device. Its resistance varies with

w.E
temperature. This is mostly proffered in the biomedical field
compared with thermocouple. Thermister can be manufactured in

asy
En
RR e +β(1
t=r

gin
/
1 0C
various shapes. In this relationship between resistance change &
temperature in non – linear. Resistance of thermister is given by

J τ
-1/τ )

Ae
Rt = resistance at temperature Tt
Rr = resistance at temperature to (ref temperature)

S eri
T1 = Temperature at which measurement is taken T0
= Ref temperature
β = Temperature coefficient (range 3000 -4000)
1
ng.
Sp circuit are used to overcome nonlinear characteristics

n
M
1
of thermister Sp circuit consists of 2 matched thermister.
Problem in thermister:
Self heating this problem overcome by limiting current used
et
in measure power dissipation of thermister is maintained mV range
to overcome this problem. Thermister problem is should be chosen
based on resistance change sensitivity.
Skin temperature measurement:
0
Skin temperature is not constant throughout body varied from 30 C-
0
35 C. Various factors affect skin temperature
How fat covers over capillary area.

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How skin portion is exposed to ambient temperature. Blood

circulation pattern beneath skin
Probes used – small, flat thermister probe is used.
Infrared thermometer – Device used to measure skin temperature. It
is used to identity spots in which blood circulation is poor

BLOOD CELL COUNTER

The blood cells have important functions in our body. The
red blood cell is used for transport of oxygen and carbon-di-oxide.
When the haemoglobin in the blood decreses, anemia is

ww
produced.

E
The number of red blood cells can be counted using a

w.E
microscope, but the microscopic counting is time consuming. Now-
a-days automatic red blood cell counters are used.

asy
Automatic Red Blood Cell Counter:

En J C
This method us based on the fact that red cells have a higher
electrical resistivity than the saline solution in which they are

gin
Ae
suspended. Fig (1) shows the automatic blood cell counter using
electronic circuitry.

S eri
ng.
n
M et

Fig 2.26: Automatic Red Blood Cell Counter [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]

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Operation
The threshold is first set to zero and the counter output is
given by the total number of particles (WBCs + RBCS + platelets)
per litre. Then the threshold is set to T1 and the counter gives the total
number RBCS and WBCS per litre. After that the threshold is set to
T2 and the counter reads the total number of WBC S per litre.
Laser Blood Cell Counter:

ww
w.E
asy
C E
En
gin J
Ae
S eri
Fig 2.27: Laser Blood Cell Counter [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
This is a modern technique which gives the number of
ng.
RBCs, WBCs and Platelets, hematocrit and concentration of
n
M
haemoglobin. The basic Principle is that the angle of scattered light
intensity is different for different sized particles. The sample blood is
heavily diluted to reduce the number of particles counted to one at a
time.
BLOOD PRESSURE MEASUREMENT.
Pressure is defined as force per unit area p = F / A
et
P = pressure in pascal,
F= force,
A=Area
Pressure is increased by increasing the applied force or by
decreasing the area.

Hydrostatic Pressure: .If the force in a system under pressure is

not varied then pressure is known as Hydrostatic pressure

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Hydrodynamic Pressure: If the force in a system under pressure is

varied then pressure is known as Hydrodynamic pressure
Methods:
1. Indirect method using sphygmomanometer
2. Direct method
Indirect Method using Sphygmomanometer:
In this method Sphygmomanometer is used to measure
blood pressure indirectly. It consists of inflatable rubber bladder
which is known as cuff, rubber squeeze ball pump & valve assembly.
Pressure is measured using manometer with mercury column.
Procedure to use Sphygmomanometer: Cuff is wrapped

ww
around the patient‘s upper arm at a point midway between elbow &

E
shoulder. Stethoscope is placed over as artery distal to the off,

w.E
because at this place, brachial artery comes close to surface.

asy
En
gin J C
S Ae eri
ng.
n
M
a) Oscillometric method [Source: Leslie Cromwell - Biomedical instrumentation
and measurement]
et

b) Oscillometric in cuff pressure

Fig 2.28 Indirect method using sphygmomanometer [Source: Leslie

Cromwell - Biomedical instrumentation and measurement]

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Then doctor slowly reduces the pressure in the cuff & he

watches the mercury column when the systolic pressure exceeds the
cuff pressure. Then doctor can hear some crashing, snapping sound
through stethoscope. This sound is known as korotkoff sound.
Advantages

 Method is very simple

 Painless techniques
 There is no hazardous surgical procedure

ww
involved. Disadvantages
Effective result depend on the fact how accurately doctor

Direct method

asy
C E
read pressure values when koratkoff sound is heard.
w.E Direct method of blood pressure is used when accurate

J
blood pressure reading. If we want to know blood pressure in deep

En
region indirect method is not useful.so direct method is used.

gin
S Ae eri
ng.
n
M et

Fig 2.29 Direct blood pressure measurement [Source: Leslie Cromwell -

Biomedical instrumentation and measurement]

Probe used in Direct Blood Pressure Measurement:

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Catheter tip probe sensor mounted at the tip of the probe. Pressure exerted on the tip is
converted to the corresponding electrical signal. In fluid filled catheter type. Pressure exerted on
the fluid filled column is transmitted to external transducer. This transducer converts pressure in
to electrical signal.

Direct Method of Blood Pressure Measurement:

Here fluid filled cattheter is used. Before inserting catheter into blood vessel, fluid filled
system should be completely flushed out. Usually sterile saline is used for this purpose. Because
blood clotting is avoided.

Working:
Blood taken from vessel using Cather tip probe. Pressure exerted is transmitted to the
pressure transducer. The output of transducer is given to pressure monitor.

ww
w.E
asy
C E
En
gJ
Ain
S eer
i ng.
M net
Fig 2.30 Circuit diagram for measurement of systolic and diastolic blood pressure [Source:
Leslie Cromwell - Biomedical instrumentation and measurement]

Which is used to stable display. Clamping circuit is

available C1 & D1 used to develop voltage is equal to peak to peak value of the pressure pulse.
M2 reading = peak systolic value - peak to peak pressure value.

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UNIT III

ASSIST DEVICES AND BIO-TELEMETRY

Cardiac pacemaker, DC Defibrillator, Telemetry principles,

Frequency selection, Bio-Telemetry, Radio-pill and Telestimulation

INTRODUCTION:
Physiological assist device are very helpful to the patients
of different categories. Pacemakers are extending the life of cardiac
ww
patients having total bundle block. Implanted artificial heart valves

PACEMAKER:

asy
C E
are maintaining the circulation of blood in a normal manner.

w.E
J
Pacemaker is an electrical pulse generator for starting and/or

En
maintaining the normal heart beat. The output of Pacemaker is
applied either externally to the chest or internally to the heart muscle.

gin
Ae
In case of cardiac standstill the use of pacemaker is temporary just
long enough to start a normal heart rate.

S eri
Energy Requirements to Excite Heart Muscle:
The heart muscle can be stimulated with an electric shock. The

ng.
minimum energy required to excite heart muscle is 10µJ. For better
stimulation and safety purposes 100µJ pulse energy is applied on heart

n
M
muscle. During ventricular fibrillation heart muscle contracts so rapidly
and irregularly. The pulse to space ratio 1:10000 et

Fig 3.1: Pacemaker pulses [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]

The negatively going pulses to avoid ionization of muscles.

Pulse repetition rate is usually 70 pulses/min but many pacemaker s

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are adjustable in the range of 50-150pulses/min. The circulation of

each pulse is between 1to2ms.

Methods of Stimulation:
There are two types of stimulation
(i) Internal stimulation
(ii) External stimulation
(i) Internal stimulation: It is employed for long term pacing
because of permanent damage. Electrodes in the form of fine wires of
Teflon coated stainless steel. The current range is 2-5mA.Bipolar and
Unipolar electrode are used.
ww(ii) External stimulation: It is employed to restart the normal rate

w.E
150mA

asy
C E
of heart in case of cardiac stand still. The paddle shaped electrode
are applied on the surface of chest current in the range of 20-

Based on the placement of pacemaker there are two types

(i) External

En Jpacemaker
(ii)Implanted (Internal pacemaker)

Different Modes of Operation: gin

Ae
S
Pacing modes can be either competitive or
eri
noncompetitive. Asynchronous pacing is called competitive
because the fixed rate impulses may occur along with natural
pacing impulses and competition with them in controlling theng.
n
M
heart beat. Non competitive pacemakers are programmed either in
demand or synchronized mode

Ventricular Asynchronous pacemaker (Fixed rate pacemaker):

It can be used in atrium or ventricle. It has the simplest
mechanism and the longest battery life. This pacemaker is suitable
et
for patients with either a stable, total AV block, a slow atrial rate. It
is basically a simple astable multivibrator which produces at a fixed
rate of heart .

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ww
w.ESquare Wave Generator

asy
C E
Monostable Multivibrator

En
gin J
Fig 3.2: Ventricular Asynchronous pacemaker
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

Ae
There may be competition between the natural heart beats
and pacemaker beats. If the pacemaker impulse reaches the heart

S eri
during a certain period, ventricular fibrillation may occur. Nowadays

ng.
the fixed pacemaker is fabricated on a large scale integrated circuit
are used. The circuit consists of a square wave generator and a

n
M
positive edge triggered monostable multivibrator. The output of this
combination provides a positively and negatively going square waves
with equal duration for positive and negative pulses. The period of
et
square wave generator is given by
T= -2RC ln(1-α/1+α)
Where α=R2/(R1+R2)
α – feedback voltage fraction
T can be changed by changing α or time constant RC. The
square wave generator is nothing but astable multivibrator which
switches the output voltage between |Vsat |and -|Vsat|. The output of

square wave generator in coupled to the positive edge triggered

monostable multivibrator circuit. A positive edge trigger input will
pass through capacitor Cc and diode and will raise the voltage at non-
inverting terminal of second amplifier. The capacitor Cc is chosen so
as to make five time constants equal to pulse duration TD.
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Disadvantages:
1. Using fixed rate pacemaker the heart rate cannot be
increased
2. Simulation with a fixed impulse frequency results in the
ventricles and atria beating at different rates. This varies the
stroke volume of heart and causes some loss in cardiac
output.
3. Possibility of ventricular fibrillation will be more.
Ventricular synchronous pacemaker (standby pacemaker):

ww This is used for patients with only short periods of AV block

E
or bundle block. This type does not complete with the normal heart

w.E
activity. A single transverse electrode placed in the right ventricle
both senses R wave and delivers the stimulation.

asy
C
En
gin J
Ae
S eri
ng.
n
Leslie
measurement]
Working:
M
Fig 3.3: Ventricular Synchronous Pacemaker [Source:
Cromwell - Biomedical instrumentation and
et
Using the sensing electrode heart rate is detected and is
given to the timing circuit in pacemaker. If the detected heart rate is
below a minimum level the fixed rate pacemaker is turned on. The
pacemaker may detect noise and interpret as its ventricular excitation.
This can be eliminated by refractory period or gate circuit. In heart
blocks P waves with respect to ventricular excitation. P and R waves
have different frequency bands. The high pass filter completely
eliminates P-waves and the R-waves. Input amplifier increases peak-
to-peak amplitude of R-wave.
Ventricular Inhibited Pacemaker (Demand Pacemaker)
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It is also known as R-wave inhibited pacemaker. If the

normal heart rate falls below minimum the pacemaker will turn on
and provide the heart a stimulus. Hence it is called as
Demand pacemaker.
There is a piezoelectric sensor stielded inside the
pacemaker. When the pacemaker can automatically increase or
decrease its rate. Thus it can match with greater physical effort.

ww
w.E
asy
C E
En
ginJ
Ae
S eri
ng.
n
M
Fig 3.4: Ventricular Inhibited Pacemaker [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]
The sensing electrode picks up R-wave. The refractory
circuit provides a period of time for the sensed R-wave. The sensing
circuit detects the R-wave resets the oscillator. The reversion circuit
et
allows the amplifier to detect R wave in the low level SNR. IN the
absence of R wave oscillator in timing circuit delivers pulses at its
preset rate. The timing circuit determines the pulse rate of pulse
generator. The output of timing circuit is fed in to the pulse width
circuit which is an RC network.

Atrial synchronous pacemaker:

It is used for young patient with a mostly stable block.

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Atrial pacing is a temporary pacing and has many uses in physiologic

investigation. It is used in stress testing and coronary artery diseases.
It can act as a temporary pacemaker for atrial fibrillation. The atrial
activity is picked up by a sensing electrode placed in the dorsal wall
of atrium.

ww
w.E
asy
C E
En
gin J
Ae
Fig3.5: Atrial synchronous pacemaker

S measurement]
Atrial sequential Ventricular inhibited pacemaker:
eri
[Source: Leslie Cromwell - Biomedical instrumentation and

ng.
n
M
It has the capability of stimulating both atria and ventricles.
If atrial function falls this pacemaker will stimulate the atriam and
then sense the subsequent ventricular beat. et
DEFIBRILLATOR:
A Defibrillator is an electronic device that creates a
sustained myocardial depolarization of a patient‘s heart in order to
stop ventricular fibrillation or atrial fibrillation. Ventricular
fibrillation is a serious cardiac emergency resulting from
asynchronous contraction of heart muscles. This results from electric
shock or abnormalities of body chemistry.

Types of defibrillators:There are two types of defibrillators based

on electrodes placement
(i) Internal defibrillator
(ii) External defibrillator

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Internal Defibrillator:
It is used when the chest is opened. It uses large spoon
shaped electrodes with insulated handle. Since the electrodes are
direct contact with heart the contact impedance is about 50Ω.

ww
w.E E
Fig3.6: Spoon Shaped Electrode [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]

asy
C
External Defibrillator:
En
gin J
External defibrillator is used on the chest using paddle

Ae
shaped electrodes. The bottom of the electrode consists of a copper
disc and is attached with highly insulated handle.

S eri
ng.
n
M et
Fig3.7: Paddle Shaped Electrode [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
Depending upon the nature of voltage applied the
defibrillators can be divided in to six groups.
1. A.C defibrillator
2. D.C defibrillator
3. Synchronised D.C defibrillator
4. Square pulse defibrillator
5. Double squre pulse defibrillator
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D.C defibrillator
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A.C Defibrillator:
It is the earliest and simplest type of defibrillator. It has
appropriate voltages for both internal and external defibrillation. It
consists of a step-up transformer with various tappings on secondary
side.

ww
w.E
asy
C E
En
gin J
Fig3.8: A.C Defibrillator [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]

Ae
An electronic timer circuit is connected to the primary of the
transformer. The timer connects the output of the electrodes for a

S eri
preset time. The timing device may be simple capacitor and resistor
network which is triggered by a push button switch.
ng.
n
M
D.C Defibrillator:
D.C defibrillator would not produce undesirable side effects
and at the same time it produces normal heart beat effectively.
et
Ventricular fibrillation is terminated by passing a high energy shock
through discharging a capacitor to exposed heart or chest of patient .

In this position the capacitor charges to a voltage set by the

positioning of auto transformer. During the delivery of shock to
patient a push button switch mounted on handle of electrodes
operated. The high voltage switch changes to position B‘and the
capacitor are discharged across the heart through electrodes. An
inductor L‘ is placed in one of the electrode leads so that the discharge
from the capacitor is slowed down by the induced counter voltage.

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Fig3.9(a): D.C Defibrillator(ordinary type) and its output

ww[Source: Leslie Cromwell - Biomedical instrumentation and

E
measurement] Dual Peak D.C Defibrillator:

w.E The passage of high current may damage the myocardium

and the chest wall.

asy
En
gin J C
S Ae eri
ng.
n
M
Fig3.9(b): Dual peak d.c defibrillator [Source: Leslie
et
Cromwell - Biomedical instrumentation and measurement]
Fig3.9(c): output of Dual peak d.c defibrillator [Source:
Leslie Cromwell - Biomedical instrumentation and measurement]
Truncated defibrillator:
In this type the capacitor discharge is adjusted so that the
effective defibrillation is obtained at the desirable low voltage level.
The voltage level of the wave is almost constant but its duration is
extended to obtain the required energy.

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Fig3.10: Truncated defibrillator discharge waveform [Source: Leslie

Cromwell - Biomedical instrumentation and measurement]
Synchronised D.C defibrillator:
ww
E
Defibrillator is a risky procedure since if it is applied

w.E
incorrectly it could induce fibrillation in a normal heart. It is essential
to use a defibrillator with synchronizer circuit.

asy
En
gin J
defibrillator electrocardioscope and pacemaker.
C
Fig. shows the modern d.c defibrillator circuit consisting of

S Ae eri
ng.
n
M et

Fig3.11: Modern D.C Defibrillator Circuit [Source: Leslie Cromwell -

Biomedical instrumentation and measurement]
Working:
1 The electrocardiogram is obtained by means of an ECG

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unit connected to the patient who is going to receive

defibrillation pulse.
2. The switch is placed in the defibrillator mode if ventricular
fibrillation is suspected.
3. The QRS detector in that mode consists of a threshold circuit
that would pass the signal as output if R wave is almost in
electrocardiogram. Otherwise it would not give any output
if wave is present.
4. Meanwhile the medical attendant energizes the switch to
deliver the defibrillation pulse.
5. AND gate ‗B‘ delivers signal to the defibrillator only when
the R wave is absent, provided the signal from medical
ww attendant is also present at one of the two inputs of AND

w.E
6.

asy
gate ‗B‘.

E
If any one of the input is missing then it would not give any

C
output. By this way defibrillator is inhibited and would not
deliver the defibrillation pulse.
7.

J
The fibrillation detector searches the ECG signal for
En
frequency components above 150Hz. If they are present

gin
Ae
fibrillation is probable and detector gives an output signal.
A defibrillator pulse is delivered only if the fibrillation

S
detector produces an output at the same time that the
eri
attendant energizes the switch. This is provided by the AND

8.
gate ‗C‘.
ng.
When AND gate ‗B ‘and ‗C‘ are simultaneously triggering
n
M
the defibrillator the defibrillation pulse is delivered.
Square Wave Defibrillator:
Here the capacitor is discharged through the subject by
turning on a series silicon controlled rectifier (SCR). When
sufficient energy has been delivered to the subject a shunt SCR
short circuits the capacitor and terminates the pulse. The output
et
can be contrilled by varying the voltage on capacitor or duration
of discharge. Defibrillation is obtained at less peak current and
so there is no side effect.

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Analysis:

ww
w.E E
Fig3.12: Equivalent circuit of square pulse
defibrillator and its output waveform [Source: Leslie Cromwell -

asy
C
Biomedical instrumentation and measurement]

J
In fig

En
RD-Internal resistance of defibrillator
RE-electrode skin resistance RT-

gin
Ae
Thorax resistance
The energy in the pulse
EP = VDIDTD

S eri
Where VDID-Instantaneous voltage and current
available from defibrillator pulse
TD-Duration of pulse
Total circuit resistance ng.
n
M
R=RD+2RE+RT
EC = ET + 2 EEL + EDL
Thus ET is dismissed from available due to effects of RD and RE et
Double Square Pulse Defibrillator:
It is used normally after the open heart surgery.
Conventional A.C and D.C defibrillators are producing myocardial
injury during the delivery of shock.

Fig3.13: Double Square Pulse Defibrillator Waveform[Source: Leslie

Cromwell - Biomedical instrumentation and measurement]
If the chest is opened only lower energy electrics shock

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should be given. Instead of 800-1500V in D.C defibrillators here 8-

60V double pulse is applied with a mean energy of 2.4 watt-sec. When
the first pulse is delivered some of fibrillating cells will be excitable
and will be depolarized.

Using double square pulse defibrillator efficient and quick
recovery of heart to beat in normal manner without side
effect like burning of myocardium or inducement of atrial or
ventricular fibrillation.

The double square pulse with required pulse space ratio
can be produced with the use of digital circuits.
Biphasic D.C defibrillator:

ww It is similar to double square pulse defibrillator such that it

E
delivers D.C pulses alternatively in opposite direction. This type of

w.E
waveform is found to be more efficient for defibrillation of
ventricular muscles.

asy
BIO TELEMETRY
Introduction:
En J C
Bio telemetry is electrical technique for conveying

gin
Ae
biological information from a living organism to a location where this
information can be observed or recorded.

S eri
Elements of Bio-telemetry:
The transducer converts the biological signal into electrical

ng.
signal. The signal conditioner amplifies and modifies the signal for
effective transmission.

n
M et

Fig3.13: Block diagram of Bio-Telemetry System [Source:

Leslie Cromwell - Biomedical instrumentation and measurement]
Design of a Bio-Telemetry System:
1. The telemetry system should be selected to transmit the

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bioelectric signals with maximum fidelity and simplicity.

2. There would not be any constraint for living system and
any interference with the living system.
3. The size and weight of the telemetry system should be
small.
4. It should have more stability and reliability.
5. The power consumption should be very small.
6. For wire transmission shielding of cable is a must to reduce
noise level.
Radio telemetry system:
Most biotelemetry systems are involved with radio
transmission and reception of biosignals. There are single channel
ww
and multichannel

w.E
Single channel telemetry system:

asy
biopotential to a remotely located receiver.

C E
A miniature battery operated radio transmitter is connected
to the electrodes of the patients. This transmitter broadcasts the

En
gin J
Ae
S eri
ng.
n
M
Fig3.14: Block Diagram of a Typical Single Channel Telemetry System
[Source:eslie Cromwell - Biomedical instrumentation and measurement]

The only risk of electric shock to the patient is due to the

et
battery powered transmitter. Since it is kept low there is negligible
risk to the patient. The radio frequency used in this system varies
from a few 100khz to about 300mhz. Beyond this frequency range
Attenuation becomes excessive.

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Transmission of Bioelectrical Variables:

In a single channel telemetry system the measurements are made

under any of the two categories.
1. Active Measurements: Here the bioelectric variables
like ECG, EMG, and EEG are directly measured without any
excitation voltage.
2. Active Measurements: Here the bioelectric variables
like blood pressure, temperature, blood flow etc are measured
indirectly using transducer and excitation voltage.
Multi Channel Telemetry System:
Most bio medical experiments need simultaneous

ww
recordings of several signals.

E
There are two types

w.E 1. Frequency division multiplex

2. Time division multiplex

asy
(a) Frequency Division Multiplex System:

J C
Each signal is frequency modulated on a subcarrier

En
frequency. Then these modulated subcarrier frequencies are
combined to modulate the main R.F carrier.

gin
S Ae eri
ng.
n
M et

Fig3.15: Frequency Division Multiplex System [Source: Leslie Cromwell -

Biomedical instrumentation and measurement]
(b) Time Division Multiplex System:
Since most biomedical signals have low frequency

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bandwidth requirements we can use time division multiplex system

by the time sharing scheme.

ww
w.E
asy
C E
En
gin J
Ae
S eri
Fig3.16 : Time division multiplex system
[Source: Leslie Cromwell - iomedical instrumentation and measurement]

The transmission channel is connected to each signal ng.

n
M
channel input for a short time to sample and transmit that signal. Then
the transmitter is switched to next signal channel in a definite
sequence. When all the channels have been scanned once a cycle is
completed and the next cycle will start.
Conditions:
The scanning frequency fn should be at least greater than
et
twice the maximum signal frequency fs.
(ie) fn>2fsmax
If Tn=1/fn=scanning period and tn is the sampling time of each
channel than the maximum no. of channels n=Tn/Tn. Practically the
no. of channels is smaller than ‗n‘ to avoid interference between
channels.

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Telemetry Circuits:
a) Tunnel diode FM transmitter

ww
w.E Biomedical instrumentation and measurement]

asy E
Fig3.17: Single Channel FM Transmitter [Source: Leslie Cromwell -

Tunnel diodes are active devices (TD, BD) and this circuit

C
has higher fidelity and sensitivity. Total weight is about 1.44gm
2

Advantages:


En J
with battery. Size is so small (0.8x0.22 cm ).

gin
Ae
All the signals can be transmitted to a receiver in a normal
hospital environment. No shielded room is needed.

S eri
Interference is greatly reduced
b) Hartley type F.M transmitter:
For the transmission of ECG, EEG and EMG ng.
n
M et

Fig3.18: Hartley type F.M transmitter [Source: Leslie Cromwell -

Biomedical instrumentation and measurement]
In this circuit C1 and L form the tank circuit components of Hartley
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oscillator. C2-coupling capacitor

T1-Driver amplifier transistor T2-
oscillator transistor
The capacitance between the emitter and base of a transistor
is voltage sensitive is used to frequency modulate the carrier.
c) Pulsed Hartley Oscillator:
To measure temperature a thermistor is placed in the place
of R1. To measure pressure the pressure changes should be given to
more the core M‘.

ww The transducers and conditioner are integrated in to

can be obtained by reducing then value of R1.

asy
C E
components of the oscillator-transmitter. Continuous wave operation
w.E
En
gin J
Ae
S eri
ng.
n
M
Fig3.19: Physiological Parameters Telemetering Transmitter
[Source: Leslie Cromwell - Biomedical instrumentation and
measurement]
Advantages:
et
 The circuit is so simple
 Low power consumption from 5µW to 10µW
Limitations:
 In pulse mode operation large error can be produced by
power supply voltage variations.

 Interference can be generated over wide frequency band

because of self blocking pulsed carrier mode operation

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d) Radio telemetry with a sub-carrier:

When the relative position of transmitter changes the carrier
frequency and amplitude will change. This is due to the loading
change of the carrier frequency resonant circuit.

ww
w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M
Fig3.20: Biotelemetry System with Subcarrier [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]
If the signal has frequency different from loading effect they
can be separated by filters. Otherwise the real signal will be distorted
by the loading effect. To avoid this loading effect subcarrier system
is needed. The signal is modulated on a subcarrier to convert the
et
signal frequency to the neighborhood of subcarrier frequency.
Problems in Implant Telemetry:
For long term telemetry implant telemetry is more useful
one. The whole electronic circuit is fully packed as a capsule and then
implanted deep in the body to be closer to the signal source and to
avoid mechanical difficulties of surface mounted units.
The size and weight limitations are much more serious and

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the reliability requirement is more critical.

Power supply: Two special types of power supplies
are used
(i) Environmental power supply
(ii) Microwatt power supply
Uses of bio-telemetry:
1. Biotelemetry helps us to record the biosignals over long periods
and while the patient is engaged in his normal activities.
2. The medical attendants can easily diagnosis the nature of disease
by seeing the telemetered signals without attending the patient‘s
room.

ww
RADIO-PILL:

w.E
transmission of biological signal.

asy
C E
Radio-pill is used in biotelemetry. It is the

En
gin J
Ae
S eri
ng.
n
M
Fig3.21: Block Diagram of Radio Pill [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]
The radio pill is capable of measuring various parameters.
With the help of radio pill type devices, it is possible for use to
measure or sense temperature, pH, enzyme activity, and oxygen
et
tension values. These measurements can be made in associated with
transducers.

TELEMETRY PRINCIPLES:
Design considerations for a telemetry system

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1. Simplicity of the telemetry system

2. Transmission should be with maximum fidelity
3. Telemetry components should be less weight and size
Telemetry system:
Telemetry is defined as the process by which the
information regarding the quantity being measured transmitted to a
remote location for application like data processing ,recording or
displaying

ww
w.E
asy
C E
En
gin J
Ae
S eri
Fig 3.22: Telemetry System [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]

ng.
In other words telemetry means measuring at a distance.
Therefore it becomes essential to transmit data through some form of
n
M
communication channels.
Methods of Classification of Telemetry System:
a) On the basis of the characteristics of electric signal such as
voltage current position ,frequency and pulse
b) Based on form of data transmitted –analog and digital
The physiological quantity to be measured by a suitable detector
et
and given to the transmitter. The electrical telemetry system is
broadly classified as DC systems and AC systems.
DC telemetry system:
The signal is transmitted through a telemetry or
communication channel which uses direct transmission via cables in
order to convey the desired information . This is known as land line

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telemetry.
AC telemetry system:
It is used both for land line and radio frequency air borne telemetry techniques.
Amplitude modulation:
In this type of modulation the amplitude of the carrier is varied in accordance with
the signal to be transmitted.
Frequency modulation:
In this type of modulation the instantaneous frequency of the carrier is varied in
accordance with the amplitude of the modulating signal.
Phase modulation:
Here phase angle is varied in accordance to be transmitted
signal.
FREQUENCY SELECTION:

ww
The radio frequencies normally used for medical telemetry purposes are of the order of
37, 102, 153, 159, 220and 450 MHz.
The transmitter is typically of 50mW at 50Ω., which can give a transition range of about 1.5km
.

w.E
However in medical telemetry system factors such as receiver and antenna design may
make the power and frequency characteristics less significant.
TELE STIMULATION:

asy
C E
Tele stimulations are described for chronic indirect muscle stimulation in caged rabbits
and mice. Both systems use a 5MHz carrier frequency transmission and consist of a transmitter

receiver.
En
gJ
and a receiver. The system for rabbit uses pulse width modulation for transmitting stimulation
and amplitude.

Ain
Duration of the stimulus impulse is generated in the

S eer
i ng.
M net

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UNIT-IV

RADIOLOGICAL EQUIPMENTS

Ionosing radiation, Diagnostic x-ray equipments, use of

Radio Isotope in diagnosis, Radiation Therapy.

INTRODUCTION
X rays are discovered by Rontgen and hence referred to as
Rontgen rays. This type of radiation could penetrate opaque objects
ww
and provide an image of their inner structures.
IONIZING RADIATION
w.E
asy
C E
The radiation originating in the x ray tube or radioactive
materials ionizes the gases through which it travels. Hence it is
termed as ionizing radiation. Non ionizing types of radiation are radio

En
gin J
waves, light and infrared radiation.
X RAY TUBE (Generation of Ionizing radiation)

Ae
X rays are produced by bremsstrahlung radiation. When
the fast moving electron enters in to the orbit of the anode material

S eri
atom, its velocity is continuously decreased due to scattering by the
orbiting electrons.

ng.
n
M et

Fig4.1: X Ray Tube [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]

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Approximately 1% of the electron is converted in to x ray and the

remaining energy is appeared in the form of thermal energy which
may raise the anode temperature. There are proper cooling
arrangements. The x ray generation efficiency is very low and is
given by
ή=

Where z-Atomic number of anode material

The minimum wavelength of the emitted x rays is
given by. =
The intensity of x-rays can be controlled by varying the filament

ww
current. Therefore the quality and quantity of x-rays can be easily

E
controlled.

w.E
X- RAY MACHIN (Diagnostic x-ray equipment):
The basic components of diagnostic X ray machine are

asy
C
power supply arrangement ,X ray tube aluminum filters ,collimator

J
,Bucky diaphragm and lead shield. The various components in the

En
machine are used to improve the quality of the image, increase the
contrast between different tissues ,improve size resolution and
gin
S Ae
minimize the dose of X rays used on the patient ..

eri
ng.
n
M et

Fig 4.2: Diagnostic X Ray Machine [Source: Leslie Cromwell

- Biomedical instrumentation and measurement]

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The contrast between two tissues 1 and 2 is given by

Let -Emergent x-ray intensity from tissue

-Incident x-ray intensity
But I= by Lambert‘s law
Where -density of tissue
s-thickness of tissue
=10
Db

ww
If any one of the tissue absorbs more x-rays then its contrast will be

w.E
to the patient.

asy
High voltage source

C E
more. Sharpness or clarity of the edges of the image is often reduced
due to distortion in the x rays beam as it passes from the x ray tube

J
A high voltage source is an autotransformer which is used

En
to get high voltages from 20 to 200 kV in the X ray machine. There
is a timer which controls the exposure time so that the patient does
gin
not receive an excessive dose.
High voltage rectifier

S Ae eri
X-Ray tube requires a high D.C voltage; due to practical
difficulties a high D.C voltage with small A.C ripples is used. The
ng.
full wave rectifier which gives almost constant beam current with a

n
M
limited ac ripple. But it is not suited because it cannot handle power
in an efficient manner.
et

4.3: Power Supply Single and Three Phase Supply [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]

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The main voltage is stepped up by a high voltage

transformer which is normally an auto transformer. The KV control
gives the necessary input to the x ray tube to produce the required
wavelength of x rays.

ww
w.EBiomedical instrumentation and measurement]

asy
C E
Fig 4.4: Power Supply Arrangement [Source: Leslie Cromwell -

There is a contactor linked with the timer is used to deliver

rectifier.
X Ray Tube
En
gin J
the x ray output in the required time interval. After that it is given to
another high voltage transformer followed by the high voltage

Ae
S
X ray tube is the important element in the x ray machine.
eri
Rotating anode rotates at speeds from 3600 to 10000 rpm by rotating
magnetic fields.
Aluminium Filters ng.
n
M
The emitted x rays contain a broad range of frequencies. The
x rays at unwanted frequencies only increase the patient dose and
decrease the image contrast.
Collimator:
et

Fig 4.5: Collimator [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]

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Between the patient and aluminum filters the collimator is

placed. It is an aperture diaphragm which restricts the beam falling
on the patient.
Bucky Grid:
The Bucky grid is introduced between the patient and the
film cassette to improve the sharpness of image. A grid consists of
thin lead vanes separated by spacers of a low attenuation material.

ww
w.E
asy
C E
En
gin J
Ae
S eri
Fig 4.6: Bucky grid [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
ng.
n
M
VISUALIZATION OF X RAYS
X rays normally cannot be detected by human senses. For
visualization 3 different techniques are in common use.
et
Fluoroscopy
Certain metal salts glowed in the dark when struck by the
radiation. The brightness of this fluorescence is a function of the
radiation intensity and cardboard pieces coated with such metal salts
used to visualize x ray images.
The fluoroscopic image obtained is faint and x ray intensity
to obtain a bright image can be harmful to both the patient and
observer. If the radiation intensity is reduced to a safer level, then the
fluoroscopic image becomes so faint and must be observed in a
completely darkened room.

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X ray film
Although X-rays have a much shorter wavelength than
visible light they react with photographic emulsion. The film that has
been exposed to X-rays shows an image of X-ray intensity. The
sensitivity can be increased by the use of intensifying screens.
Image intensifiers
The faint image of a fluoroscopic screen can be made
brighter with the help of an electronic image intensifier. The

ww intensifier tube contains a fluorescent screen, the surfaces is coated

E
with suitable material to act as a photocathode.

w.E The output image is smaller than the primary fluorescent

image. It is possible to observe the image in a normally illuminated

asy
room.

En
gin J C
S Ae eri
ng.
n
M et

Fig4.7: Image Intensifiers

[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

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SPECIAL TECHNIQUES FOR DIAGNOSTIC X-RAYS

Special techniques must be used to obtain usable
images from certain body structures.
Grids
The x-rays entering the body of patient or actually
scattered and no longer travel in a straight line. If the section
examined is very thick and if the x-rayed area is large, scattered x-
rays can cause a blurring of x-ray image. This effect can be reduced
by the use of a grid or a bucky diaphragm.

ww Foreign bodies and bone absorb the x-rays much more

E
readily than soft tissue. Soft tissue structure of body show very little

w.E
difference in x-ray absorption.
Angiography

asy
C
In angiographic procedures, the outlines of blood vessels are

J
made visible on x-ray image by injecting a bolus of contrast medium

En
directly into the blood stream.
Cardiac Catheterization
gin
S Ae
It is a technique used to diagnose valve deficiencies, septal

eri
defects, and other conditions of heart characterized by hemodynamic
changes. For this, a special catheter is inserted through artery, vein
directly through chest wall into the heart.
Three Dimensional Visualization ng.
n
M et
A basic limitation of x-ray images is the fact that they are
two-dimensional presentations of three dimensional structures. One
organ located in front of another organ frequently obscures details in
the image of other organ.
In Tomography-ray photo shows the structure of only a thin
slice or section of body. Several photos representing slices taken at
different levels permits 3D visualization.

USE OF RADIO ISOTOPE IN DIAGNOSIS

Instrumentation For The Medical Use Of Rodioisotopes
The radiation exposure during x-ray examination occurs
during only a very short time interval. In diagnostic methods

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involving radioisotopes into the body, the exposure time is much

larger and hence the radiation intensity must be kept much smaller to
get a safe radiation dose.
The concentration of radioactive material in an unknown
sample can be determined by comparing the count with a known
standard. Greater accuracy is obtained if the number of
disintegrations counted is high.
The amplitude of output pulse is proportional to the energy
of radiation. This property is used to reduce the background (counts
due to natural activity)by means of a pulse height analyzer.

ww Two types of scintillation detectors are used for the

E
determination of concentration of gamma-emitting radioisotopes.

w.E i. Well counter

C
ii.Collimated detector

asy
i) Well counter

background count.
En
gin J
In the well counter, the scintillation crystal has a hole in to
which a test tube with the sample is inserted. All the radiation from
the sample passes the crystal and is counted. Lead shield reduces the

Ae
S eri
ng.
n
M et

Fig4.8: Well Counter [Source: Leslie Cromwell - Biomedical

instrumentation and measurement]

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ii) Collimated Detector

The lead shield around the scintillation crystal has holes

arranged in such a way that radiation from a source at one particular
point can reach the crystal. Only a small part of radiation coming
from source in front of detector passes the crystal. This detector is
much sensitive than the well counter.

ww
w.E
asy
C E
En
ginJ
Ae
S eri
ng.
n
M
Fig 4.9: Collimated Detector [Source: Leslie Cromwell -
Biomedical instrumentation and measurement]

Instrumentation System for Radioisotope Measurements

The pulses from the photomultiplier tube are amplified and
shortened before they pass through the pulse height analyzer. A timer
et
and gate allow the pulses that occur in a set time interval.
Hydrogen and carbon are the 2 elements that constitute the
largest percentage of all organic substances. With these
radioisotopes, many natural and synthetic substances can be
radioactive and their pathways in the organism can be traced. The
detectors for beta radiation are
i) Planchet counter
ii) Liquid scintillation counter
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ii) Collimated Detector

ww
w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M
Fig 4.10: Instrumentation System for Radioisotope
et
Measurements Detectors for Beta Radiation [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]
i) Planchet Counters
In this, the planchet becomes part of a Geiger Muller
counter. The thin layer in which the sample is spread and its close
contact with electrodes results in high counting efficiency by a flow
of gas that removes ionization products. The sensitivity of planchet
counter is marginal.

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ww
w.E
asy
E ngi
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Fig 4.11: Planchet [Source: Leslie Cromwell

ww
- Biomedical instrumentation and measurement]Counter ii)
Liquid scintillation
w.E
asy
C E
The sample is placed in a small counting vial where it is
mixed with a solvent containing chemical when struck by beta rays.
The vial is placed in a detector which is positioned between 2
photomultiplier tubes.

En
gin J
Ae
S eri
ng.
n
M et
Fig 4.12: Liquid Scintillation [Source:
Leslie Cromwell - Biomedical instrumentation and
measurement] RADIATION THERAPY
The ionizing effect of radiation is used for the treatment of
cancer. The use of radiation for the treatment of diseases has
become an important subfield of medicine called radiation therapy.
There is 3 different types of radiation. Alpha rays are positively

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charged particles that travel at a moderate velocity of 5 to 7 percent of velocity of light. Beta
rays are negatively charged particles and their velocity can vary over a wide range and almost
reach the velocity of light.

ww E=h f

w.E
Where E-energy of radiation (e v) h-planks constant f- frequency

E
The ionizing effects of X rays are utilized in the treatment of certain diseases especially of certain

asy
tumors. In dermatology, very soft x rays are used for the treatment of skin. Soft x rays do not have
enough penetration power to enter more deeply

C
En
gJ
Ain
S eer
i ng.
M net

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UNIT V

RECENT TRENDS IN MEDICAL INSTRUMENTATION

Thermograph, Endoscopy unit Laser in Medicine, Diathermy unit,

Electrical safety in Medical Equipment.
THERMOGRAPH:
Thermography is the process of recording true thermal
images of surface of objects under study. In medicine, it displays
image representing the thermal radiation of skin areas. Thermogram
ww
contains both qualitative and quantitative information relevant to the
image and to temperature.
w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M
Fig5.1: Simplified Block Diagram of a Thermo Graphic
Equipment [Source: Leslie Cromwell - Biomedical
instrumentation and measurement]
Every thermo graphic equipment is provided with a special
et
Infrared camera that scans the object and Display unit for displaying
thermal pictures on screen. The camera contains an optical system in
the form of an oscillating flat plane mirror which scans at a very high
speed and focuses the collected infrared radiation onto the chopper.
The chopper disc interrupts the infrared beam so that A.C signals are
produced, amplified and demodulated further. The demodulated
signals are given to the cathode ray tube in synchronization with
scanning mechanism.
1. Infrared Thermography

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2. Liquid crystal Thermography

3. Microwave Thermography

Infrared Thermography:

Human skin emits infrared radiation as an exponential

function of its absolute temperature and emissive properties of skin
temperature. The radiant energy is emitted in a broad band of
wavelengths with maximum emission dependent upon surface
temperature.

ww Photovoltaic and Photo- conductive infrared radiation

E
detectors are commonly used. The operation of a thermography

w.E
apparatus is as follows. A chopper is inserted infront of a Infrared
radiation detector. Infrared radiation from body and from block

asy
 Short frame time En
A good thermography equipment must have

gin
C
body enters the detector surface through optical focusing system

J
alternately by chopper to compare the both.






High resolution

Ae
A small size and light weight optical head

S
A wide spectrum band detector
eri
ng.
An easy handling instrument in wards or operation rooms
Containing interfaces for image processing

n
M
 Absolute temperature can be measurable
Solid state electronic circuits can achieve the above said
things. There are two types of infrared cameras for medical purpose.
a] High speed b] High resolution.
et
Infra eye, Thermoscope, Thermoviewer, Thermocamera and Infra
vision are of the thermographic equipments.
Liquid Crystal Thermography:
Liquid crystals are a class of compounds which exhibit
colour-temperature sensitivity in cholesteric phase. Scattering effects
with the material give rise to iridescent colours, dominant wavelength
being influenced by very small changes in temperature. The high
temperature sensitivity makes cholesteric liquid crystals useful for
thermal mapping.
i. Red for relatively low temperature.
ii. Violet for high temperature.
In Infrared thermograms violet colour is used to identify low
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temperature regions and the bright colour or red for high

temperature regions
Microwave Thermography:
Microwave emission intensity from skin surface is very
small when compared with infrared radiation intensity. Modern
microwave radiometer can defect temperature change of 0.1k.
Measurement of temperature by this corresponds to radiations from
the skin surface to a depth of several cm.
The error lies in the order of 1-2k. The problem has been

ww
solved by adding artificial microwave noise from the antenna, thus
providing a radiation balance between the receiver and body

w.E  Detector and its response

asy
 Parameters of optical system

C E
surface. Hence a temperature sensitivity of 0.1k could be obtained.
To design a thermographs, we must the choice of

 Scanning mechanism
En J
 Time constant of total system

gin
Ae
 Method of data presentation

S eri
Medical Application of
Thermography i]Health cases

ng.
The distribution of a health person‘s skin temperature is
symmetrical. This is true with regard to head, face & limbs.
n
ii] Tumors

M
In case of benign tumors, difference in temperature with

iii] Inflammation
0
the surrounding tissues is very small, about 1 C.

The area of an acute inflammation shows a high temperature

because of active metabolism and increase in local blood flow.
et
iv] Diseases of Peripheral Vessels
When the arteries are occluded, blood flow of peripheral
vessels either decreases or disappears resulting a low temperature in
that part.
v] Burns and Perniones:
In the treatment of burns and perniones, the first thing to do

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is deciding on their degree of serenity.

vi] Skin Grafts and Organ Transplantation
The condition of skin grafts after transplantation can be
detected by means of local blood flow.
vii] Collagen Diseases
Collagen diseases are usually attended with peripheral
vascular discarders.
viii] Orthopedic Diseases
Fractures, arthritis, bruises and sprains can be easily

ww
diagnosed because the local skin temperature rises in these cases.

E
ix] Brain and Nervous diseases

w.E Temperature distribution can be quantitatively diagnosed by

means of thermogram.

asy
x] Hormone diseases

J C
Thyroid glands normally register high temperature due to

En
their active metabolism. Patients affected with hyper thyrodism have
high temperature.
gin
temperature.
S Ae
xi] Examination of placenta attachment
Detection of location of placenta is possible by means of
eri
thermogram because increase in local blood flow leads to a high

ng.
Notes:Theremography- Heat camera in Medicine‘ is useful as a
n
M
screening procedure and can be used to diagnose breast cancer.
ENDOSCOPES
Optical fibers play a vital role in medical field. Endoscopes
or fiberoscopes are designed with low quality, large diameter and
short silica fibers. Broncho fiberoscopes, gastrointestinal
fiberoscopes and laproscopes are the important endoscopes.
et
Endoscopes are used in hospital for examination, treatment of
diseases and surgery.
There are two types
1. Flexible
2. Rigid
In each endoscope, there are two fiber bundles.
A typical glass fiber consists of a central ‗core‘ glass having

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high refractive index surrounded by a cladding made of glass of slightly

lower refractive index. The numerical aperture (light
efficiency) of the fiber is equal to (n 2 2 1/2 collection -n 2
where
n1 & n2 are refractive index of core and cladding respectively.

Endoscopic Laser Coagulator

It uses argon ion laser as high energy optical source and
endoscope as the delivery unit. Argon ion lasers are very useful for

ww
the coagulation of blood vessels since its green light is highly
absorbed by red blood vessels and hemoglobin.

w.E E
To control gastric haemorrhage photocoagulation technique
is adopted. In fiber optic endoscope, output from argon ion laser is

asy
C
delivered to required spot to arrest the gastric bleeding.

En
gin J
Ae
S eri
ng.
n
M et

Fig 5.2: Endoscopic Laser Coagulation [Source:

Leslie Cromwell - Biomedical instrumentation and measurement]

LASER IN MEDICINE
LASER- Light Amplification by Stimulated Emission of
Radiation Basic principle of laser action. Laser beam consists of high
intense radiation in unique direction without spreading its energy in
other direction. It has high mono chromaticity and high directionality.
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Population of atoms in higher energy level is smaller than

the lower energy level in an atomic system. During population
inversion, the number of atoms in the higher level is more than the
number of atoms in the ground level. This can be done by pumping
source. Assume that there is population inversion such that the atom
in the higher metastable energy level is more.

ww
w.E
asy
C E
En
gin J
Ae
Fig5.3: Laser Principle [Source: Leslie Cromwell - Biomedical

S eri
instrumentation and measurement]
There are two type of emission
1. Spontaneous emission ng.
n
M
2. Stimulated emission
In the case of spontaneous emission, the emission takes place
without any inducement. (i.e) Transition from high energy state to any
lower energy state takes place voluntarily with the emission of
et
polychromatic radiation. A photo emitted by spontaneous emission
has an energy equal to energy difference between laser transmission
levels.
Hence laser output can be obtained. The biomedical
applications of laser are based on the fact that lasers could produce
high photon flux on a localized spot.
The properties of the laser are
 Monochromaticity
 Spatial & Temporal coherence
 Directionality

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 Brightness
When light photons fall on the tissues, four bask optical
processes may occur
i. Direct reflection at the boundaries of the layer due to
change in the refractive index
ii. Scattering by molecules, particle, fibers, cell organelle and
cells within the layer
iii. Absorption

ww iv. Direct transmission through the layer

All the above process depend on

w.E a. Wave of laser

b. Energy density

asy
c. Pulse duration

C E
d. Irradiation time

En
gin J
e. Absorption characteristics of target molecule
The laser photon of wavelength of 600 – 1300 nm can penetrate deep

Ae
into tissues and that fact is used for phototherapy and selective
surgery.

S
Laser Instrumentation
eri
ng.
Laser irradiation of patients with skin tumors is performed
in a specially designed operating unit which consists of three
n
M
It is intended for remote control unit. The operation can be
absorbed by means of a television arrangement.. Lasers are equipped
with water cooling system. The energy of radiation is indicated by
energy meter and the irradiation time is controlled properly by a
timer. The rooms are equipped with warning signal circuits and a
blocking system that presents the laser system from working unless
et
the doors of that room are closed.
Advantages of Laser surgery
a. Highly sterile
b. Highly localized & precise
c. Noncontact surgery
d. Dry field, almost bloodless surgery
e. Clear field of view and easy access in confined areas

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f. Prompt heating with minimal post operative swelting and

scarring

Medical Application of Laser

a) Photothermal Application
Laser heating of tissues is used for two surgical functions.
Cutting and photo coagulation. Cutting was used in ophthalmology.
It is used to treat variety of eye problems, including retinal bleeding,
excessive growth of blood vessels in the eye caused by diabetes and
also for spot welding. Spot-welding - Reattaching retinas from back
surface of eye, choroid.
b) Photochemical Application

ww Laser can be used to diagnose and treat diseases non-

E
surgically. Low power lasers can induce more chemical, enzymatic

w.E
and metabolic changes in human body.

asy
DIATHERMY
Introduction

En J C
Operation theatre equipment are very useful both
diagnostically and therapeutically.They are mainly useful for

gin
monitoring and treatment purpose. During operation, the patient‘s

S
Surgical Diathermy Ae
condition is followed carefully by measuring variable
H
flow velocity, cardiac output, blood pressure, P value.
eri
like blood

ng.
Diathermy is the treatment process by which cutting,
coagulation of tissues are obtained. When high frequency current of

n
M
1-3 MHz is applied, heating of tissues takes place. The evolving
steam bubbles in the tissues continuously rupture the tissues and by
that way cutting action is obtained.
et
The various electro surgery techniques using diathermy unit are
1. Fulguration
When the electrode is held near the tissue without touching
it and due to the passage of electric are, destruction of superficial
tissues take place. It is related to the localized surface level
destruction of tissues. Needle or Ball electrodes are used.
2. Desiccation
The needle point electrodes are stuck into tissue, while
passing electric current a local increase in heat creates drying of

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tissues.
3. Electrotomy
When the electrode is kept above the skin, an electrical are
is sent. The developed heat produces a wedge shaped cutting of tissue
on surface. Continuous R.F current is used for cutting.
4. Coagulation
When the electrode is kept above the skin, high frequency
current is sent through the tissues in the form of bursts and heating it
locally so that it coagulates from inside.
5. Blending
When the electrode is kept above the skin, the separated
tissues can be combined together by an electric arc. This is called

ww
blending.

w.E
asy
C E
En
gin J
Ae
S eri
ng.
Fig.5.4: Different Types of Waveforms used in Electrosurgical
Diathermy Unit
n
M et

Fig5.5: Block Diagram of Electrosurgical Diathermy Unit [Source:

Leslie Cromwell - Biomedical instrumentation and measurement]

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Logic board is the main part of the unit which produces the
necessary waveforms for cutting, coagulation and hemostasis mode
of operation. An astable multivibrator generates 500 KHz square
pulses. The outputs divided into a number of frequencies using binary
counters.
Special Features
(i) To secure safety for the patient or operator, the output
unit is isolated and insulated from the low frequency primary and
secondary voltages.
(ii) The bipolar electrodes are used such that the active
electrode is mounted in an insulated handle and in different electrode
is placed at the back of patient in the form of plate.
ww
E
(iii) The output of the unit may be earth referenced or

w.E
isolated. The isolated output dose not produces any fibrillation and
any serious burns.

C
Short – Wave Diathermy

asy The heating of tissues is carried out at a high frequency of

En
gin J
27.12 MHz and a wavelength of 11 m. By using currents with very
high frequencies, the motor nerves are not stimulated and there is no
contraction of muscles. Thus there is no discomfort to the patient.

Ae
The output of R.F oscillator is applied to the pair of patient
electrodes. The R.F energy heats the tissues and promotes the heating

S
of injured tissues and inflammations.
eri
ng.
When R.F current applied to the pads, the dielectric loss of

n
M
the capacitor produces heat in the intervening tissues. This technique
is called condenser or capacitor method. In inductive method, a
flexible cable is coiled around the arm. et

Fig5.6: Block Diagram of Short Wave Diathermy Unit [Source: Leslie

Cromwell - Biomedical instrumentation and measurement]

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Instead of continuous R.F wares, R.F pulses of 65 µs with

on interval between pulses of 1600 µs are also used. This is called
Dia-pulse shortwave diathermy.
Microwave Diathermy
The frequency used is 2450MHz and wavelength of 12.25
cm. heating of tissues is produced due to adsorption of microwave
energy. Better therapeutic results are obtained by using microwave
diathermy than short wave diathermy. There is no pad shaped
electrode. Microwaves are transmitted into the body directly.
Magnetrons are used to produce microwaves.
Ultrasonic diathermy

ww Ultrasonic therapy is used where short wave treatment is

to cure the diseases of peripheral nervous system.

asy
C E
failed and where localization of heat effect is desired. It is very helpful
w.E
En
gin J
Ae
S eri
Fig5.7: Block Diagram of an Ultrasonic Diathermy Unit [Source: Leslie
Cromwell - Biomedical instrumentation and measurement]
ng.
R.F oscillator produces a high frequency alternating current
n
M
which excites the piezo electric transducer. The ultrasonic waves can
be applied in contained or pulsed mode. In
ELECTRICAL SAFETY IN MEDICAL EQU PMENTS
The physiological effects or shock range from discomfort to
injury to death, if the heart or respiratory systems are affected. An
electrical shock is an unwanted physiological response to current.
et
Microshock and Macroshock
Macroshock
A physiological response to a current applied to the surface
of the body that produces unwanted stimulation like muscle
contractions or tissue injury is called macroshock. All hospital
patients and medical attendants are exposed to macroshock from

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defective electric devices and biomedical equipment.

Microshock
A physiological response to a current applied to the surface
of heart that results in unwanted stimulation like muscle contraction
or tissue injury is called microshock.
Electrical Accidents in Hospitals.
One of the main hazards connected with the use of medical
equipment is electrical shock. A macroshock may cause secondary
injury to a limb of technician repairing equipment, such as acts on

ww
hand as the person pulls away from equipment.

w.E
asy
Table 5.4: skin Resistance at 50 Hz

Condition

C E
Skin resistance per
Square Centimeter of

J
Electrode
Dry Skin
En
Electrode gel on skin
93.0k Ω
10.8k Ω
gin
Penetrated skin

S Ae 200.0Ω

eri
All electrical and electronic devices in the hospitals are

ng.
sources of potentially harmful current. The electrical power has
consists of three wires a hot wires H‘, a neutral wire N‘and a ground

n
M
wire G‘.
Microshock hazards
Many devices have a metal chassis and cabinet that can be
touched by the medical attendants and patients. If they are not ground
et
then an insulation failure or short circuit result and leads to
macroshock or microshock.
a) Leakage currents
Most of the accidents occur due to improper grounding and
leakage currents, the leakage currents are an extraneous current
flowing along a path. This dangerous accident arises because of
open ground of the pacemaker by using a two wire extension cord.
The leakage current flow is due to
 Undergrounded equipment
 Broken ground wire
 Unequal ground potential
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Fig5.8: Microshock due to leakage current [Source: Leslie Cromwell -

Biomedical instrumentation and measurement]
Even if the three wire (H, N, G) power cord is used with the

ww broken ground wire connection, then the above accident could be

E
occurred. For example the doctor it holding a pacemaker wire by his

w.E
one hand touching the electrical bed frame by his other hand as shown
in fig.

asy
En
ginJ C
S Ae eri
ng.
n
M
Fig5.8: Microshock for the Patient from the Broken Ground Wire
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]
Broken ground connection on the electric bed allows a
voltage to exist on the frame due to capacitive coupling between bed
et
frame and power line. The pacemaker wire is going into the heart of
patient.
b) Static Electricity
Static electricity may be dangerous to people and sensitive
equipment having integrated circuit. Sparks from static electricity
could ignite flammable gases causing an explosion. Shocks from
static electricity could cause cardiac arrest if applied to a pacing
catheter. Floor carpeting is very common source of static electricity

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charge buildup.

ww
w.E
asy
C E
En
gin J
Ae
Fig5.8: Microshock from static electricity
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

S
c) Interruption of Power
eri
ng.
n
Interruption of electrical power to life support equipment

M
can also be hazardous. If a delay occurs before emergency power is
brought into operation, the failure of a respirator monitor,
defibrillator, pacemaker can be fatal.
Macroshock hazards
Macroshock occurs more often with two-wire system than
with three-wire system. If the patient touches H and N wires
et
simultaneously with two limbs, then the currents are flowing directly
through vital organs of circulation and respiration. N wires are
internally grounded, hence touching H and G wires can produce
macroshock.

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ww
w.E
asy
C E
En
gin J
Ae
S eri
ng.
n
M
Fig5.9: Microshock Situations in the Case of Two Wire Units
[Source: Leslie Cromwell - Biomedical instrumentation and measurement]

Fig illustrates additional hazardous situations that result

et
from faults which occur in the equipment. In part (a), H lead shorts to
patient lead P. Thus a macroshock result if the patient touches ground
or chassis.

DEVICE TO PROTECT AGAINST ELECTRICAL HAZARDS

Several devices are available to protect patient and health
care workers from hazardous electrical currents.

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Ground Fault Interrupter

A ground fault interrupter (GFI) protects against a shock
that occurs if a person touches the hot lead with one hand and ground
with the other.

ww
w.E
asy
instrumentation and measurement]
When the system is normal IN = IH

C E
Fig5.10: Ground Fault Interrupts [Source: Leslie Cromwell - Biomedical

En
gin J
The magnet flux φ in the coil cancels.
Sensing coil does not have a voltage induced in it When the hot

Ae
lead faults or is touched by a person, the
fault current. If is shunted to ground. IN = I H - IF

S eri
I is not equal to I
The corresponding fluxes in the coil are unequal and a net
ng.
flux exists in the coil which induces a voltage into sensing amplifier.

n
M
Isolation Transformer
Isolation transformer provides a second means of protecting
against an H lead to G-lead macro shock. It prevents sparks when H
et
lead touches ground, particularly protection in an explosive or
flammable environment. Fig (a) shows that a fault such as a short
circuit from either secondary lead of transformer to ground will carry
no current.

Fig 5.11: An Isolation Transformer

[Source:Leslie Cromwell - Biomedical instrumentation and measurement]

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Line Isolation Monitor:

A line isolation monitor (LIM) puts relatively large

impedance from either secondary lead through an ammeter to ground
of isolation transformer. If there is a conductive path through the
equipment as shown in fig (b) the meter in the LIM will read a current.

ww
w.E
asy
C E
En
gin J
Ae
Fig 5.12: An Isolation Transformer Connected to a

S eri
Line Isolation Monitor and Other Equipment [Source: Leslie

ng.
Cromwell - Biomedical instrumentation and measurement]

n
M et

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QUESTION BANK

SUBJECT : EC 8073 – MEDICAL ELECTRONICS

SEM / YEAR: V / III year B.E.

UNIT I - ELECTRO-PHYSIOLOGY AND BIO-POTENTIAL RECORDING

Sources of bio medical signals, Bio-potentials, Biopotential electrodes, biological amplifiers, ECG, EEG,
EMG, PCG, typical waveforms and signal characteristics.

Q. No ww Questions
PART A
BT Level Competence

1.
w.E
List the types of bioelectric potentials. BTL 1 Remembering

E
2. Summarize electrode and the types of electrodes used in the bipolar measurement. BTL 2 Understanding
3.
4.
asy
Define Lead. Name the type of leads used for ECG.
Differentiate micropipette and metal microelectrode.
BTL 1
BTL 2
Remembering
Understanding
5.
6.
7.
8.
How would you describe the term Conduction velocity?

En J
List out the disadvantages of surface electrodes.
Name the electrodes used for recording EMG and ECG?

g
C BTL 1
BTL 4
BTL 1
Remembering
Analyzing
Remembering

Ainee
Construct the typical ECG waveform and mention the cause for first & second heart BTL 3 Applying
Sounds.
9.

S
Examine the term phonocardiogram. BTL 4 Analyzing
10. Assess the important bands of frequencies in EEG & their importance. BTL 5 Evaluating
11.
12.
Distinguish the signal characteristics of ECG and PCG.
Show the EMG signal characteristics.
rin BTL 4
BTL 2
Analyzing
Understanding
13.
14.
15. M
Define relative refractory period.
Describe the latency related to EMG.
Compose biological amplifier.
g.n
e
BTL 6
BTL 2
BTL 6
Creating
Understanding
Creating
16.
17.
18.
Name the 10-20 lead system used in ECG recording.
State the importance of PCG signals.
Justify the use of Einthoven triangle.
BTL 1
BTL 1
BTL 5
t
Remembering
Remembering
Evaluating
19. Choose the various EEG signals with amplitude and frequencies. BTL 3 Applying
20. Identify the importance of biological amplifier. BTL 3 Applying
PART – B
1. (i) What should be the characteristics of bio potential amplifier? (8) BTL 1 Remembering
(ii) Show with necessary diagram the origin of bio potential. (5)
2. (i) Analyze in detail about the 10-20 lead system of recording EEG. (8) BTL 4 Analyzing
(ii) List the typical ECG waveform and mark the important features and their
associated function of the heart. (5)

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3. (i) Give an account on surface electrode and state its application. (5) BTL 2 Understanding
(ii) Explain different lead system used in an ECG recorder. (8)
4. Identify and describe the different types of bio potential electrodes used in BTL 1 Remembering
measurement of bio signals. (13)
5. (i) Compare the signal characteristics of ECG and EMG. (7) BTL 5 Evaluateing
(ii) Measure the heartbeat using ECG recording system in detail. (6)
6. (i) How a metal microelectrode is formed? Draw its electrical equivalent BTL 1 Remembering
circuit and explain. (7)
(ii) Show the circuit diagram of Darlington pair isolation amplifier and
explain. (6)
7. Construct the characteristics of EMG and EOG signals with typical waveform. BTL 3 Applying
(13)
8. (i) Explain the medical use of Chopper amplifier? Draw the diagram of BTL 2 Understanding
mechanical Chopper amplifier and explain its working? (7)
(ii)Illustrate the ECG curves for normal adult, myocardial infraction, coronary

9.
ww insufficiency and ventricular fibrillation.
Develop the EEG waveform in detail and its signal frequency bands.
(6)
(13) BTL 6 Creating

w.E
10. (i) Pointout the different requirements for biomedical amplifiers?
(ii) Examine the characteristics of a medical preamplifier with neat diagram
(4) BTL 4 Analyzing

E
and deduce an expression for its net gain. (9)

asy
11. (i) Examine the action potential waveform and discuss about polarization and BTL 1 Remember

C
repolarization. (8)
(ii) Show the bipolar limb lead system of an ECG. (5)

about half cell potential. En J

12. (i) Draw the equivalent circuit of biopotential electrode interface and explain
(5)
BTL 2 Understanding

g
Ainee
(ii) List out the advantage and disadvantage of biopotential measurement.
(8)
13.
system equivalent to the same.
S
Infer the physiology of heart and lungs and derive an approximate engineering BTL 4 Analyzing

rin
14. Illustrate an ultrasonic transducer is applied in clinical diagnostic circuit.
(13)
BTL 3 Applying

M PART – C
1. Design a suitable amplifier that can be used in the front end of an ECG
g.n
(13)

e BTL 5 Evaluating

2.
machine. Justify your by specifying the features of the selected amplifier. (15)
(i) Summarize the instrumentation amplifier with circuit diagram.
(ii) Evaluate the origin of brain waves.
t
(8) BTL 5 Evaluating
(7)
3. (i) Generalize the international standard 12 lead system used to record ECG. BTL 6 Creating
(10)
(ii) Formulate the list and discuss the important characteristics of bio-amplifier.
(5)
4. (i) Invent the different types of surface electrodes and discuss its applications. BTL 6 Creating
(10)
(ii) Elaborate the steps for the typical recording setup of EMG with
diagram. (5)

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UNIT II - BIO-CHEMICAL AND NON ELECTRICAL PARAMETER MEASUREMENT

pH, PO2, PCO2, Colorimeter, Blood flow meter, Cardiac output, respiratory, blood pressure,
temperature and pulse measurement, Blood Cell Counters.
PART A
Q.No Questions BT Level Competence
1. State the principle behind Rheographic method of blood pressure measuring BTL 1 Remembering
technique.
2. Justify the meaning of pH value of blood. BTL 5 Evaluating
3. Infer the measurement method of PO2 and PCO2. BTL 2 Understanding
4. Define stroke volume of heart. BTL 1 Remembering
5. Identify the use of auto analyzer in medical field and types of test performed BTL 3 Applying
using it.
6.
7. ww
Elaborate the principle used in pulse rate measurement.
What is colorimeter? State its use.
BTL 6
BTL 1
Creating
Remembering
8.
w.E
Summarize the merits & demerits of electromagnetic blood flow meter. BTL 2 Understanding

9.
10.
constructed.
asy
Examine auto fiber optic temperature sensor.

En J C E
Name any 4 physical principles based on which blood flow meters are
BTL 4
BTL 2
Analyzing

Understanding

g
11. What are the typical values of blood pressure and pulse rate of an adult. BTL1 Remembering
12.

13.
14.
Ainee
Develop the stroke volume in millimeters if the cardiac output is 5.2
litres/minute and heart rate is 76 beats/minute.

S
Demonstrate the methods of measurement of cardiac output.
List out the components of blood.
rin
BTL 3 Applying

BTL 2 Understanding
BTL 4 Analyzing
15.
16. M
Assess the use of Flame photometer.
Describe the cardiac output. What are the methods used to measure cardiac
output?
g.n
e
BTL 5 Evaluating
BTL 1 Remembering

17.
18.
Compile the demerits of indirect method of blood pressure measurement.
Organize the importance of Plethysmographs.
BTL 6 Creating
BTL 3 Applying
t
19. How is the respiration rate measured? BTL 1 Remembering
20. Analyze the term “Korotkoff sounds” and total lung capacity. BTL 4 Analyzing
PART – B
1. Examine the principle of following: BTL 4 Analyzing
(i) Filter Photometer (7)
(ii)PO2 measurement (6)
2. Explain the following techniques with necessary diagram: BTL 2 Understanding
(i) pCO2 measurement principle (7)
(ii) Dye dilution (6)
4

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3. Discuss about the measurement of pH and pO2 of the blood with the help of BTL 6 Creating
neat diagram. (13)
4. How would you describe about spirometer and blood cell counter with neat BTL 1 Remembering
block diagram. (13)
5. Interpret the working principle of electromagnetic blood flow meter. What are BTL 2 Understanding
its advantages and disadvantages? (13)
6. Explain the different techniques used in the measurement of pulse rate. (13) BTL 2 Understanding

7. Describe in detail the principle of calorimeter with neat diagram. (13) BTL 1 Remembering

Explain the working principle of conductive method blood cell counter

8. with its construction details. (13) BTL 5 Evaluating

9. (i) Analyse the measurement of pH of blood using PH meter. (7) BTL 4 Analyzing
(ii) Classify the temperature measurement methods. (6)
10.
ww
Inspect the parameter with suitable figures and explain how pH, pCO2 and pO2
are measured? (13)
BTL 4 Analyzing

11.
w.E
(i) Identify the method for cardiac output measurements.
(ii) Construct the need for blood pH measurement.
(9)
(4)
BTL 3 Applyv

12.

13.
How would you use the ultrasonic waves in measuring,
(i) Blood Flow
(ii) Blood pressure
asy
En J C E
(i) Which device is used to measure the Lung capacity and volume with neat
diagram and explain its operations?
(7)
(6)

(7)
BTL 3 Applying

BTL 1 Remembering

14.
g
(ii) Show the measurement of heart sound with suitable diagram.

Ainee
(6)
(i) What is the principle of sphygmomanometer and explain the operation? (7)
(ii) How is the pulse rate measured? (6)
BTL 1 Remembering

S PART – C
rin
M
1. Assess the principle of coulter counter and with block diagram explain multi BTL 5 Evaluating
parameter coulter counter.
g.n
(15)
Summarize the different types of ultrasonic blood flow meter? Explain each in
2.

3.
detail.

Invent the term “Cardiac output”. How is Cardiac output measured by dye
e
(15)

t
BTL 5 Evaluating

BTL 6 Creating
dilution technique? Explain. (15)
4. Develop auscultatory blood pressure measurement and write its advantages and BTL 6 Creating
disadvantages. (15)

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UNIT III ASSIST DEVICES

Cardiac pacemakers, DC Defibrillator, Dialyser, Ventilators, Magnetic Resonance Imaging Systems,
Ultrasonic Imaging Systems.

PART A
Q.No Questions BTL Competence
Level
1. Interpret the need for using a cardiac pacemaker. BTL 2 Understanding
2. What are the two parts of pacemaker? BTL 1 Remembering
3. Classify the types of Pacemaker. BTL 2 Understanding
4. List the types of batteries used for implantable pacemaker. BTL 1 Remembering
5. Why do we require a synchronization function in defibrillator? BTL 1 Remembering
6.
ww
Differentiate internal and external defibrillator. BTL 4 Analyzing
7.
w.E
Draw the schematic diagram of a d.c defibrillator. BTL 3 Applying

E
8. Define LVAD. BTL 1 Remembering
9.
asy
State dialysate and mention its composition. BTL 1 Remembering
10.

11.
Infer the function of membrane in the dialysis process.

En J C
Inspect the mechanism of respiration and need for use of artificial
ventilation.
g
BTL 2

BTL 4
Understanding

Analyzing

12.

13.
Write the function of a ventilator.

SAinee
Calculate the energy stored in 16  F capacitor of a DC defibrillator
that is charged to a potential of 5000Vdc.

rin
BTL 1

BTL 5
Remembering

Evaluating

M
14. Identify the types of imaging sequences. BTL 3 Applying
15. Deduct the basic components of an NMR imaging system.
g.n
BTL 6 Creating
16.

17.
Evaluate the biological effects of MRI imaging modality.
List the advantages of Nuclear Magnetic Resonance and ultrasonic
imaging system.
e
BTL 5

BTL 4
Evaluating

t
Analyzing

18. Express characteristic impedance in ultrasound. BTL 3 Applying

19. Summarize the advantages of an ultrasound imaging system. BTL 2 Understanding
Explain the role of frequency, focusing and active element diameter
20. BTL 6 Creating
with reference to ultrasound transducers.
PART B
(i) How pacemakers are classified based on the modes of operation? (6)
1. (ii) Show the block diagram of stand by and demand pacemakers and BTL 1 Remembering
explain its working principle. (7)
Illustrate the following types of pacemakers with diagram.
2. (i) Demand pacemaker. (6) BTL 2 Understanding
(ii) Atrial Synchronous pacemaker. (7)

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Explain the heart lung machine with neat block diagram and discuss
3. BTL 3 Applying
about the different types of oxygenators. (13)
(i) Propose the difference between haemodialysis and peritoneal
dialysis. (6)
4. BTL 6 Creating
(ii) Elaborate about a haemodialysis machine with the help of block
diagram. (7)
(i) Demonstrate the principle and operations of DC defibrillators. (8)
5. BTL 3 Applying
(ii) Identify the advantages and disadvantages of DC defibrillator. (5)
Write a brief note on:
6. (i) Implantable defibrillator. (6) BTL 1 Remembering
(ii) LVAD. (7)
Elaborate the principle of Nuclear Magnetic Imaging system with the
7. BTL 6 Creating
help of appropriate illustrations. (13)

8.
ww
Draw a block diagram of microprocessor controlled ventilator and
analyze the importance of each block. (13)
(i) Interpret the image reconstruction techniques used in NMR imaging.
BTL 4 Analyzing

9.
w.E (8) BTL 4 Analyzing

E
(ii)What is the commonly used method in modern scanners. (5)

asy
(i) Estimate the various imaging modes of ultrasound imaging system.
(8)

C
10. BTL 5 Evaluating
(ii)Distinguish between ‘A’ and ‘B’ mode of ultrasound imaging
system.
En J
Write the function of a ventilator. How many types of ventilators are
(5)

11.
there? Explain with the help of diagrams.
g
Ainee
(13)
(i) Outline the significance of relaxation process in MRI imaging and
BTL 1 Remembering

12. compare T1 and T2 relaxation times.

(ii) Discuss about FID.
S (7)
(6)
rin
BTL 2 Understanding

13.
basic pulse- echo apparatus.
M
Describe with the help of a diagram the various building blocks of a
(13)
Discuss the working principle of linear array scanner with the help of a
g.n
BTL 2

e
Understanding

14. block diagram.

PART C
(13) BTL 4 Analyzing
t
(i) Deduct the various types of implantable pacemakers and explain
their functions with necessary diagrams. (10)
1. BTL 5 Evaluating
(ii)Demonstrate the two types of electrode system used in implantable
pacemaker. (5)
Evaluate the principle of dialysis in the artificial kidney. What are the
2. different types of dialyzers? Explain their construction and principle of BTL 5 Evaluating
operation. (15)
Elaborate a real time ultrasound imaging system. What are the special
3. BTL 6 Creating
requirements of real time imaging systems? (15)

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Discuss the following in detail
4. (i) Intravascular imaging. (7) BTL 6 Creating
(ii) Tissue harmonic imaging. (8)
UNIT IV PHYSICAL MEDICINE AND BIOTELEMETRY
Diathermies- Shortwave, ultrasonic and microwave type and their applications, Surgical Diathermy,
Biotelemetry.
PART A
BTL
Q.No Questions Competence
Level
1. Write the principle of high frequency heat therapy. BTL 1 Remenbering
2. State the term Diathermy. BTL 1 Remenbering
3. Draw a circuit diagram of a short wave diathermy unit. BTL 4 Analyzing

4. Why do require automatic tuning in a short wave diathermy machine? BTL 6 Creating

5.
ww
Analyze the features of Ultrasonic type diathermy. BTL 4 Analyzing
6.
w.E
Define desiccation and haemostasis. BTL 1 Remembering

E
7. Show a block diagram of an ultrasonic therapy unit. BTL 2 Understanding
8.
asy
List the applications of diathermy. BTL 1 Remembering
9.

10. En J C
Identify two main circuits in a short wave diathermy machine.
Interpret the various ways of regulating the intensity of current

g
supplied to the patient from a short wave diathermy machine.
BTL 2

BTL 3
Understanding

Applying

11.
12.

13.
Ainee
Classify shortwave and microwave diathermy.

S
What are the two designs of applicators in microwave diathermy?
Compare the heat distribution in the body tissues with short wave and
rin
BTL 4
BTL 1

BTL 5
Analyzing
Remembering

Evaluating

M
microwave Diathermy.

14.
Evaluate the common modulation methods used in biotelemetry
system. g.n
BTL 5 Evaluating

15.

16.
Discuss the applications of Bio-Telemetry.
Organize the choices of radio carrier frequency for medical telemetry
purposes.
e
BTL 6

BTL 3
Creating

Applying t
17. Construct a block diagram of ECG telemetry transmitter. BTL 3 Applying
18. Outline various components of the radio telemetry system. BTL 2 Understanding
19. Summarize the different elements in Bio-Telemetry. BTL 2 Understanding
20. How do we control the dosage in ultrasonic therapy units? BTL 1 Remembering
PART B
Define diathermy. Draw the circuit diagram of a short-wave diathermy
1. unit and discuss its impact on therapy purpose in detail. Also briefly BTL 1 Remembering
describe how it can be applied to human subjects? (13)

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(i) Interpret the application techniques in short- wave diathermy
2. machines. (8) BTL 2 Understanding
(ii) Why the pulsed therapy is preferred? (5)
(i) Explain the principle of heating using microwaves. (5)
3. (ii) Elaborate the working of microwave diathermy machine with BTL 6 Creating
the help of a simplified circuit diagram. (8)
(i) With a block diagram, evaluate the working function of ultrasonic
therapy. (8)
4. BTL 5 Evaluating
(ii) what are the advantages of using ultrasonic for therapeutic
purposes? (5)
Illustrate the following with respect to ultrasonic therapy unit
5. (i) Dosage control. (6) BTL 2 Understanding
(ii) Application technique. (7)
(i) Summarize the modulation and coding techniques used in bio-

ww
telemetry system. (5)
6. BTL 2 Understanding
(ii) Demonstrate the working of pulse width modulator system with a
help of circuit diagram. (8)

7.
w.E
Describe the working principle of single channel ECG telemetry
BTL 1 Remembering

E
system with a block diagram. (13)

asy
(i) Analyze which type of modulation system is used in a
8.
multichannel bio-telemetry system?

multichannel bio-telemetry systems.

En J
(ii) Explain the multiplexing methods commonly used in

g
C (5)

(8)
BTL 4 Analyzing

Ainee
How to transmit bio-signals over telephone lines? Explain a single
9. BTL 1 Remembering
channel telephone telemetry system with the help of a diagram. (13)

10.
Write a brief note on:
(i) Telemetry of ECG and Respiration.
(ii) Multi Patient Telemetry. S (6)
(7)
rinBTL 1 Remembering

11.
M
Draw a block diagram of a generalized FM telemetry transmitter and
receiver and discuss the working in detail. (13) g.n
BTL 3

e
Applying

12.

13.
Experiment an implantable blood flowmeter based on ultrasonic
Doppler shift principle.

block diagram of the internal radio telemetry capsule.

(13)
Examine the various components of the radio telemetry system with a
(13)
BTL 3

BTL 4
Applying

Analyzing
t
Inspect biotelemetry application on WIMAX networks with necessary
14. BTL 4 Analyzing
diagrams. (13)
PART C

Evaluate the various types of High frequency heat therapy for healing
1. BTL 5 Evaluating
injured tissues. (15)
Explain the different methods of applying electrodes in shortwave
2. BTL 5 Evaluating
diathermy treatment. (15)
Develop an implantable telemetry system for flow, pressure and ECG
3. BTL 6 Creating
measurements. (15)

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Elaborate the working of three channel telephone transmitter and
4. BTL 6 Creating
receiver with the help of a block diagram. (15)

UNIT V RECENT TRENDS IN MEDICAL INSTRUMENTATION

Thermograph, endoscopy unit, Laser in medicine, cryogenic application, Introduction to telemedicine.

Telemedicine, Insulin Pumps, Radio pill, Endomicroscopy, Brain machine interface, Lab on a chip.
PART A
BT
Q. No Questions Competence
Level
1. Define BMI. BTL 1 Remembering
2. Analyze the principle of BMI method and list its applications. BTL 4 Analyzing
3. Give the advantages of Insulin pumps. BTL 2 Understanding
4. List out the feature of lab on chip. BTL 1 Remembering

ww
5. Develop some few applications BMI based system.
6. Label the parts of an endomicroscopy.
7. Summarize the necessary Parameters of cell signaling in the CNS.
BTL 3 Applying
BTL 1 Remember
BTL 2 Understanding

w.E
8. Identification the framework of BMIs. BTL 3 Applying

E
9. Mention the advantages of performance of lab on chip module. BTL 4 Analyzing

asy
10. Show any one of the implantable infusion system. BTL 1 Remembering

C
11. Illustrate the uses of component used in an implantable insulin pump. BTL 2 Understanding
12. Can you recall the principle of telemedicine? BTL 1 Remembering
13. Write the working principle of radio pill.
En J
14. Illustrations of condition number and nonstationary properties of the
BTL 1 Remembering

input autocorrelation matrix.

g
Ainee
15. Discuss the applications passive pumping device of LOC.
BTL 3 Applying
BTL 6 Creating

S
16. Compare the merits and demerits of various feature of BMI.
17. Outline the simplified block diagram of insulin pump equipment.
18. Point out the applications of Endomicroscopy method.
BTL 5 Evaluating
BTL 2 Understanding

rin
BTL 4 Analyzing

M
19. Conclude the applications of telemedicine in health care.
20. Justify the term Telemedicine for remote diagnosis and treatment in
hospital.
BTL 6 Creating

g.n
BTL 5 Evaluating

e
1.
block diagram.
PART – B

Explain the telemedicine based communication method with a suitable

(13)
BTL 5 Evaluating
t
Describe the working principle of implantable type infusion system.
2. BTL 1 Remembeing
(13)

Summarize the need for each of the essential components in an

3. BTL 2 Understanding
endmicroscope & its applications. (13)
Discuss on the design procedure involve in the BMI with neat diagram.
4. (13) BTL 6 Creating

Categorize the detailed description of about infusion pumps system.

5. BTL 4 Analyzing
(13)

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(i) Demonstrate about radio pills explain with necessary diagram. (9)

6. BTL 2 Understanding

(ii) Give some applications radio pills in recent trend medicine field.(4)

(i) Illustrate the different operations performed using endomicroscopy.

7 (5) BTL 3 Applying
(ii) Develop and explain the block diagram of LOC. (8)
Show the various component used in an implantable insulin pump.
8. BTL 1 Remembering
(13)
(i) Define the nonlinear mixture of competitive linear models in BMI.
(7)
9. (ii) Can you recall about Reaching task neuronal sensitivities sorted BTL 1 Remembering
from minimum to maximum for a movement in Sensitivity-Based

ww
10.
Pruning.
(i) List out the LOC applications.
(6)
(8)
BTL 4 Analyzing

w.E
(ii) Inspect the salient features of Insulin pumps.
Write brief notes on the working principle of:
(5)

11.

12.
(i) Programmable volumetric infusion pump.

asy
(ii)Drop rate counter type infusion system

En J C E
Construct and discuss the working of an endomiroscopic unit. (13)

A LOC how to diagnosis HIV. Find out design procedure for HIV test
(7)
(6)
BTL 1 Remembering

BTL 3 Applying

13. BTL 4 Analyzing

using LOC.

i) Write notes on BMI. g

Ainee
(13)

(5)
14.

S
ii) Explain how telemedicine helps the patients and medical
practitioners.
rin
(8)
BTL 2 Understanding

M g.n
e
1.
PART – C
(i) Explain the various type of insulin pups system in recent trend
medicine. (10)
BTL 5 Evaluating t
(ii) Conclude the specific advantages of insulin pumps. (5)
BTL 5 Evaluating
(i) Summarize the benefits and limitations of telemedicine. (7)
2.
(ii) Assess the importance of LOC in recent trend medicine. (8)
Elaborate the principle of operation and application of Radio pill. (15) BTL 6 Creating
3.
Compile the basic application of BMI to implement different motor BTL 6 Creating
4. function interconnection between brains to hand and leg. (15)

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UNIT-1 ELECTRO-PHYSIOLOGY AND BIO-POTENTIAL RECORDING

PART A

1. State all or none law in respect of cell biopotential.

Regardless of the method of excitation of cells or the intensity of the stimulus, which is assumed to be greater than
the threshold of stimulus, the action potential is always the same for any given cell. This is known as ‘all or none
law’.
2. Define the term Conduction Velocity.
The rate at which an action potential moves down a fiber of a nerve cell or is propagated from cell to cell is called
the propagation rate (or) conduction velocity. The conduction velocity is defined as V =[ (l1 – l2 ) / (t1 – t2)] .The

ww
conduction velocity in peripheral nerves is normally 50m/s.

w.E
3. Draw a typical ECG waveform.

asy
En J C E
g
Ainee
4. State how a phonocardiogram and an electrocardiogram signals differ in their clinical
information.
S rin
In electrocardiography, only the voltage generated by the electrical activity of the heart is recorded. Any form of

M
arrhythmia (disturbance in the heart rhythm) can be easily diagnosed using electrocardiogram.

g.n
The graphic record of the heart sounds is called phonogram. Because the sound is from the heart, it is called as
phonocardiogram. The basic aim of phonocardiograph is to pick up the different heart sounds, filter out the heart
sounds and to display them.
e t

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5. Define resting and action potential.

The membrane potential caused by the different concentration of ions is called as resting potential of the cell. The
positive potential of the cell membrane during excitation is called as action potential and it is about 20mV.
6. Define Latency as related to EMG.
Latency is defined as the elapsed time between the stimulating impulse and the muscle‟s action potential.
7. List the names and frequency bands of EEG signals
The names and frequency bands of EEG signals are
Alpha waves - 8-13 Hz
Beta waves - 13-30Hz
Theta waves - 4-8 Hz
Delta waves - 05-4 Hz
8. What is the importance of PCG Signal ?
The importance of PCG signals are
1. Different types of heart sounds are measured.
2. Due to vibration setup in the blood inside the heart by sudden closure of valves

ww 3. Additional sounds are hard between normal heart sounds.

9. Mention the importance of biological amplifier.
Generally, Bio signal are having low amplitude and low frequency .so, amplifier are needed to boost the

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amplitude level of the bio signals. These amplifiers are known as bio- amplifiers.

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10. Mention the various lead systems used in ECG recording.

asy
The various lead system used in ECG recording are
(i) Bipolar limb lead/standard lead
(ii)Augmented unipolar limb lead
(iii) Chest lead/precordial lead
En J
(iv)Frank Lead system/corrected orthogonal lead system.

g
C
Ainee
11. What is half cell Potential?
The voltage developed at an electrode-electrolyte interface is designated as the half cell potential or
electrode potential. A Characteristics potential difference established by the electrode and its surrounding electrolyte

12. Give the EMG Signal Characteristics. S

which depends on the metal, concentration of ions in solution and temperature.

rin
M g.n
The EMG signal ranges from 0.1mV to 0.5mV.The frequency components of the EMG signal vary from
20HZ to 10 KHz and they are restricted to the frequency range of 20HZ to 200HZ for Clinical purpose using a low
pass filter.

e
13. What is EOG?
EOG –Electro oculography – It is the recording of the biopotential generated by the movement of eyes.
14. Compare the signal characteristics of ECG and PCG. t
PCG related to mechanical events of heart while ECG related to electrical activity of heart. PCG has three
different waves but ECG has only one wave from to analysis the function of heart.
15. What is PCG?
The graphic record of the heart sounds is called as phonogram. Because the sound is from the heart, it is
called phonocardiogram. The instrument used to measure the heart sounds is called as phonocardiograph.
16. What are the different types of electrodes used in bipolar measurement?
The different types of electrodes used in bipolar measurement are
a) Metal plate electrodes, b) Suction cup electrode, c) Adhesive tape electrode,
d) Multipoint electrode, e) Floating electrode.

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17. Give the ECG Signal Characteristics.
The ECG signal characteristics is given below
P wave 0.25 mV
R wave 1.60 mV
Amplitude
Q wave 25% of R wave
T Wave 0.1 to 0.5 mV
P-R interval 0.12 to 0.20 sec
Q-T interval 0.35 to 0.44 sec
Duration S-T interval 0.05 to 0.15 sec
P wave interval 0.11 sec
QRS interval 0.09 sec

18. What is bio electric potential?

The ionic voltages produced as a result of the electrochemical activity of certain special type of cells are known as
bio-electric potential.
19. The contraction of skeletal muscle is termed as what? Give its specification.
The contraction of skeleton muscle is termed as Twitch and Tetanic contractions.Twitch contraction is a short burst
of stimulation causes the muscle to contract, but the duration is so short that the muscle begins relaxing even

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before reaching peak force. If the stimulation is long enough, the muscle reaches peak force and plateaus at this
level, resulting in a Tetanic contraction.
20. Enlist the electrodes used for recording EEG.

w.EScalp electrodes: Fp1, Fp2, Fz, F3, F4, F7, F8, Cz, C3, C4, Pz, P3, P4, Oz, O1, O2, T3, T4, T5, T6
Nasopharyngeal electrodes: Pg1 and Pg2,

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Ear electrodes: A1 and A2

asy
21. Define CMRR. Give its importance in physiological signal amplifiers.

En J C
The common mode rejection ratio (CMRR) should be more than 80dB so as to eliminate the 50Hz
interference from the mains.

g
Ainee
22. List the characteristics needed for Bio Amplifier.
a) The voltage gain of the amplifier should be >100dB.

S
b) It should have low frequency response.
c) Gain and frequency response should be uniform throughout the Bandwidth.

rin
d) There is no drift in the amplifier.
e) The output impedance should be very small.

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f) The common mode rejection ratio (CMMR) should be >80dB.
23. What are the requirement of a biological amplifier?
g.n
1. The voltage gain of the amplifier should be more than 100dB so as to amplify the biosignal properly to
drive the recorder.

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2. The gain and the frequency response should be uniform throughout the required bandwidth.
3. There is no drift in the amplifier.
4. The output impedance of the amplifier should be very small.
24. Draw the wave form of a typical PCG signal and label its components.
t

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25. Name the electrode used for recording ECG and EMG
Surface Electrode and Needle Electrodes are used for recording ECG and EMG.
26. What are the different types of bio potential electrodes?
There are three types of electrodes
1. Micro Electrodes – ( Metal micro electrode and Micropipet)
2. Depth and Needle Electrode
3. Surface Electrode – ( Metal Plate Electrode, Suction cup electrode , Adhesive tape
electrode, Multipoint electrode ,Floating Electrode)
27. Mention the normal amplitude and frequency of EMG signal ?
The normal amplitude of EMG signal is about range from 0.1 to 0.5 mV
The normal frequency of EMG signal is about 60 Hz
28. What is the range of resting potential?
The resting potential range from 70 to 90 mill volt.
29. What are artifacts?
The term artifacts refer to any component of a signal that is extraneous to the variable represented by a
signal.

ww 30. Differentiate between heart sound and murmurs.

Heart sound have a transient character and it is of short duration, whereas heart murmurs have a noisy

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characteristics and last for a longer time. Heart sounds are due to the closing and opening of the valves, murmurs are
due to the turbulent flow of blood in the heart and larger vessels.
31. List the important characteristics required for bio-amplifier.

asy
a. The voltage gain of the amplifier should be >100dB.
b. It should have low frequency response.

C E
c. Gain and frequency response should be uniform throughout the Bandwidth.

En J
d. There is no drift in the amplifier.
e. The output impedance should be very small.

g
f. The common mode rejection ratio (CMMR) should be >80dB.

Ainee
32. Mention the electrodes used to record bio-potential from a single muscle fibre.

S
Microelectrodes – i) Metal Microelectrodes ii) Micropipet.
33. State all none law

rin
The all-or-none law is the principle that the strength by which a nerve or muscle fiber responds to a stimulus is

M
independent of the strength of the stimulus. If that stimulus exceeds the threshold potential, the nerve or muscle fiber
will give a complete response; otherwise, there is no response.
34. What is ment by conduction velocity g.n
In modern EMG systems, nerve conduction time and nerve velocity are measured. For

e
this measurement, initially nerve is stimulated and EMG is measured.This conduction velocitymeasurement is used
to indicate the location and type of nerve lesion
35. Define absolute and relative refractory period
t
Absolute refractory period: During a short period after the generation of an action potential, the cell does not
respond to any stimulus at all. This period is known as theabsolute refractory period.
Relative refractory period: It is the time period between the instant when the membrane potential becomes negative
again and the instant when the membrane potential returns to RMP. During this period, the cell responds to a
stimulus but less strongly than usual.
36. Mention the cause of first and second heart sounds
Record of heart sounds – 1st and 2nd heart sounds are heard well but 3rd and 4th are not. Heart sounds are generally
used for diagnosis of valverelated diseases. Such abnormal heart sounds are called murmurs.
1st heart sound: due to closure of AV valves – long, soft & low-pitched sound – sounds like„lubb‟ – 0.14-0.2 sec –
30-40 Hz.
2nd heart sound: due to closure of semilunar valves – short, sharp & high-pitched sound –sounds like „dub‟ – 0.08-
0.1 sec – 50-70 Hz.

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37. List the important characteristics required for bioamplifier

The requirements for bio-potential amplifiers can often be more demandingthan for a lot of electronic equipment as
might be used in the entertainment ortelecommunications sectors. When measuring electrical signals, such as the
ECG,from the surface of the body typical requirements could be:
• Very High Input Impedance:
• Moderate Bandwidth:
• Sufficient Gain-Bandwidth Product:
• High Common-Mode-Rejection:
38. Mention the electrodes used to record bio potential from a single muscle fiber
single-fiber electromyography electrode within a motor unit used to record bio potential from a single muscle fiber

UNIT-1 PART B& C

1. i) Discuss in detail about Action Potential and Resting Potential.

ii) Write short notes on bio potential electrodes.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:4-8 & 24-27.

ww 2. i) Explain the working principle of a ECG machine with a neat block diagram.ii) What is
Phonocardiography?
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:117-142.
3.
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i) Explain in detail various types of bio potential electrodes.
ii) Write a short note on electromyogram.

4.
asy
C E
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:21-33 & 153-156.

i) Draw an action potential waveform and discuss in detail about polarization and repolarization.
ii) Draw the bipolar limb lead system of an ECG.

En J
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:4-8 & 120-121.

5. i)What is Half cell potential?

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Ainee
ii) What are the three types of electrodes and mention its use.
iii) Discuss Microelectrodes in detail.

6.
S
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 21, 24 -27.
i) Bring out the salient features of phonocardiography.

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ii) With suitable diagram, explain the method of measurement of conduction velocity in peripheral nerves.

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Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 133-142 & 153-156.

7. Explain the working principle of EEG recording machine.

g.n
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 144
8. A) (i) explain the international standard 12 lead system used to record ECG(10)
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(ii) list and discuss the important characteristics and frequency bands of EEC signal(6)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 132,77 t
9. (i) discuss in detail about the orgin potential and resting potential with necessary equations.(10)
(ii) describe the typical recording setup of EMG (6)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:89,123
10. a) discuss the genesis of ECG and explain the working of an ECG machine which is block diagram along
with its various lead configuration(16)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 184
11. What is know as biopotential electrodes? Draw its equivalent circuit explain various types of biopotential
electrodes with suitable example(16)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 192
12. (i) explain the international standard 12 lead system used to record ECG(10) (i) list and
discuss the important characteristics of bioamplifier(6)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 132, 98
13. (i) discuss in detail about the 10 – 20 lead system.(10)
(ii) describe the typical EMG waveform and its characteristics(6)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 126,67
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UNIT-2 – BIO CHEMICAL &NONELECTRICAL PARAMETER MEASUREMENT

PART A

1. What are cardiac output and phonocardiogram?

Cardiac output is the amount of blood delivered by the heart to aorta per minute. Phonocardiogram is used to
measure heart sounds in graphical manner
2. What is cardiac output .Mention the methods of measurement of cardiac output .
Cardiac output is the amount of blood delivered by the heart to aorta per minute various Methods to
measure the cardiac output is
Fick‟s method
Indication dilution method
By impedance change
3. What are demerits of electromagnetic blood flow meter?
i) The output voltage of the method is only few micro volts.
ii) Change of magnetic field causes the transducer to act like a transformer and induces error

ww Voltage.
4. Name any two methods of respiration rate measurement?
1. Maximum mid expiratory

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2. Maximal expiration flow rate
3. Maximal breathing capacity.
5. What is residual volume?

asy
6. Mention the application of flame photometer.

En J C E
The Residual Volume (RV) is the volume of gas remaining in the lungs at the end of a maximal expiration.

A flame photometer is used to Analyzing urine or blood in order to determine the concentration of
potassium (K), sodium (Na), Calcium (Ca) and Lithium (Li).

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7. What is meant by Mean Arterial Pressure (MAP)?

Ainee
Mean Arterial Pressure is a weighted average of systolic and diastolic pressure. Generally, MAP falls about
one-third of the way between the diastolic low and the systolic peak. A simple formula for computing MAP is:

S
MAP = 1/3 (systolic - diastolic) + diastolic
8. What are Korotkoff’s sounds?

rin
When an artery is partially occluded so that the blood velocity through the constriction is increased
sufficiently, identifiable sounds can be heard downstream through a stethoscope. These sounds are called

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Korotkoff‟s sounds, are used in the common method of blood pressure measurement.
9. What is a colorimeter? State its uses?
g.n
The Colorimeter is used to measure the transmitted and absorbed light as it passes through a sample. The

e
colorimeter uses light absorption to determine blood proteins and iron levels. Colorimeter can be in the filter
photometer or spectrophotometer. When an interference filter is used to select a given wavelength it is called filter
photometer. When a diffraction grating or prism is used as a monochromatic to get different spectral components or
wavelength of interest in the colorimeter, then it is called spectrophotometer.

10. Name the four physical principles based on which blood flow meters are constructed?
t
1. Electromagnetic induction
2. Ultrasonic principle(Transit time type, Doppler type)
3. Thermal convection
4. Radiographic Principle
5. Indicated dilution Principle.

11. Name the instrument used to measure PO2 and PCO2?

Blood Gas Analyzer

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12. How is the pulse rate measured?

The pulse rate is measured using one of the following methods
a) Electrical Impedance Method
b) Strain gauge Method
c) Photoelectric Method
d) Microphone Method
13. What is Stroke Volume?
Stroke Volume (SV) is the Volume of blood pumped from one ventricle of the heart with each beat.

14. What is systolic and diastolic pressure?

Contraction of heart muscle is called as systolic. The systolic pressure is 120 mm of Hg.
Relaxation of heart muscle is called as diastole. The diastolic pressure is 80 mm of Hg.
15. How is respiration rate measured?
The measurement of respiration rate provides ideas about relative respiratory activity .Various techniques
are used for this measurement are
1. Displacement method
2. Thermistor Method
3. Impedance pneumography

ww 4. CO2 Method
5. Apnora Detector
16. Which transducer is used for measuring temperature? Why?

w.E
Thermoelectric type transducer is used for measuring temperature, because to store and carry plasma,
antibiotics etc.
17. What is the principle used in pulse rate measurement?

asy
18. Which flow meters are used to measure pulsatile flow of blood?
Pulsed Doppler Blood flow meter
19. Draw lung volume diagram.
En J C E
Piezoelectric type transducer is the principle used in pulse rate measurement.

g
Ainee
S rin
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20. How does the pH value determine the acidity and alkalinity in blood fluid? g.n
e
The pH is a measure of the acid – base balance of a fluid. A neutral solution has a pH of 7.Lower pH
numbers indicate acidity , whereas higher pH values define a basic solution .
21. List the various indirect methods for the measurement of blood pressure.
The various indirect methods for the measurement of blood pressure are
1. Percutaneous insertion
t
2. Catheterization (Vessel cut down)
3. Implant of a transducer in a vessel or in the heart.
22. Write the principle behind electromagnetic blood flow meter.
Continuous measurement of blood velocity can be obtained by placing the electromagnetic flow
probe around arteries and veins. This probe operates on Faraday’s law of induced e.m.f. Blood is a
conductor of electricity. When a magnetic field is applied to a blood vessel, the blood flow in the vessel
causes an electric field to be induced in a direction mutually perpendicular to the direction of the applied
magnetic field and the blood velocity.

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23. Nitrogen washout technique is meant for what measurements?

A nitrogen washout can be performed with a single nitrogen breath, or multiple ones. Both
tests use similar tools, both can estimate functional residual capacity and the degree of non uniformity of gas
distribution in the lungs, but the multiple-breath test more accurately measures absolute lung volumes

24. What is Fick’ s Principle? Give its advantages.

The Fick‟s method is based on the determination of cardiac output by the analysis of the gas keeping of the
organism. Thus the cardiac output can be calculated by continuously infusing oxygen in to the blood or removing it
from the blood and measuring the amount of the oxygen in the blood before and after its passage.This method is
complicated, difficult to repeat, necessitates catheterization, it is practiced at some places.

25. Define cardiac output. Find the cardiac output of a person if his heart rate is 72 BPM and stoke
volume is 70ml.
Cardiac output is the amount of blood delivered by the heart to aorta per minute.

ww 26. What are the components of Blood?

w.EThe components of blood include:

Red blood cells, White blood cells, Platelets, and Plasma.

asy
arterial Pressure.(Nov/Dec 2013)
MAP = 1/3(systolic – diastolic) + diastolic
MAP = 1/3(110-82) + 82 = 36.66 mm Hg.

En J C E
27. If systolic and diastolic blood pressures are given as 110mmHg and 82 mm Hg . Calculate mean

28. Mention the basic principle behind electrochemical pH determination.

The Principle is illustrated as below. Inside the glass bulb is a highly acidic buffer solution. Measurement

g
of the potential across the glass interface is achieved by placing a silver- Silver chloride electrode in the solution

Ainee
inside the glass bulb and a calomel or silver – silver chloride reference electrode in the solution in which the pH is
being measured.

S
29. What is an auto Analyzingr? What are the essential units in it?
Auto Analyzingr is used to measure blood chemistry and display on a graphic recorder.

30. Give the typical values of blood pressure and pulse rate of an adult.
rin
Blood Pressure: 120/80 mmHg
Pulse Rate :

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60 to 80 bpm
31. Mention the applications of auto Analyzingr? g.n
e
1. Clinical analysis – Determine levels of albumin, alkaline phosphates, aspartate transaminase(AST),
blood urea nitrogen ,bilirubin ,calcium ,cholesterol ,creatinine , glucose , inorganic phosphorus ,
proteins and uric acid in blood serum or other bodily samples.
2. Industrial analysis – Mainly for water ,soil extracts and fertilizer.
32. Calculate the stroke volume in millilitres if the cardiac output is 5.2 litres/minute and heart rate is
t
76 beats/minute?
Cardiac output(ml/min) = Heart rate (beat/min)* Stroke Volume (ml/beat)
Stroke Volume = 5200/76 = 68.42 ml/beat

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33. Define cardiac output. Find the cardiac output of a person if his heart rate is 70BPM and stroke
volume is 70ml.
Cardiac output is the amount of blood delivered by the heart to aorta per minute.

34. What are the different types of test performed using auto Analyzingr?
1. Pipetting 2.Diluting 3.Incubatting
35. What is blood pressure state the normal values of blood pressure
The sphygmomanometer consists of (i) an inflatable rubber bladder called the “cuff”,
(ii) a rubber squeeze ball pump and valve assembly and (iii) a manometer
36. State the different types of test performed using auto analyser
An automated analyser is a medical laboratory instrument designed to measure different chemicals and other
characteristics in a number of biological samples quickly, with minimal human assistance

ww
37. Define cardiac output
Cardiac output is the quantity of blood delivered by the heart to the aorta per minutes. It is amajor determinant of
oxygen delivery to the tissues.
38. Stae beer’s law

w.E
If the path length or concentration increases, the transmittance decreases andabsorbance increases
Absorbtivity related to the nature of the A=aCL absorbing substance and opticalwavelength (known for a standard
solutionconcentration).
C: Concentration
L: Cuvette path length

volume is 70 ml
asy
En J C E
39. Define cardiac output find the cardiac output of person if his heart beat rate is 70 BPM and stroke

Cardiac output is the product of two variables, stroke volume and heart beat. Heartbeat is simply a count of the

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number of times a heart beats per minute. Stroke volume is the amount of blood circulated by the heart with each

CO=70*70=4900

SAinee
beat. The formula for this is expressed as CO = SV x HR.

40. Sate the different types of test performed using auto analyser
An automated analyser is a medical laboratory instrument designed to measure different chemicals and other

rin
characteristics in a number of biological samples quickly, with minimal human assistance

M PART B & C

1. a) i) Discuss the working principle of a colorimeter with a neat block Diagram.

ii) How will you measure blood pressure using Sphygmomanometer?
g.n
e
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:284-286 & Notes.

2. a) i) Explain the working principle of a electromagnetic type blood flow Meter

ii) Define Cardiac output .Discuss a technique to determine cardiac Output.
t
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:233-237 &246-253.

3. a) i) Explain the working principle of a electromagnetic type blood flow Meter.

ii) Describe the operation of a blood cell counter.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 233-237 & 274-277.
4. a) i) Define the terms : residual volume , tidal volume ,vital capacity and Total lung capacity.
ii)Discuss Fick‟s method for determining cardiac output.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:254&246-247.
5. a) Describe the measurement of pH in blood.
b) Explain the following : Auto Analyzer
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:265-267 &Notes.

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6. Draw a block diagram of ultrasonic blood flow meter .Explain the method of measuring the velocity of
blood flow using (i) Transit time principle (2) Doppler effect
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:237-244.

7. Explain the function of a human respiratory system and the possible measurement and inferences made out
of them.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:253.
8. A) (i) Describe the measurement of PH of blood using pH meter (8)
(ii)Explain the meseremeent of respiration rate using impedencetechinique.(8)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 208,211
9. (i) state and explain the working principal of electromagnetic blood flow meter.
(ii) describe the working of coulter counter.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 200
10. a) With suitable diagram describe how ultra sound principles are used in measuring the flow of blood?(16)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 206

11. (i)Define blood pressure how it can be measured using sphygmomanometer?(8)

(ii)How the lungs volume can be measured ? explain with necessary diagram.(8)

ww Ans: Text book: Bio medical instrumentation , Notes

12. A) (i) Deacribe the measurement of PO2 (8)
(ii)Explain the block diagram and working of colorimeter.(8)

w.E
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 204,215
13. (i) Define the term cardiac output how is cardiac output measured by dye diluation

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technique? Explain

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(ii) describe the working principal of electromagnetic blood flow meter.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 230,222

En J
UNIT-3 – ASSIST DEVICES

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Ainee
PART A

1. What is meant by Bradycardia and Tachycardia?

S
The normal value of heart rate lies in the range of 60 to 100 beats per minute. A slower rate than this is
called asBradycardia (Slow rate) and a higher rate, Tachycardia (fast heart).
2. When does the need for pacemaker arise? What is its function?
rin
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In cardiac diseases, where the ventricular rate is too low, it can be increased to normal rate by using

g.n
pacemakers. The various arrhythmias ( rhythm disturbance) that result in heart block and Adams stokes attacks
represent a serious pathological condition. During that time, the patient becomes invalid because of the constant risk
of sudden losing consciousness. By fixing the artificial electronic pacemakers, the above defects in the heart can be
eliminated.
3. List the typical ranges of pacemaker parameters.
Pulse rate
Pulse width
- 25-155pulses per minute
- 0.1-2.3 ms
e t
Pulse amplitude - 2.5-10 volts
Battery capacity - 0.44-3.2amp-hours
Longevity - 3.5-18 years
End-of-life indicator - 2-10%drop in pulse rate
Weight - 33-98 grams
Size - 22-80cm3
Encapsulization - Silicon rubber, Stainless steel, titanium
4. What are pacemakers?
Pacemaker is an electrical pulse generator for starting and maintaining the normal heart beat.

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5. What is meant by demand pacemaker?

If the R wave is missing for a preset period of time, the pace will supply a stimulus. Therefore if the heart
rate falls below a pre- determined minimum the pacemaker will turn on and provide the heart a stimulus. For this
reason it is called as Demand Pacemaker.
6. What are the batteries used for implantable pacemakers.
The batteries used for implantable pacemakers are
1. Mercury cells
2. Lithium cells
3. Rechargeable cells
4. Nuclear cells
5. Bio Fuel cells
6. Bio Mechanical power generation sources.
7. What is meant by Fibrillation?
The heart is able to perform its important pumping function only through precisely synchronized action of
the heart muscle fibers. The rapid spread of action potential over the surface of the atria causes these two chambers
of the heart to contract together and pump blood through the two atrio ventricular values in to the ventricles. After a
critical time delay the powerful ventricular muscles are synchronously activated to pump blood through the
pulmonary and systemic circulatory systems. A condition in which this necessary synchronism is lost is known as

ww
Fibrillation.
8. Calculate the energy stored in 16µ F capacitor of a DC defibrillator that is charged to a potential of
5000 V dc.

w.E
Energy stored (E) = ½ C V2
E= ½ *16*10-6 * 5000 *5000 = 200 Joules.

asy E
9. Why should a patient susceptible to ‘ventricular fibrillation’ be watched continuously?
Ventricular fibrillation is far more dangerous, for under this condition the ventricles are unable to pump
blood and if the fibrillation is not corrected death will usually occurs with in a few minutes. So patient
should be watched continuously.

En J
10. Distinguish between internal pacemakers and external pacemakers.
C
S.No External Pacemaker
g
Ainee
Internal Pacemaker

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1. The pacemaker is placed outside the body The pacemaker is miniaturized and is surgically implanted
beneath the skin near the chest or abdomen with its output

rin
leads are connected directly to the heart muscle.

2.

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The electrodes are called endocardiac
electrodes and are in contact with the inner
surface of the heart chambers g.n
The electrodes are called myocardiac electrodes and are in
contact with the outer wall of the heart muscle.

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3.

4.
It does not required open chest surgery

The battery can be easily replaced

It requires an open chest minor surgery to place the circuit

The battery can be replaced only by minor surgery t

5. During placement, swelling and pain do During placement, swelling and pain arise due to minimum
not arise due to minimum foreign body foreign body reaction.
reaction.

6. No safety for the pacemaker Cent percent safety for the pacemaker

7. Mostly used for temporary heart Mostly used for permanent heart damages
irregularities

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12. Classify pacing modes.

Competitive mode Asynchronous mode

Pacing modes ( fixed rate)
Non competitive mode
Ventricular programmed Atrial programmed

Demand mode Standby mode Synchronous mode

(R-wave inhibited) (R-wave triggered) (P-wave)
13. What is Defibrillator? State its use.
A Defibrillator is an electronic device that Creatings a sustained myocardial depolarization of a patient‟s heart in
order to stop ventricular fibrillation (or) atrial fibrillation .The instrument for administering the electric shock is
called as defibrillator.
1. The method of defibrillation is the application of an electric shock to the area of the heart.
2. Defibrillators are also used to convert other potentially dangerous arrhythmias to one that is easily
managed – CARDIO VERSION.
3. Defibrillator discharge may used to convert a tachycardia (fast heart) arrhythmia to a normal rhythm.

ww 14. Draw the circuit of DC Defibrillator and give its output specification.

w.E
asy
15. What is heart – Lung Machine?
En J C E
g
During open heart surgery for installation of a valve prosthesis or correction of a congenital mal formation,

machine called Heart – Lung Machine .

16. What is Systole and Diastole?
Ainee
the heart cannot maintain the circulation. It is then necessary to provide extra- corporeal circulation with a special

S
Systole is the period of contraction of the ventricular muscles during that time blood is pumped in to the

rin
pulmonary artery and the aorta. Diastole is the period of dilation of the heart chambers as they fill with blood.

M
17. What are the types of oxygenators?
They are four types of oxygenators. They are
1. Bubble oxygenators
2. Film oxygenators
g.n
e
3. Membrane oxygenators
4. Liquid – Liquid oxygenators
18. Define dialysis.
Dialysis is a process by which the waste products in the blood are removed and restoration of normal pH
t
value of the blood is obtained by an artificial kidney machine.

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19. Compare Hemodialysis and peritoneal dialysis?

S.No Hemodialysis Peritoneal dialysis
1. In this procedure, blood is purified by an The peritoneal cavity in our body is used as a semi
artificial kidney machine called permeable membrane and by passing the dialysate
Hemodialysis in which the blood is taken into it waste products are removed from the blood
out from the body and waste products by diffusion.
diffuse through a semi permeable
membrane which is continuously rinsed by
a dialyzing solution or dialysate.
2. More effective to separate the waste Less effective
products
3. Technically complex and risk one because Simple and risk free
the blood is taken out from the body.
4. Dialyzing time is about 3 to 6 hours Dialyzing time is about 9 to 12 hours
.
20. What are the three physical processes used in dialysis?
The three physical process used in dialysis are i) Diffusion ii) Osmosis iii) Ultra filtration.
21. What are the two types of procedures for doing dialysis?

ww The two types of procedures for doing dialysis

1. Hemodialysis
2. Peritoneal dialysis

w.E
22. Which type of electrode is applied in the case of external stimulation and what is the current range?
The paddle shaped electrodes are applied on the surface of the chest and the current range is 20 -150 mA

asy E
23. Which types of electrodes are used in internal stimulation and what is the current range?

C
The electrodes in the form of fine wires of Teflon coated stainless steel , spoon like electrodes are used
.The current range in 2 -15 mA
24. What is external stimulation employed?
En J
The external stimulation is employed to restart the normal rhythm of the heart in case of cardiac stand still.

25. What is internal stimulation employed? g

Ainee
S
Internal stimulation is employed in cases requiring long term pacing because of permanent damage that
prevents normal self triggering of heart.
26. What are the modes of operation of pacemakers?
The modes of operation of pacemakers are
rin
M
1. Ventricular asynchronous pacemaker(Fixed rate pacemaker)
2. Ventricular synchronous pacemaker
3. Ventricular inhibited pacemaker(Demand pacemaker)
4. Atrial synchronous pacemaker
g.n
e t
5. Atrial sequential ventricular inhibited pacemaker
27. What are the types of defibrillator?
The types of defibrillator are
1. A.C Defibrillator
2. D.C Defibrillator
3. Synchronized D.C Defibrillator
4. Square Pulse D.C Defibrillator
5. Double Square Pulse Defibrillator
6. Biphasic D.C Defibrillator
28. Why are asynchronous pacemakers no longer used?
A synchronous pacing is called competitive pacing because the fixed rate impulses may occurs along with natural
pacing impulses and would therefore in competition with them in controlling the heart rate.

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29. When do you need heart lung machine?

During open heart surgery for installation of a valve prosthesis or correction of a congenital mal formation, the heart
cannot maintain the circulation .It is then necessary to provide extra-corporeal circulation with a special machine
called heart lung machine.
30. What is the systolic and diastolic pressure of Aorta?
Systolic Pressure/Diastolic pressure: 130/75
31. What is the systolic and diastolic pressure of different areas of heart?
Left Ventricle: 130/5
Right Ventricle: 25/0
Left Atrium: 9/5
Right Atrium: 3/0
32. Differentiate internal and external defibrillator
Momentary application of strong electrical stimulus to bring all the cardiac cells simultaneously into a refractory
period thereby arresting their irregular, uncoordinated twitching is known as defibrillation. Types: (i) ac
defibrillation & (ii) dc defibrillation.
The ac defibrillation: A brief (0.25 to 1 sec) burst of 60 Hz ac at an intensity of 6 A is applied to the chest of the
patient. As an attempt to correct the atrial fibrillation using ac often results in even more serious ventricular
fibrillation, ac defibrillation is no longer used.

ww
The dc defibrillation: Several volts of dc is momentarily applied across or through the chest – only fewer repetitions
are required to correct ventricular fibrillation so less harm than ac defibrillation – successful in correcting atrial
fibrillation.

w.E
33. What is dialyasate mentation its composition
themake up of dialysate or the dialysis 'bath', is: sodium chloride, sodim bicarbonate or sodium acetate, calcium

E
chloride, potassium chloride, and magnesium chloride. This is the general composition of dialysate, but other

asy
compounds such as glucose may also be included.
34. Distinguish between endocardiac and myocrdiac electrodes.

C
The endocardial approach (Fig. 2) is to place electrodes at the apex of the right ventricle via any suitable superficial

En J
vein above the diaphragm. This may include use of either the external or the internal jugular, the cephalic, or the
subclavian vein. It is not advisable to use any veins below the diaphragm for long-term endocardial stimulation. The
cephalic and the subclavian are the most desirable veins in as much as they avoid "draping" the electrode catheters

g
Ainee
over the clavicle. As a practical matter it is wise, when surgically preparing the patient, that the entire side of the
chest and neck on the side to be employed be made available for a surgical field.

EXTERNAL DEFIBRILLATOR:
S
35. Mention few difference between internal and external defibrillator

rin
A unit based on computer technology and designed to Analyzing the heart rhythm itself, and then advise whether a

M
shock is required. It is designed to be used by lay persons, who require little training. It is usually limited in their
interventions to delivering high joule shocks for VF and VT rhythms
36. Why are asynchronous pacemaker no longer used?
g.n
e
Heart beat rate cannot be changed. If it is fixed in atrium, atrium beat at a fixed rate. If ventricle beat at a different

t
rate, and then it leads to a severe problem. Ventricular fibrillation may be occurred.
37. When do you need heart lungs machine?
A machine that does the work both of the heart and of the lungs: pumping and oxygenating blood. Blood returning
to the heart is diverted through a heart-lung machine before being returned to arterial circulation. Such machines
may be used during open-heart surgery. Also known as pump-oxygenator or cardiopulmonary bypass machine.

PART B & C

1. Discuss with suitable block diagram the different modes of operation of Cardiac pacemakers.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:167-175.

2. a) i) What is defibrillator? ii) Distinguish between Internal and External Defibrillator.

iii) With block diagram describe the operation of synchronized D.C Defibrillator.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:185-186 &190-193.

3. Explain the operation of Dialyzer with a neat sketch.

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Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:212.
4. Explain the operation of Heart – Ling machine with a neat sketch.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:202.
5. Discuss with suitable block diagram of atria and ventricle Cardiac pacemakers.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:167-175

6. With block diagram describe the operation of D.C Defibrillator.

Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:185-186 &190-193.
7. A (i) With a neat diagram explain the block diagram of arterial and ventricular triggered pacemaker.(16)

Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 210

8. Explain in detail the principal and diagram working of hacmodialyser.(16)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 285
9. a)How pacemakers are classified based on the modes of operation draw the block
diagram of stand by and demand pacemakers and explain its working principle.(16)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 260
10. Enumerate the following oxygenators peritionial dialysis(8+8)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 243

ww 11. A) (i) With a neat diagram explain the block diagram of DC defibrillator.(8)
(ii) Describe the working of atrial synchronous pacemaker. (8)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 206, 241

w.E
12. Explain in detail the different types of oxygenators and pumps used in heart lung machine.(16)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 228

asy
UNIT-4 – PHYSICAL MEDICINE AND BIO TELEMETRY

En J
PART A

1. Write the physiological effects of electricity. C E

Type of Current
Threshold 1-5 g
Ainee
Current range (mA)
Tingling Sensation
Physiological effect

S
Pain 5-8 Intense or painful sensation
Let-go 8-20 Threshold of involuntary muscle contraction
Paralysis
Fibrillation
>20
80-1000
rin
Respiratory paralysis and pain
Ventricular and heart fibrillation
Defibrillation

M 1000-10000

2. What is the principle of diathermy?

Sustained myocardial contraction, temporary

g.n
respiratory paralysis and possible tissue burns

e
High frequency currents ,apart from their usefulness for therapeutic applications , can also be used in operating
rooms for surgical purposes involving cutting and coagulation .The frequency of current used in surgical diathermy
units is in the range of 1-3MHz in contrast with much higher frequencies employed in short – wave therapeutic
diathermy machines.
3. Mention the situations which account for hazards from electric shock.
t
Many devices have a metal chassis and cabinet that can be touched by the medical attendants and
patient. If they are not grounded, then short circuit leads to micro or macro shock. Other situations which may
be hazards is due to
➢ Leakage currents
➢ Static electricity
➢ Interruption of power
➢ Unequal ground potential
➢ Broken ground wire, etc.,

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4. Can pain be relieved through electrical stimulation? What is the equipment used for it?

Yes pain can be relieved through electrical stimulation.The equipment used for it is Transcutaneous
Electrical Nerve Stimulator (TENS).
5. Define Let-go current.
Let-go current is the minimum current to produce muscular contraction. Let-go current for men is about 16
mA and for women is about 10.5 mA.
6. Distinguish between Micro shock and Macro shock.

MICRO SHOCK MACRO SHOCK

A physiological response to a current A physiological response to a current
applied to the surface of the heart that results applied to the surface of the body that
in unwanted stimulation like muscle produces unwanted or unnecessary
contraction or tissue injury is called Micro stimulation like muscle contraction or
shock. tissue injury is called Macro shock.

7. What is diathermy? List its types.

ww Diathermy is the treatment process by which cutting, coagulation, etc., of tissues are obtained.
The various types are:
1. Surgical diathermy

w.E
2. Short wave diathermy
3. Microwave diathermy

E
4. Ultrasonic diathermy

asy
8. What are the electrical safety methods used in hospitals?
The electrical safety methods used in hospitals
1. Proper grounding of equipment.
2. Double insulation
3. Protection by Low voltage
4. Ground Fault Interrupter En J
g
C
Ainee
5. Isolation Transformer.
9. How electrical hazards do occurs due to medical equipments?

S
One of the main hazards connected with the use of medical equipment is electrical shock.
10. What is the use of ultrasonic diathermy?

rin
It is used for curing the diseases of peripheral nervous system, skeletal muscle system and skin ulcers.
11. What is tele- stimulation?

M g.n
Tele-stimulation is the measurement of biological signals over long distance. Tele- stimulation refers to
study of diseases by stimulating into animals without killing them and to monitor them by receiving their bio –
signals.
12. List the application of Bio- Telemetry.
e
The application of Bio- Telemetry
1. Monitoring ECG even under ergonomic conditions
2. Monitoring the health of astronauts in space
3. Patient Monitoring in an ambulance and other locations away from hospital
4. Research on anaesthetized animals.
t
13. List out any six bioelectric and physiological variables adaptable for biotelemetry Measurements

Bioelectric variables---ECG, EEG, EMG and Physiological variables---blood pressure, gastrointestinal

pressure, blood flow, temperature.
14. What is radio pill?

Radio pill is used to monitor stomach pressure or pH. A pill consisting of a sensor and miniature
transmitter is swallowed and the data are picked up by a receiver and recorded

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15. List out the advantages of a Bio-telemetry system

The advantages of a Bio-telemetry system
● Bio-telemetry helps us to record the bio-signals over long periods and while the patient is engaged in
his normal activities.
● Computer or the medical attendants can easily diagnosis the nature of disease by seeing the telemetric
bio-signals without attending the patient‟s room.
● Patient is in his room without any mechanical (or) physical disturbance during recording by means of
Bio-telemetry
● For future reference (or) to study the treatment effect, the bio-telemetry is the essential one.
● For recording on animals, particularly for research, the bio-telemetry is greatly used.
● For monitoring the person who is in action, the bio-telemetry is an ideal one.
16. Explain the principle of tele-stimulation.
Tele-stimulation is the measurement of biological signals over long distance.
17. Draw the block diagram of a Bio – Telemetry system.

Biological Transducer Conditione Transmission Read-out

Signal r Link Devices

ww 18. What care must be taken while measuring responses to electrical stimulation?
The care must be taken while measuring responses to electrical stimulation

w.E
1. Proper Grounding
2. Protection is provided by removing the power from the defective

E
3. Device by tripping the circuit breaker.

asy
19. What is meant by single channel telemetry?

C
For a single channel system, a miniature battery operated radio transmitter is connected to the electrodes of
the patients. This transmitter broadcasts the bio potential over a limited range to a remotely located receiver, which

En J
detects the Radio signals and recovers the signals for further processing.
20. List the two types of multiplexing involved in multi channel wireless telemetry?

g
The two types of multiplexing involved in multi channel wireless telemetry are

Ainee
1. Time division Multiplexing
2. Frequency division Multiplexing

S
21. What are the precaution necessary to avoid micro shock?
1. In the vicinity of the patient, use only apparatus or appliances with three-wire power cords.
2. Provide isolated input circuits on monitoring equipment
22. Specify the frequencies used for biotelemetry?
rin
M
23. Give the types and frequencies of operation of diathermy units
The types and frequencies of operation of diathermy units are
1. Fulguration -100Hz
g.n
The frequencies used for biotelemetry are of the order of 37,102,153,159,220 and 450MHz.

e
2. Deciccation-100Hz
3. Electrotomy-500Hz
4. Coagulation-250Hz
5. Blending-500Hz
t
24. Name the instrument needed for a bio-telemetry system.
The instruments needed for a bio-telemetry system are
1. Tunnel Diode FM transmitter
2. Hartley type FM transmitter
3. Radio Telemetry with a sub-carrier
4. Pulsed Hartley oscillator
25. What is use of high frequency current in diathermy?
The use of high frequency current is to avoid the intense muscle activity and the electrocution hazard
which occurs if low frequencies are used.

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26. Where is ultra sonic diathermy used?

Ultra sonic diathermy is used where short wave treatment is failed and in cases where localization of the
heart effect is desired.
27. Name few diseases that can be cured by ultrasonic diathermy?
The few diseases that can be cured by ultrasonic diathermy are
1. Neurits
2. Arthritis
3. Skin ulcers.
28. What are the factors of leakage current flow?
The factors of leakage current flow are
1. Ungrounded equipment
2. Broken ground wire
3. Unequal ground potential
29. What are the two divisions in patient monitoring systems?
The two divisions in patient monitoring systems are
1. Intensive care unit
2. Intermediate coronary care unit
30. What is the purpose of patient monitoring system?

ww The purpose of patient monitoring system is to follow the patient condition carefully by repeated
measurement of many variables.
31. Define desiccation and haemostasis

w.E
Desiccation is the state of extreme dryness, or the process of extreme drying. A desiccant is a hygroscopic
(attracts and holds water) substance that induces or sustains such a state in its local vicinity in a
moderately sealed container

asy
This involves coagulation, blood changing from a liquid to a gel
32. List the applications of biotelemetry
En J
Motorracing Agriculture Water Management Rocketry Flight Test
C E
Hemostasis or haemostasis is a process which causes bleeding to stop, meaning to keep blood within a
damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing.

g
33. What are the choices of radio carrier frequency for medical telemetry purposes

Ainee
Use and Outcomes of Telemetry Monitoring on a Medicine Service. Telemetry is a powerful tool for real-
time monitoring of a patient's heart rhythm and QRS pattern. Beds with telemetry monitoring are limited

S
and expensive in most institutions; therefore, the use of this resource would ideally be evidence based.

34. Define let go current.

rin
The "Let Go" Threshold is the current level where we lose control of our muscles and the electricity

M
causes muscles to contract until the current is removed
35. List the devices used to safeguard against electrical hazards
Ground Fault Interrupter (GFI)
Line Isolation Monitor (LIM)
g.n
e
Safety Analyzingr
Receptacle Tester
36. Which is radio pill mentaion the application of radio pill
It contains transducer sensitive to pH, temperature and pressure. It is used for telemetering continuous
t
informations about one or various variables from lumen of the gut. Temperaturesensitive pills are
designed by the medical research council‟s bioengineering lab.

PART B & C
1. Explain working principle of a diathermy unit with a neat block diagram.

Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:219

2. a) i) Explain in detail the components of a Bio –telemetry system.

ii) Discuss the various applications of telemetry in patient care.

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Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:311&320.

3. a) i) Explain the physiological effects of electric current at 50Hz.

ii) With reference to electrical safety explain
a) Ground fault circuit interrupter
b) Protection by low voltage
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 329

4. Explain the single channel and multi channel bio telemetry system with neat diagram.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 312

5. Write short notes on frequency selection for telemetry applications.

Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 313

6. Explain working principle of a surgical diathermy unit with a neat block diagram.

7. Briefly explain about the electrical safety Instrumentation.

ww Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:322-340.

8. A) (i) Explain the working and application techniques of short wave diathermy(10)

w.E
(ii) Discuss the different operation performed using surgical diathermy treatment.(6)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 284, 291

asy
En J C E
9. B) (i) Describe the physiological effect of electricity on humans(8)
(ii) write a short notes on frequency selection for telemetry applications .(8)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 290, 312

10. a) Define diathermy draw the circuit diagram of a short wave diathermy unit and discuss its impact on
therapy purpose in details also brief describe how its can be applied to human subjects(16)

g
Ainee
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 273

11. (i) Explain the working of ground fault interrupter(8)

(ii)
system.(8)

S
With suitable diagram explain how ECG signal can be transmitted using single channel telemetry

Ans: Text book: Bio medical instrumentation By Arumugam , notes

rin
M
12. A) (i) Explain the simplified circuit diagram of a microwave diathermy machine(10)
g.n
(ii) Discuss the different methods of applying electrodes in shortwave diathermy treatment.(6)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 261, 242

e
13. (i) Describe the single channel ECG telemetry system(8)
(ii) briefly discuss about micro and macro shocks.(8)
Ans: Text book: Bio medical instrumentation By Arumugam .,notes
t

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UNIT-5 – RECENT TRENDS IN MEDICAL INSTRUMENTATION
PART A

1. List the parts of endoscope unit.

The parts of endoscope unit are:
1. High power argon laser
2. Partial beam splitter
3. Power meter and heat sink
4. Lens system
5. Micropositioner
6. Encapsulated quartz fibreguide
7. Endoscope
8. Synchronous filter shutter
9. Firing control and timing unit
2. Name the laser commonly used for ophthalmic application. Why?
The Laser commonly used for ophthalmic application is Argon ion Laser and Nd-YAG Laser. Argon ion
laser which emits blue green light that is readily absorbed by the blood are preferred for photocoagulation of small
blood vessels in the eye.

ww 3. Bring out the clinical applications of endoscopy?

Type Range of Use Diagnostic problem

1.
w.E
Bronchoscope Trachea larger airways Foreign bodies infections, aspiration of mucus,

E
Heart cavities valvular defects and septal defect
2. Cardioscope

asy
Abdominal cavity Tumors, family planning operation

C
3. Laparoscope

4. Cystoscope Urinary bladder

En J Tumors ,inflammation,stones.

4. Mammograms are used for what purposes?

g
Ainee
A mammogram is a low dose x-ray exam of the breast that is used to detect and evaluate breast changes (or) breast

S
cancer. It is used to aid in the early detection and diagnosis of breast diseases in women.
5. List out the properties of LASER.
The properties of LASER are
1. Laser light is highly coherent
rin
M
2. Laser is highly powerful
3. It is also directional and monochromatic
4. It is capable of propagation over long distance
g.n
e
5. It is extremely bright

t
6. Laser beams are not easily absorbed by the water.
6. What is Thermograph? State its applications.
Thermograph is the process of recording true thermal images of the surfaces of objects under study. In
medicine, Thermograph displays images representing the thermal radiation of skin areas.
Application: 1. It is important diagnostic aid in Breast cancers
2. Rheumatic diseases or joint diseases.
3. Tumors
4. Collagen and Orthopedic diseases
5. Examination of placenta attachment
6. Harmone, Brain and Nervous diseases.

7. What are the functions of endoscopy unit?

Endoscope is a tubular optical instrument to inspect or view the body cavities which are not visible to the
naked eye normally. The endoscope is so designed for easy sterilization. In the endoscope, at the object end there is
an assembly of objective lens and prism and at the viewing end, there is an eye lens. Endoscopic pictures can be
recorded with color film and video tape recorder.

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8. Mention the advantages of performing surgery using LASER.

1. Highly sterile
2. Highly localized and precise
3. Noncontact surgery
4. Dry – field ,almost bloodless surgery
9. Which laser is used for surgery?
LASER is used for surgery are : Argon Iron, CO2 and Nd-YAG laser.
10. Mention the application of LASER in ophthalmology.
1. Photocoagulation of retinal bleeding
2. Retinal Reattachment
3. Iridectmies
4. Glaucoma
5. Senile macular degeneration
6. Lens capsule surgery
11. What type of LASERs are used for patient treatment?
The types of LASERs used for patient treatment are
1. Pulsed Nd-Yag Laser
2. Continuous Wave CO2 Laser

ww 3. Continuous Wave Argon ion Laser

12. What is Telemedicine?
Telemedicine is the application of telecommunication and computer technology to deliver health care from

w.E
one location to another.
13. State the application of Telemedicine.
The applications of Telemedicine are

asy E
1. Tele-radiology – Radiological images like X-ray , CT or MRI Scan etc

C
2. Tele-pathology- microscopic images of pathology slides and biopsy reports
3. Tele-cardiology – Transmission of ECG , Echo ,Color Doppler

En J
4. Tele-education – Delivery of medical education programmes to the physicians
14. What are essential parameters for Telemedicine?

1. Primary patient data

2. Patient History g
The essential parameters for telemedicine relating to a patient are

Ainee
S
3. Clinical Information
4. Investigation
5. Data and Reports

rin
M
15. Name the technologies used in telemedicine.
The technologies used in telemedicine are :
1. Transmission of Medical Images
2. Transmission of Video Images g.n
3. Transmission of digital Audio
4. Video Conferencing
5. Digital Communication Systems
6. Telemedicine using Mobile Communication
e t
7. Use of Internet resources for telemedicine
16. Name some uses of CO2 Laser in surgery?
The CO2 Laser are used for the distruction of tumors by coagulation whereas CO 2 Laser functions as a
nonmaterial, light knife for performing tissues incisions and tumor nodule excisions.
17. Mention few advantages of Laser Surgery.
The advantages of Laser Surgery are
1. Highly sterile
2. Highly localized and precise
3. Non Contact Surgery
4. Dry-Field ,almost bloodless surgery
5. Short periods of surgical time.

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18. What are the diseases that can be diagnosed by thermograph?

Thermograph is an important diagnostic in many diseases especially in breast cancers in rheumatic diseases
or joint diseases.
19. What are the classifications of thermograph?
The classifications of thermograph
1. Infrared thermograph
2. Liquid crystal thermograph
3. Microwave thermograph
20. What are the characteristics of good thermograph equipment?
The characteristics of good thermograph equipment
1. Short frame time
2. High resolution
3. A small size and light weight optical head
4. Absolute temperature can be measureable
21. List out the factors of photo physical event that depends on?
The factors of photo physical event that depends on
1. Wavelength of Laser
2. Energy density

ww 3. Pulse duration
4. Irradiation time
5. Absorption characteristics of target molecule

w.E
22. List out the four photo biological Laser processes.
The four photo biological Laser processes are
1. Photo chemical processes
2. Thermal processes

asy
3. Photoablative processes
4. Electromechanical processes

En J
23. Name the type of LASER used in Photo chemical processes.
The LASER used in Photo chemical processes are He-Ne .Nd-YAG. C E
g
24. Name the type of LASER used in Photo thermal processes.

Ainee
The LASER used in Photo Thermal processes are CO2 andNd-YAG.
25. Name the type of LASER used in Electro mechanical processes.

S
The LASER used in Electro mechanical processes are Nd-YAG.
26. List the types of pumping sources used in LASER.
Stimulated Emission
rin
M
27. What is LASER?
LASER is Light Amplification by Stimulated Emission of Radiation.
28. On What factor LASER action depends?
g.n
e
LASER action depends upon the phenomenon of stimulated emission.
29. On what properties LASER is determined?
1. The gain of the medium
2. The pumping Mechanism
3. The resonator design
30. What is cryogenic surgery?
t
It is based on the development of heat at the operating site during irradiation. Tissues are killed when their
temperature is below 20 degree C.When the tissue are at 20 degree C ,there is no formation of ice crystals
and increase of salt concentration within the cells. Thus necrosis of the tissue takes place. This method of
killing diseased cells is called as cryogenic surgery which is painless and it is taking place without blood
shedding.
31. What makes thermograph useful?
● Get a visual picture so that you can compare temperatures over a large area
● It is real time capable of catching moving targets
● Able to find deteriorating components prior to failure
● Measurement in areas inaccessible or hazardous for other methods
● It is a non-destructive test method

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32. List the properties of laser beam

Characteristics of Laser Light
A laser generates a beam of very intense light. Laser light has three distinct characteristics that distinguish it from
ordinary light: Laser light is:
Collimated
Monochromatic
Coherent
33. Define the physical factors which affect the amount of infrared radiation from human body
All objects, including human bodies, emit electromagnetic radiation. The wavelength of radiation emitted depends
on the temperature of the objects. Such radiation is sometimes called thermal radiation. Most of the radiation
emitted by human body is in the infrared region, mainly at the wavelength of 12 micron.
34. Mentation few applications of lasers in medicine
Angioplasty cancer diagnosis cancer treatment cosmetic dermatology such as scar revision, skin resurfacing, laser
hair removal, tattoo removal dermatology to treat melanoma frenectomy lithotripsy laser mammography medical
imaging microscopy ophthalmology (includes Lasik and laser photocoagulation) optical coherence tomography
optogenetics prostatectomy plastic surgery, in laser liposuction surgery to ablate and cauterize issue
35. Sate the application of telemedicine
Telemedicine is the use of telecommunication and information technology to provide clinical health care from a

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distance. It has been used to overcome distance barriers and to improve access to medical services that would often
not be consistently available in distant rural communities.
Blood Pressure

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Interstitial Fluid Pressure (IFP)
Pressure-Volume Loop Studies

E
Telemetry Biopotential
Telemetry Pressure and Biopotential
Specialized Telemetry

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36. List the types of pumping sources used in LASER ‎

En J C
Optical pumping · ‎Pumping cavities · ‎Flashlamp pumping · ‎External laser pumping

g
PART B & C

Ainee
1. a) Discuss working principle of an infrared thermo graphic equipment. Mention applications of thermo
graph (May/June 2007) (Apr/May 2011)(Nov/Dec 2011) (Nov/Dec 2014) (May/June 2013)(May/June

S
2016)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:367-373.

rin
2. a) Discuss in detail the different application of Laser in medicine. (Nov/Dec 2007)(Apr/May 2012)
(April/May 2015)(May/June 2014) (May/June 2013)(May/June 2016)

(Nov/Dec11)(Apr/May
2013)(May/June 2016) M
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:347.
What is an endoscope? Discuss the working of an endoscopic unit.
2012(April/May2015)(Nov/Dec 2015)(May/June
g.n(Apr/ May 2008)

e
2014)(May/June

t
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:219-223 &356-359.
3. Briefly explain about the importance of Telemedicine.
Ans: Text book: Bio medical instrumentation By R.S.Khandpur .pg.no:303
4. What is cryogenic? List some cryogenics agents with its operating temperature and explain how it is used
to perform surgery?
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:359.
5. Explain the basic principle of LASER.
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no:347.
6. A) (i) What is thermography ? explain the block diagram of infrared imaging system(10)
(ii) Describe the different operation involved in endoscopy(6) (May/June 2016)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 310,295
7. (i) what is cryogenic list some cryogenics agents with its operating temperature and explain how it is used
to perform surgery(10) (May/June 2016)
(ii) write short notes on applications of LASER in medicine.(6) (May/June 2016)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 324,290
8. a)Explain the infrared thermographic instrumentation with a suitable block diagram and what are the

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different medical applications(16) (Nov/Dec 2016)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 320
9. (i) Write a notes on cryogenic surgery(8) (Nov/Dec 2016)
(ii) Write a notes on endoscopy unit(8) (Nov/Dec 2016)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 336, 314
10. A) (i) What is endoscope ? explain the different types of operations performed using endoscopy(10)
(May/June 2017)
(ii) Describe the working principle of thermograph(6) (May/June 2017)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 290, 298
11. B) (i) Explain different typers of LASER(10) (May/June 2017)
(ii) write short notes on cryogenic applications.(6)
Ans: Text book: Bio medical instrumentation By Arumugam .pg.no: 318,338

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w.E
asy
En J C E
g
Ainee
S rin
M g.n
e t

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EC8073 Medical Electronics Regulations 2017

Answer: a
Explanation: The input resistance of both the
EC8073 MEDICAL inputs is very high and does not change as the
gain is varied in and instrumentational
ELECTRONICS amplifier. Voltage gain from differential input
(V1–V2) to single ended output, is set by one
resistor. V0 does not depend on common-
ECE - mode voltage, but only on their difference.

PROFESSIONAL 2. Which of the following is not the property

of the instrumentational amplifier?
ELECTIVE I a) Extremely high input impedance
b) Low bias and offset currents

wRegulations
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c) High slew rate
d) Very low CMRR

Answer: d

.Ea Explanation: Instrumentational amplifiers

syE CE
have very high CMRR. The instrumentation
amplifier offers the following advantages for
UNIT I ELECTRO- its applications in the biomedical field. Some

ngJi
of them are like extremely high input
PHYSIOLOGY AND BIO- impedance, low bias and offset currents, high
POTENTIAL slew rate.

RECORDING

S A nee
ri
TOPIC 1.1 SOURCES OF BIO
3. CMRR is measured in ___________
a) v/s
b) dB
c) dB/s
MEDICAL SIGNALS

M d) dB/ms
ng.
1. Which of the following statement is true
for an instrumentational amplifier?
a) the input resistance of both the inputs is
very high and does not change as the gain is
Answer: b
Explanation: CMRR is an important
specification referred to the differential
amplifier and is normally expressed as
net
varied decibels. The ability of the amplifier to reject
b) the input resistance of both the inputs is common voltages on its two input leads is
very low and does not change as the gain is known as common-mode rejection. It is
varied specified as the ratio of common-mode input
c) the input resistance of both the inputs is to differential input to elicit the same
very high and does change as the gain is response.
varied
d) the input resistance of both the inputs is 4. The carrier amplifier consists of an
oscillator and a capacitance coupled
very low and does change as the gain is
amplifier.
varied
a) True
b) False

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Answer: a side of the isolation barrier.

Explanation: The carrier amplifier consists a) True
of an oscillator and a capacitance coupled b) False
amplifier. The oscillator is used to energize
the transducer with an alternating carrier Answer: a
voltage. The transducers, which require ac Explanation: The isolation includes different
excitation, are those whose impedance is not supply voltage sources and different grounds
purely resistive. on each side of the isolation barrier. Three
methods are used in the design of isolation
5. Electromagnetic coupling cannot be amplifiers: (i) transformer isolation (ii)
reduced by ___________ optical isolation (iii) capacitive isolation.
a) shielding Isolation amplifiers are commonly used for
b) wire twisting providing protection against leakage currents.

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c) multiple grounding
d) common grounding 8. _________ are commonly used for
providing protection against leakage currents.
Answer: c
w.E
Explanation: Having multiple grounds in a
a) Isolation amplifiers
b) Differential amplifiers
single circuit increases the electromagnetic

asy
coupling effect by producing ground loop
which may generate so much noise that it
may completely obscure the useful signal.

En J
Thus, the electromagnetic coupling is reduced
Answer: a
E
c) Instrumentational amplifiers
d) Inverting amplifiers

C
Explanation: Isolation amplifiers are
commonly used for providing protection
by shielding, wire twisting and proper
grounding which provide a balanced signal
pair with satisfactory noise rejection g
Ainee
against leakage currents. They break the
ohmic continuity of electric signals between
the input and output of the amplifier. The
characteristics.

S
6. Which on the following is not a type of
isolation amplifier?
isolation includes different supply voltage

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sources and different grounds on each side of
the isolation barrier.

M
a) capactively coupled isolation amplifiers
b) optically isolated isolation amplifiers
c) resistive coupled isolation amplifiers
TOPIC 1.2 BIO-POTENTIALS g.n
e
d) transformer type isolation amplifiers

Answer: c
Explanation: There is nothing such as the
1. Source of Bioelectric potential is
____________ in nature.
a) electronic
t
resistive coupled isolation amplifiers. All the b) electric
other three types are in common use, though c) ionic
the transformer isolation amplifier is more d) mechanical
popular. Opto-coupled amplifier uses a
minimum number of components and is cost Answer: c
effective, followed by the transformer Explanation: Bioelectric potentials are
coupled amplifier. The capacitor coupled generated at cellular level and the source of
amplifier is the most expensive. these potentials is ionic in nature. The
prominent ions are K+, Na+, and Cl–.
7. The isolation includes different supply Electronic potential is seen in commonly used
voltage sources and different grounds on each cells for example the Galvanic cell.

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Mechanical potential is found nowhere. membrane potential of quiescent cell. That is

Electrical potential is found in electricity. if the resting membrane potential of a neuron
is about -70 mV (mV=millivolt) it means that
2. Palsied muscles mean _____________ the inside of the neuron is 70 mV less than
a) paralyzed muscles the outside of the neuron. An action potential
b) active muscles occurs when the potential of the membrane of
c) voluntary muscles a given axonal position increases and
d) involuntary muscles decreases rapidly. This depolarization causes
depolarization of adjacent positions in a
Answer: a similar way.
Explanation: Palsied is an adjective that
means paralyzed. It is used to describe a 5. The variation of the electrical potential
muscle on which an individual has lost all associated with the passage of a pulse along

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control (cannot move). Voluntary muscles are
the muscles on which the individual has
complete control. Involuntary muscles are the
the membrane of a muscle cell or a nerve cell
is called __________
a) muscle potential

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ones on which the individual has no control
for example heart wall muscles.
b) action potential
c) resting potential

______________
a) sodium
b) potassium
asy
3. The principal ion that is not involved with
the phenomena of producing cell potentials is

En J
Answer: b

C E
d) half cell potential

Explanation: An action potential occurs

when the potential of the membrane of a
given axonal position increases and decreases
c) chlorine
d) hydrogen g
Ainee rapidly. This depolarization causes
depolarization of adjacent positions in a
Answer: d
Explanation: Sodium (Na+), Potassium (K+),
and Chlorine (Cl–) are the principal ions
S similar way. Resting membrane potential or
the resting potential is the relative static

rin
membrane potential of a quiescent cell.

M
involved with the phenomena of producing
cell potentials. Na+ is present outside the cell
membrane and creates a positively charged
g.n
6. Cells depolarize and action potential in
generated as soon as a stimulus is applied.
a) True

e
environment outside the cell membrane. Cl–
is present inside the cell membrane and is
responsible for the negative environment
b) False

Answer: b
Explanation: This statement is False. This is
t
inside the cell membrane. because unless a stimulus above a certain
minimum value is applied, the cell will not be
4. What is the relatively static membrane
depolarized and no action potential will be
potential of quiescent cells called?
generated. This value of potential above
a) half-cell potential
which the depolarizes and an action potential
b) action potential
is generated is known as the stimulus
c) resting membrane potential
threshold.
d) cell potential
7. After a cell is stimulated, a finite period of
Answer: c
time is required for the cell to return to its
Explanation: Resting membrane potential or
pre-stimulus state. This period is known as
the resting potential is the relative static

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EC8073 Medical Electronics Regulations 2017

____________ Electroencephalography is the electrical

a) restoration period recording of brain.
b) refactory period
c) regain period 10. Phonocardiography is listening to
d) regenerative period __________
a) arm muscle sound
Answer: b b) lungs sound
Explanation: After a cell is stimulated, a c) heart sound
finite period of time is required for the cell to d) respiratory tract sound
return to its pre-stimulus state. This is
because the energy associated with the action Answer: c
potential is developed from metabolic process Explanation: A phonocardiogram (or PCG)
within the cell which takes time for is a record high-constancy recording of

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completion. This time period is called
refactory period.
sounds and mumble made by the heart with
the assistance of the machine called
phonocardiography. Consequently,

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8. Electrooculography (EOG/E.O.G.) is a
technique for measuring what?
phonocardiography is the chronicle of the
considerable number of sounds made by the
a) abnormal function of the retina
b) heart rate
c) respiration rate asy
d) cornea-retinal standing potential

Answer: d En J C E
heart amid a heart cycle. Mostly stethoscope
is used phonocardiography.

TOPIC 1.3 BIOPOTENTIAL

ELECTRODES
Explanation: Electrooculography (EOG /
E.O.G) is a technique for measuring the
potential of the corneal retinal standing
g
Ainee 1. The material used in limb surface electrode

S
potential that exists between the front and
back of the human eye. The resulting signal is
called electrooculogram. The main
is ___________
a) German silver
b) Copper
c) Gold rin
M
applications are in the diagnosis of
ophthalmology and the recording of eye
movements.
d) Platinum

Answer: a
g.n
e
9. EKG stands for _________________
a) Electrocardiography
b) Electroencephalography
Explanation: The most common type of
electrode most routinely used for recording
ECG are rectangular or circular surface limb
electrodes. The material used in them is
t
c) Electromyography German silver, nickel silver or nickel plated
d) Electrtokinetcography steel. They are applied to the surface of the
body with electrode jelly.
Answer: a
Explanation: Electrocardiography (ECG or 2. Welsh cup electrodes have __________
EKG) is the way toward recording the a) low contact impedance
electrical action of the heart over some stretch b) negligible contact impedance
of time utilizing anodes put on the skin. It c) high contact impedance
could simply be understood as the electrical d) zero contact impedance
representation of heart beat.

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Answer: c polarization associated with the half-cell

Explanation: Welsh cup electrodes or suction potential constant.
electrodes is a metallic cup shaped electrode
which is used for recording ECG from 5. Recording electrical activities associated
various positions from the chest. It has a high with heart is known as ____________
contact impedance as only the rim of the a) EEG
electrode is in contact with the skin. It is b) EOG
commonly used to record the unipolar chest c) EMG
leads. d) ECG

3. In floating electrodes metal electrode does Answer: d

not make direct contact with the skin. Explanation: The recording of the electrical
a) True activities associated with the functioning of

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b) False

Answer: a
the heart is known as electrocardiogram. ECG
is a quasi-periodical, rhythmically repeating
signals synchronized by the function of the

w.E
Explanation: In floating electrode the metal
electrode does not make direct contact with
heart, which acts as a generator of bioelectric
events. This generated signals can be
the skin. The electrode consists of a light

asy
weighted metalled screen or plate held away
from the subject by a flat washer which is
connected to the skin. Floating electrodes can

En J
be recharged, i.e. the jelly in the electrodes
dipole.

C E
described by the means of a simple electric

6. Which of the following is considered to be

the primary pacemaker of the heart?
a) sino-atrial node
can be replenished if desired.

4. The main design feature of pregelled

disposable electrodes which helps to reduce
g
Ainee
b) atrio-ventricular node
c) purkinje fibres
d) bundle of his

wandering is _____________
S
the possibility of artefacts, drift and baseline

a) low absorbency buffer layer with isotonic

Answer: a
rin
Explanation: Located in the top right atrium
electrolyte

M
b) high absorbency buffer layer with isotonic
electrolyte
g.n
near the entry of the vena cava, are a group of
cells known as the sino-atrial node (SA node)
that initiates the heart activity. Because this is

e
also considered as the primary pacemaker of
c) high absorbency buffer layer without
isotonic electrolyte
d) low absorbency buffer layer without
isotonic electrolyte
the heart. The SA node is 25 to 30 mm in
length and 2 to 5 mm in thickness. t
7. Atrio ventricular node is located at
Answer: b __________
Explanation: The main design feature of a) upper part of the heart wall between the
pregelled disposable electrode that helps in two atrial
reducing the possibility of artefacts, drift and b) lower part of the heart wall above the two
baseline wandering is the provision of high atrial
absorbency buffer layers with isotonic c) lower part of the heart wall between the
electrolyte. This layer absorbs the effects of two atrial
movement of the electrode in relationship to d) upper part of the heart wall above the two
the skin and attempts to maintain the atrial

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EC8073 Medical Electronics Regulations 2017

Answer: c wirelessly and displayed on a laptop

Explanation: The AV node is located in the computer.
lower part of the wall between the two atria.
The AV node delays the spread of excitation 10. Before placing the electrodes the skin
for about 0.12s, due to the presence of a should be __________
fibrous barrier of non-excitable cells that a) wet
effectively prevent its propagation from b) dry
continuing beyond the limits of stria. c) hairy
d) oily
8. Buffer amplifier converts ____________
a) low impedance signals to high impedance Answer: b
signals Explanation: The skin should be dry. Poor
b) high impedance signals to low impedance skin prep prompts undesirable curio and not

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signals
c) ac impedance signals to dc impedance
signals
putting the terminals where they ought to be
can change the morphology (shape) of the
waveforms the specialist will decipher. The

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d) dc impedance signals to ac impedance
signals
purpose of decent skin prep is to expel soil,
dead skin cells, oils, skin cream, counterfeit

Answer: b
asy
Explanation: Noise is typically generated
from motion artefacts and power line
interference. A common solution used to
En J
E
tan, body powder, sweat and so forth. These
sources can prompt poor contact with the

C
sensors and ancient rarity.

TOPIC 1.4 BIOLOGICAL

suppress noise in dry electrode signals is a
buffer amplifier. A buffer amplifies is
essentially an impedance converter, that g
Ainee
AMPLIFIERS

converts high impedance signals to low

impedance signals.
S
9. Which of the following is a wireless ECG
1. Bio potential amplifiers have
____________ input terminals.
a) 3
b) 4 rin
acquiring system?

M
a) pregelled disposable electrodes
b) limb electrodes
c) 5
d) 6 g.n
e
c) pasteless electrodes
d) smart pad

Answer: d
Answer: a
Explanation: Bio potential has three input
terminals. Out of the three one is arranges at
the reference potential. The other two are live
t
Explanation: Smart pad is a system that terminals. Bio potential amplifiers are also
displays patients electrocardiogram signals known as differential amplifiers. The
without adhesive pads, wires or active differential amplifier is employed when it is
intervention from a clinician. The system necessary to measure the voltage difference
automatically selects three electrodes from an between two points, both of them varying in
array of Cu/Ni fabric based electrodes amplitude at different rates and in different
patterned on a thin pad on which the patient patterns.
lies. The selected electrodes are used to
provide a differential 3 lead measurement of 2. The ability of the amplifier to reject
the patient’s ECG, which is then transmitted common voltages on its two input leads is
known as ________

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a) common mode rejection rate to the differential amplifier and is normally

b) coupled mode rejection rate expressed as decibels.
c) common mode rejection ratio
d) coupled mode rejection ratio 5. The common mode rejection for most op-
amps is typically between __________
Answer: c a) 10-50dB
Explanation: The ability of the amplifier to b) 20-40dB
reject common voltages on its two input leads c) 60-90dB
is known as common-mode rejection. It is d) 100-120dB
specified as the ratio of common-mode input
to differential input to elicit the same Answer: c
response. It is abbreviated as CMRR Explanation: The common mode rejection
(Common-mode rejection ratio). for most op-amps is typically between 60 dB

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3. CMRR is measured in ____________
a) V/s
and 90 dB. This may not be sufficient to
reject common mode noise generally
encountered in biomedical measurements.
b) dB
c) dB/s w.E Also, the input impedance is not very high to
handle signals from high impedance sources.
d) dB/ms

Answer: b
asy
Explanation: CMRR is an important
specification referred to the differential
amplifier and is normally expressed as En J
E
6. The output of differential gain is given by
_________

C
a) (difference of the two input voltage)*
(feedback resistance/input resistance)
b) (sum of the two input voltage)*(feedback

common voltages on its two input leads is

known as common-mode rejection. It is
g
decibels. The ability of the amplifier to reject

Ainee
resistance/input resistance)
c) (difference of the two input voltage)*(input
resistance/feedback resistance)

to differential input to elicit the same

response. S
specified as the ratio of common-mode input d) (sum of the two input voltage)*(input

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resistance/feedback resistance)

high as possible.
a) True
M
4. CMRR of the preamplifiers should be as
Answer: a
g.n
Explanation: The output of differential gain
is given by (difference of the two input

e
voltage)*(feedback resistance/input
b) False

Answer: a
resistance). gain is given by (feedback
resistance/input resistance). The input
resistances of but the inputs are the same.
t
Explanation: CMRR of the preamplifiers
should be as high as possible so that only the 7. In order to be able to minimize the effects
wanted signals find a way through the of changes occurring in the electrode
amplifier and all unwanted signals get impedances, it is necessary to employ a
rejected in the preamplifier stage. The ability preamplifier having a high input impedance.
of the amplifier to reject these common a) True
voltages on its two input leads is known as b) False
common-mode rejection and is specified as
the ratio of common-mode input to Answer: a
differential input to elicit the same response. Explanation: True. In order to be able to
CMRR is an important specification referred minimize the effects of changes occurring in

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the electrode impedances, it is necessary to ECG circuit?

employ a preamplifier having a high input a) band pass filters
impedance. It has been found that a low value b) high pass filters
of input impedance gives rise to considerable c) notch filters
distortion of the recordings. d) low pass filters

8. The impedance of the input should be Answer: c

________ in order to obtain high CMRR in Explanation: A notch filter is employed to
the differential amplifier. suppress the hum noise generated by the
a) low power supply in the ECG circuit. CMRR of
b) High the order of 100–120 dB with 5 kW
c) Does not matter unbalance in the leads is a desirable feature of
d) Very low ECG machines. The instability of the

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Answer: b
Explanation: This shows that high input
baseline, originating from the changes of the
contact impedance, demands the application
of the automatic baseline stabilizing circuit.

w.E
impedance is very necessary in order to
obtain a high CMRR. Also, the electrode skin 3. The branch of medicine that deals with the
resistance should be low and as nearly equal

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as possible. In order to be able to minimize
the effects of changes occurring in the
electrode impedances, it is necessary to
employ a preamplifier having a high input
En J
E
provision and use of artificial devices such as
splints and braces is _________

C
a) prosthetics
b) orthotics
c) laproscopic
impedance. d) augmentative communication

TOPIC 1.5 ECG g

Ainee Answer: c
Explanation: The branch of medicine that

1. The frequency range of ECG is

____________ S deals with the provision and use of artificial

rin
devices such as splints and braces are
orthotics. A modality-specific appliance that
a) 0.05-150 HZ
b) 500-1500 Hz
c) 5-500 kHz
d) 0.5-150 MHz
M g.n
aids the performance of a function or
movement by augmenting or assisting the
residual capabilities of that function or

e
Answer: a
Explanation: The diagnostically useful
movement. An orthopaedic brace is an
orthosis.

4. The sensitivity of an electrocardiograph is

t
frequency range is usually accepted as 0.05 to typically set at 10 mm/mV.
150 Hz. Although the electric field generated a) True
by the heart can be best characterized by b) False
vector quantities, it is generally convenient to
directly measure only scalar quantities, i.e. a Answer: a
voltage difference of mV order between the Explanation: It is true. The sensitivity of an
given points of the body. electrocardiograph is typically set at 10
mm/mV. For routine work, the paper
2. Which of the following amplifier recording speed is 25 mm/s. Amplitude
circulatory is employed to reduce the hum measurements are made vertically in
noise generated by the power supply in the millivolts. Time measurements and heart rate

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measurements are made horizontally on the change in resistance with volume of the cell
electrocardiogram. to hold good, it is recommended that the ratio
of the aperture length to the diameter of the
5. The volume of blood within the dialyzer is aperture should be 0.75:1, i.e. for an orifice of
known as ___________ 100 m diameter the length should be 75 m.
a) secondary volume The instrument based on the Coulter principle
b) quarterly volume works most satisfactorily when the average
c) priming volume diameter of the particles ranges between 2 to
d) residual volume 40% of the diameter of the measuring hole.
Answer: c 8. The blood is a poor conductor of
Explanation: The volume of blood within the electricity.
dialyzer is known as priming volume. It is a) True

ww
desirable that this should be minimal. Priming
volume of present day dialyzers ranges from
75 to 200 ml, depending on the membrane
b) False

Answer: a

w.E
area geometry and operating conditions. Explanation: It is true. Blood is a poor
conductor of electricity. This principle is used
6. The ideal membrane should possess
___________ to water.
asy
a) low permeability to water
b) high permeability to water
c) medium permeability to water
d) high permeability to waste En J C E
in Coulter counters to count the number of
RBCs in the blood.

9. In floating electrodes metal electrode does

not make direct contact with the skin.
a) True

Answer: b
Explanation: The ideal membrane should
g
Ainee
b) False

Answer: a

S
possess high permeability to water, organic
metabolites and ions, and the capability of
retaining plasma proteins. The membrane
Explanation: In a floating electrode, the

rin
metal electrode does not make direct contact
with the skin. The electrode consists of a light

all body cells. M

should be of sufficient wet strength to resist
tearing or bursting and non-toxic to blood and
g.n
weighted metalled screen or plate held away
from the subject by a flat washer which is
connected to the skin. Floating electrodes can

e
be recharged, i.e. the jelly in the electrodes
7. To achieve optimum performance and to
enable the relationship of change in resistance
with the volume of the cell to hold good, it is
can be replenished if desired.

TOPIC 1.6 EEG

t
recommended that the ratio of the aperture
length to the diameter of the aperture should
be __________ 1. Electrodes to measure EEG are placed on
a) 75:1 ________
b) 0.75:100 a) forehead
c) 0.75:1 b) scalp
d) 0.5:10 c) cheek
d) ears
Answer: c
Explanation: To achieve optimum Answer: b
performance and to enable the relationship of Explanation: Electrode to measure EEG are

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placed on the scalp. The position of each 5. The letter T in the EEG electrode
electrode is specified using the International placement system denotes?
10/20 system. Each electrode site is labeled a) temporal lope
with a letter and a number. b) temper lobe
c) trace
2. According to the international 10/20 d) timpanic
system to measure EEG, even number
denotes which side of the brain? Answer: a
a) left Explanation: T denotes temporal lobe of the
b) top head. The position of each electrode is
c) bottom specified using the International 10/20
d) right system. Each electrode site is labeled with a
letter and a number.

ww
Answer: d
Explanation: The position of each electrode
is specified using the International 10/20
6. According to the international 10/20
system to measure EEG, odd number denotes

w.E
system. Each electrode site is labeled with a
letter and a number. Even number denotes the
which side of the brain?
a) left
right side of the head.

system denotes?
a) front
b) face
asy
3. Letter F in the EEG electrode placement

En J
b) right
c) top
d) front

Answer: a
C E
Explanation: The position of each electrode
c) frontal lobe
d) fast g
Ainee
is specified using the International 10/20
system. Each electrode site is labeled with a
letter and a number. Odd number denotes the
Answer: c
Explanation: F denotes frontal lobe of the
head. The position of each electrode is S left side of the head.

rin
7. The delta wave in EEG ranges from

letter and a number. M

specified using the International 10/20
system. Each electrode site is labeled with a
___________
a) 0.5-4Hz
b) 4-8Hz
c) 8-13Hz
g.n
e
4. Normal EEG frequency range is _______
a) 50-500Hz
b) 0.5-50HZ
d) 13-22Hz

Answer: a
t
c) 0.05-5Hz Explanation: The delta wave in EEG ranges
d) 1-200Hz from 0.5-4Hz. The theta wave in EEG ranges
from 4-8Hz. The alpha wave in EEG ranges
Answer: b from 8-13Hz and beta from 13-22Hz.
Explanation: The frequency varies greatly
with different behavioral states. The normal 8. Disturbance in the EEG pattern resulting
EEG frequency content ranges from 0.5 to from the external stimuli is called ________
50Hz. The nature of the wave varies over the a) provoked response
different parts of the scalp. b) ckoored response
c) evoked response
d) impulse response

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Answer: c a) (7.07,45⁰,53⁰)
Explanation: Disturbance in the EEG pattern b) (0.707,45⁰,53⁰)
resulting from the external stimuli is called c) (7.07,54⁰,63⁰)
evoked response. The stimuli could be a flash d) (0.707,54⁰,63⁰)
light or a click of sound. The stimuli can be
repeated and the EEG waveform can be Answer: a
observed to find the activities occurring Explanation: r = √(x2+y2+z2) = √50 = 7.07
because of the stimuli. Θ = cos-1(z/r) = cos-1(5/5√2) = 45⁰
9. The peak to peak amplitude of the waves Φ = tan-1(y/x) = tan-1(4/3) = 53⁰.
that can be picked from the scalp is
2. Example of spherical system in the
______________
following is
a) 100mV
a) Charge in space

ww
b) 100V
c) 100uV
d) 10mV
b) Charge in box
c) Charge in dielectric
d) Uncharged system
Answer: c w.E Answer: a
Explanation: The EEG signal can be picked

asy
up with electrodes either from the scalp or
directly from the cerebral cortex. The peak to
peak amplitude of the waves that can be

En J
picked up from the scalp is normally 100uV.
E
Explanation: From a point charge +Q, the
electric field spreads in all 360 degrees. The

C
calculation of electric field in this case will be
spherical system. Thus it is charge in the
space.
The frequency varies greatly with different
behavioral states.

10. Which rhythm is the principal component

g
Ainee 3. Spherical systems are employed in
waveguides. State True/False

brain?
a) theta rhythm S
of the EEG that indicates the alertness of the
a) True
b) False
rin
b) gamma rhythm
c) beta rhythm
d) alpha rhythm M Answer: b

g.n
Explanation: There is no waveguide
designed spherically to avoid absorption,
rather than propagation.
e
Answer: d
Explanation: The alpha rhythm is the
principal component of the EEG and is an
4. Choose which of following condition is not
required for a waveguide to exist.
a) The dimensions should be in accordance
t
indicator of the state of alertness of the brain. with desired frequency
It serves as an indicator of the depth of b) Cut-off frequency should be minimum
anesthesia in the operating room. The 6GHz
frequency of the EEG seems to be affected by c) The shape should be spherical
the mental activity of a person. d) No specific condition is required for
waveguide design
TOPIC 1.7 EMG
Answer: c
Explanation: A waveguide need not be
1. Convert the point (3,4,5) from Cartesian to
spherical, it has to be rectangular or circular,
spherical coordinates
as it violates the propagation of the wave.

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5. Find the spherical coordinates of A(2,3,-1) 9. The scalar factor of spherical coordinates is
a) (3.74, 105.5⁰, 56.13⁰) a) 1, r, r sin θ
b) (3.74, 105.5⁰, 56.31⁰) b) 1, r, r
c) (3.74, 106.5⁰, 56.13⁰) c) r, r, 1
d) (3.74, 106.5⁰, 56.31⁰) d) r, 1, r

Answer: b Answer: a
Explanation: r = √(x2+y2+z2) = √14 = 3.74 Explanation: The radius varies from unity to
Θ = cos-1(z/r) = cos-1(-1/3.74) = 105.5⁰ infinity, the plane angle from zero to 360 ⁰
and the z plane from (-∞, ∞) .
Φ = tan-1(y/x) = tan-1(3/2) = 56.31⁰.
10. Transform the vector (4,-2,-4) at (1,2,3)
6. Find the Cartesian coordinates of into spherical coordinates.
B(4,25⁰,120⁰)

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a) (0.845, 1.462, 3.625)
b) (-0.845, 1.462, 3.625)
c) (-8.45, 2.462, 6.325)
a) 3.197i – 2.393j + 4.472k
b) -3.197i + 2.393j – 4.472k
c) 3.197i + 2.393j + 4.472k

w.E
d) (8.45, 2.462, 6.325)
d) -3.197i – 2.393j – 4.472k

Answer: b

120⁰ = -0.845 asy

Explanation: x = r sin θ cos φ = 4 sin25⁰ cos

En J
y = r sin θ sin φ = 4 sin 25⁰ sin 120⁰ = 1.462
z = r cos θ = 4 cos 25⁰ = 3.625.
Answer: b

E
Explanation: r = √(x2+y2+z2) = 3.74

C
Θ = cos-1(z/r) = cos-1(3/3.74) = 36.7⁰
Φ = tan-1(y/x) = tan-1(2/1) = 63.4⁰
A = (4 sin θ cos φ – 2 sin θ sin φ – 4cos θ)i +

7. The area of sphere can be computed from

the sphere volume. State True/False. g
Ainee
(4 cos θ cos φ – 2 cos θ sin φ + 4 sin θ)j + (-4
sin φ – 2 cos φ)k
On substituting r, θ, φ, A = -3.197i + 2.393j –
a) True
b) False
S 4.472k.

TOPIC 1.8 PCG rin

Answer: a

M
Explanation: On double integrating the
differential volume, the area can be computed
for a sphere.
g.n
1. An arrhythmia monitor is basically a
______
e
8. Given B= (10/r)i+( rcos θ) j+k in spherical
coordinates. Find Cartesian points at (-3,4,0)
a) -2i + j
a) Sophisticated monitoring system
b) Sophisticated alarm system
c) Patient monitoring system
d) ECG interpretation system
t
b) 2i + k
c) i + 2j Answer: b
d) –i – 2k Explanation: An arrhythmia monitor is
basically a sophisticated alarm system. It is
Answer: a not an ECG interpretation system. It
Explanation: r = √(x2+y2+z2) = √25 = 5 constantly scans ECG rhythm patterns and
Θ = cos-1(z/r) = 1 issues alarms to events that may be
premonitory or life threatening.
Φ = tan-1(y/x) = tan-1(-4/3)
Thus, B = -2i + j. 2. In arrhythmia monitoring system, it gives
alarm light signals whenever the prematured

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or widened ectopic beats exist up to the rate a) 16 bit

of ___________ b) 12 bit
a) 6/min to 10/min c) 32 bit
b) 6/min to 12/min d) 64 bit
c) 6/min or 10/min
d) 6/min or 12/min Answer: b
Explanation: In signal conditioning, ECG
Answer: d signal is amplified, filtered and digitized
Explanation: In arrhythmia monitoring using an 8 or 12 bit analog-to-digital
instrument, it gives alarm light signals converter with a typical sampling rate of 250
whenever the prematured or widened ectopic Hz.
beat exist up to the rate of 6/min or 12/min.It
is one of the operating sequences of the 6. By using a _________ rather than a

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arrhythmia monitoring instrument.

3. In automated arrhythmia monitoring

_________ the amplitude of low frequency
noise as well as the low frequency
components of the ECG will be reduced

w.E
system, which task is performed after the
Ventricular fibrillation detection?
without affecting the QRS.
a) High-pass filter, Band-pass filter
a) Rhythm definition
b) Beat labeling
asy
c) Atrial fibrillation detection
d) Noise detection

Answer: a En J
E
b) Low-pass filter, Band-pass filter
c) Band-pass filter, Low-pass filter

C
d) Band-pass filter, High-pass filter

Answer: c
Explanation: The maximum of the QRS
Explanation: In automated arrhythmia
monitoring system, Rhythm definition is g
Ainee
performed after the Ventricular fibrillation
energy spectrum is in the vicinity of 10 Hz,
the filter is designed to have a bandwidth of
about 15 Hz with a centre frequency of 10-12
detection. Rhythm definition is also
S
performed after the beat labeling and atrial
fibrillation detection in automated arrhythmia
Hz. By using a bandpass filter rather than a

rin
low-pass filter, the amplitude of low
frequency noise as well as the low frequency
monitoring and analysis system.

M
4. In signal conditioning, ECG signal is
amplified, filtered with 0.05-100 Hz for
without affecting the QRS.g.n
components of the ECG will be reduced

e
7. The steep, large amplitude variation of the
monitoring purposes and 1-40 Hz for
diagnostic purposes.
a) True
QRS complex is the obvious characteristics to
use and this is the function of the R wave
detector.
t
b) False a) True
b) False
Answer: b
Explanation: ECG signal is amplified and Answer: a
filtered with 0.05-100 Hz for diagnostic Explanation: Arrhythmia monitors require
purposes and 1-40 Hz for monitoring reliable R wave detectors as a prerequisite for
purposes in signal conditioning. subsequent analysis. The steep, large
amplitude variation of the QRS complex is
5. Which analog-to-digital converter is used the obvious characteristics to use and this is
in the digitization of ECG signal in signal the function of the R wave detector.
conditioning?

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8. In the process of the ECG waveform, the maintain no more than 10-20 clusters at a
detection filter removes _______ and time, order to limit the amount of
_______ computation needed to assign a QRS complex
a) Baseline wander, motion noise to a cluster.
b) Muscle artifact, motion noise
c) Low frequency noise, motion noise 11. When will be R-R interval declared
d) Baseline wander, muscle artifact premature?
a) If it is greater than 85% of the predicted
Answer: c interval
Explanation: The ECG waveform is b) If it is less than 85% of the predicted
processed by two digital filters: a detection interval
filter and a classification filter. The detection c) If it is greater than 75% of the predicted
filter removes low frequency noise (baseline interval

ww
wander) and muscle artifact. P waves and T
waves are diminished.
d) If it is less than 75% of the predicted
interval

detection? w.E
9. How many steps are there in QRS Answer: b
Explanation: In timing classification, the
a) Three steps
b) Two steps
c) Four steps
d) One step

Answer: b
asy
En J
E
observed R-R interval is compared to an
estimate of the expected R-R interval. An R-

C
R interval will be declared premature if it is
less than 85% of the predicted interval.
Similarly, an R-R interval is long if it is
greater than 110% of the predicted value.
Explanation: QRS detection is now almost
universally performed digitally in a two-step
process. The ECG is first preprocessed to
g
Ainee 12. Which is the final stage in arrhythmia
analysis?
enhance the QRS complex while suppressing
noise, artifact and non-QRS portions of the
S
ECG. The output of the preprocessor stage is
a) Beat labeling
b) Alarms
c) Rhythm labeling rin
M
subjected to a decision rule that confirms the
detection of QRS if the processor output
exceeds a threshold.
d) Summary statistics

Answer: c
g.n
e
Explanation: Rhythm labeling is the final
10. _________ is based on analyzing the
shape of the QRS complexes and separating
beats into groups or clusters.
stage in arrhythmia analysis. It is based on
defined sequences of QRS complexes. The
analysis systems are heavily oriented towards
t
a) Timing classification detecting ventricular arrhythmias, particularly
b) Morphology characterization single PVCs.
c) Beat labeling
d) Noise detection 13. Ventricular Fibrillation is detected by
_________
Answer: b a) Shape of the QRS complexes
Explanation: Morphology characterization is b) Difference of the R-R interval
based on analyzing the shape of the QRS c) Timing sequence of QRS complexes
complexes and separating beats into groups or d) Frequency domain analysis
clusters of similar morphology. Most
algorithms for real time arrhythmia analysis

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Answer: d
TOPIC 1.9 TYPICAL
Explanation: Ventricular fibrillation is
usually detected by frequency domain WAVEFORMS AND SIGNAL
analysis. The system is characterized as a CHARACTERISTICS
narrow-band, low frequency signal with
energy concentrated in a band around 5-6 Hz. 1. The variation of a quantity such as voltage
It can be distinguished from noise by or current shown on a graph is known as
appropriately designing band-pass filters. ___________
a) Waveform
14. Which techniques are used in a new b) Peak value
algorithm proposed by Jen and Hwang to c) Instantaneous value
obtain the long term ECG signal feature and d) Period
extract the meaningful information hiding in

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the QRS complex?
a) Cepstrum time warping and Dynamic
coefficient
Answer: a
Explanation: The variation of a quantity,
which is voltage or current in this case,
warping w.E
b) Cepstrum coefficient and Dynamic time shown on a graph with the x-axis as time is
known as a waveform.
c) QRS detection and Dynamic coefficient

Answer: b
asy
d) QRS detection and Cepstrum time warping

Explanation: Jen and Hwang proposed a new

En J
_________
a) Waveform
E
2. What is the duration of one cycle known as

C
b) Peak value
algorithm using cepstrum coefficient and the c) Instantaneous value
dynamic time warping techniques to obtain
g
Ainee
the long term ECG signal feature and extract
d) Period

S
the meaningful information hiding in the QRS
complex. This algorithm may also be used for
arrhythmia detection by simply checking the
difference of R-R wave intervals through
Answer: d
Explanation: The duration of one cycle is

rin
known as a period. A function which repeats

certain period of time.

M
signal feature extraction comparison for a
the same waveform at equal intervals of time

g.n
is known as a periodic function.

e
3. The repetition of a variable quantity,
15. What is the sampling rate of the analog-
to-digital converter in digitizing of ECG
signal in signal conditioning?
a) 250 Hz
recurring at equal intervals, is known as
___________
a) Waveform
b) Instantaneous value
t
b) 215 Hz c) Cycle
c) 40-100 Hz d) Period
d) 200-215 Hz
Answer: c
Answer: a Explanation: Each repetition of a variable
Explanation: In signal conditioning, ECG quantity, recurring at equal intervals, is
signal is amplified, filtered (0.05-100 Hz for termed as a cycle.
diagnostic purposes, 1-40 Hz for monitoring
purposes) and digitized using an 8 or 12-bit 4. The value of a given waveform at any
analog-to-digital converter with a typical instant time is termed as ___________
sampling rate of 250 Hz. a) Waveform

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b) Instantaneous value instantaneous value is the peak-to-peak value.

c) Cycle For a sinusoidal waveform, it is twice the
d) Period peak value. Hence Vp-p=2Vp.

Answer: b 8. If the peak to peak voltage is 10V, calculate

Explanation: Instantaneous value is the value the peak voltage.
of the waveform at that instant. Hence the a) 10V
value of a given waveform at any instant time b) 2V
is termed as instantaneous value. c) 4V
d) 5V
5. The maximum instantaneous value
measured from zero value is known as? Answer: d
a) Peak value Explanation: Vp-p=2Vp

ww
b) Peak to peak value
c) Cycle
d) Period
Substituting the values from the question, we
get Vp=5V.

Answer: a
w.E 9. If the peak voltage is 9V, calculate the peak
to peak voltage.
Explanation: The maximum instantaneous

as the peak value.

asy
value measured from the zero value is termed

6. The maximum variation between the

maximum positive and the maximum En J
a) 9V
b) 20V
c) 18V
d) 12V

Answer: c C E
negative value is known as?
a) Peak value
b) Peak to peak value
g
Ainee
Explanation: Vp-p=2Vp
Substituting the values from the question, we
get Vp-p= 18V.
c) Cycle
d) Period
S rin
Answer: b

M
Explanation: The maximum variation
between the maximum positive instantaneous
value and the maximum negative
UNIT II BIO-CHEMICAL
AND NON ELECTRICAL
g.n
e
instantaneous value is the peak-to-peak value.

7. What is the correct relation between the

PARAMETER
MEASUREMENT
t
peak value and peak to peak value for a
sinusoidal waveform? TOPIC 2.1 PH
a) Vp=4Vp-p
b) Vp=Vp-p
c) Vp-p=2Vp 1. Which of the following is the formula for
d) Vp=2Vp-p pH calculation?
a) log10[H+]
Answer: c b) -log10[H+]
Explanation: The maximum variation c) log2[H+]
between the maximum positive instantaneous d) -log2[H+]
value and the maximum negative

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Answer: b b) Value of hydroxyl ion concentration is

Explanation: pH is defined as the negative greater
logarithm of hydrogen ion concentration. c) They are both always the same
Hence, its formula is -log10[H+]. d) The concentrations keep changing

2. Pure water is known to be which of the Answer: c

following? Explanation: In water, the value of hydrogen
a) Weak electrolyte and hydroxyl ion concentrations are the same.
b) Strong electrolyte It can be represented as [H+]=[OH-].
c) Neither weak nor strong
d) Not an electrolyte 6. The Nernst equation is given by which of
the following statements?
Answer: a a) E=Eo + 2.303 RT/F log CH

ww
Explanation: Pure water is a weak
electrolyte. It dissociates to form hydrogen
ions and hydroxyl ions.
b) E=Eo – 2.303 RT/F log CH
c) E=Eo + 2.303 RT×F log CH
d) E=Eo – 2.303 RT×F log CH
w.E
3. Which of the following is the value of
hydrogen ion concentration of pure water?
a) 1×107 moles/litre
b) 1×105 moles/litre
c) 1×106 moles/litre
d) 1×108 moles/litre
asy
En J
Answer: a

C E
Explanation: The Nernst equation is
represented as, E=Eo + 2.303 RT/F log CH. it
is used for measuring the potential of
electrodes.

Answer: a g
Ainee
Explanation: The hydrogen ion concentration
7. Which of the following is the relation
between the concentration of hydrogen and
hydroxyl ions in an acidic solution?

represented as [H+]=1×107 moles/litre.

S
of pure water is 1×107 moles/litre. It can be a) Value of hydrogen ion concentration is
greater
rin
b) Value of hydroxyl ion concentration is

M
4. Which of the following is the value of
hydroxyl ion concentration of pure water?
a) 1×107 moles/litre
greater
g.n
c) They are both always the same
d) The concentrations keep changing

e
b) 1×105 moles/litre
c) 1×106 moles/litre
d) 1×108 moles/litre
Answer: a
Explanation: In acidic solution, the value of
hydrogen ion concentration is greater than
t
that of hydroxyl ion concentration. It can be
Answer: a represented as [H+]>[OH-].
Explanation: The hydroxyl ion concentration
of pure water is 1×107 moles/litre. It can be 8. Which of the following is the relation
between the concentration of hydrogen and
represented as [OH-]=1×107 moles/litre.
hydroxyl ions in a basic solution?
a) Value of hydrogen ion concentration is
5. Which of the following is the relation
between hydrogen and hydroxyl ion greater
concentration of pure water? b) Value of hydroxyl ion concentration is
greater
a) Value of hydrogen ion concentration is
greater

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c) They are both always the same respiratory functions. It is maintained at a

d) The concentrations keep changing fairly constant value to within a few percents
in a healthy organism.
Answer: b
Explanation: In basic solution, the value of 2. Liquid part of blood is __________
hydroxyl ion concentration is greater than that a) Platelets
of hydrogen ion concentration. It can be b) Red Blood Cells
represented as [H+]<[OH-]. c) White Blood Cells
d) Plasma
9. The measurement of hydrogen ion
concentration can be made by measuring the Answer: d
potential developed in an electrochemical Explanation: The plasma (liquid part of the
cell. blood) is a very poor carrier of oxygen. At the

ww
a) True
b) False
pressures available, only 0.3 ml of oxygen
can dissolve in 100 ml of plasma, which is
quite insufficient for the needs of the body.
Answer: a
w.E
Explanation: The measurement of hydrogen 3. What does red blood cells contain for
ion concentration can be made by measuring

cell.
asy
the potential developed in an electrochemical

10. Slope factor is independent of

temperature. En J
a) Proteins
E
combining with a large volume of oxygen?

b) Haemoglobin
c) Lipids

C
d) Platelets

a) True
b) False g
Ainee
Answer: b
Explanation: The red blood cells contain
haemoglobin which can combine with a large
Answer: b

S
Explanation: Slope factor is dependent on
temperature. Slope factor is given by – 2.303
volume of oxygen so quickly that in the lungs

rin
it may become 97% saturated forming a
compound called oxyhaemoglobin.
RT/F.

TOPIC 2.2 PO2 M g.n

4. How much quantity of oxygen bound with
haemoglobin in the normal arterial blood?
a) 20.3ml %
e
1. Which gas saturation is of great importance
in clinical practice?
b) 21.5ml %
c) 19.4ml %
d) 20.1ml %
t
a) oxygen
b) carbon dioxide Answer: c
c) hydrogen Explanation: The total quantity of oxygen
d) nitrogen bound with haemoglobin in the normal
arterial blood is approximately 19.4 ml
Answer: a percent at a pO2 of 95 mmHg. On passing
Explanation: In clinical practice, the through the tissue capillaries this amount is
percentage of oxygen saturation in the blood reduced to 14.4 ml percent at a pO2 of 40
is of great importance. This saturation being a mmHg.
bio-constant is an indication of the
performance of the most important cardio-

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5. When blood is withdrawn from the subject a) heart

under anaerobic conditions and measurement b) brain
for oxygen saturation is made at a later time c) ear
in the laboratory, the procedure is referred to d) eyes
as _________ oximetry.
a) in vitro Answer: c
b) in vivo Explanation: Blood in the ear must be made
c) transmission similar to arterial blood in composition. This
d) reflection is done by increasing the flow through the ear
without appreciably increasing the
Answer: a metabolism. Maximum vasodilatation is
Explanation: When blood is withdrawn from achieved by keeping the ear warm.
the subject under anaerobic conditions and

ww
measurement for oxygen saturation is made at
a later time in the laboratory, the procedure is
referred to as in vitro oximetry.
9. By keeping the ear warm, maximum
vasodilatation is achieved.
a) True

w.E
6. For discrete blood samples, a
b) False

spectrophotometric measurement of oxygen

a) in vitro
b) in vivo
c) transmission
asy
saturation can be made by which method?

En J
Answer: a

C E
Explanation: Yes, maximum vasodilatation is
achieved by keeping the ear warm. It takes
about 5 or 10 min for the ear to become fully
dilated after the ear unit has been put up in
place and the lamp turned on.
d) cannot be determined

Answer: c
Explanation: For discrete blood samples, a
g
Ainee 10. What is time taken for the ear to become
fully dilated after ear unit has been placed?
spectrophotometric measurement of oxygen
saturation can be made by either a
S
transmission method or a reflection method.
a) 5-10 min
b) 10-15 min
c) 15-20 min rin
usually?
a) in vivo
M
7. Which principle is used by ear oximeter
d) 20-25 min

Answer: a g.n
e
Explanation: Maximum vasodilatation is
b) transmission
c) reflection
d) in vitro
achieved by keeping the ear warm. It takes
about 5 or 10 min for the ear to become fully
dilated after the ear unit has been put up in
t
place and the lamp turned on.
Answer: b
Explanation: Ear oximeters usually make use 11. Merrick and Hayes (1976) describe details
of the transmission principle to measure of a _________ oximeter which enables the
arterial oxygen saturation. In this case, the measurement of oxygen saturation of blood.
pinna of the ear acts as a cuvette. Blood in the a) Pulse
ear must be made similar to arterial blood in b) Ear
composition. c) Skin Reflactance
d) Intravascular
8. Blood in _________ must be made similar
to arterial Blood in composition.

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Answer: b that the optical absorbers act independently

Explanation: Merrick and Hayes (1976) and additively and that the effects of light
describe details of an ear oximeter which scattering by the ear tissue can be minimized
enables the measurement of oxygen by a proper source and detector geometry.
saturation of the blood. This measurement is
independent of a wide range of encountered
variables and is made without involving
TOPIC 2.3 PCO2
patients in any calibration or standardization
procedure. 1. pH meters can be considered as voltage
sources with which of the following internal
12. This technique involves measuring the resistances?
optical transmittance of the ear at how many a) Very low resistance
wavelengths? b) Moderate resistance

ww
a) 12
b) 6
c) 8
c) Very high resistance
d) No resistance

d) 10
w.E Answer: c
Explanation: pH meters can be considered as
Answer: c

asy
Explanation: In brief, the technique involves
measuring the optical transmittance of the ear
at 8 wavelengths in the 650 to 1050 nm range.

En J
A 2.5 m long flexible fibre ear probe connects
C E
voltage sources with very high internal
resistance. In order to eliminate errors, no
current should flow from the source.

2. The electrodes used in pH measurement

have which of the following internal
the patient to the instrument.

g
Ainee
13. Ear probe which connects the patient to
instrument is ___________ m long.
resistances?
a) Very low resistance
b) Moderate resistance
a) 1.5
b) 2.0
c) 2.5 S c) Very high resistance
d) No resistance
rin
d) 3.0

Answer: c M
Explanation: A 2.5 m long flexible fibre ear
Answer: c
g.n
Explanation: The electrodes used in pH
measurement have very high internal

e
resistance. It is of the order of 1000M ohm.
probe connects the patient to the instrument.
The ear probe can be either held in position
for discrete measurements or can be
3. Which of the following is not a failure in
pH meters?
t
conveniently mounted to a headband for a) Defective electrodes
continuous display. b) Defective input circuitry
c) Defective electronic circuitry
14. Ear oximeter instrument is based on Beer- d) Defective calibration
Lambert law.
a) True Answer: d
b) False Explanation: Defective calibration is not a
failure in pH meters. Failure occurs due to
Answer: a defective electrodes, defective input circuitry
Explanation: The instrument is based on the and defective electronic circuitry.
Beer-Lambert law. However, it is assumed

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4. Which of the following is the simplest of Answer: b

pH meters? Explanation: Null-detector type pH meter
a) Null-detector type pH meter has greater accuracy than 0.01 pH. pH value
b) Direct reading type pH meter is read from the calibrated precision voltage
c) Digital pH meter source dial.
d) Modern pH meter
8. Which of the following is not the
Answer: a characteristic of direct reading type pH
Explanation: Null-detector type pH meter is meters?
the simplest of all pH meters. It is also known a) Simple operation
as the potentiometer type. b) Quick to use
c) Continuous indication output
5. In which of the following ways can zero d) It requires balancing process

ww
drift be reduced in pH meters?
a) Using filter
b) Giving zero adjustment arrangement
Answer: d
Explanation: Direct reading type pH meters

w.E
c) Keeping the input impedance high
d) Using balanced and differential amplifiers
do not require balancing process. Its
operation is simple and readings can be read

Answer: d
asy
Explanation: Zero drift be reduced in pH
meters using balanced and differential

En J
amplifiers. Their response to external signals
are additive and to internal noise are
directly.

E
9. Which of the following is not the

C
characteristic of chopper amplifier pH meter?
a) Direct voltage from the electrodes is
chopped at the main frequency
subtractive.

6. Which of the following can be used to

g
Ainee
b) Using choppers for high-input resistance
gives rise to spikes of waveforms at the
output
provide automatic temperature
compensation?
a) Proper insulation S c) It leads to stability in DC output of phase-
sensitive rectifier
rin
d) Magnitude of surge increases in the glass

c) Thermistor
d) Thermometer M
b) Calibration for different temperatures electrode output

Answer: c
g.n
e
Explanation: The use of chopper amplifier in
Answer: c
Explanation: To provide automatic
temperature compensation, thermistors must
pH meter leads to zero instability. It leads to
various other problems for high-input
resistance.
t
be used. As the temperature of the solution
changes, the circuit constants are altered 10. In which of the following ways can the
accordingly. disadvantages of chopper amplifier type pH
meter be overcome?
7. Which of the following is not the a) Using zero corrected DC amplifier
characteristic of null-detector type pH meter? b) Using modern design
a) It can be battery operated c) Using digital design
b) It has less accuracy d) Using vibrating condenser
c) It is easy to maintain
d) Its electronic circuits are simple Answer: d
Explanation: The disadvantages of chopper

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amplifier type pH meter can be overcome component.

using a vibrating condenser. It is used in the
place of the mechanical chopper.

11. The zero stability of vibrating condenser

amplifier type pH meter is much better than a
direct coupled amplifier.
a) True
b) False

Answer: a
Explanation: The zero stability of vibrating
condenser amplifier type pH meter is much a) Filter
b) Buffer

ww
better than a direct coupled amplifier. The
capacity can be changed by vibrating one of
its plates.
c) A/D converter
d) D/A converter

w.E
12. In vibrating condenser amplifier type pH Answer: c
meter, to maintain good performance which

asy
of the following has to be done?
a) Frequency of the vibrator should be stable
b) Frequency of the vibrator should be
constant
c) Amplitude of the vibrator should be En J present.
C E
Explanation: The unmarked component is
A/D converter. Microprocessor operates only
on digital data. Electrodes give analog
signals. Hence, A/D converter must be

constant
d) Both frequency and amplitude of the
vibrator should be constant and stable
g
Ainee TOPIC 2.4 COLORIMETER

Answer: d
Explanation: In vibrating condenser S 1. What is the use of a bomb calorimeter?

rin
a) To calculate the calorific value of a volatile
liquid

M
amplifier type pH meter, to maintain good
performance, both frequency and amplitude
of the vibrator should be constant and stable.
b) To calculate the calorific value of a gas

volatile liquid g.n

c) To calculate the calorific value of a non-

e
d) To calculate the calorific value of sparingly
13. If an instrument fails to balance at zero, it
is most likely that the electrodes are
defective.
soluble salt

Answer: c
t
a) True Explanation: It can also be used for
b) False calculating the calorific value of solids. If the
compound in a volatile liquid or gas, the
Answer: b flame calorimeter offers itself as an
Explanation: If an instrument fails to balance instrument due to which further processes
at zero, it is most likely that the electronic cannot take place.
circuitry is defective. Errors may also occur
due to leakage of capacitance. 2. Why does bomb calorimeter require high
pressure oxygen?
14. Given below is the block diagram of a) To increase the rate of reaction
digital pH meter. Identify the unmarked b) To ensure that the given sample in the

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crucible burns completely Answer: c

c) To increase the ignition temperature Explanation: When there is a change in
d) To increase the kinetic energy temperature inside the bomb, there is a loss of
heat due to radiation which is then absorbed
Answer: b by the air jacket and water jacket present in it.
Explanation: A pressure of 30 bar should be
used to carry out this whole process. The 6. Why only Beckmann or fixed zero
oxygen assists in the burning of coal sample. thermometer are used to note down the
temperature reading?
3. Which material is used in the making of the a) Since they can read temperature difference
cylindrical bomb? upto 1/100th of a degree
a) Carbon steels b) Since they have a high mercury level
b) Alloy steels c) Since they give a precise value of the

ww
c) Ferritic stainless steels
d) Austenitic stainless steels
temperature
d) Since they give accurate readings when
dissolved in water
Answer: d
w.E
Explanation: These steels are used to prevent Answer: a
the bomb from corrosion. These steels are

least 50 atm.

to the electrode in a bomb?

asy
also capable of withstanding a pressure of at

En J
4. What is the role of the small ring attached
C E
Explanation: When the current is supplied
from a 6 volt battery, then there is a rise in
temperature, due to which some temperature
change occurs which is very small, so to
calculate a perfect value for this temperature
change Beckmann thermometer is used.
a) It acts as a support to the crucible
g
Ainee
b) It is used to connect the electrode and the
crucible
7. What is the use of gas releasing pin in the
bomb?

wire
S
c) It is used as an intermediate for magnesium

d) It helps to collect the fuel at a point in the

a) To remove the oxygen gas from the bomb

rin
b) To release the pressure from the bomb
c) To release the water vapour
crucible

Answer: a M
Explanation: Since the electrode connected
(such as CH4, CO2 etc) g.n
d) To remove the carbon containing gases

e
is of tubular form, the ring attached to it
makes good support between them. This
electrode also acts as an oxygen inlet.
Answer: b
Explanation: The pressure required in the
bomb should be constant, so as to measure
the change in enthalpy of the solution.
t
Sometimes when the value of pressure is
5. Why does the copper calorimeter increased above to the suitability of the bomb,
surrounded by an air jacket and water jacket then to keep the pressure constant gas
respectively in a bomb? releasing pin is used.
a) To resist the calorimeter with moisture
particles 8. Which material is used for making the
b) To carry out the process of combustion wires, which are connected to the crucible
c) To prevent the loss of heat due to radiation containing fuel sample?
d) To provide stability to the crucible inside a) Arsenic
the bomb b) Phosphorous

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c) Sulphur within the body have to meet certain stringent

d) Magnesium specifications; e.g. sensitivity and stability
requirements depend upon the magnitude of
Answer: d flow, location and the diameter of the
Explanation: Since these wires are connected individual vessels.
to the electrode from the crucible, they should
be good conductors. Platinum is also used for 2. Which of the following instrument is most
this process. commonly used for measurement of blood
flow?
9. What is the basic formulae for calculating a) NMR Blood Flowmeter
gross calorific value in bomb calorimeter? b) Ultrasonic Blood Flowmeter
a) θ = [(W+w)(t2+t1)]/m c) Electromagnetic Blood Flowmeter
b) θ = [(W-w)(t2-t1)]/m d) Laser Doppler Blood Flowmeter

ww
c) θ = [(W+w)(t2-t1)]/m
d) θ = [(W+w)(t2+t1)]/m
Answer: c
Explanation: The most commonly used
Answer: c
w.E instrument for the measurement of blood flow
is of the electromagnetic type. With this type
Explanation: Its unit is cal/gm. Here t2-t1 is

total weight.
θ = [(W+w)(t2-t1)]/m
asy
the temperature difference and W+w is the

where θ is gross calorific value, W is the

En J
E
of instrument, blood flow can be measured in
intact blood vessels without cannulation and

C
under conditions which would otherwise be
impossible. However, this method requires
that the blood vessel be exposed so that the
weight of the water sample taken in flow head or the measuring probe can be put
calorimeter, w is the weight of water
g
Ainee
equivalent, t1 is the initial temperature, t2 is
across it.

3. Magnitude of voltage picked up is denoted

the fuel sample taken respectively.
S
the final temperature and m is the weight of
as e = CHVd, where H is ___________

rin
a) velocity of blood flow
b) strength of magnetic field
TOPIC 2.5 BLOOD FLOW
METER
M g.n
c) diameter of blood vessel
d) constant of proportionality

Answer: b
e
1. Which of the following physiological
parameter is most difficult to measure
accurately?
Explanation: The magnitude of the voltage
picked up is directly proportional to the
strength of the magnetic field, the diameter of
t
a) Blood pressure the blood vessel and the velocity of blood
b) Blood Flow flow, i.e. e = CHVd, where e = induced
c) Blood Volume voltage, H = strength of the magnetic field, V
d) Skin color = velocity of blood flow,d = diameter of the
blood vessel and C = constant of
Answer: b proportionality.
Explanation: Blood flow is one of the most
important physiological parameters and also 4. Magnitude of voltage picked up is denoted
one of the most difficult to measure as e = CHVd, where C is __________
accurately. This is because instruments for a) velocity of blood flow
measuring the flow through blood vessels b) strength of magnetic field

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c) diameter of blood vessel the blood vessels which have various

d) constant of proportionality diameters. It is naturally more difficult to
construct flow heads suitable for use with
Answer: c very small blood vessels. However, flow
Explanation: The magnitude of the voltage heads having as small as 1 mm external
picked up is directly proportional to the diameter have been reported in the literature.
strength of the magnetic field, the diameter of
the blood vessel and the velocity of blood 7. The operating principle underlying all
flow, i.e. e = CHVd, where e = induced electromagnetic type flowmeters is based
voltage, H = strength of the magnetic field, V upon Kirchoff’s law.
= velocity of blood flow, d = diameter of the a) True
blood vessel and C = constant of b) False
proportionality.

ww
5. The induced emf is picked by point
electrodes made from ______ in
Answer: b
Explanation: False, The operating principle
underlying all electromagnetic type

a) copper w.E
electromagnetic blood flowmeter. flowmeters is based upon Faraday’s law of
electromagnetic induction which states that
b) graphite
c) platinium
d) copper tungsten

Answer: c
asy
Explanation: In actual practice, the En J
E
when a conductor is moved at right angles
through a magnetic field in a direction at right

C
angles both to the magnetic field and its
length, an emf is induced in the conductor. In
the flowmeter, an electromagnetic assembly
provides the magnetic field placed at right

g
electromagnetic flowmeter transducer (Wyatt,

Ainee
1984) is a tube of non-magnetic material to
ensure that the magnetic flux does not bypass
angles to the blood vessel in which the flow is
to be measured.

tube. The tube is made of a conducting

S
the flowing liquid and go into the walls of the

material and generally has an insulating lining

8. The average flow velocity appears to be

rin
_______ cm/s in arteries.
a) 5 to 10

M
to prevent short circuiting of the induced emf.
The induced emf is picked up by point
electrodes made from stainless steel or
b) 10 to 12
c) 12 to 18
d) 20 to 25
g.n
e
platinum.

6. What is the external diameter of flow

heads?
Answer: d
Explanation: The flow-induced voltage of an
electromagnetic flowmeter is, within certain
t
a) 0.5 mm limitations, proportional to the velocity of the
b) 1 mm flow. This velocity is the average across the
c) 1.5 mm flow stream with an axis symmetric velocity
d) 2 mm profile. The average flow velocity appears to
be 20 to 25 cm/s in arteries and 10 to 12 cm/s
Answer: b in veins.
Explanation: The flow head contains a slot
through which the intact blood vessel can be 9. What is the average flow velocity in veins?
inserted to make a snug fit. Several probes of a) 5 to 10 cm/s
different sizes must therefore accompany the b) 10 to 12 cm/s
flowmeter to match the full range of sizes of

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c) 12 to 18 cm/s a) True
d) 20 to 25 cm/s b) False

Answer: b Answer: a
Explanation: The flow-induced voltage of an Explanation: True, To protect the probe from
electromagnetic flowmeter is, within certain chemical attack, it must be encapsulated in a
limitations, proportional to the velocity of the biologically inert material having a high
flow. This velocity is the average across the electrical and chemical resistance, e.g.
flow stream with an axis symmetric velocity silicone rubber. The probes can generally be
profile. The average flow velocity appears to sterilized by chemical means. Probe
be 20 to 25 cm/s in arteries and 10 to 12 cm/s calibration is carried out in 0.9% saline
in veins. during manufacture and each probe is given a
calibration factor that is engraved on the

ww
10. What is velocity for the cardiovascular
system taken for designing the probe?
a) 5 cm/s
connector.

13. The cable from the transducer to an

b) 10 cm/s
c) 15 cm/s w.E instrument is sleeved with medical grade
silicon rubber.
d) 20 cm/s

Answer: c
asy
Explanation: For designing the probe,
velocity for the cardiovascular system is
En J
taken as 15 cm/s. For non-cannulated probes,
a) True
b) False

Answer: a

C E
Explanation: True, the cable from the
transducer to the instrument should comprise
a uniform magnetic field over the measuring
g
Ainee
area is so selected that it has a convenient
shape and the smallest size (Cunningham et
of a teflon insulated wire completely shielded
with a tinned copper braid. The entire cable is
sleeved with medical grade silicone rubber
al. 1983).

11. Iron cored electromagnets are used inS tubing and impregnated with silicone rubber

rin
to minimize leakage and electrical noise.

b) 1 to 8.2 mm
c) 8.2 to 10 mm
M
probes having a diameter between ______
a) 0.1 to 1 mm
g.n
14. Air cored electromagnets are used in
probes having a diameter _________
a) between 0.5 to 1 mm
b) between 1 to 2 mm
e
d) 10 to 15 mm

Answer: b
c) below 8.2 mm
d) above 8.2 mm t
Explanation: Iron cored electromagnets are Answer: d
used in probes having a diameter between 1 Explanation: Iron cored electromagnets are
to 8.2 mm, and air cored electromagnets are used in probes having a diameter between 1
used in diameters above 8.2 mm. Cannulated to 8.2 mm, and air cored electromagnets are
probes for extracorporeal use can have greater used in diameters above 8.2 mm. Cannulated
field strengths and magnet size as the probes for extracorporeal use can have greater
constraint of small size is no longer present. field strengths and magnet size as the
constraint of small size is no longer present.
12. To protect probe from chemical attack, it
must be encapsulated in silicon rubber.
TOPIC 2.6 CARDIAC OUTPUT

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1. Which of the following statement is for the age of the person. High BP is when
correct? blood pressure is high than 120/80 mm Hg.
a) 130/90 mm Hg is considered high and
require treatment 5. A normal heart rate in an adult at rest is
b) 100/55 mm Hg is considered an ideal ______________
blood pressure a) 110
c) 105/50 mm Hg makes one active b) 125
d) 190/110 mm Hg may harm vital organs c) 60
d) 75
Answer: d
Explanation: The high blood pressure may Answer: d
harm vital organs of the body. It is the Explanation: A normal resting heart rate for
condition in which the force of blood against an adult ranges from 70-85 beats a minute.

ww
the artery valve is very high.

2. Blood pressure is the pressure exerted by

Generally, a lower heart rate at rest implies
more efficient heart function and better
cardiovascular fitness.

a) kidneys w.E
blood against ___________
6. Unhealthy growth of tissue due to higher
b) artery walls
c) brain
d) stomach

Answer: b
asy
Explanation: Blood pressure exerted by En J
b) aroma
c) adenoma
C E
pressures on the walls of the artery is termed
as __________
a) atheroma

d) aroma and adenoma

circulating blood on the walls of blood
vessels. g
Ainee Answer: a
Explanation: Atheroma is the growth of

____________
a) mm Hg S
3. Blood pressure is measured in terms of tissues due to higher pressure on walls of

rin
artery. High pressures increases heart work
load.
b) mm
c) cm Hg
d) Hg M g.n
7. Any mechanism that increases heart rate is
said to have a positive ________ effect.
a) cholinergic
e
Answer: a
Explanation: Blood pressure values are
generally measured in terms of millimeters of
b) inotropic
c) chronotrophic
d) feedback
t
mercury. It is measured using an instrument
called as sphygmomanometer. Answer: c
Explanation: Chronotrophic are those that
4. A person can suffer from both low blood change the heart rate. It changes the heart rate
pressure and high blood pressure. by affecting the electrical conduction system
a) True of the heart.
b) False
8. The colloid osmotic pressure of blood
Answer: a plasma is due to high concentration of
Explanation: Low blood pressure is when the _______
systolic and diastolic blood pressure is below a) albumin

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b) hemoglobin gaseous exchange in the body while

c) sodium cardiovascular regulates the blood flow
d) glucose throughout the body.

Answer: a 2. Nose, larynx, pharynx, lungs, trachea, and

Explanation: Albumin is a family of globular bronchi are the parts of the respiratory
protein. The most important function is system.
maintaining intra vascular colloid osmotic a) True
pressure. b) False

9. The sinoatrial node depolarizes more Answer: a

frequently under the influence of ________ Explanation: Respiratory system consists of
a) medulla oblongata all the organs which take part in the

ww
b) vagus nerve
c) norepinephrine
d) acetylcholine
respiration. It includes bronchi, trachea,
lungs, nose, larynx, and pharynx.

Answer: c
w.E 3. Which of the following is NOT the
function of the respiratory system?
Explanation: Norepinephrine is similar to

conditions.
asy
adrenaline. It is used to treat life threatening
low BP that can occur with certain medical

10. _________ is the enzyme that converts En J

E
a) Regulate blood pH
b) Helps in gaseous exchange
c) Protection against blood loss

C
d) Contains receptors for the sense of smell

Answer: c
Angiotensinogen to Angiotensin I.
a) Rennin
b) ACE
g
Ainee
Explanation: Respiratory system helps in
regulation of blood, pH, and also contain
receptors of smell, produces vocal sound and
c) ANP
d) ADH
S filter inspired air while cardiovascular system

rin
protects against blood loss by the formation
of blood clots.
Answer: a

M
Explanation: Angiotensin is a peptide
hormone that causes an increase in blood
pressure. Angiotensin I is produced by the
pulmonary respiration? g.n
4. Which of this statement is TRUE for

e
a) Exchange of gases between alveoli of
action of rennin, which is formed in the liver.

TOPIC 2.7 RESPIRATORY

lungs and the blood
b) Exchange of gases between blood and
tissue cells
t
c) Breathing between the atmosphere and the
alveoli of the lungs
1. Name the process of gaseous exchange in d) Production of ATP
the body.
a) Lymphatic system Answer: a
b) Respiration Explanation: Pulmonary respiration is the
c) Cardiovascular system exchange of gases between the alveoli of the
d) Respiratory system lungs and the blood in the capillaries.
Exchange of gases between blood and tissue
Answer: b cell occurs in internal respiration.
Explanation: Respiration is the process of

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5. Which of the following controls the normal Answer: b

breathing process? Explanation: Pineal gland is the smallest
a) Amino acids endocrine gland attached to the roof of the
b) Cholesterol brain and secrete melatonin. Melatonin is
c) Ventral respiratory group responsible for settling of the biological
d) Dorsal respiratory group clock.

Answer: d
Explanation: Ventral respiratory group TOPIC 2.8 BLOOD PRESSURE
contains both inspiratory and expiratory
neurons and controlled forced breathing while 1. Which of the following statement is
dorsal respiratory group contains only correct?
inspiratory neurons control normal breathing. a) 130/90 mm Hg is considered high and

ww
6. Oxygen and hemoglobin bind in a
reversible manner to form______
require treatment
b) 100/55 mm Hg is considered an ideal
blood pressure

w.E
a) Carboxyhemoglobin
b) Oxyhemoglobin
c) 105/50 mm Hg makes one active
d) 190/110 mm Hg may harm vital organs
c) Methoglobin
d) BPG

Answer: b
asy
Explanation: Oxyhemoglobin is formed by
the combination of oxygen and hemoglobin.En J
Answer: d
E
Explanation: The high blood pressure may

C
harm vital organs of the body. It is the
condition in which the force of blood against
the artery valve is very high.
Oxygen binds to the hemoglobin in a
reversible manner. 98% of oxygen is trapped
inside RBC.
g
Ainee 2. Blood pressure is the pressure exerted by
blood against ___________

7. How many oxygen molecules bound to

hemoglobin to give 50% saturation? S a) kidneys
b) artery walls
c) brain rin
a) 6
b) 4
c) 2
d) 7
M d) stomach

Answer: b g.n
e
Explanation: Blood pressure exerted by

Answer: c
Explanation: Hemoglobin can bind with
circulating blood on the walls of blood
vessels. t
maximum 4 oxygen molecules, so for 3. Blood pressure is measured in terms of
obtaining 50% saturation only 2 molecules of ____________
oxygen should be bound to hemoglobin. a) mm Hg
b) mm
8. What is the name of the gland which c) cm Hg
secrete melatonin? d) Hg
a) Pituitary gland
b) Pineal gland Answer: a
c) Thyroid gland Explanation: Blood pressure values are
d) Hypothalamus generally measured in terms of millimeters of

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mercury. It is measured using an instrument Answer: c

called as sphygmomanometer. Explanation: Chronotrophic are those that
change the heart rate. It changes the heart rate
4. A person can suffer from both low blood by affecting the electrical conduction system
pressure and high blood pressure. of the heart.
a) True
b) False 8. The colloid osmotic pressure of blood
plasma is due to high concentration of
Answer: a _______
Explanation: Low blood pressure is when the a) albumin
systolic and diastolic blood pressure is below b) hemoglobin
for the age of the person. High BP is when c) sodium
blood pressure is high than 120/80 mm Hg. d) glucose

ww
5. A normal heart rate in an adult at rest is
______________
Answer: a
Explanation: Albumin is a family of globular
a) 110
b) 125
w.E protein. The most important function is
maintaining intra vascular colloid osmotic
c) 60
d) 75

Answer: d asy
En J
Explanation: A normal resting heart rate for
an adult ranges from 70-85 beats a minute.
pressure.

E
9. The sinoatrial node depolarizes more

C
frequently under the influence of ________
a) medulla oblongata
b) vagus nerve

more efficient heart function and better

cardiovascular fitness.
g
Generally, a lower heart rate at rest implies

Ainee
c) norepinephrine
d) acetylcholine

S
6. Unhealthy growth of tissue due to higher
pressures on the walls of the artery is termed
Answer: c

rin
Explanation: Norepinephrine is similar to
adrenaline. It is used to treat life threatening
as __________
a) atheroma
b) aroma
c) adenoma
M conditions.
g.n
low BP that can occur with certain medical

e
10. _________ is the enzyme that converts
d) aroma and adenoma

Answer: a
Angiotensinogen to Angiotensin I.
a) Rennin
b) ACE
t
Explanation: Atheroma is the growth of c) ANP
tissues due to higher pressure on walls of d) ADH
artery. High pressures increases heart work
load. Answer: a
Explanation: Angiotensin is a peptide
7. Any mechanism that increases heart rate is hormone that causes an increase in blood
said to have a positive ________ effect. pressure. Angiotensin I is produced by the
a) cholinergic action of rennin, which is formed in the liver.
b) inotropic
c) chronotrophic
d) feedback

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TOPIC 2.9 TEMPERATURE AND general function of the brain activity, is the
superimposed wave of neuron potentials
PULSE MEASUREMENT operating in a non-synchronized manner in
the physical sense.
1. Which of the following instrument is used
for recording the electrical activity of the 4. Which of the following is material is used
brain? to improve electrical contact?
a) ECG a) Silver Tungsten
b) EMG b) Electrode jelly
c) PCG c) Silver Graphite
d) EEG d) Copper Tungsten

Answer: d Answer: b

ww
Explanation: Electroencephalograph is an
instrument for recording the electrical activity
of the brain, by suitably placing surface
Explanation: Electrode jelly or paste is used
to improve the electrical contact. If the
electrodes are intended to be used under the

w.E
electrodes on the scalp. EEG, describing the
general function of the brain activity, is the
skin of the scalp, needle electrodes are used.
They offer the advantage of reducing
superimposed wave of neuron potentials

the physical sense. asy

operating in a non-synchronized manner in

En J
2. EEG electrodes are larger in size than ECG a) VCG
b) PCG C E
movement artefacts.

5. Whose electrodes give high skin

impedance as compared to ECG?

electrodes.
a) True
b) False g
Ainee
c) EMG
d) EEG

Answer: b
S
Explanation: Several types of electrodes may
be used to record EEG. These include: Peel
Answer: d

rin
Explanation: EEG electrodes give high skin
contact impedance as compared to ECG

M
and Stick electrodes, Silver plated cup
electrodes and Needle electrodes. EEG
electrodes are smaller in size than ECG
g.n
electrodes. Good electrode impedance should
be generally below 5 kilohms. The impedance
between a pair of electrodes must also be

e
balanced or the difference between them
electrodes.

3. _______ is the superimposed wave of

neuron potentials operating in a non-
should be less than 2 kilohms.

6. What are generally designed to have a very

t
synchrronized manner in a physical sense. high value of input impedance to take care of
a) VCG high electrode impedance?
b) ECG a) Montages
c) EEG b) Electrodes
d) PCG c) Preamplifiers
d) Filters
Answer: c
Explanation: Electroencephalograph is an Answer: c
instrument for recording the electrical activity Explanation: Good electrode impedance
of the brain, by suitably placing surface should be generally below 5 kilohms.
electrodes on the scalp. EEG, describing the Impedance between a pair of electrodes must

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also be balanced or the difference between several hundred microvolts, but 50 microvolts
them should be less than 2 kilohms. EEG peak-to-peak is the most typical.
preamplifiers are generally designed to have a
very high value of input impedance to take 10. A pattern of electrodes on the head and
care of high electrode impedance. the channels they are connected to are
__________
7. Voltage difference between an active a) Amplifiers
electrode on the scalp with respect to b) Oscilloscope
reference electrode at ear lobe or any other c) Montage
part of body is known as ___________ d) Wires
recording.
a) Monopolar Answer: c
b) Bipolar Explanation: A pattern of electrodes on the

ww
c) Unipolar
d) Nonpolar
head and the channels they are connected to is
called a montage. Montages are always
symmetrical. The reference electrode is
Answer: a
w.E
Explanation: EEG may be recorded by
generally placed on a nonactive site such as
the forehead or earlobe.
picking up the voltage difference between an

asy
active electrode on the scalp with respect to a
reference electrode on the ear lobe or any
other part of the body. This type of recording
is called ‘monopolar’ recording.
En J
b) cervical
c) forehead
d) facial
E
11. Where is the reference electrode placed?
a) nasal

C
8. How is bipolar recording done?
a) Omni channel EEG
b) Multi channel EEG
g
Ainee Answer: c
Explanation: A pattern of electrodes on the
c) Uni Channel EEG
d) Non Channel EEG
S head and the channels they are connected to is

rin
called a montage. Montages are always
symmetrical. The reference electrode is
Answer: b

M
Explanation: ‘bipolar’ recording is more
popular wherein the voltage difference
between two scalp electrodes is recorded.
the forehead or earlobe.
g.n
generally placed on a nonactive site such as

e
12. What is the typical value of the
Such recordings are done with multi-channel
electroencephalographs.
calibration signal?
a) 10 uV/cm
b) 30 uV/cm
t
9. EEG signals picked up by surface c) 50 uV/cm
electrodes are usually small as compared to d) 70 uV/cm
ECG.
a) True Answer: c
b) False Explanation: A calibrating signal is used for
controlling and documenting the sensitivity of
Answer: a the amplifier channels. This supplies a
Explanation: Yes, EEG signals picked up by voltage step of adequate amplitude to the
the surface electrodes are usually small as input of the channels. A typical value of the
compared with the ECG signals. They may be calibration signal is 50 uV/cm.

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13. Preamplifiers used in detection and filtering of frequencies up to

electroencephalograph have high gain and several hundred Hertz. This may be of
low noise characteristics. importance in some intracranial recordings.
a) True
b) False
TOPIC 2.10 BLOOD CELL
Answer: a COUNTERS.
Explanation: Yes, preamplifier used in
electroencephalographs must have high gain 1. The blood corpuscles are of _________
and low noise characteristics because the kinds.
EEG potentials are small in amplitude. In a) 5
addition, the amplifier must have very high b) 4
common-mode rejection to minimize stray c) 2

ww
interference signals from power lines and
other electrical equipment.
d) 3

Answer: d

w.E
14. EEG machines have notch filter sharply
tuned at _______ Hz as to eliminate mains
Explanation: The blood corpuscles are of 3
types. They are colored corpuscles-
frequency interference.
a) 10
b) 30
c) 50
d) 70
asy
En J C E
erythrocytes, Colorless corpuscles –
Leucocytes and blood platelets.

2. Blood is stained with _________ stain.

a) Methylene blue
b) Safranin
Answer: c
Explanation: EEG machines have a notch g
Ainee
filter sharply tuned at 50 Hz so as to eliminate
c) Leishman stain
d) Carbol fuchsine

S
mains frequency interference. These however
have the undesirable property of ‘ringing’ i.e.
they produce a damped oscillatory response
Answer: c

rin
Explanation: Leishman stain is used in
microscopy for staining blood smears. It is

M
to a square wave calibration waveform or a
muscle potential. The use of notch filters
should preferably be restricted to exceptional
g.n
generally used to differentiate and identify
leucocytes malaria parasites and
trypanosomas.
e
circumstances when all other methods of
eliminating interference have been found to
be ineffective.
3. Process of formation of blood corpuscles is
called _____________
a) Haemolysis
t
15. What is the typical frequency range of b) Haemozoin
standard EEG machines? c) Haemopoesis
a) 0.025 to 0.05 Hz d) Haemoter
b) 0.05 to 0.1 Hz
c) 0.1 to 70 Hz Answer: c
d) 70 to 140 Hz Explanation: The Process of formation of
blood corpuscles is called Haemopoesis. It
Answer: c occurs in the bone marrow.
Explanation: The typical frequency range of
standard EEG machines is from 0.1 Hz to 70 4. Graveyard of RBC is ________
Hz, though newer machines allow the a) Spleen

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b) Liver vitamin k might decrease the effectiveness of

c) Kidney warfarin.
d) Thymus
8. Hemoglobin is a ___________
Answer: a a) Reproductive pigment
Explanation: Old red blood cells are recycled b) Respiratory pigment
in the spleen. Platelets and white blood cells c) Carbohydrate
are stored there. Spleen also helps fight d) Fat
certain kinds of bacteria that cause
pneumonia and meningitis. Answer: b
Explanation: Hemoglobin is a protein in
5. Which leucocytes release heparin and RBC that carries oxygen throughout the body.
histamine in blood? Lower Hemoglobin counts indicate anemia.

ww
a) Neutrophil
b) Basophil
c) Eosinophil
9. Absence of which clotting factor leads to
Hemophilia-A?
d) Monocytes
w.E a) Factor VII
b) Factor VIII
Answer: b

blood cell.
asy
Explanation: Basophil contains heparin
which is an anticoagulant. It is a type of white

6. Which blood cells secrets antibody? En J

c) Factor IX
d) Factor X

Answer: b

C E
Explanation: Hemophilia-A is also called
factor VIII deficiency or classic hemophilia.
a) Eosinophils
b) Monocytes
c) Lymphocytes
g
Ainee
It is a genetic disorder caused by missing or
defective factor VIII a clotting protein.

d) Neutrophils

Answer: c S 10. What prevents the clotting of blood inside

blood vessels?
a) Heparin
rin
M
Explanation: A Lymphocyte is a type of
white blood cell that is a part of the immune
system. There are 2 main types of
Lymphocyte: B cells and T cells. The B cells
b) Serotonin
c) Fibrinogen
d) Fibrin g.n
e
produce antibodies that are used to attack
invading bacteria, viruses and toxins.
Answer: a
Explanation: Heparin is an anticoagulant that
prevents the formation of blood clots. It is
t
7. Vitamin essential for blood clotting is used to treat blood clots in veins arteries or
_____________ lung.
a) Vitamin K
b) Vitamin A 11. Red cell count is carried out by
c) Vitamin B _________
d) Vitamin C a) Electrogram
b) Sphygmomanometer
Answer: a c) Haemoglobinometer
Explanation: Vitamin K is used by the body d) Haemocytometer
to help blood clot. Warfarin is used to slow
blood clotting. By helping the blood clot

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Answer: d c) Morphological-Rhythm statements

Explanation: Haemocytometer is a device d) Rhythm-Morphological statements
designed and used for counting blood cells. It
was invented by Louis Charles Malassez. Answer: b
Explanation: Morphological statement-
12. Blood is five times more viscous than primarily based on ECG wave shapes that
distilled water. attempt to describe the state of the working
a) True muscle masses. The other type of diagnostic
b) False statement is Rhythm statement. These both
diagnostic statements are observed from the
Answer: a ECG records.
Explanation: When hematocrit raised to 60%
or 70% the blood viscosity can become as 3. Rhythm statements concerned with the site

ww
great as 5 to 6 times that of water and it flows
through blood vessels is greatly retarded
because of increased resistance to flow.
and rate of the cardiac pacemaker and the
propagation of impulses through the
conduction system.

w.E a) True
b) False

UNIT III ASSIST DEVICES

TOPIC 3.1 CARDIAC

asy
En J
Answer: a

C E
Explanation: Rhythm statements concerned
with the site and rate of the cardiac
pacemaker and the propagation of impulses
through the conduction system is true because
PACEMAKERS
g
Ainee
the other type of the diagnostic statements is
Morphological statements and it is primarily
based on ECG wave shapes that attempt to
1. Any disturbance in the heart’s normal
rhythmic contraction is called?
a) Heart stroke S describe the state of the working muscle
masses.
rin
b) Cardiac arrest
c) Arrhythmias
d) Premature contraction
M g.n
4. Which wave from ECG waveforms
becomes widened when the self-triggering
impulse does not arrive through the AV node?
a) P wave
e
Answer: c
Explanation: Any disturbance in the heart’s
normal rhythmic contraction is called an
arrhythmias or cardiac dysrhythmia. In this
b) QRS wave
c) ST wave
d) T wave
t
arrhythmias heart can’t beat in a regular
rhythm. In arrhythmia heart-rate will be Answer: b
higher than normal rate or will be less than Explanation: Sometimes irritation occurs in
the normal rate. the ventricles, the self-triggering impulse
does not arrive through the node and thus
2. Which diagnostic statement is based on travels a different and slower path in
ECG wave shapes that attempt to describe the spreading over the ventricles. The QRS wave
state of the working muscle masses? then becomes widened and is classified as a
a) Rhythm statements ventricular ectopic beat.
b) Morphological statements

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5. When the self-triggering impulse does not when the heart-rate is to fast(greater than
arrive at the AV node and travels a different 100). Here the answer is Bradycardia because
and slower path over the ventricles, the QRS heart rate is less than 60.
becomes widened and is classified as
___________ 8. Which of the following are resuscitation
a) Ectopic beat techniques?
b) Ventricular-ectopic beat a) Cepstrum coefficient
c) Ventricular beat b) Prophylactic therapy
d) Atrio-ventricular beat c) Transthoracic defibrillation
d) Dynamic time warping
Answer: b
Explanation: Sometimes irritation occurs in Answer: d
the ventricles, the self-triggering impulse Explanation: The necessity for early

ww
does not arrive through the node and thus
travels a different and slower path in
spreading over the ventricles. The QRS wave
detection of the arrhythmias led to the
establishment of coronary care units in
hospitals for the intensive monitoring and

w.E
then becomes widened, and is classified as a
ventricular ectopic beat. This ectopic beat is
treatment of such patients. The attempt in
these units was to effectively carry out
classified from ventricles so it is called as a
ventricular ectopic beat.
asy
6. An ectopic beat, which starts in an

En J
abnormal location in the heart and is often
C E
resuscitation techniques such as cardiac
massage and transthoracic defibrillation.

9. If heart rate is x, then which value of x is

known as tachycardia?
a) x < 60
premature, therefore also called _______
a) Pre ventricular contraction
b) Premature ventricular beat g
Ainee
b) x > 60
c) 60 < x < 100
d) x > 100
c) Pre ventricular beat
d) Premature ventricular contraction

Answer: d S Answer: d
rin
Explanation: There are 2 types of

M
Explanation: An ectopic beat is a beat, which
starts in an abnormal location in the heart and
is often premature, therefore also called
g.n
arrhythmias,i)Bradycardia-when the heartrate
is to slow(less than 60), ii)Tachycardia-when
the heartrate is to fast(greater than 100).Here

e
the answer is Bradycardia because,heart rate
premature ventricular contraction (PVC), i.e.
it occurs sooner than the next expected beat.

7. When the heartbeat is slower than the

is less than 60.

10. Photo-diodes work in ___________

t
normal rate of the heart(less than 60), this a) forward biased
type of arrhythmias called _______ b) reverse biased
a) Bradycardia c) independent of forward and reverse biasing
b) Tachycardia d) any configuration
c) Arterial contraction
d) Ventricular contraction Answer: b
Explanation: The photodiode is a P-N
Answer: a junction semiconductor diode. It always
Explanation: There are 2 types of operated in the reversed biased condition. The
arrhythmias, i) Bradycardia-when the heart- light is always focused through a glass lens
rate is to slow(less than 60), ii)Tachycardia- on the junction of the photo diode.

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11. Parallel flow dialyzer has a low internal arrhythmias or cardiac dysrhythmia. In this
resistance. Because of this blood pump is arrhythmias heart can’t beat in a regular
required. rhythm. In arrhythmia heart-rate will be
a) True higher than normal rate or will be less than
b) False the normal rate.

Answer: b 2. Which diagnostic statement is based on

Explanation: Parallel flow dialyzer has a low ECG wave shapes that attempt to describe the
internal resistance which allows adequate state of the working muscle masses?
blood flow through the dialyzer with the a) Rhythm statements
patient’s arterial blood pressure, eliminating b) Morphological statements
the need for a blood pump. The dialyzing c) Morphological-Rhythm statements
surface area of a parallel flow dialyzer is d) Rhythm-Morphological statements

ww
about 1 sq m. At a blood flow rate of 200
ml/min and a dialysate flow of 500 ml/min,
the urea and creatinine clearance is about 80
Answer: b
Explanation: Morphological statement-

w.E
and 64 ml/min. primarily based on ECG wave shapes that
attempt to describe the state of the working
12. CMRR is measured in _______________
a) V/s
b) dB
c) dB/s
d) dB/ms
asy
En J
E
muscle masses. The other type of diagnostic
statement is Rhythm statement. These both

C
diagnostic statements are observed from the
ECG records.

3. Rhythm statements concerned with the site

Answer: b
Explanation: CMRR is an important
specification referred to the differential
g
Ainee
and rate of the cardiac pacemaker and the
propagation of impulses through the
conduction system.
amplifier and is normally expressed as
S
decibels. The ability of the amplifier to reject
common voltages on its two input leads is
a) True
b) False
rin
M
known as common-mode rejection. It is
specified as the ratio of common-mode input
to differential input to elicit the same
Answer: a
g.n
Explanation: Rhythm statements concerned
with the site and rate of the cardiac

e
pacemaker and the propagation of impulses
response.

TOPIC 3.2 DC DEFIBRILLATOR

through the conduction system is true because
the other type of the diagnostic statements is
Morphological statements and it is primarily
t
based on ECG wave shapes that attempt to
1. Any disturbance in the heart’s normal describe the state of the working muscle
rhythmic contraction is called? masses.
a) Heart stroke
b) Cardiac arrest 4. Which wave from ECG waveforms
c) Arrhythmias becomes widened when the self-triggering
d) Premature contraction impulse does not arrive through the AV node?
a) P wave
Answer: c b) QRS wave
Explanation: Any disturbance in the heart’s c) ST wave
normal rhythmic contraction is called an d) T wave

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Answer: b a) Bradycardia
Explanation: Sometimes irritation occurs in b) Tachycardia
the ventricles, the self-triggering impulse c) Arterial contraction
does not arrive through the node and thus d) Ventricular contraction
travels a different and slower path in
spreading over the ventricles. The QRS wave Answer: a
then becomes widened and is classified as a Explanation: There are 2 types of
ventricular ectopic beat. arrhythmias, i) Bradycardia-when the heart-
rate is to slow(less than 60), ii)Tachycardia-
5. When the self-triggering impulse does not when the heart-rate is to fast(greater than
arrive at the AV node and travels a different 100). Here the answer is Bradycardia because
and slower path over the ventricles, the QRS heart rate is less than 60.
becomes widened and is classified as

ww
___________
a) Ectopic beat
b) Ventricular-ectopic beat
8. Which of the following are resuscitation
techniques?
a) Cepstrum coefficient

w.E
c) Ventricular beat
d) Atrio-ventricular beat
b) Prophylactic therapy
c) Transthoracic defibrillation

Answer: b
asy
Explanation: Sometimes irritation occurs in
the ventricles, the self-triggering impulse
does not arrive through the node and thus
En J
Answer: d

C E
d) Dynamic time warping

Explanation: The necessity for early

detection of the arrhythmias led to the
establishment of coronary care units in
travels a different and slower path in
spreading over the ventricles. The QRS wave
g
Ainee
then becomes widened, and is classified as a
hospitals for the intensive monitoring and
treatment of such patients. The attempt in
these units was to effectively carry out

S
ventricular ectopic beat. This ectopic beat is
classified from ventricles so it is called as a
ventricular ectopic beat.
resuscitation techniques such as cardiac

rin
massage and transthoracic defibrillation.

M
6. An ectopic beat, which starts in an
abnormal location in the heart and is often
premature, therefore also called _______ a) x < 60
b) x > 60
g.n
9. If heart rate is x, then which value of x is
known as tachycardia?

e
a) Pre ventricular contraction
b) Premature ventricular beat
c) Pre ventricular beat
d) Premature ventricular contraction
c) 60 < x < 100
d) x > 100 t
Answer: d
Answer: d Explanation: There are 2 types of
Explanation: An ectopic beat is a beat, which arrhythmias,i)Bradycardia-when the heartrate
starts in an abnormal location in the heart and is to slow(less than 60), ii)Tachycardia-when
is often premature, therefore also called the heartrate is to fast(greater than 100).Here
premature ventricular contraction (PVC), i.e. the answer is Bradycardia because,heart rate
it occurs sooner than the next expected beat. is less than 60.

7. When the heartbeat is slower than the 10. Photo-diodes work in ___________
normal rate of the heart(less than 60), this a) forward biased
type of arrhythmias called _______ b) reverse biased

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c) independent of forward and reverse biasing 1. Dialysis commonly refers to ___________

d) any configuration a) heamo dialysis
b) chemo dialysis
Answer: b c) liver dialysis
Explanation: The photodiode is a P-N d) pancreatic dialysis
junction semiconductor diode. It always
operated in the reversed biased condition. The Answer: a
light is always focused through a glass lens Explanation: When the term dialysis is
on the junction of the photo diode. mentioned, it usually means the purification
of blood and removal of nitrogenous wastes
11. Parallel flow dialyzer has a low internal from the body. It refers to the work done by
resistance. Because of this blood pump is the kidney by drawing out blood and
required. purifying it.

ww
a) True
b) False 2. The membrane used for dialysis is made of
____________
Answer: b
w.E
Explanation: Parallel flow dialyzer has a low
a) cellulose
b) polyvinyl chloride
internal resistance which allows adequate

asy
blood flow through the dialyzer with the
patient’s arterial blood pressure, eliminating
the need for a blood pump. The dialyzing

En J
surface area of a parallel flow dialyzer is
about 1 sq m. At a blood flow rate of 200
d) chitin

Answer: a

C E
c) polyethylene

Explanation: Cellulose is an easily available

material which does not cause any harm to
ml/min and a dialysate flow of 500 ml/min,
g
Ainee
the urea and creatinine clearance is about 80
and 64 ml/min.
the blood or body. It is cheap and with certain
tampering, it’s strength can be increased. It
has a good pore size, small enough to stop the

12. CMRR is measured in _______________

a) V/s S blood cells but large enough to pass out the
waste products.
rin
b) dB
c) dB/s
d) dB/ms M g.n
3. The latest form of dialysis machine being
used has what kind of membrane
arrangements
a) Parallel Plate
e
Answer: b
Explanation: CMRR is an important
specification referred to the differential
b) Hollow Fibre
c) Coil Tube
d) Hollow Plate
t
amplifier and is normally expressed as
decibels. The ability of the amplifier to reject Answer: b
common voltages on its two input leads is Explanation: The hollow fibre is dialyzer is a
known as common-mode rejection. It is tube like structure with fibers planted in
specified as the ratio of common-mode input polyurathanes at the opposite ends. This
to differential input to elicit the same forms hollow pipe like structures for the
response. blood to flow through and allow for the
exchange of materials across the membrane.
TOPIC 3.3 DIALYSER 4. Dialysis can also be used in situations of
_________

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a) extreme fever Answer: b

b) acute poisoning Explanation: In this procedure, the
c) low blood pressure diaphragm is used to conduct dialysis. There
d) blood transfusions is cannula which allows the electrolyte to be
entered in the body. The electrolytes stay in
Answer: b the body for up to 6 hours during which the
Explanation: When a person is suspected of person’s blood vessels and diaphragm act as
acute poisoning, the person may be made to filtering membranes and the unwanted
undergo dialysis. Poison will be regarded as a products like creatinine and urea get filtered
toxin by the body and will be removed out. Then the stopper on the cannula is
normally by kidney and liver which may opened once more and the electrolyte is
cause damage to these organs. Thus, the allowed to flow out.
blood is extracted out and sent to the dialysis

ww
machine so that any harm to the organs and
the body can be minimized.
7. The principle behind dialysis is ________
a) Adhesion
b) Cohesion

w.E
5. The parameters being monitored during
dialysis are _________
c) Capillary Action
d) Reverse – Osmosis
i. Blood Pressure
ii. Diabetes
iii. Embolus Formation
iv. Pulse
v. Temperature
asy
En J
Answer: d

C E
Explanation: It is the movement of solutes
from the area of high concentration to low
concentration through a semi permeable
vi. Flow Rate membrane. Dialysis is done with the
v. Albumin level
vi. Createnine g
Ainee electrolytes flowing through one side and the
blood flowing in the opposite direction. The
vii. Repiratory Rate
a) i, ii, vi, vii
b) ii, iii, iv, vii
c) i, ii, iv, v, vi, vii S two fluids flow in opposite directions across a
semi permeable membrane which causes a

rin
pressure to be created and the wastes flow out
from the blood to the dialysate.
d) vi, v, vi, vii

Answer: c M g.n
8. The dialysate consists of __________
i. Sodium

e
Explanation: All the parameters mentioned
above are monitored for dialysis but some are
monitored before and some after the dialysis.
The parameters monitored during dialysis are
ii. Potassium
iii. Iron
iv. Carbon
v. Magnesium
t
of blood pressure, embolus formation, pulse, vi. Manganese
temperature, flow rate and respiratory rate as vii. Chlorine
they directly affect the health of the patient viii. Sulphur
and are indicative of abnormalities. ix. Phosphorus
x. Calcium
6. The dialysis that can be performed even at a) i, iii, viii,ix
home is ___________ b) vi, vii, ix,
a) Apheresis c) i, ii, v, vii, x
b) Peritoneal Dialysis d) ii, iii, ix, x
c) Hemodialysis
d) Perfusion

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Answer: c incision at the site of insertion is made and is

Explanation: Sodium 140.0 mmol / l, used to insert the catheter. Usually, it is filled
potassium 1.0 mmol / l, calcium 1.25 mmol / with heparin & capped to maintain patency
l, bicarbonate 34.0 mmol / l, magnesium 0.5 between dialysis treatments.
mmol / l, chloride 107.5 mmol / l, glucose 5.5
mmol / l. Normally, these ions are present in
the blood plasma as well. Since the principle
TOPIC 3.4 VENTILATORS
is osmosis under high pressure, also called as
ultra-filtration, these salts help create a 1. The term _________ is used to mean the
pressure difference across the membrane. free passage of clean air in a structure.
This causes the unwanted materials like a) Circulation
creatinine and urea to be filtered out from the b) Ventilation
blood. c) Dissipation

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9. How does the doctor diagnose dialysis?
a) GFR via Blood Test
d) Condensation

Answer: b

w.E
b) Number of WBCs in Blood Test
c) Presence of blood in urine
Explanation: In other words, the removal of
all vitiated air from a building and its
d) Low urine quantity

Answer: a asy
Explanation: Glomerular Filtration Rate
(GFR) is used to test if the kidneys are
En J C E
replacement with fresh air is known as
ventilation. It is important from the
engineering viewpoint for various reasons.

2. For comfortable working, the

___________ content should be limited to
functioning normally. In kidneys, the

g
Ainee
glomerulus is the site for ultrafiltration, i.e.
filtration of blood under high pressure.
about 0.6% by volume.
a) Oxygen
b) Hydrogen

S
Everything except cellular components moves
out in this phase and the required materials
are reabsorbed in the following phases. Thus,
if the glomerulus is not functioning well,
c) Carbon monoxide
d) Carbon dioxide
rin
M
unwanted wastes like creatinine will be high
in the blood which will all get reflected in the
GFR. Thus, the doctors will be able to
Answer: d
g.n
Explanation: It is observed that breathing is
difficult when the amount of carbon dioxide

e
by volume is about 6% and a man loses
suggest if the person needs to go for dialysis
or not.

10. When a subclavian vein or a femoral vein

consciousness when it reaches about 10% or
so. The more the amount of carbon dioxide,
the more difficult is the breathing.
t
is used for dialysis, what kind of
incision/insertion is made? 3. The difference of temperature between the
a) Catheter outside air and inside air tends to the
b) Shunt deposition of moisture in the room surfaces
c) Graft known as ___________
d) Fistula a) Ventilation
b) Diffusion
Answer: a c) Condensation
Explanation: When the femoral vein or the d) Dissipation
subclavian vein is used to extract blood for
dialysis, a simple catheter is used. A simple

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Answer: c c) Relative humidity

Explanation: The proper and sufficient d) Wet bulb temperature
ventilation results in the absence of
condensation. It can be effectively controlled Answer: c
by the provision of suitable ventilation of the Explanation: The value of relative humidity
room. is obtained by comparing dry bulb and wet
bulb temperature. For higher temperatures,
4. Where people are working, there has to be the low humidity and greater air movements
______________ to cause proper ventilation are necessary for removing greater portion of
of the premises. heat from the body.
a) Air change
b) Humidity 7. The ________________ plays an important
c) Temperature role in the comfort of persons affected by

ww
d) Moisture

Answer: a
ventilation system.
a) Carbon monoxide
b) Purity of air

w.E
Explanation: The minimum and maximum
rates of air change per hour is 1 and 60
c) Volume of room
d) Health of occupant
respectively. If the rate of change is less than

asy
1/hour, it will not create any appreciable
effect of the ventilation system. On the other
hand, at the rate of air changes more than

En J
60/hour, it will result in discomfort due to
Answer: b
E
Explanation: The air should be free from

C
odours, organic matter, inorganic dust and
unhealthy fumes of gases such as carbon
monoxide, carbon dioxide and Sulphur
high velocities of air.

g
Ainee
5. The rate of amount of water vapour present
to the amount it would have contained, had it
Dioxide, etc. All the above impurities depend
on the habits of occupants, volume of a room,
source of ventilating air, etc.

the temperature being same.

a) Relative humidity S
been saturated, is known as the ___________

rin
8. It is quite evident that the incoming air for
ventilation should be ________ in summer
b) Saturated air
c) Dry bulb temperature
d) Wet bulb temperature M a) cool, warm
b) warm, cool
g.n
and ________ in winter before it enters the
room.

e
Answer: a
Explanation: When a certain volume of air at
a certain temperature contents as much water
c) humid, dry
d) dry, humid t
vapour as it can, it is said to be Saturated air. Answer: a
Generally, the air is not saturated at all times. Explanation: The usual difference of
But it contains a certain amount of water temperature between inside and outside is
vapour in it. kept as about 8°C to 10°C. With regards to
human comfort, the term effective
6. For working a temperature of 21 degree temperature is used. It is an index which
Celsius, range of 30% to 70% of combines the effect of air movements,
____________ is desirable. humidity and temperature.
a) Saturated air
b) Dry bulb temperature 9. __________________ is an index which
combines the effect of air movement,

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humidity and temperature. economical in the sense that no special

a) Saturated air equipment is necessary for making the room
b) Effective humidity adequately ventilated and that is affords
c) Dry bulb temperature living under natural conditions.
d) Effective temperature
12. In _____________ system, some
Answer: d mechanical arrangement is adopted to provide
Explanation: Effective temperature indicates enough ventilation to the room.
the temperature of air at which sensation of a) Natural ventilation
same degree of cold or warmth will be b) Skylight
experienced as in quite a fully saturated at the c) Artificial ventilation
same temperature. Thus, if two rooms have d) Man made
the same effective temperature, no change of

ww
temperature will be experienced by a person
when he suddenly leaves one room and enters
the room.
Answer: c
Explanation: Mechanical or Artificial
ventilation has become popular due to recent

w.E
10. The value of ______________ depends
change in notion regarding ventilation. At
present, the ventilation is required not nearly
on type of activity, geographical conditions,
age of occupants, etc.
a) Saturated air
b) Relative humidity
c) Effective temperature
asy
En J
E
to furnish warm air or cool air. But the
ventilation system should provide air of such

C
qualities regarding humidity, temperature, etc.

13. Exhaust system, supply system, air

conditioning, etc. comes under ________
d) Condensation

Answer: c g
Ainee
Explanation: The popular values of effective
type of ventilation system.
a) Natural
b) Mechanical
temperature in winter and summer or 20°C
S
and 22°C respectively. It should however be
remembered that the effective temperature
c) Man made
d) Doors
rin
M
indicates same feeling of cool or warmth. But
it results in human comfort only when it is
correlated with humidity and air movements.
Answer: b
g.n
Explanation: The mechanical system is
costly, but it results in a considerable increase

e
in the efficiency of the person under the
11. In ______________ system, the use is
made of doors, windows, ventilators and
skylights to make the room properly
command of the system. This system is
adopted for big offices, banks, industrial
plants, theatres, etc.
t
ventilated.
a) Artificial ventilation 14. In ______________ system, the partial
b) Air conditioning vacuum is created inside of the room by
c) Natural ventilation exhausting the vitiated inside air by fans or
d) Mechanical ventilation blowers.
a) Supply
Answer: c b) Plenum
Explanation: Natural ventilation is useful for c) Air conditioning
small buildings and it cannot be adopted for d) Exhaust
big offices, theatres, auditoriums, etc. The
only advantage of the system is that it is

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Answer: d a) Helium
Explanation: In exhaust system, the b) Neon
extraction of air from inside sets of the c) Argon
current of fresh air from outside to inside and d) Xenon
thus, it becomes possible to provide fresh air
to the room through doors and windows. The Answer: a
fans or blowers are installed at suitable places Explanation: Helium is a noble gas which is
in the outside wall and they are connected to non reactive in nature. A good coolant has a
different rooms through duct system. high thermal capacity, low viscosity, non
toxic, chemically inert, all the properties that
15. _______________ system is just the Helium possesses. Another advantage is that
reverse of the exhaust system. Helium does not have the tendency to absorb
a) Air conditioning any neutrons and so it cannot become

ww
b) Exhaust
c) Plenum
d) Supply
radioactive. Being a noble gas, it is non
reactive and so non corrosive in nature. Thus,
it is used a coolant for the MRI machine,

Answer: d w.E especially the magnet.

Explanation: Supply system consist in

asy
supplying fresh air to the room by installing
input fans in outside walls. This system is
used for ventilating rooms near an unusual

En J
quantity of heat or odours is not produced.
_________ E
3. If an MRI was done for a long bone, the
part of the bone that will be imaged is the

C
a) Bone salts
b) Bony Prominence
c) Inflamed Joints
TOPIC 3.5 MAGNETIC
RESONANCE IMAGING
g
Ainee d) Bone Marrow

Answer: d

1. The commonly used MRI’s have a

magnetic strength of ______ S Explanation: Bone marrow is a soft tissue as

rin
compared to the encasing bone structure.
Also, it had water whose Hydrogen is used by
a) 1.5 – 3 Tesla
b) 3 – 6 Tesla
c) 6 – 12 Tesla M g.n
the MRI to form an image. The other parts of
the bone do contain hydrogen but the
hydrogen is placed in a crystal structure,

e
d) 12 – 24 Tesla

Answer: a
Explanation: MRI’s have three major
making it difficult to move or be magnetized.
Thus, it is difficult to image any other parts of
the bone with MRI except for the bone
marrow.
t
portions which work together to form an
image. The largest portion is taken up by the 4. A hypothetical MRI is made having a
magnet. This magnet is always on and magnetic field (B0) of 7 Tesla. This uses
produces a Magnetic Field of the strength of nitrogen for study. The gyrometric ratio of
1.5 – 3 Tesla. Commercially, 1.5 – 2 T was nitrogen 15 is -4.316. Find the Lamar
used but now even with 3T have been frequency.
introduced. For research purposes, MRI of 7T a) -35.889
has also been constructed. b) – 30.212
c) 0
2. The cooling agent for the MRI magnet is d) -189.812
_______

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Answer: b nature and thus, volumetric pixel or voxel is

Explanation: Gyrometric ratio is the ratio of used.
the magnetic moment to the angular moment
of the element. Lamar frequency, also called 7. MRI has a high _______ resolution.
as Lamar precision is the frequency by which a) spatial
the element will undergo a change in b) temporal
orientation when placed in a strong external c) frequency
magnetic field. Lamar frequency is given by d) magnitude
the formula: f = γn x B0/2Π
Here γn/2Π is the gyrometric ratio. Thus, Answer: a
f = -4.316*7 = -30.212. Explanation: MRI can form a 3D image of
the organ which is anatomical in nature. It
5. If the XY grid is selected in MRI then the gives good clarity and resolution for the finer

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slice selection is in which plane?
a) X plane
b) Y plane
details of the image. In the same way, fMRI
has a good temporal resolution. It maps the
brain with respect to time, scanning the
c) Z plane
d) XY plane w.E oxygen used at the regular intervals.

Answer: c
asy
Explanation: An MRI can give a 3D image
of an object and we can choose the form
which direction and from which angle we
En J
E
8. In a brain scan of a person
suffering/suspected of suffering from
schizophrenia, the brain _______

C
a) has gray matter which more than normal
b) has white matter which more than normal
c) is of a size bigger than normal
would like to view the image. The image is

g
Ainee
always perpendicular to the grid that has been
selected. As it is given that our grid is XY,
d) has shrunk

Answer: b

plane.
S
then slice selection can be done only in Z
plane and so, therefore, the image is also in Z Explanation: A person suffering from

rin
schizophrenia suffers from problems like
hallucinations, listening to non existent
6. The smallest unit in the

M
reconstruction/projection of an MRI image is
called as ________
g.n
sounds etc. The persistent problem can be
analyzed by looking at the brain scan which
shows that the white matter in a particular

e
part of the brain has become more than
a) pixel
b) voxel
c) binary unit
d) dot
normal. Since white matter is responsible for
sending impulses, a bigger area of white
matter will mean faster travelling of impulses
t
and therefore such thoughts. However, since
Answer: b the CT shows the negatives of the original,
Explanation: Voxel stands for the volumetric the white matter will look gray and gray
pixel. MRI is unique in a way that it can matter will look white. Thus, in a scan, if
image segments of the organ from different there is a large gray area and the person
angles with various slice selections. These suffers from symptoms like hallucinations or
slice selections help choose which layer of anxiety etc, then it’s a high possibility that
the organ will be imaged and the smallest unit they have schizophrenia.
of this image is called a voxel. Since MRI can
produce 3D scans, the image is volumetric in 9. The scans for lissencephaly will show a
brain _______

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a) with no gyri and sulci wave gets refracted when the medium
b) with excess gyri and sulci changes and are reflected back that the image
c) with deformed brain structure is formed. Thus, the principle for ultrasound
d) with a smaller than normal brain size is reflection and refraction.

Answer: a 2. Ultrasound is also useful for __________

Explanation: Lissencephaly is a neuronal i. detecting fault in metal sheets ii. imaging
defect that is present right from birth. It may marine depths iii. looking for metals beneath
or may not be detected in the fetal stage. In the earth’s surface iv. detecting distances v.
this disorder, the brain in smooth without the detecting earthquakes
presence of any gyri and sulci. A child born a) ii, iii, v
with lissencephaly often has a normal head b) i, iv, v
structure so it is often difficult to detect the c) i, ii, iv

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presence of this defect till a later age.

10. Frontotemporal Dementia brain scan

d) ii, iii

Answer: c

w.E
shows a __________
a) growing brain
Explanation: Ultrasound is used for detecting
the fault in metal sheets, imaging marine
b) shrinking brain
c) brain with lesions
d) brain with a tumour

Answer: b
asy
Explanation: Frontotemporal Dementia En J
E
depths and detecting distances. If the metal
sheets have faults like cracks or deformity,

C
the reflected sound waves will not be
uniform. SONAR and RADAR are used to
detect distances and work on the principle of
ultrasound.
(FTD) is the most common kind of dementia
found in the population. In this, the neuralg
Ainee
cells of the brain go for apoptosis (cell death)
3. Which of the following medical imaging
modality other than ultrasound does not use

This causes the person to have memory

disorders. S
causing an atrophy (shrinkage) of the brain. any form of radiation?
a) PET Scan
b) SPECT Scan rin
TOPIC 3.6 | 3.7 ULTRASONIC
IMAGING SYSTEMS.
M c) CT Scan
d) MRI

Answer: d
g.n
e
1. What property of sound waves acts like the
principle of ultrasound?
Explanation: MRI uses the electromagnetism
of the atoms present in the body to get the
images while all the other imaging modalities
t
a) Reflection and Refraction use some sort of radioactivity in order to take
b) Reflection only the images. Ultrasound relies on the sound
c) Refraction only waves while MRI relies on the
d) Propagation electromagnetic waves. Thus, they are both
non radioactive imaging modalities.
Answer: a
Explanation: The ultrasound works on the 4. For which of these areas can the ultrasound
principle of reflection and refraction. While it be taken for an infant but not for an adult?
is necessary that sound waves need a medium a) Cranium
to travel, so we can say propagation is b) Chest
important but it is only because the sound

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c) Arms impedance offered by the bones is extremely

d) Legs high.

Answer: a 7. The wave velocity of ultrasound in soft

Explanation: Bones are natural impedance tissues is 1540m/s and the impedance offered
providers to ultrasound and so if any organ is by it is 1.63 X 106 kg/m2s. What is the
covered or surrounded by bones, it is not density of the soft tissue?
possible or very difficult to take their
a) 0.1058441 kg/m3
ultrasound. For an infant, their bones are soft
and do not provide so much of a resistance to b) 10.58441 kg/m3
the passage of the ultrasound waves. Thus, it c) 1058.441kg/m3
is possible to take an ultrasound of the brain d) 105844.1 kg/m3
at an infant stage but not at an adult stage.

ww
5. A piezoelectric crystal is used to produce
the ultrasound waves. What kind of
Answer: c
Explanation: The impedance is given by z =
ρc where z = impedance, ρ = density and c =

w.E
ultrasound is produced?
a) Pressure wave ultrasound
velocity of the ultrasound. Since the wave
velocity and the impedance offered are given,
b) Electrical wave ultrasound
c) Sound wave ultrasound
d) Simple ultrasound

Answer: a
asy
Explanation: A piezoelectric crystal is a En J C E
ρ = z/c. This results in 1058.441 kg/m3 of
density for the soft tissue.

8. Which of the following relations are true?

a) γ increases, penetration of sound increases,
resolution decreases
special transducer which converts mechanical
g
Ainee
energy into electrical energy and vice-versa.
Thus, when the electrical impulses are given
b) γ increases, penetration of sound decreases,
resolution decreases
to the transducer, it is converted into
mechanical energy. The transducer starts
S
vibrating causing a pressure difference and
c) γ increases, penetration of sound decreases,
resolution increases

rin
d) γ decreases, penetration of sound increases,

M
the ultrasound waves are produced.

6. How is a medium characterized?

a) By its thickness
resolution increases

Answer: a g.n
e
Explanation: When the frequency (γ) of the
b) By its acoustic impedance
c) By its water content
d) By its density
sound waves increases, it gains more energy
to overcome the impedance barrier and so is
able to penetrate deeper. However, the
penetration may not be uniform in all places
t
and reflection may be uneven thus it affects
Answer: b the resolution of the image.
Explanation: Acoustic impedance is the
resistance that a sound wave faces when it 9. When an abdominal ultrasound is done,
propagates from one medium to another in why is it advised to have a full bladder?
the body. Thickness, density and water a) To have a good acoustic window
content (for a living body) are all factors that b) To increase the water content
are taken into account when measuring the c) To lower impedance
acoustic impedance. Thus the medium is d) To allow for better propagation of waves
characterized by its acoustic impedance. The

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Answer: a which the body is treated by the

Explanation: Acoustic window is a small electromagnetic waves or waves of high
opening through which the sound waves can frequency. These waves beyond certain
pass and can help image the structures frequencies have heating effects and can help
beyond. When the bladder is full, it is in easing the pain in the body. This type of
properly stretched and the folds of the bladder diathermy is used for therapeutic purposes.
do not provide any impedance. The water When the heat is increased and concentrated
helps in the better propagation of the sound at a point, it can cause cutting action by
and visualization of the structures beyond the boiling and burning the cells. This type of
bladder. diathermy is used for surgical purposes.

10. What does the red dot on the probe help 2. What surgical functions are performed by
within the produced image? the diathermy machine?

ww
a) To check if the correct probe was used
b) To check the probe orientation
c) To check the depth of the probe that was
a) cutting, coagulation, fulguration
b) cutting, fulguration
c) cutting, coagulation
used
w.E
d) To check the plane of the image.
d) coagulation, fulguration

Answer: b
asy
Explanation: When the probe is being used,
it can move in various ways but the image

En J
being formed is a horizontal image. Thus, the
Answer: a

E
Explanation: Cutting happens when the heat

C
is given is so high that the cell burns and is
separated. This causes the incision to be
formed, hence cutting. Coagulation happens
red dot at the head of the probe appears to the when the cytoplasm is heated so much that it

orientation of the organ or the foetus. g

Ainee
left of the image and helps in working out the boils and joins together. Fulguration is a
process in which the heat is applied and a

S spread out action takes place. It covers a

larger area.

rin
3. The types of therapeutic diathermy
UNIT IV PHYSICAL
MEDICINE AND
BIOTELEMETRY 9
M g.n
machines that exist are ___________
a) Short wave, micro wave and ultrasound
b) Short wave, ultrasound and cold compress

e
TOPIC 4.1 DIATHERMIES-
c) Cold compress, microwave and electrical
impulse
d) Electrical impulse, microwave and
ultrasound
t
SHORTWAVE
Answer: a
1. For what all purposes is diathermy Explanation: Shortwave diathermy uses the
principal used? infrared heat waves to treat the patient while
a) Surgical and Therapeutic microwaves go inside the body and produce
b) Therapeutic and Diagnostic heat for treatment. Ultrasound also produces
c) Diagnostic and surgical sound waves which travel in the body,
d) Diagnostic and rehabilitative produce heat and cause healing.

Answer: a 4. Which of the diathermy machine is good

Explanation: Diathermy is a process by for deep tissue healing?

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a) short wave 7. In heat wave diathermy, the maximum

b) ultrasound power given out is 500 W and the maximum
c) cold compress voltage possible is 4000V. Thus, what is the
d) electrical impulse highest resistance that heat wave diathermy
machine can deal with?
Answer: a a) 3.2 K ohm
Explanation: The short wave diathermy b) 32 K ohm
produces heat by sending in infrared waves. c) 320 K ohm
These waves are produced by the plates or d) 3200 K ohm
coils that are placed around the area to be
treated. These heat waves can travel deeper Answer: b
into the body than the waves produced by Explanation: The simple formula for power,
microwave diathermy or ultrasound voltage and resistance is used. P = V2/R

ww
diathermy.

5. What is the frequency range of the sound

R = V2/P
R = 40002/500
R = 32 K ohm.

w.E
used for ultrasound diathermy?
a) 0.1 – 0.7 MHz 8. Which of the following is used to measure
b) 0.7 – 3.3 MHz
c) 3.3 – 5 MHz
d) 5 – 15 MHz

Answer: b
asy
En J
Explanation: The ultrasound treatment can
a) Curie
b) Rem
c) Rad
C
d) Roentgens
E
the biological damage caused by radiation?

g
penetrate up to 2 – 5 cm deep within the skin

Ainee
to relieve pain. The frequency of 0.7 – 3.3
MHz is used. If the frequency is increased, it
Answer: b
Explanation: Rem is also a forming unit of
radiation. It is used to measure the amount of

the body and doing damage rather than

therapy. S
can cause excess heat causing heat burns in exposure to radiation the person has had and

rin
determine if it is within safe limits or beyond
it. If the safety limits have been crossed, the

M
6. What precaution is used in diathermy?
a) the patient is made to lie on a soft pillow
b) pads are used for grounding and
g.n
person must stay away from the radiology
area for a specific period of time of quit
working there altogether.

e
completing the circuit
c) the patient is made to drink a large number
of fluids
9. Beyond what dose is the cerebral system
shows signs of failure?
a) 25 – 200 rad
t
d) wooden blocks are used for grounding b) 200 – 600 rad
c) 600 – 1000 rad
Answer: b d) > 1000 rad
Explanation: Diathermy machines produce
electromagnetic waves and the current used to Answer: d
produce these waves is huge. In case of any Explanation: Various studies show that more
accidents, the person on whom diathermy is mature a cell, higher is its resistance to
being performed and the one who is radiations. Nerve cells and muscle cells show
performing it, both can get severely injured. high resistance to radioactivity. Nerve cells
Thus, electrode gel and pads are both used for once generated, they stay for a long period of
diathermy, surgical and therapeutic.

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time. Thus, they are highly mature cells and Answer: b

so provide high resistance to the radioactivity. Explanation: N = N0 e -λt where N =
particles left after decay, N0 is the original
10. What is the relation between 1 Rad, 1 number of particles, t is the time duration and
Rem and 1 R? λ is the decay constant. Thus, putting the
a) 1 Rad ≈ 1.5 Rem ≈ 1000 R values in the formula, we get :
b) 1 Rad ≈ 10 Rem ≈ 1.8 R -17
c) 1 Rad ≈ 1 Rem ≈ 1 R N = 20000 * e(- (4.916* 10 ) *
d) 1 Rad ≈ 10 Rem ≈ 100 R 365*100*24*60*60)= 19999.99999.

Answer: c 13. If the half life is found to be 100 msec,

Explanation: All three units have almost the what is the decay constant?
same values and they all are units and doses a) 693 per second
b) 24948 per hour

ww
of radiations. Rad stands for radiation
absorbed dose and it measures the radiation
absorbed by the tissues of the body. Rem is
c) 0.1155 per minute
d) 59875.2 per day

w.E
radiation equivalent and it measures the
biological damage caused by different types Answer: b

E
of radiation.R is for Roentgens and is used as Explanation: Half life is and decay constant
are related by t 1/2 = ln2/λ
a unit for X – Rays.
asy t 1/2 = 0.693/λ
11. The two known units of radioactivity and
the relation between the two are _______
En J
a) Curie and Becquerel 1 Ci = 3.7 x 1010 Bq
b) Curie and Becquerel 1 Bq = 3.7 x 1010 Ci
g
C
Since the half life is given in seconds,
appropriate conversions are used for hours,
minutes and day. By this, we get:

c) Curie and Roentgens 1 Ci = 1000 R

d) Roentgen and Becquerel 1 R = 1000 Bq

Answer: a
SAinee
Explanation: Curie and Becquerel signify the
λ = 0.693*3600/t1/2 = 249480 per hour.

14. With what energy must the radiation be

given to image a bone of thickness 5 cm

rin
which has covering of skin of thickness of 2

M
amount of disintegration of the radioactive
substance in a unit time. Curie was an older
unit and had a very high value which was not
feasible for elements with lower activity.
cm on the both sides and the emerging

g.n
intensity of the X – Ray is 200MeV.
(impedance for bone = b for skin = s )
a) 2000e9
e
Thus, Becquerel unit was created which is
one disintegration per second.
b) 200e(4s + 5b)
c) 20/e
d) 2e
t
12. In a hypothetical radioactive material, the
total number of active photons are 20000 and Answer: b
the decay constant is found out to be 4.916 X Explanation: The formula goes like : I =
10-17 per second. How much of the material I0e(-μt) where I is the final radiation, I0 is the
will be left in a 100 years? (1 year = 365 initial radiation, μ is the impedance and t is
days. Leap year is not assumed in the the thickness. Since we know the emerging
calculations) radiation, by using back processing formula,
a) 1589.99999 we get 200e(4s+5b).
b) 19,999.9999
c) 19.999999
d) 123.99999

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TOPIC 4.2 ULTRASONIC AND 5. Which of the following type sound

generators are not possible?
MICROWAVE TYPE AND THEIR a) Piezo electric
APPLICATIONS b) Magnetostrictive
c) Both piezo electric and magnetostrictive
1. Basically sound waves are d) None of the mentioned
______________
a) Voltage signals Answer: d
b) Pressure waves Explanation: Both piezo electric and
c) Current magnetostrictive devices are successful
d) Radiation sources of sound waves.

Answer: b 6. Mosaic regarding sonar is ____________

ww
Explanation: Sound waves are pressure
waves in character.
a) Surface of sonar
b) Frequency of sound wave
c) Pattern of vibrating elements

w.E
2. Which of the following is not a character of
a sensor of a sound wave?
d) Depth of sea to which it is applicable

a) Causes no health hazard

asy
b) They are suitable in a harsh environment
c) They are only suitable in cold environment
d) They can be used in corrosive environment
En J
Answer: c

E
Explanation: Specific pattern of the vibrating
element is known as mosaic.

C
7. All elements of sonar are driven
electrically.
Answer: c
Explanation: Sound sensors can be used in
any environment. g
Ainee
a) True
b) False

all aspects.
a) True S
3. Sound waves are similar to light waves in Answer: a

rin
Explanation: All elements of sonar are
driven electrically using an external power
b) False

Answer: b M supply.
g.n
8. Piezo electric materials are well cut for
_____________
e
Explanation: While considering reflection
and refraction, sound waves and light waves
are similar.
a) Good dimension
b) Good coupling coefficient
c) Compact shape of device
t
4. SONAR stands for _______________ d) Increasing frequency
a) Sound navigation and ranging
b) Sound number approximation and ranging Answer: b
c) Sound nullifying ranging Explanation: Piezo electric materials are so
d) None of the mentioned cut as to have maximum coupling coefficient
between mechanical strain and electrical
Answer: a polarization direction.
Explanation: Sonar is the short form of
sound navigation and ranging. 9. Which of the following can be used in
sonar?
a) ADP

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b) Rescelle salt b) cutting, fulguration

c) ADP and Roscelle salt c) cutting, coagulation
d) ADP and Roscelle salt in sealed condition d) coagulation, fulguration

Answer: d Answer: a
Explanation: ADP and Roscelle salt are used Explanation: Cutting happens when the heat
as sealed with oil since they are soluble in is given is so high that the cell burns and is
water. separated. This causes the incision to be
formed, hence cutting. Coagulation happens
10. Magnetostriction transmitter uses when the cytoplasm is heated so much that it
_______________ boils and joins together. Fulguration is a
a) Electrostrictive phenomena process in which the heat is applied and a
b) Horizontal vibration of nickel tube spread out action takes place. It covers a

ww
c) Longitudinal vibration of nickel tube
d) All of the mentioned
larger area.

3. The types of therapeutic diathermy

Answer: c
w.E
Explanation: Magnetostriction transmitter
machines that exist are ___________
a) Short wave, micro wave and ultrasound
uses longitudinal vibration of nickel tube
used.

TOPIC 4.3 SURGICAL

DIATHERMY
asy
En J
impulse

ultrasound
C E
b) Short wave, ultrasound and cold compress
c) Cold compress, microwave and electrical

d) Electrical impulse, microwave and

1. For what all purposes is diathermy g

Ainee
Answer: a
Explanation: Shortwave diathermy uses the
infrared heat waves to treat the patient while

S
principal used?
a) Surgical and Therapeutic microwaves go inside the body and produce
b) Therapeutic and Diagnostic
c) Diagnostic and surgical rin
heat for treatment. Ultrasound also produces
sound waves which travel in the body,

Answer: a M
d) Diagnostic and rehabilitative

Explanation: Diathermy is a process by

g.n
produce heat and cause healing.

4. Which of the diathermy machine is good

for deep tissue healing?
e
which the body is treated by the
electromagnetic waves or waves of high
frequency. These waves beyond certain
a) short wave
b) ultrasound
c) cold compress
t
frequencies have heating effects and can help d) electrical impulse
in easing the pain in the body. This type of
diathermy is used for therapeutic purposes. Answer: a
When the heat is increased and concentrated Explanation: The short wave diathermy
at a point, it can cause cutting action by produces heat by sending in infrared waves.
boiling and burning the cells. This type of These waves are produced by the plates or
diathermy is used for surgical purposes. coils that are placed around the area to be
treated. These heat waves can travel deeper
2. What surgical functions are performed by into the body than the waves produced by
the diathermy machine? microwave diathermy or ultrasound
a) cutting, coagulation, fulguration diathermy.

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5. What is the frequency range of the sound R = 40002/500

used for ultrasound diathermy? R = 32 K ohm.
a) 0.1 – 0.7 MHz
b) 0.7 – 3.3 MHz 8. Which of the following is used to measure
c) 3.3 – 5 MHz the biological damage caused by radiation?
d) 5 – 15 MHz a) Curie
b) Rem
Answer: b c) Rad
Explanation: The ultrasound treatment can d) Roentgens
penetrate up to 2 – 5 cm deep within the skin
to relieve pain. The frequency of 0.7 – 3.3 Answer: b
MHz is used. If the frequency is increased, it Explanation: Rem is also a forming unit of
can cause excess heat causing heat burns in radiation. It is used to measure the amount of

ww
the body and doing damage rather than
therapy.
exposure to radiation the person has had and
determine if it is within safe limits or beyond
it. If the safety limits have been crossed, the

w.E
6. What precaution is used in diathermy?
a) the patient is made to lie on a soft pillow
person must stay away from the radiology
area for a specific period of time of quit
b) pads are used for grounding and
completing the circuit
asy
c) the patient is made to drink a large number
of fluids
d) wooden blocks are used for grounding
En J
E
working there altogether.

9. Beyond what dose is the cerebral system

C
shows signs of failure?
a) 25 – 200 rad
b) 200 – 600 rad
Answer: b
Explanation: Diathermy machines produce g
Ainee
electromagnetic waves and the current used to
c) 600 – 1000 rad
d) > 1000 rad

S
produce these waves is huge. In case of any
accidents, the person on whom diathermy is
being performed and the one who is
Answer: d

rin
Explanation: Various studies show that more
mature a cell, higher is its resistance to

M
performing it, both can get severely injured.
Thus, electrode gel and pads are both used for
diathermy, surgical and therapeutic.
g.n
radiations. Nerve cells and muscle cells show
high resistance to radioactivity. Nerve cells
once generated, they stay for a long period of

e
time. Thus, they are highly mature cells and
7. In heat wave diathermy, the maximum
power given out is 500 W and the maximum
voltage possible is 4000V. Thus, what is the
so provide high resistance to the radioactivity.

10. What is the relation between 1 Rad, 1

t
highest resistance that heat wave diathermy Rem and 1 R?
machine can deal with? a) 1 Rad ≈ 1.5 Rem ≈ 1000 R
a) 3.2 K ohm b) 1 Rad ≈ 10 Rem ≈ 1.8 R
b) 32 K ohm c) 1 Rad ≈ 1 Rem ≈ 1 R
c) 320 K ohm d) 1 Rad ≈ 10 Rem ≈ 100 R
d) 3200 K ohm
Answer: c
Answer: b Explanation: All three units have almost the
Explanation: The simple formula for power, same values and they all are units and doses
voltage and resistance is used. P = V2/R of radiations. Rad stands for radiation
R = V2/P absorbed dose and it measures the radiation

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absorbed by the tissues of the body. Rem is c) 0.1155 per minute

radiation equivalent and it measures the d) 59875.2 per day
biological damage caused by different types
of radiation.R is for Roentgens and is used as Answer: b
a unit for X – Rays. Explanation: Half life is and decay constant
are related by t 1/2 = ln2/λ
11. The two known units of radioactivity and t 1/2 = 0.693/λ
the relation between the two are _______ Since the half life is given in seconds,
a) Curie and Becquerel 1 Ci = 3.7 x 1010 Bq appropriate conversions are used for hours,
b) Curie and Becquerel 1 Bq = 3.7 x 1010 Ci minutes and day. By this, we get:
c) Curie and Roentgens 1 Ci = 1000 R
d) Roentgen and Becquerel 1 R = 1000 Bq λ = 0.693*3600/t1/2 = 249480 per hour.

14. With what energy must the radiation be

ww
Answer: a
Explanation: Curie and Becquerel signify the
amount of disintegration of the radioactive
given to image a bone of thickness 5 cm
which has covering of skin of thickness of 2
cm on the both sides and the emerging
w.E
substance in a unit time. Curie was an older
unit and had a very high value which was not intensity of the X – Ray is 200MeV.
feasible for elements with lower activity.

asy
Thus, Becquerel unit was created which is
one disintegration per second.

En J
12. In a hypothetical radioactive material, the
total number of active photons are 20000 and
a) 2000e9

c) 20/e
d) 2e
C E
(impedance for bone = b for skin = s )

b) 200e(4s + 5b)

the decay constant is found out to be 4.916 X

10-17 per second. How much of the material g
Ainee Answer: b
Explanation: The formula goes like : I =
will be left in a 100 years? (1 year = 365
days. Leap year is not assumed in the
calculations)
S I0e(-μt) where I is the final radiation, I0 is the
initial radiation, μ is the impedance and t is

rin
the thickness. Since we know the emerging

M
a) 1589.99999 radiation, by using back processing formula,
b) 19,999.9999
c) 19.999999
we get 200e(4s+5b).
g.n
d) 123.99999

Answer: b
Explanation: N = N0 e -λt where N =
TOPIC 4.4 BIOTELEMETRY
e
1. Leucocytes are in the shape of ________
t
particles left after decay, N0 is the original a) sphere
number of particles, t is the time duration and b) cube
λ is the decay constant. Thus, putting the c) hollow
values in the formula, we get : d) cuboid
-17
N = 20000 * e(- (4.916* 10 ) *
365*100*24*60*60)= 19999.99999. Answer: a
Explanation: Leucocytes are in the shape of
13. If the half life is found to be 100 msec, a sphere. Leucocytes have a nucleus. They
what is the decay constant? live for seven to fourteen days and there is a
a) 693 per second rapid turn over, with constant destruction and
b) 24948 per hour replacement. There are normally 5000–

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10,000 white cells per cubic mm of blood but reluctance of the coupling capacitors. The
their number varies during the day. response should be down to less than one
hertz which is a very frequent requirement.
2. What should be the frequency response of To achieve the low frequency response
the amplifiers that are used for the required for medical applications, the
amplification purpose of the input signal in amplifier must have large values of coupling
medical devices? capacitance.
a) high frequency response
b) low frequency response 5. Neutrophils are bigger than the red cells.
c) frequency response has no role to play in it a) True
d) average frequency response b) False

Answer: b Answer: a

ww
Explanation: The response should be down
to less than one hertz which is a very frequent
requirement. The bioelectric signals in
Explanation: It is True. Neutrophils are
nearly twice as big as the red
cells.Lymphocytes are of the same size as the

w.E
medical science contain components of
extremely low frequency. Thus the amplifiers
red cells but contain a large density staining
nucleus and no granules. Neutrophils contain
must also have a low frequency response.

asy
3. Leucocytes are not responsible for the
formation of the defence mechanism of the
body that fights against infection.
a) True En J
E
both a nucleus divided into several lobes and
granules in their protoplasm.

C
6. High pass filter amplifies frequency
_____________
a) above certain value
b) False

Answer: b
g
Ainee
b) below certain value
c) above and below certain value
d) at certain value

defence mechanism of the body against

S
Explanation: It is False. Leucocytes form the

infection. The number and proportion of these

Answer: a
rin
Explanation: High pass filter amplifies signal

M
types of leucocytes may vary widely in
response to various disease conditions. They
are of two main types: the neutrophils and the
lymphocytes. Neutrophils ingest bacteria and
g.n
above a certain frequency. Band pass filter
amplifies frequencies with in a certain band.
Band stop filter amplifies all the frequencies

e
except those in a certain band. Low pass filter
lymphocytes are concerned with
immunological response.
amplifies signals below a certain frequency.

7. Mean Platelet Volume is the ratio of the

t
4. To achieve the ______________ required ___________ and is expressed in femolitres.
for medical applications, the amplifier must a) integrated platelet volume to the platelet
have large values of coupling capacitance. count
a) random frequency response b) integrated platelet volume to the WBC
b) high frequency response count
c) average frequency response c) integrated RBC volume to the platelet
d) low frequency response count
d) integrated platelet volume to the RBC
Answer: d count
Explanation: In all RC-coupled amplifiers,
low frequency response is limited by the

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Answer: a Answer: b
Explanation: Mean Platelet Volume (MPV) Explanation: Plateletcrit is the percentage of
is the ratio of the integrated platelet volume to the total specimen volume occupied by the
the platelet count and is expressed in platelets. Red Cell Distribution Width is a
femolitres. Platelet Distribution Width is numerical expression of the width of the size
related to the size range covered by those distribution of red cells. Mean Platelet
platelets lying between the sixteenth and Volume is the ratio of the integrated platelet
eighty fourth percentile. Red Cell Distribution volume to the platelet count and is expressed
Width is a numerical expression of the width in femolitres.
of the size distribution of red cells.
11. Modern instrument use ________ for
8. Unit of Mean Platelet Volume is expressed intravascular oximetry?
in? a) photodiode

ww
a) millilitres
b) femolitres
c) picolitres
b) red and infrared LED’s
c) optical fibre
d) phototransistor
d) decilitres
w.E Answer: c
Answer: c

asy
Explanation: Unit of Mean Platelet Volume
is expressed in femolitres. 1f/l = 10–15 . 1
litre of blood contains 0.45 litres of red cells.
Mean Platelet Volume (MPV) is the ratio of
En J
E
Explanation: For intravascular oximetry,
modern instruments make use of optical

C
fibres to guide the light signal inside the
vessel and the reflected light from the red
blood cells back to the light detector.
the integrated platelet volume to the platelet
count and is expressed in femolitres.

9. Low pass filter amplifies signals below a

g
Ainee
12. Optical fiber sensors are immune to
electromagnetic disturbances.
a) True
certain frequency.
a) True
b) False S b) False

Answer: a rin
Answer: a
M
Explanation: It is true. Low pass filter
amplifies signals below a certain frequency.
g.n
Explanation: It is True. Optical fiber sensors
are electrically passive and consequently
immune to electromagnetic disturbances.

e
They can be miniaturized and are most
Band stop filter amplifies all the frequencies
except those in a certain band. High pass
filter amplifies signal above a certain
suitable for telemetry applications. They are
geometrically flexible and corrosion resistant. t
frequency. Band pass filter amplifies 13. Currently available oximeters utilize
frequencies within a certain band. __________ wavelengths.
a) Equal to 2
10. _______ is the percentage of the total b) Cannot be determined
specimen volume occupied by the platelets. c) Less than 2
a) Mean Platelet Volume d) More than 2
b) Plateletcrit
c) Red Cell Distribution Width Answer: d
d) Platelet Distribution Width Explanation: Currently available fiber-optic
oximeters utilize more than two wavelengths
to adjust for haematocrit variation. For

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estimating SO2, usually the reflectance at two

wavelengths, one in the red and the other in
the near infrared regions, are used.
UNIT V RECENT TRENDS
14. Mix venous saturation is measured by
__________
IN MEDICAL
a) Ear Oximeter INSTRUMENTATION 9
b) Intravascular Oximeter
c) Skin Reflectance Oximeter
d) Pulse Oximeter TOPIC 5.1 TELEMEDICINE

Answer: b 1. _______________ will reject any common

Explanation: Mixed venous saturation varies mode signal that appears simultaneously at

ww
in reflecting the changes of oxygen
saturation, cardiac output, haematocrit or
haemoglobin content and oxygen
both amplifier input terminal.
a) ac coupled amplifiers
b) dc amplifiers

w.E
consumption. Intravasacular oximeters are
normally used to measure mixed venous
c) carrier amplifiers
d) differential amplifiers
saturation, from which the status of the

asy
circulatory system can be deduced.

15. Which of the following is correct

expression for RDW index?
En J
Answer: d

C E
Explanation: Most of the amplifiers used for
measuring bioelectric signals are of the
differential type. A differential amplifier is
a) [(20th – 80th) Percentile Volume / (20th – one which will reject any common mode
80th) Percentile Volume] X 100 X K
g
Ainee
b) [(20th – 80th) Percentile Volume / (20th +
signal that appears simultaneously at both
amplifier input terminals and amplifies only
80th) Percentile Volume] X 100 X K
S
c) [(20th + 80th) Percentile Volume / (20th –
the voltage difference that appears across its
input terminals. AC amplifiers have a limited

rin
frequency response and are, therefore, used

M
80th) Percentile Volume] X 100 X K
d) [(20th + 80th) Percentile Volume / (20th +
80th) Percentile Volume] X 100 X K
only for special medical applications such as

g.n
electrocardiograph machine.

e
2. The amplifier from the following that has a
Answer: b
Explanation: The total erythrocyte count is
scanned by a continuously variable
limited frequency response is _________
a) dc amplifiers
b) differential amplifier
c) ac coupled amplifiers
t
thresholding circuit. The RDW index is d) carrier amplifiers
expressed by the following equation [(20th –
80th) Percentile Volume / (20th + 80th) Answer: a
Percentile Volume ] X 100 X K. It is a Explanation: AC amplifiers have a limited
numerical expression of the width of the size frequency response and are, therefore, used
distribution of red cells. It is derived by only for special medical applications such as
analog computation. The upper threshold is electrocardiograph machine. For
moved progressively lower from a level electrocardiograms, an ac amplifier with
equivalent to 360 femolitres until 20 per cent sensitivity, giving 0.5 mV/cm, and frequency
of all erythrocytes present have a size above a response up to 1 kHz and an input impedance
certain value. of 2 to 5 MW is used. For such applications

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as retinography, EEG and EMG, more Answer: a

sensitive ac amplifiers are required, giving a Explanation: It is True. Digital filters are
chart sensitivity of say 50 mV/cm with a high insensitive to temperature as compared with
input impedance of over 10 MW. analog filters. They are also insensitive to
ageing, voltage drift and external interference
3. Which of the following amplifiers are used as compared to analog filters. Their response
with transducers which require an external is completely reproducible and predictable,
source of excitation? and software simulations can exactly reflect
a) ac coupled amplifiers product performance.
b) dc amplifiers
c) carrier amplifiers 6. The number of amplifiers incorporated in
d) differential amplifier the module of a Chopper stabilized dc
amplifiers are ___________

ww
Answer: c
Explanation: Carrier amplifiers are used with
transducers which require an external source
a) 1
b) 2
c) 3

w.E
of excitation. They essentially contain a
carrier oscillator, a bridge balance and
d) 4

calibration circuit, a high gain ac amplifier, a

asy
phase-sensitive detector and a dc output
amplifier. They are characterized by high
gain, negligible drift, extremely low noise and

En J
the ability to operate with resistive, inductive
Answer: c

E
Explanation: Chopper stabilized dc

C
amplifiers are used for low level but
preferably wideband applications such as
oscilloscopes, tape recorders and light beam
or capacitive type transducers. oscilloscope recorders. This includes an ac

4. Which feedback system is employed in DC

amplifiers?
g
Ainee amplifier for signals above about 20 Hz, a dc
chopper input amplifier for signals from

matter
b) Negative S
a) Can be any positive or negative doesn’t
about 20 Hz down to dc plus wideband
feedback stabilized dc amplifier. These are

rin
complex amplifiers having three amplifiers
incorporated in the module.
c) Depends on the application
d) Positive

Answer: b
M g.n
7. _____________ is employed with resistive
transducers which require an external source

e
Explanation: DC amplifiers are generally of
the negative feedback type. They are not
practical for very low level applications
of excitation.
a) differential amplifier
b) dc bridge amplifier
c) carrier amplifier
t
because of dc drift and poor common-mode d) ac coupled amplifier
rejection capabilities. They are used for
medium gain applications down to about 1 Answer: b
mV signal levels for full scale. Explanation: Essentially, the amplifier
comprises a stable dc excitation source, a
5. Digital filters are not sensitive to bridge balance and calibration unit, a high
temperature as compared with analog filters. gain differential dc amplifier and a dc output
a) True amplifier. DC bridge amplifiers are employed
b) False with resistive transducers which require an
external source of excitation. They can be
used as conventional dc high gain amplifiers

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and offer operating simplicity and high- the amplifier must have large values of
frequency response. coupling capacitance. The response should be
down to less than one hertz which is a very
8. Which of the following IC is a variable frequent requirement. In all RC-coupled
negative voltage regulator? amplifiers, low frequency response is limited
a) 7912 by the reluctance of the coupling capacitors.
b) 7905
c) LM337
d) LM317 TOPIC 5.2 INSULIN PUMPS

Answer: c 1. Diabetes insipidus is due to insufficient

Explanation: LM337 is a variable negative release of _________
voltage regulator IC. It is capable of drawing a) Insulin

ww
current up to 1.5A and voltage range from
(-1.25V) – (-30V) ideally. LM317 is a
variable positive voltage regulator IC. 7905
b) ADH
c) Thyroxine
d) Glucagon

w.E
and 7912 are fixed voltage regulator IC that
give output voltage as -5V and -12V Answer: b
respectively.

asy
9. Chopper input dc amplifiers are preferred
for high level inputs to instrumentation
systems because of their high sensitivity,
negligible drift and excellent common modeEn J ADH.
C E
Explanation: Diabetes insipidus is a disorder
of salt and water metabolism marked by
intense thirst and heavy urination. Diabetes
insipidus is due to insufficient release of

rejection capability.
a) True
b) False
g
Ainee
2. Which of the following gastrointestinal
hormone stimulates insulin secretion?
a) GIP

Answer: b
Explanation: It is False. Chopper input dc S b) CCK
c) Gastrin
d) Secretin rin
M
amplifiers are preferred for low level inputs
to instrumentation systems because of their
high sensitivity, negligible drift and excellent
common mode rejection capability. Their
Answer: a
g.n
Explanation: GIP is gastroinhibitory peptide.

e
It is also known as glucose dependent
high frequency response is limited to about
one half of the input chopper frequency.
insulinotroic peptide. It is a weak inhibitor of
gastric acid secretion; its main role is to
stimulate insulin secretion.
t
10. The amplifier configuration must contain
_____________ to achieve the low frequency 3. Which of the following element is needed
response for medical applications? for insulin to exert its maximal effect in
a) higher resistance glucose uptake?
b) lower resistance a) Vanadium
c) lower capacitance b) Molybdenum
d) higher capacitance c) Selenium
d) Chromium
Answer: d
Explanation: To achieve the low frequency Answer: d
response required for medical applications, Explanation: Chromium is an essential

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mineral that appears to have a beneficial role b) Beta somatostatin

in the regulation of insulin action and its c) Delta insulin
effects on carbohydrate, protein and lipid d) Alpha glucagon
metabolism. Chromium is an important factor
for enhancing insulin activity. Answer: d
Explanation: Alpha glucagon is secreted by
4. Insulin promotes _______ endocrine cells of the pancreas. They make
a) Glucosuria up to 20% of human islet cells synthesizing
b) Glycogenesis and secreting glucagon.
c) Glycogenolysis
d) Gluconeogenesis 8. Where does synthesis of insulin begin?
a) rRER
Answer: b b) sRER

ww
Explanation: Glycogenesis is a process of
glycogen synthesis from sugar. Insulin
promotes Glycogenesis.
c) Nucleolus
d) Mitochondria

w.E
5. Humulin is being commercially produced
Answer: c
Explanation: Nucleolus is a part of eukaryote
from a transgenic species of _______
a) Rhizobium
b) Saccharomyces
c) Escherichia
d) Mycobacterim
asy
En J
E
cell where ribosomes are made. It is the
largest structure in the nucleus. Synthesis of
insulin begins in Nucleolus.

C
9. How many intermolecular and
interamolecular disulfide bond is present in
Answer: c
Explanation: Humulin is being commercially
produced from a transgenic species of
g
Ainee
insulin?
a) 1 Intermolecular, 2 intramolecular
b) 2 Intermolecular, 2 intramolecular

S
Escherichia. Humulin is a man-made form of
hormone that is produced from the body. It
was first done by Eli Lily company.
c) 2 Intermolecular, 1 intramolecular

rin
d) 1 Intermolecular, 3 intramolecular

a) Extrinsic protein
b) Intrinsic protein
M
6. Insulin receptors are ___________
Answer: c
g.n
Explanation: There are 2 Intermolecular and
1 intramolecular disulfide bond is present in
insulin.
e
c) G protein
d) Trimeric protein 10. Which of the following order is correct?
a) Insulin > Proinsulin > Preproinsulin
t
Answer: a b) Preproinsulin > Insulin > Proinsulin
Explanation: Insulin receptors are extrinsic c) Proinsulin > Preproinsulin > Insulin
protein. Insulin binds to r4ecetors on the cell d) Preproinsulin > Proinsulin > Insulin
surface. This activates the cell’s glucose
transporter molecules to form a doorway in Answer: d
the cell membrane so that glucose can enter Explanation: Insulin is made up of two
the cell. peptide chains referred to as A chain and B
chain. A and B chains are linked together by
7. What do endocrine cells of the pancreas disulfide bonds and an additional disulfide
secrete? bond is formed within A chain.
a) Omega growth hormone

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11. What is the beta subunit of the insulin 1. Radio telemetry is useful when source and
receptor? receiver is at ________________
a) Protein kinase a) Long distance separation
b) Tyrosine kinase b) Short distance separation
c) Tryptophan kinase c) Varying separation distance
d) Taurine kinase d) All of the mentioned

Answer: b Answer: d
Explanation: Tyrosine kinase is an enzyme Explanation: Radio telemetry can be used
that can transfer a phosphate group from ATP where the distance between source and
to a protein in the cell. It functions as an on or receiver may vary.
off switch in many cellular functions.
2. PLCC stands for _________________

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12. What do delta cells secrete?
a) Cortisol
b) Glucose
a) Power Load Carrier Current
b) Power Line Carrier Current
c) Peak Line Carrier Current

w.E
c) Pancreatic enzyme
d) Somatostatin
d) None of the mentioned

Answer: d
asy
Explanation: Somatostatin is also known as
growth hormone. It is a peptide hormone.
Somatostatin is secreted by delta cells.
En J
Answer: b

E
Explanation: PLCC is the short of power line
carrier current.

C
3. Multiplexing is not possible in radio
telemetry.
13. What is the function of GLUT 4?
a) Glucose transport
b) Glycogen transport
g
Ainee
a) True
b) False

c) Insulin transport
d) Glucagon transport
S Answer: b

rin
Explanation: Multiplexing of data in radio
telemetry is possible.
Answer: a

M
Explanation: GLUT 4 is the insulin regulated
glucose transporter found primarily in
adipose tissues and striated muscle.
_________________
a) Very low value
g.n
4. Carrier frequency in radio telemetry will be

e
14. Hyperglycemia is a condition of high
blood glucose.
b) Very high value
c) Any value greater than 100 Hz
d) Frequency appropriate to conductor size
t
a) True
b) False Answer: d
Explanation: For multiplexing in radio
Answer: a telemetry, carrier frequency should be
Explanation: Hyperglycemia is an appropriate to conductor size.
abnormally high blood glucose level. It is a
sign of diabetes. The main symptoms are 5. For space telemetry, carrier frequency
increased thirst and frequent need to urinate. should be _______________
a) Very high value
b) Very low value
TOPIC 5.3 RADIO PILL

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c) Frequency appropriate to distance Answer: a

d) Any value greater than 100 Hz Explanation: Output power of the transmitter
is kept very low.
Answer: a
Explanation: Very high value of carrier 10. Output power of transmitter will be
frequency helps in reducing antenna size. ______________
a) 2 to 10 w
6. Frequency range of space telemetry should b) 2 to 50 w
be _________________ c) 2 to 100 w
a) Less than 216 MHz d) Above 100 w
b) Between 216 – 235 MHz
c) Between 235 – 412 MHz Answer: c
d) Above 412 MHz Explanation: Output power of the transmitter

ww
Answer: b
Explanation: Carrier frequency range of
is always kept very low and it lies in the
range of 2 to 100 w.

w.E
space telemetry system should be between
216 MHz and 235 MHz. TOPIC 5.4 ENDOMICROSCOPY

relaxation for RF carrier?

a) 0 %
b) +/- 1 %
c) +/- 0.1 %
asy
7. Which of the following represent stability

En J
E
1. The endoscope that examines the
respiratory tract is called as ____________

C
a) Bronchoscopy
b) Laparoscopy
c) Colonoscopy
d) None of the mentioned

Answer: c
g
Ainee
d) Arthroscopy

Answer: a

within +/- 0.1 %.

S
Explanation: RF carrier must remain stable Explanation: Broncoscope is inserted in the

rin
body via the nasal passage and it used to
image the respiratory tract. It has a very thin

bandwidth allowed?
a) 0.2 MHz
b) 0.5 MHz
M
8. For FM/FM modulation, what is the
g.n
tube so that the patient feels minimal
discomfort as the scope goes down the track.
A laryngoscope can be used to examine the

e
larynx. It is inserted through the mouth and
c) 0.9 MHz
d) 1 MHz
the direction of the scope is changed at the
epiglottis. This allows the scope to look at the
larynx and not enter the GI tract.
t
Answer: b
Explanation: For FM/FM modulation, 2. Endoscope used to examine the upper GI
bandwidth allowed is 0.5 MHz. tract is ___________
a) Laparoscopy
9. Output power of transmitter will be b) Bronchoscopy
_____________ c) Esophagogastroduodenoscopy
a) Very low d) Laryngoscopy
b) Very high
c) Varying Answer: c
d) None of the mentioned Explanation: As the name suggests, this
particular endoscope has a really long range

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and can be used to view esophagus, stomach x) Vinegar

and the duodenum. The region till here is a) i,iv, vi, vii, viii
mostly considered as the upper GI tract. b) i, vii, viii, ix, x
c) ii, iii, ix, x
3. Capsule endoscope has a ________ for d) iii, iv, v, ix
taking images.
a) CCD camera Answer: a
b) LED camera Explanation: The body of an endoscope is
c) X-Ray camera flexible because it is made of polymers. The
d) US camera cleaning agents used need to be harsh enough
for the microbes that may get attached to the
Answer: a endoscope as it is examining the patient but
Explanation: The CCD (Charge coupled they should not corrode or harm the body of

ww
device) camera is small and is easily fitted in
the capsule. It does not require too much
energy and the range of the camera is wide
the endoscope.

6. None of the endoscopic procedures require

w.E
enough. It may also be called as CMOS
(Complementary Metal Oxide
any cuts.
a) True
Semiconductor) imager.

organ is called __________

a) biopsy
b) surgery
asy
4. Extraction of a small piece of the diseased

En J
b) False

Answer: b

C E
Explanation: Some procedures like
laparoscopy and arthroscopy require a small
cut to allows the devices to go in.
c) chemotherapy
d) replacement g
Ainee
Laparoscopy is done for the diaphragm and
the organs in that region. It can help look at
kidneys and the reproductive organs in
Answer: a

S
Explanation: The smallest unit of any system
is its cell. Every organ is made of tissues and
women.

rin
7. Which of the following operations can be

M
tissues are a collection of similar cells. Thus,
what a tissue system does is a result of the
network of the similar cells. So, when a tissue
is diseased or injured, a part of the tissue is
done with an endoscope?
i. Bypass surgery
ii. Cardiac Catherization
iii. Kidney Stone Removal
g.n
e
extracted to study the nature of the trauma or
disease. This extracted part is called a biopsy.
iv. Knee Replacement
v. Biopsy
vi. Tracheotomy
t
5. The cleaning of the endoscope is done with vii. Appendix Removal
____________ a) i, ii, iii, iv, vii
i) 2% Glutarldehyde (CIDEX) b) ii, iii, v, vii
ii) Sodium Hypochlorite c) iii, vii
iii) Hydrochloric acid d) v, vi, vii
iv) Iodophor (Betadine-providone)
v) 1% Saline Solution Answer: b
vi) 70% ethyl or isopropyl alcohol Explanation: All of the above mentioned
vii) Ethylene oxide (ETO) processes are minimally invasive procedures
viii) Formaldehyde vapour and can be quickly resolved with the help of
ix) Phenol Solution endoscopes. Come to require a small cut to

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allow insertion of the scope along with the c) speaking

micro instruments while others may be d) all of the mentioned
performed without any incisions. These use
the nasal opening, oral opening, the anal Answer: c
opening and the vaginal opening for Explanation: None.
visualization and surgery.
2. Elementary linguistic units that are smaller
8. Which if the following diagnostic than words are?
procedures require an endoscope? a) allophones
a) Transesophagal Echocardiography b) phonemes
b) X Ray of the Chest c) syllables
c) Counting the Number of Platelets d) all of the mentioned
d) Detecting Leukemia
Answer: d

ww
Answer: a
Explanation: This is a type of Ultrasound of
Explanation: None.

w.E
the heart where the endoscope is sending
through the oral cavity and placed close to the
3. In LISP, the atom that stands for “true” is
_____________
heart via the oesophagus. This helps in taking

asy
an unhindered ultrasound of the heart.

9. Which endoscope can be used to look at

the knees before and after a surgery?
a) Colonoscopy En J
a) t
b) ml
c) y
d) time

Answer: a C E
b) Arthroscopy
c) Bronchoscopy
d) Laryngoscopy
g
Ainee
Explanation: None.

4. A mouse device may be _____________

Answer: b
S
Explanation: Arthroscopy is a process where
a) electro-chemical
b) mechanical
c) optical
rin
M
the bones are visualized and worked upon
with the help of an endoscope. The soft parts
of the knee like the cartilage or the synovial
capsule cannot be properly visualized with an
d) both mechanical and optical

Answer: d
Explanation: None.
g.n
e
X-Ray so an arthroscope is used to look at
them. The healing of the bones after a surgery
can be monitored by the arthrocope. Small
5. An expert system differs from a database
program in that only an expert system
_____________
t
operations regarding the bones can be
performed with the help of the arthroscope. a) contains declarative knowledge
b) contains procedural knowledge
c) features the retrieval of stored information
TOPIC 5.5 BRAIN MACHINE d) expects users to draw their own
INTERFACE conclusions

Answer: b
1. What is the primary interactive method of Explanation: None.
communication used by humans?
a) reading 6. Arthur Samuel is linked inextricably with a
b) writing program that played _____________

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a) checkers 1. How many gates per chip are used in first

b) chess generation Integrated Circuits?
c) cricket a) 3-30
d) football b) 30-300
c) 300-3000
Answer: a d) More than 3000
Explanation: None.
Answer: a
7. Natural language understanding is used in Explanation: The first generation ICs
_____________ belongs to small scale integration, which
a) natural language interfaces consists of 3-30 gates per chip
b) natural language front ends (approximately).
c) text understanding systems

ww
d) all of the mentioned

Answer: d
2. Find the chip area for a Medium Scale
Integration IC?
a) 8 mm3

w.E
Explanation: None.
b) 4 mm2
c) 64 mm3
8. Which of the following are examples of

a) debuggers
b) editors asy
software development tools?

En J
c) assemblers, compilers and interpreters
d) all of the mentioned
d) 16 mm2

Answer: d

C E
Explanation: The approximate length and
breadth of Medium Scale Integration would

Answer: d
Explanation: None.
g
Ainee
be 4 mm. Therefore, its area is given as =
length × breadth = 4mm × 4mm = 16mm2
.

9. Which is the first AI programming

language? S 3. The number of transistors used in Very

rin
Large Scale Integration is
a) BASIC
b) FORTRAN
M
c) IPL(Inductive logic programming)
d) LISP
a) 107 transistors/chip

g.n
b) 106 – 107 transistors/chip
c) 203 – 105 transistors/chip
d) 102 – 203 transistors/chip
e
Answer: d
Explanation: None.
Answer: c
Explanation: Very Large Scale Integration
t
(VLSI) ICs are fabricated using more than
10. The Personal Consultant is based on?
3000 gates/chip, which is equivalent to
a) EMYCIN
20,000 – 1,00,00,00 transistors/chip.
b) OPS5+
c) XCON 4. What type of integration is chosen to
d) All of the mentioned fabricate Integrated Circuits like Counters,
multiplexers and Adders?
Answer: d
a) Small Scale Integration (SSI)
Explanation: None.
b) Medium Scale Integration (MSI)
c) Large Scale Integration (LSI)
TOPIC 5.6 LAB ON A CHIP. d) Very Large Scale Integration (VLSI)

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Answer: b Semiconductor
Explanation: Fabrication of ICs like counter, b) Bell telephone laboratories and Fair child
multiplexers and Adders requires 30-300 Semiconductor
gates per chip. Therefore, Medium Scale c) Fairchild Semiconductor
Integration is best suitable. d) Texas instrument and Bell telephone
Laboratories
5. Determine the chip area for Large Scale
Integration ICs. Answer: a
a) 1,00,000 mil2 Explanation: The concept of Integrated
b) 10,000 mil2 circuits was introduced by Texas instrument
and Fairchild Semiconductor, whereas Bell
c) 1,60,000 mil2 telephone laboratories developed the concept
d) 16,000 mil2 of transistors.

ww
Answer: c
Explanation: The chip area for a Large Scale
8. Which process is used to produce small
circuits of micron range on silicon wafer?

w.E
Integration IC is 1 cm2.
=> Area of LSI = 10mm × 10mm = 1cm × 1
a) Photo etching
b) Coordinatograph
cm = 1cm2.

asy
=> 1,60,000mil2 (1cm=400mil).

En J
6. Ultra Large Scale Integration are used in
fabrication of
Answer: c

C E
c) Photolithography
d) Ion implantation

Explanation: It is possible to fabricate as

many as 10,000 transistors on a 1cmX1cm
a) 8-bit microprocessors, RAM, ROM
b) 16 and 32- bit microprocessors
c) Special processors and Smart sensors g
Ainee
chip, using photolithography process.

9. Mention the technique used in

d) All of the mentioned

Answer: c S photolithography process

rin
a) X-ray lithographic technique
b) Ultraviolet lithographic technique

M
Explanation: Ultra Large Scale Integration
have nearly 106 – 107 transistors/chip. Hence,
it is possible to fabricate smart sensors and
special processor.
d) All of the mentioned

Answer: d
g.n
c) Electron beam lithographic technique

e
7. The concept of Integrated circuits was
introduced at the beginning of 1960 by
Explanation: All these techniques are used to
produce device dimension as small as 2µm or
even down to sub micron range (<1µm).
t
a) Texas instrument and Fairchild

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