Biomedical Instrumentation Fourth Year Biomedical Engineering Department

Why Study Biomedical Instrumentation?

Medical devices are used for
• Diagnosing of disease
• Treatment of disease
• Care and monitoring of patients

Important to know about medical devices

• Technical, design, development aspects
• Physiological basis
• Clinical applications
• Safety and regulatory environment

“Biomedical instruments” refer to a very broad class of devices and systems. A biomedical
instrument is an ECG machine to many people. To others, it’s a chemical biosensor, and to
some it’s a medical imaging system. Current estimates place the worldwide market for
biomedical instruments at over $200 billion. Biomedical instruments are universal; they are
significant to the broader technology and biotechnology sectors; and, finally, they are vital to
many medical and scientific fields. Bottom line: This course is worthwhile!!

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 Biomedical Instrumentation Fourth Year Biomedical Engineering Department

Even though there is a wide variety of instruments, almost all of them can be modelled using the
simple diagram as follows. All biomedical instruments must interface with biological materials
(by definition). The interface can by direct contact or by indirect contact (e.g., induced fields).

Bioinstrumentation Components

The sensor converts energy or information from the measureand to another form (usually
electric). This signal is then processed and displayed so that humans can perceive the
information. Elements and connections shown by dashed lines are optional for some
applications

Biomedical instruments’ major components include:

1. Basic Sensors and Principles : including biopotential electrodes

2. Electronic Interfacing : including system noise figure, system bandwidth, pre-amplifiers,
postamps, instrumentation amps, A/D and D/A converters, aliasing, triggering and signal
averaging

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 Biomedical Instrumentation Fourth Year Biomedical Engineering Department

3. Computation : including data capture and signal processing

4. Systems : complete system response using specific examples (electromyogram,
pressure sensors and blood pressure measurements, flowsensors and blood flow
measurements, and chemical biosensors)

Sensors and Actuators

Sensors Actuators

A device that detects events or changes in A component of machine that is responsible

the environment (biochemical, bioelectrical, for moving and controlling mechanism
or piophysical parameters) and sends that delivering external agents via direct or
information to other electronic device indirect contact
Reproducing the physiologic time response of Controlling biochemical, bioelectrical, or
these parameters biophysical parameters
Help to monitor the changes in the Helps to control the environment or physical
environment changes
Providing a safe interface with biological Providing a safe interface with biologic
materials materials
Connected to the input part of the system. Connected to the output part of the system.
Output is an electrical signal Output is a movement
Ex. Biosensors, image sensors, motion Ex. Electric motors, stepper motor, comb
sensors, chemical sensors. drives and hydraulic cylinder

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 Biomedical Instrumentation Fourth Year Biomedical Engineering Department

Electronic Interface
The electronics interface must:

• Match the electrical characteristics of the sensor/actuator with the computation unit
• Preserve signal-to-noise ratio (SNR) of sensor
• Preserve efficiency of actuator
• Preserve bandwidth (i.e., time response) of sensor/actuator
• Provide a safe interface with the sensor/actuator
• Provide a safe interface with the computation unit
• Provide secondary signal processing functions for the system

Computation System
The computation unit must:

• Provide primary user interface

• Provide primary control for the overall system
• Provide data storage for the system
• Provide primary signal processing functions for the system
• Maintain safe operation of the overall system

Types of Biomedical Instrumentation Systems

Direct / Indirect: The sensing system measure a physiologic parameter directly, such as the
average volume blood flow in an artery, or measures a parameter related to the physiologic
parameter of interest (e.g., ECG recording at the body surface is related to propagation of the
action potential in the heart but is not a measurement of the propagation waveform).

Invasive / Noninvasive: Direct electrical recording of the action potential in nerve fibres using
an implantable electrode system is an example of an invasive sensor. An imaging system
measuring blood flow dynamics in an artery (e.g., ultrasound colour flow imaging of the carotid
artery) is an example of a non-invasive sensor.

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Contact / Remote: A strain gauge sensor attached to a muscle fibre can record deformations
and forces in the muscle. An MRI or ultrasound imaging system can measure internal
deformations and forces without contacting the tissue.

Sense / Actuate: A sensor detects biochemical, bioelectrical, or biophysical parameters. An

actuator delivers external agents via direct or indirect contact and/or controls biochemical,
bioelectrical, or biophysical parameters. An automated insulin delivery pump is an example of a
direct, contact actuator. Noninvasive surgery with high intensity, focused ultrasound (HIFU) is
an example of a remote, noninvasive actuator.

Dynamic / Static: Static instruments measure temporal averages of physiologic parameters.

Real-time instruments have a time response faster than or equal to the physiologic time
constants of the sensed parameter. For example a real-time, ultrasound Doppler system can
measure changes in arterial blood velocity over a cardiac cycle.

Characteristics of Signals
“A signal is any physical quantity that varies with time (or other independent variable) and carries
information. Signals can be classified as either continuous or discrete. A continuous signal
changes smoothly, without interruption. A discrete signal changes in definite steps, or in a
quantized manner. The terms continuous and discrete can be applied either to the value
(amplitude) or to the time characteristics of a signal” In nature (including biology), most signals
are analogue, i.e., they take on continuous values (amplitude and time) within a particular range.

“Continuous-time” signals exist continually at all times (during a specified time period). “Discrete-
time” signals are defined only at selected instances of time. Sampling is the process to convert
continuous-time signals to discrete-time signals. Quantizing is the process that converts
continuous (in amplitude) discrete-time signals to digital signals. Signals in which time is the
independent variable are referred to as “time-domain” signals. Likewise, when frequency is the
independent variable, the signals are referred to as “frequency-domain” signals.

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Physiological Origin of Biomedical Signals

From the broad definition of the biomedical signal presented in the preceding section, it is clear
that biomedical signals differ from other signals only in terms of the application — signals that
are used in the biomedical field. As such, biomedical signals originate from a variety of sources.

The following is a brief description of these sources:

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Bioelectric Signals
Nerve and muscle cells generate bioelectric signals that are the result of electrochemical
changes within and between cells. If a nerve or muscle cell is stimulated by a stimulus that is
strong enough to reach a necessary threshold, the cell will generate an action potential. The
action potential, which represents a brief flow of ions across the cell membrane, can be
measured with intracellular or extracellular electrodes. Action potentials generated by an excited
cell can be transmitted from one cell to adjacent cells via its axon.

Figure 1 Electrogram recorded from the surface of a pig’s heart during normal sinus rhythm. Electrocardiogram recorded from
the surface of the same pig’s heart during ventricular fibrillation (VF). (Sampled at 1,000 samples/s.)

When many cells become activated, an electric field is generated that propagates through the
biological tissue. These changes in extracellular potential can be measured on the surface of
the tissue or organism by using surface electrodes. The electrocardiogram (ECG),
electrogastrogram (EGG), electroencephalogram (EEG), and electromyogram (EMG) are all
examples of this phenomenon.

The bioelectric signals of clinical interest, which are often recorded, are produced by the
coordinated activity of large groups of cells. In this type of synchronized excitation of many cells,
the charges tend to migrate through the body fluids towards the still unexcited cell areas. Such
charge migration constitutes an electric current and hence sets up potential differences between
various portions of the body, including its outer surface. Such potential differences can be
conveniently picked up by placing conducting plates (electrodes) at any two points on the surface

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of the body and measured with the help of a sensitive instrument. These potentials are highly
significant for diagnosis and therapy.

Biomagnetic Signals
Different organs, including the heart, brain, and lungs, also generate weak magnetic fields that
can be measured with magnetic sensors. Typically, the strength of the magnetic field is much
weaker than the corresponding physiological bioelectric signals. Biomagnetism is the
measurement of the magnetic signals that are associated with specific physiological activity and
that are typically linked to an accompanying electric field from a specific tissue or organ.

Figure 2 Local ion current involved in magnetic field creation during depolarization and repolarization of neurons and muscle
cells (brain, heart, lung)

With the aid of very precise magnetic sensors or SQUID (superconducting quantum interference
device) magnetometers, it is possible to directly monitor magnetic activity from the brain
(magnetoencephalography, MEG), peripheral nerves (magnetoneurography, MNG),
gastrointestinal tract (magnetogastrography, MGG), and the heart (magnetocardiography,
MCG).

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Biochemical Signals
Biochemical signals contain information about changes in concentration of various chemical
agents in the body. The concentration of various ions, such as calcium and potassium, in cells
can be measured and recorded. Changes in the partial pressures of oxygen (PO2) and carbon
dioxide (PCO2) in the respiratory system or blood are often measured to evaluate normal levels
of blood oxygen concentration. All of these constitute biochemical signals. These biochemical
signals can be used for a variety of purposes, such as determining levels of glucose, lactate,
and metabolites and providing information about the function of various physiological systems.

Biomechanical Signals
Mechanical functions of biological systems, which include motion, displacement, tension, force,
pressure, and flow, also produce measurable biological signals. Blood pressure, for example, is
a measurement of the force that blood exerts against the walls of blood vessels. Changes in
blood pressure can be recorded as a waveform.

Figure 3 Blood pressure waveform recorded from the aortic arch of a 4-year-old child. (Sampled at

The upstrokes in the waveform represent the contraction of the ventricles of the heart as blood
is ejected from the heart into the body and blood pressure increases to the systolic pressure, the
maximum blood pressure. The downward portion of the waveform depicts ventricular relaxation
as the blood pressure drops to the minimum value, better known as the diastolic pressure.

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Bioacoustic Signals
Bioacoustic signals are a special subset of biomechanical signals that involve vibrations
(motion). Many biological events produce acoustic noise. For instance, the flow of blood through
the valves in the heart has a distinctive sound.

Measurements of the bioacoustics signal of a heart valve can

be used to determine whether it is operating properly.

The respiratory system, joints, and muscles also generate

bioacoustic signals that propagate through the biological
medium and can often be measured at the skin surface by
using acoustic transducers such as microphones and
accelerometers.

Biooptical Signals
Biooptical signals are generated by the optical or light induced attributes of biological systems.
Biooptical signals can occur naturally, or in some cases, the signals may be introduced to
measure a biological parameter with an external light medium. For example, information about
the health of a fetus may be obtained by measuring the fluorescence characteristics of the
amniotic fluid.

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Estimates of cardiac output can be made by using the dye dilution method that involves
monitoring the concentration of a dye as it recirculates through the bloodstream. Finally, red and
infrared light are used in various applications, such as to obtain precise measurements of blood
oxygen levels by measuring the light absorption across the skin or a particular tissue.

Bioimpedance Signals
The impedance of the tissue is a source of important information concerning its composition,
blood distribution and blood volume etc. The measurement of galvanic skin resistance is a typical
example of this type of signal. The bio-impedance signal is also obtained by injecting sinusoidal
current in the tissue and measuring the voltage drop generated by the tissue impedance. The
measurement of respiration rate based on bio-impedance technique is an example of this type
of signals.

Biopotentials
The physical quantity or condition that the instrumentation system measures is called the
measurand. The source for the measurand is the human body which generates a variety of
signals. The measurand may be on the surface of the body (electrocardiogram potential) or it
may be blood pressure in the chambers of the heart.

A transducer is a device that converts one form of energy to another. Because of the familiar
advantages of electric and electronic methods of measurement, it is the usual practice to convert

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into electrical quantities all non-electrical phenomenon associated with the measurand with the
help of a transducer. For example: a piezo-electric crystal converts mechanical vibrations

Normal muscular contraction is associated with the migration of ions which generates potential
differences measurable with suitably placed electrodes. For example, the heart and the brain
produce characteristic patterns of voltage variations which when recorded and analyzed are
useful in both clinical practice and research. Potential differences are also generated by the
electrochemical changes accompanied with the conduction of signals along the nerves to or
from the brain. These signals are of the order of a few microvolts and give rise to a complicated
pattern of electrical activity when recorded. The fact that the activity of the living tissues is due
to the potential changes in them suggested the use of external electricity for the diagnosis of
certain diseases affecting muscles and nerves, for the augmentation or replacement of a
deficient natural activity or for the restoration of a palsied muscle.

Experiments have shown that the internal resting

potential within a cell is approximately –90 mV with
reference to the outside of the cell. When the cell
is excited or stimulated, the outer side of the cell
membrane becomes momentarily negative with
respect to the interior. This process is called
depolarization and the cell potential changes to
approximately +20 mV. Repolarization then
takes place a short time later when the cell regains
its normal state in which the inside of the
membrane is again negative with respect to the
outside.

Repolarization is necessary in order to re-establish the resting potential. This discharging and
recharging of the cell produces the voltage waveforms which can be recorded by suitable
methods using microelectrodes.

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The wave of excitation while propagating

in the muscle causes its contraction. The
contraction wave always follows the
excitation wave because of its lower
velocity. This phenomenon is found with
the skeletal muscles, the heart muscle
and the smooth muscles. In its turn, every
contraction (movement) of a muscle
results in the production of an electric
voltage.

This voltage occurs in the muscle in such a way that the moving muscle section is always
negative with respect to its surroundings. These voltages are called action potentials because
they are generated by the action of the muscles. After complete contraction, repolarization takes
place resulting in the relaxation of the muscle and its returning to the original state.

The currents involved in bioelectricity are unlike the currents involved in electronics. Bioelectric
currents are due to positive and negative ion movement within a conductive fluid. The ions
possess finite mass and encounter resistance to movement within the fluid for they have limited
speeds. The cell action potential, therefore, shows a finite rise time and fall time.

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General Considerations for Signal Conditioning

Information obtained from the electrodes/transducers is often in terms of current intensity,
voltage level, frequency or signal phase relative to a standard. In addition to handling specific
outputs from these devices, signal conditioners used in biomedical instruments perform a variety
of general purpose conditioning functions to improve the quality, flexibility and reliability of the
measurement system.

Important functions performed by signal conditioners, before the signal is given to a display or
recording device, are illustrated below:

1. Signal Amplification
2. Frequency Response
3. Filtering
4. Isolation
5. Excitation
6. Linearization

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1. Signal Amplification
The signals available from the transducers are often very small in magnitude. Amplifiers boost
the level of the input signal to match the requirements of the recording/ display system or to
match the range of the analogue-to-digital convertor, thus increasing the resolution and
sensitivity of the measurement. Bioelectric measurements are basically low-level
measurements, which involve amplifying and recording of signals often at microvolt levels. The
problem of electrical noise makes these measurements a difficult proposition and calls for both
expert technical knowledge and skilful handling of the signal in the circuit design.

Noise can produce errors in measurements and completely obscure useful data. It is a special
problem in applications where low-level signals are recorded at high off-ground voltages, or
transmitted over distance or obtained in electromagnetic noise environments. Using signal
conditioners located closer to the signal source, or transducer, improves the signal-to-noise ratio
of the measurement by boosting the signal level before it is affected by the environmental noise.

2. Frequency Response
Modern biomedical instruments are designed to handle data with bandwidths from dc up to
several hundred cycles per second. Electrical or mechanical filters cannot separate useful
signals from the noise when their bandwidths overlap. Instruments and recording systems that
work satisfactorily for steady state or low frequency data are generally inadequate to meet this
requirement. On the other hand, recording systems that will faithfully reproduce such data are
inherently more susceptible to external noise and, therefore, they must be designed to eliminate
the possibility of signal contamination from noise. The bioelectric signals often contain
components of extremely low frequency. For a faithful reproduction of the signal, the amplifiers
must have excellent frequency response in the sub-audio frequency range. This response
should be down to less than one hertz which is a very frequent requirement. In all RC-coupled
amplifiers, low frequency response is limited by the reactance of the inter stage coupling
capacitors.

To achieve the low frequency response required for medical applications, the amplifier must
have large values of coupling capacitance. The disadvantage of using large capacitors is that

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they can cause blocking of the amplifier in cases of high-level input, arising due to switching
transients or other high-level inputs. Because of the long-time constant introduced by these large
coupling capacitors, several seconds may elapse before the capacitors have discharged back
to the normal levels. The amplifier, therefore, becomes momentarily unreceptive following each
occurrence of overdriving signals. This type of problem does not exist in direct coupled amplifiers
simply because there are no coupling capacitors.

Although the direct coupled amplifier gives an excellent frequency response at low frequencies,
it tends to drift. The drift is a slow change of output having no relation with the input signal applied
to the amplifier. Since the frequency response of the RC-coupled amplifier does not extend all
the way down to dc, it does not drift. In medical amplifiers, the advantages of both types of
coupling can be obtained in one amplifier. Typically, all stages except one are direct coupled.
The one RC coupled stage prevents the drifting of the output. Suitable measures are taken to
prevent blocking of the amplifier due to overdrive by quickly discharging the coupling capacitor
automatically after occurrence of the overdriving input.

It is not desirable to have the frequency response of the amplifiers much above the highest signal
frequency of interest. Excessive bandwidth allows passage of noise voltages that tend to
obscure the bioelectric signal. Another reason for limiting the response of an amplifier to the
signal bandwidth is to minimize the tendency towards oscillation due to stray feedback. High
frequency response, therefore, is deliberately limited as a means of noise reduction.

3. Filtering
A filter is a circuit which amplifies some of the frequencies applied to its input and attenuates
others. There are four common types:

1. High-pass, which only amplifies frequencies above a certain value;

2. Low-pass, which only amplifies frequencies below a certain value;
3. Bandpass, which only amplifies frequencies within a certain band; and
4. Band stop, which amplifies all frequencies except those in a certain band.

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Filters may be designed using many different methods. These include passive filters which use
only passive components, such as resistors, capacitors and inductors. Active filters use
amplifiers in addition to passive components in order to obtain better performance, which is
difficult with passive filters.

Operational amplifiers are frequently used as the gain blocks in active filters. Digital filters use
analogue-to-digital converters to convert a signal to digital form and then use high-speed digital
computing techniques for filtration. Additionally, signal conditioners can include filters to reject
unwanted noise within a certain frequency range. Almost all measuring and recording
applications are subject to some degree of 50 Hz noise picked up from power lines or machinery.

Therefore, most signal conditioners include low-pass filters designed specifically to provide
maximum rejection of 50 Hz noise. Such filters are called “notch” filters. Filters can be classified
as digital and analog filters. They differ by the nature of the input and the output signals. An
analog filter processes analog inputs and generates analog outputs. A digital filter processes
and generates digital data. The processing techniques followed are also different. Analog filters
are based on the mathematical operator of differentiation and digital filters require no more than
addition, multiplication and delay operators. Digital filters have several advantages over analog
filters. They are relatively insensitive to temperature, ageing, voltage drift and external
interference as compared to analog filters. Their response is completely reproducible and
predictable, and software simulation can exactly reflect product performance.

4. Isolation
Improper grounding of the system is one of the most common causes of measurement problems
and noise. Signal conditioners with isolation can prevent these problems. Such devices pass the
signal from its source to the measurement device without a physical or galvanic connection by
using transformer, optical or capacitive coupling techniques. Besides breaking ground loops,
isolation blocks high voltage surges and rejects high common mode voltages.

5. Excitation
Signal conditioners are sometimes also required to generate excitation for some transducers.
Strain gauges, thermistors, for example, require external voltage or current excitation. Signal

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conditioning part of the measurement system usually provides the excitation signal. Strain
gauges are resistance devices in a Wheatstone bridge configuration, which require bridge
completion circuitry and an excitation source.

6. Linearization
Another common signal conditioning function is linearization. Many transducers such as
thermocouples and thermistors have a non-linear response to changes in the phenomenon
being measured. Signal conditioners include either hardware-based or software-based
linearization routines for this purpose.

Physiological Transducers
Transducers are devices which convert one form of energy into another. Because of the familiar
advantages of electric and electronic methods of measurement, it is the usual practice to convert
all non-electric phenomenon associated with the physiological events into electric quantities.
Numerous methods have since been developed for this purpose and basic principles of physics
have extensively been employed. Variation in electric circuit parameters like resistance,
capacitance and inductance in accordance with the events to be measured, is the simplest of
such methods. Peizo-electric and photoelectric transducers are also very common.

Chemical events are detected by measurement of current flow through the electrolyte or by the
potential changes developed across the membrane electrodes. A number of factors decide the
choice of a particular transducer to be used for the study of a specific phenomenon. These
factors include:

1. The magnitude of quantity to be measured.

2. The order of accuracy required.
3. The static or dynamic character of the process to be studied.
4. The site of application on the patient’s body, both for short-term and long-term monitoring.
5. Economic considerations.

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Classification of Transducers
Many physical, chemical and optical properties and principles can be applied to construct
transducers for applications in the medical field. The transducers can be classified in many ways,
such as:

1) By the process used to convert the signal energy into an electrical signal. For this,
transducers can be categorized as: Active Transducers —a transducer that converts one
form of energy directly into another. For example: photovoltaic cell in which light energy
is converted into electrical energy. Passive Transducers —a transducer that requires
energy to be put into it in order to translate changes due to the measurand. They utilize
the principle of controlling a dc excitation voltage or an ac carrier signal. For example: a
variable resistance placed in a Wheatstone bridge in which the voltage at the output of
the circuit reflects the physical variable. Here, the actual transducer is a passive circuit
element but needs to be powered by an ac or dc excitation signal.
2) By the physical or chemical principles used. For example: variable resistance devices,
Hall effect devices and optical fibre transducers.
3) By application for measuring a specific physiological variable. For example: flow
transducers, pressure transducers, temperature transducers, etc. Biomedical parameters
which are commonly encountered are listed along with their characteristics and
corresponding transducers in the following Tables.

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Performance Characteristics of Transducers

A transducer is normally placed at the input of a measurement system, and therefore, its
characteristics play an important role in determining the performance of the system. The
characteristics of a transducer can be categorized as follows:

1. Static
2. Dynamic
3. Input and output impedance
4. Overlead range
5. Recovery time after overload
6. Excitation voltage
7. Shelf life
8. Reliability
9. Size and weight

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Static Characteristics
Accuracy: This term describes the algebraic difference between the indicated value and the true
or theoretical value of the measurand. In practice, accuracy is usually expressed as a percentage
of full scale output or percent of reading or ± number of digits for digital readouts.
Precision: It refers to the degree of repeatability of a measurement. Precision should not be
confused with accuracy. For example: ancompensated offset voltage in an operational amplifier
may give very reproducible results (high precision), but they may not be accurate.
Resolution: The resolution of a transducer indicates the smallest measureable input increment.
Sensitivity: It describes transfer ratio of output to input.
Drift: It indicates a change of baseline (output when input is zero) or of sensitivity with time,
temperature etc. It may be noted that the sensitivity of the device does not change the calibration
curve if shifted up or down.
Linearity: It shows closeness of a transducer’s calibration curve to a specified straight line with
in a given percentage of full scale output. Basically, it reflects that the output is in some way
proportional to the input.

Threshold: The threshold of the transducer is the smallest change in the measurand that will
result in a measureable change in the transducer output. It sets a lower limit on the measurement
capability of a transducer.

Noise: This is an unwanted signal at the output due either to internal source or to interference.

Hysteresis: It describes change of output with the same value of input but with a different history
of input variation. For example: hysteresis is observed when the input/output characteristics for
a transducer are different for increasing inputs than for decreasing inputs. It results when some
of the energy applied for increasing inputs is not recovered when the input decreases.

Span: It indicates total operating range of the transducer.

Saturation: In a transducer the output is generally proportional to the input. Sometimes, if the
input continues to increase positively or negatively, a point is reached where the transducer will

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no longer increase its output for increased input, giving rise to a non-linear relationship. The
region in which the output does not change with increase in input is called the saturation region.

Conformance: Conformance indicates closeness of a calibration curve to a specified curve for

an inherently non-linear transducer.

Dynamic Characteristics
Only a few signals of interest in the field of medical instrumentation, such as body temperature,
are of constant or slowly varying type. Most of the signals are function of time and therefore, it
is the time varying property of biomedical signals that is required to consider the dynamic
characteristics of the measurement system. Obviously, when a measurement system is
subjected to varying inputs, the input-output relation becomes quite different form that in the
static case. In general, the dynamic response of the system can be expressed in the form of a
differential equation. For any dynamic system, the order of the differential equation that
describes the system is called the order of the system. Most medical instrumentation systems
can be classified into zero-, first-, second-, and higher-order systems.

A zero-order system has an ideal dynamic performance, because the output is proportional to
the input for all frequencies and there is no amplitude or phase distortion. A linear potentiometer
used as a displacement transducer is a good example of a zero-order transducer. The first-order
transducer or instrument is characterized by a linear differential equation. The temperature
transducers are typical examples of first order measuring devices since they can be
characterized by a single parameter, i.e. time constant ‘T’.

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