UNIT IV

PHYSICAL MEDICINE
AND
BIO TELEMETRY
 Contents
• Diathermy
• Shortwave, Ultrasonic, Microwave types
• Surgical Diathermy
• Bio Telemetry principles
• Frequency selection
• Radio pill
• Electrical safety in medical equipments
 Diathermy
• A medical and surgical technique involving the
production of heat in a part of the body by
high-frequency electric currents, to stimulate
the circulation, relieve pain, destroy unhealthy
tissue, or cause bleeding vessels to clot.
 Diathermy
• Diathermy is the treatment process by which
cutting, coagulation of tissues are obtained.
• Application of high-frequency
electromagnetic energy.
• Used to generate heat in body tissues.
• Also used for non-thermal effects.
 Advantages:

• Treatment can be controlled easily.

• Use of appropriate electrodes permit the
heat to be localized only in the region to be
treated.
• Amount of heat that is to be delivered can
be adjusted accurately.
• Inter lying tissues, muscles, bones, internal
organs, etc, can be provided with heat by
using high frequency energy.
 Physiologic Responses To Diathermy
• Tissue temperature increase
• Increased blood flow (vasodilation)
• Increased venous and lymphatic flow
• Increased metabolism
• Changes in physical properties of tissues
• Muscle relaxation
• Analgesia
 Diathermy Heating
• Doses are not precisely controlled thus the
amount of heating cannot be accurately
measured
• Heating= Current2 X Resistance
 Types of diathermy
• Shortwave diathermy
• Ultrasonic diathermy
• Microwave diathermy
• Surgical diathermy

• The Shortwave diathermy and Microwave

diathermy involves electromagnetic effect and
Ultrasonic diathermy uses mechanical effect.
 Shortwave diathermy
• Short-wave diathermy involves high frequency
of 27.12 MHz and wavelength of 11 m.
• Since high frequency currents are used, the
motor and sensory nerves are not stimulated
and there is no muscle contraction.
• This method has no discomfort to the patient.
• The basic operation of the short-wave
diathermy unit can be explained with the help
of block diagram as shown below.
Shortwave diathermy
 Shortwave diathermy
• The output of RF oscillator is given to the patient
electrodes.
• The RF energy heats the tissues and helps in heating of
injured tissues.
• The power delivered by the unit is about 500 W.
• The intensity of the current used can be regulated and
adjusted.
• The electrodes are not directly in contact with the skin.
• Usually layers of towels are interposed between the
metal and surface of the body.
 Shortwave diathermy
• There are two methods of short-wave
diathermy, they are:
• Capacitive method, and
• Inductive method.
 Capacitive method
• Here, the patient electrode pads form a
capacitor plates and the body tissues between
the pads act as a dielectric.
• Thus the whole arrangement forms a
capacitor.
• When the RF current is applied to the
electrodes, the capacitor produces heat in the
interlying tissues.
• This technique is called as capacitive method.
Capacitive method
 Inductive method.
• In the inductive method a flexible cable is coiled
around the arm or knee or any other portion of the
body which is to be treated.
• This is used where the plate electrodes are
inconvenient to use.
• When the electrostatic field set up is given between
the ends of the cable, deep heating of the tissue
occurs.
• The superficial tissues are heated by the eddy currents
that are produced due to the magnetic field around the
cable.
• This technique is also called as Inductothermy.
Inductive method.
 Short-wave diathermy
• Then instead of using continuous RF waves, RF
pulses are used. This technique is called
Diapulse short-wave diathermy.
Advantages:-
• Healing rate of tissue is increased.
• Depth of penetration of RF waves can be
easily adjusted.
• There is no danger of burns or irritation and
the patient has no discomfort.
 Microwave diathermy
• In this method the tissues are heated by the
absorption of microwave energy.
• The frequency used is about 2450 MHz
• Better results are obtained by the microwave
method and it is more advantageous than the
short wave method.
• There is no pad electrodes and flexible cable.
 Microwave diathermy
• Microwave is transmitted into body and treat
directly from the direction of unit.
• Microwaves are produced with the help of
magnetron.
• Proper cooling arrangements are made for
the purpose of cooling the magnetron.
Microwave diathermy
 Precautions

• Necessary precautions should be taken during

this method of treatment
• Excessive dosage causes skin burns and the
skin should be dry as the waves are rapidly
absorbed by water.
 Disadvantages
• Patients with implanted pacemaker should not
undergo this treatment.
• There are possibilities of over heating.
• Care should be taken while the treatment is
made near the eyes.
 ULTRASONIC DIATHERMY
• It is used for curing the diseases of peripheral
nervous system, skeletal muscle system and skin
ulcers.
• It is adopted when the short wave treatment
has failed and it helps to achieve the localization
of heat to the affected part.
• The heating effect is produced in the tissues by
the absorption of ultrasonic energy.
• The absorption effect is similar to that of a micro
massage.
 ULTRASONIC DIATHERMY
• It is better than the manual massage because the
micro massage provides a greater depth of
massage without causing any pain to the patient.
• Piezo-electric transducer is excited by the high
frequency alternating current produced by the Rf
oscillator.
• Ultrasonic wave from the piezo electric
transducer is used for the purpose of treatment.
 ULTRASONIC DIATHERMY
• It can be applied in continuous mode or
pulse mode.
• Frequency range of 800 KHz to 1MHz is
suitable for the ultrasonic method of
treatment.
ULTRASONIC DIATHERMY
SURGICAL DIATHERMY
 SURGICAL DIATHERMY
• Apart from the thermal and therapeutical
applications, the high-frequency currents are
also used for surgical purposes like cutting and
coagulation.
• The frequency of current used here is 1 to 3
MHz (low-frequency currents are not suitable
for this method).
 Cutting
• When a high frequency current flows through sharp
edge of a wire or the point of a needle into the tissue,
there is a high concentration of current at this point.
• The tissues get heated and as a result the cells
immediately under the electrode are torn apart by the
boiling of cell fluid.
• The other electrode called indifferent electrode has
large area of contact with the patient and the RF
current passed through it induces only a very little heat
at the electrode.
• This type of tissue separation is called as
electrosurgical cutting.
Cutting and Coagulation waveform
 Coagulation
• The coagulation process is achieved by the
high frequency current flowing through the
tissue and results in heating and coagulation.
• The process of coagulation is accompanied by
a greyish-white discolouration of the tissue at
the edge of electrode.
• Better coagulation is achieved by high
frequency currents as this does not cause
burning.
 Coagulation
• The continuous radio-frequency current is
used for cutting and burst wave radio-
flequency is used for coagulation.
• The electrode melts through the tissues and
seals capillaries and other vessels.
• Even if the high-frequency surgery is not used,
the method of electrocoagulation can be
used.
 Advantages
• It provides simple and effortless surgery.
• This coagulation method prevents the
contamination of bacteria.
• Simplified method of coagulation saves time.
• Bleeding can be arrested immediately by
touching the spot with the coagulation
electrode.
 ELECTROSURGICAL DIATHERMY
• Center logic board is used to produce the waveform for
cutting, coagulation, etc.
• Astable multivibrator is used to generate the required
pulses.
• 250 KHz frequency signal is used for cutting.
• The generated frequency is given to the power
amplifier.
• Here, push-pull amplifier is used.
• The transformer is used at the output of the push-pull
amplifier.
• So, stepping up and stepping down is possible.
ELECTROSURGICAL DIATHERMY
 ELECTROSURGICAL DIATHERMY
• Audiotone generator is used to hear the 1 KHz
signal which is used for coagulation.
• Isolation switch board is used to provide the
isolation between main supply and the
diathermy blocks.
• Foot switch is used to avoid the explosion
formed by the existence of anesthesia gas
used for the patient near the electrical
contact.
 ELECTROSURGICAL DIATHERMY
• Now, finger switch is mostly used, because, in
emergency, the persons in the operating room
can press the foot switch without the proper
preparation.
• So, the operator gets the supply by using
Finger Switch only.
Class-B push-pull amplifier
 COMPARISON BETWEEN VARIOUS
DIATHERMY TECHNIQUES
• Various types of diathermy techniques
available.
• Penetration into the skin is varied depending
upon the technique.
• The heat penetration is different for fat,
muscle, bone.
 Comparison
Short-Wave Diathermy:
• In short-wave capacitive method diathermy,
maximum heating effect is obtained in fat. It is
reduced in muscle. It is further reduced in bone.
• In short-wave inductive diathermy, maximum
heating effect is obtained in fat, muscle interface.
• In ultra short-wave diathermy, heating effect is
more in the fat-muscle interface.
 Comparison
Microwave Diathermy:
• In this technique, more heating effect is
obtained in fat-muscle interface. There is no
heating effect in bone.
Ultrasonic Diathermy:
• Maximum heating effect is obtained in bone.
In fat and muscle, the heating effect is less.
 BIO TELEMETRY
• Telemetry is a technology that allows remote
measurement and reporting of information.
• The word is derived from Greek roots tele =
remote, and metry= measure.
• Systems that need external instructions and
data to operate require the counterpart of
telemetry, telecommand.
 BIO TELEMETRY
• Although the term commonly refers to wireless
data transfer mechanisms (e.g. using radio or
infrared systems), it also encompasses data
transferred over other media, such as a
telephone or computer network, optical link or
other wired communications.
• Many modern telemetry systems take advantage
of the low cost and ubiquity of GSM networks by
using SMS to receive and transmit telemetry
data.
 Bio telemetry
• Bio telemetry is the measurement of
biological parameters over long distance.
• For conveying biological information from a
living organism and its environment to a
different location where this can be recorded.
• This involves radio frequency signal as a
carrier for modulation, referred to as radio
telemetry.
ELEMENTS OF BIOTELEMETRY
 ELEMENTS OF BIOTELEMETRY
• ECG,EEG,EMG- Electrodes act as transducer
• For measuring temperatures-Thermistor is
used as transducer
• For measuring blood pressure-strain gauge is
used as transducer
• For measuring stomach pH-glass electrode is
used as transducer.
 DESIGN OF BIO TELEMETRY
• Telemetry system should be selected to transmit the bio –
electric Signal with maximum fidelity and simplicity.
• The system should not affect the living system by any
interference.
• Smaller in size, light in weight.
• It should have more stability and reliability.
• The power consumption at the transmitter and receiver
should be small.
• It should reject common mode interference rejection.
• Miniature radio telemetry system should be used to
reduce noise.
 RADIO TELEMETRY SYSTEMS
• Single channel telemetry system

• Multi channel telemetry system

SINGLE CHANNEL TELEMETRY SYSTEM
• For a single channel telemetry system, a
miniature battery operated radio transmitter is
connected to the electrodes of the patients.
• The transmitter broadcasts the Biopotential to a
remote place in which the receiver detects the
radio signal and recovers signal for further
processing.
• The receiving system can be located in a room
separately from the patients.
• The only risk is shock to the patient.
SINGLE CHANNEL TELEMETRY SYSTEM
SINGLE CHANNEL TELEMETRY SYSTEM
• Biosignal from the patient is converted into
electrical signals by the transducer.
• They are amplified and filtered at the
conditioner.
• Further they are frequency modulated or
pulse modulated.
• Frequency modulation provides the high noise
interference rejection and high stability.
SINGLE CHANNEL TELEMETRY SYSTEM
• The biosignals are amplified to radio
frequency range of few hundred KHz to about
300 KHz and then they are transmitted by
transmitter antenna.
• At radio receiver the corresponding
frequency are received and then they are
demodulated, amplified and displayed.
Transmission of bioelectric variables:
Active measurements:
• Bio electric variables like ECG, EEG, EMG are
measured directly without using any
excitation voltage.
Passive Measurements:
• The Physiological variables like blood pressure,
temperature, blood flow are measured
indirectly by using this method.
 Tunnel diode FM transmitter
• The tunnel diodes exhibit a specific
characteristics known as negative resistance.
They have extremely low values of inductance
an capacitance.
• It is used for the transmission of EMG,ECG,
respiration rates.
• Tunnel diodes are used as active devices and
this circuit has higher fidelity and sensitivity.
 Tunnel diode FM transmitter
• Total weight is 1.44 gm with battery and the
size is small.
• Varactor diode is basically a reverse biased
PN junction which utilizes the inherent
capacitance of depletion layer.
• Varactor diodes are voltage capacitors used
for frequency modulation.
• The signal is transmitted through the
inductor L of the tank circuit of RF oscillator.
 Advantages
• All the signal can be transmitted by using the
circuit.
• No shielded room is needed.
• Interference is much reduced.
 Radio telemetry with sub carrier
system
Transmitter side:
• When the position of transmitter to the body or
other conduction object change, the carrier
frequency and amplitude will change due to the
loading change of the carrier frequency resonant
circuit.
• If the signal has a frequency different from the
loading effect ,they can be separated by filters.
• Otherwise the real signal will be distorted by
loading effect.
 Radio telemetry with sub carrier
system
• To avoid this loading effect the sub carrier system
is needed.
• The signal is modulated on a sub carrier to
convert the signal frequency to the neighborhood
of the sub carrier frequency.
• Then the RF carrier is modulated by this sub
carrier carrying the signal.
• The 20 KHz sub carrier signal is given to
amplitude modulator.
• The signals are amplified and forwarded to the
transmitter.
Radio telemetry with sub carrier
system
 Receiver side
• At the receiver end the receiver detects the RF
and recovers the sub carrier carrying the signal.
• At the receiver side, the signals are passed to
demodulator, demodulated signal is filtered,
amplified by amplifier and then they are given to
additional demodulator.
• It is used to convert the signal from the
modulated sub carrier system an to get the
original signal.
• Finally the signal is displayed.
MULTI CHANNEL TELEMETRY SYSTEM
• For most biomedical applications,
simultaneous recording of Bio signals are
required for correlation study.
• Each signal is in need of one channel.
• When the number of channels is more than
the two or three, the simultaneous operation
of the several single channel is difficult.
• At that time multiple channel telemetry
system is adopted.
 Two types of multiplexing:

• FDM (Frequency Division Multiplexing)

• TDM (Time Division Multiplexing)
Frequency Division Multiplexing
 Frequency Division Multiplexing
• Each signal is frequency modulated on a sub
carrier frequency.

• Modulated sub carrier frequencies are

combined to modulate the RF carrier.

• At receiver the modulated sub carrier can be

separated by the proper band pass filter.
 Frequency Division Multiplexing
• Then the each signals are demodulated by
using specified frequency.

• Frequency of the sub carrier has to be

carefully selected to avoid interference.

• The low pass filter are used to extract the

signals without any noise. Finally the output
unit displays the original signal.
Time division multiplex telemetry
system
 Time Division Multiplexing
• Most biomedical signals have low frequency
bandwidth requirement, we can use time
division multiple system by time sharing
scheme.
• Transmission channel is connected to each
signal channel input for a short time to sample
and transmit that signal.
• Transmitter is switched to the next input
signal channel in a definite sequence.
 Time Division Multiplexing
• All the channels have been scanned once, a
cycle is completed and the next cycle will
start.
• Scanning follows a order from signal 1 to
signal 3.
• At the receiver the process is reversed.
• The sequentially arranged, signal pulses are
given to the individual channels by using gate
signal generator.
 Time Division Multiplexing
• If the number of scanning cycles per second is
large and if the transmitter and the receiver are
synchronized, the signal in each channel at the
receiver side can be recovered.
• But the scanning frequency has to satisfy the
following condition.
• fscan = 2fmax
• The maximum number of channels practically
allowed is smaller than the calculated value of n
to avoid the interference between channels.
 Advantages of biotelemetry:
• Used to record the biosignals over long
periods.
• Patient is not disturbed during recording
• For future reference or to study the
treatment effect
• Monitor the athletes running a race.
 Advantages of biotelemetry:
• For recording on animals, particularly for
research , the biotelemetry is greatly used.
RADIO PILLS
 Electrical Safety
Physiological Effects of Current due to 50 Hz current
passage:
• Patients and hospital equipment users are susceptible
to make physical contact with the hardware.
• The physiological effects of shock range from
discomfort to injury to death. (if the heart or
respiratory system is affected).
• An electrical shock is a physiological response to
current i.e.. electrical shock cause an unwanted cellular
depolarisation and its associated muscular contraction,
or it may cause cell vapourization and tissue injury.