by dinesh gannerlla
TRANSCRIPT
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
HOSPITAL TRAINING REPORT
To be submitted
ToCARE HOSPITALS
For partial fulfillment of the requirement for theAward of the Degree
OfBachelor of Technology
In
Bio-medical Engineering
SUBMITED BY
B.S SAI SRIDHAR -07211A1118
Y.MURALI MOHAN -07211A1112
PULIPATI KALYAN -07211A1108
G.DINESH -07211A1105A N M SWAMY -07211A1125
B.HARSHA PRIYA -07211A1106
K.AARTHI -07211A1101
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
BIOMEDICAL
INTRODUCTION:
During the last two decades, there have been tremendous advances in the field of
biomedical engineering which have been applied to the medical sciences both for diagnosis and
treatment. As a result of the interaction between these two specialties, a new discipline has
emerged as bio-medical engineering. (Jacob john-1974)
It is unique in the sense that this speciality emerged out of a combination of engineering,
sciences, medicine and biology. (Staewen Williams-1984)
Definition:
Bio medical engineering is defined as that branch of applied science which is
contained with solving and understanding the problems in biology or medicine using principles
methods and approach drawn from engineering science and technology (Richard johns-1975)
Historical aspect of Bio-Medical Engineering:
The field of Medical instrumentation is by no means new. Many instruments were
developed as early as the nineteenth century, for example the ECG was first used by cinthoren
at the end of the century. Progress was slow until after World War II when a surplus of
electronic equipment became available. At that time many technicians and engineers both
within industry and on their own started experiments with and modify existing equipment for
medical use. This progress occurred during the 1950's and the results were after disappointing
for physiological parameters and not measured in the same way as physical parameters. They
also had severe communication problem with the medical profession. During the next decade
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITmany instrument manufactures philosophy was changed equipment analysis and design were
applied directly to medical problems. A large measure of help was provided by the US govt. /in
particular by NASA. The mercury, Gemini and Apollo program needed accurate physiological
monitoring for astronauts, consequently much research and development and money went into
this area.
Some of the concepts of patient monitoring presently used in hospitals through out the
world evolved from the base of astronauts monitoring.
The efficiency of modern medicine not only depends upon the clinical acumen of the
physician but also in optimal utilization of available sophisticated bio medical equipment, and
such equipments need careful attention as well as maintenance without any breakdown or
if/there is a breakdown it should be attended within the shortest possible time. Hence the needfor bio medical engineering depart/arises which has to take up the responsibility of maintenance
equipment.
Since the new technologies are rapidly creeping into the field of medicine. It is essential to
have a Bio Medical Engineering unit attached to a modern hospital which can suggest/ can take
care of planning, organizing, installation, maintenance newly developing biomedical equipment
for rapid diagnosis and treatment of a number of ailments. Equipments from very large range
such as the X-RAY, CT-SCAN, MRI, ULTRASOUND, ECHO, IABP, HEART-LUNG
MACHINE, HOLTER, EEG, EMG, dialysis, PACEMAKER, ANESTHESIA VENTILATORS
DIATHERMIES. Monitors, ventilators, ABG, etc. have to be regularly checked and maintained
by Bio Medical Engineering department. Preventive maintenance is necessary for the proper
operating of equipment but other factors help add to the effectiveness of a good program.
Apart from the BIOMEDICAL department has the greatest responsibility of maintaining
major equipment because of service as well as emergency services, which inturn affect the
patient care. BIOMEDICAL engg dept should also maintain the service record for the major
equipment to meet the urgent requirement and keep the spare parts in stock for ready usage. The
purpose of biomedical engg dept in hospital is to guiding/advising the administration and
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITphysicians about the utility, future developments in the equipment to purchased or already
purchased or conversion of old models to the recent once, extension of the usage of equipment
for different purposes.
RESPONSIBILITIES OF A BIO-MEDICAL ENGINEER:
Attend to emergency breakdown of the essential equipment
To monitor the available equipment on regular base.
To keep stock of the spare parts.
Introducing/briefing the hospital or institute to new technology and new equipment and
how best to utilize the same.
In short it is pre purchase evaluation, planning, acceptance testing, inventory control,
training and maintenance
Preparing and performing the preventive maintenance schedule.
PREVENTIVE MAINTAINANCE: PM is defined in the ASHE manual is to clean
adjust. Check for wear and perhaps replace components that might cause total breakdown
or serious functional impairment of the equipment before the next scheduled inspection
(ASHE) PM will help eliminate hazards before they develop.
The PMprocedure is primarily a performance test to ensure that the equipment
is operating properly and is calibrated. However problems do occur because of deterioration of
equipment caused by normal use and again can be detected prior to their causing a malfunction.
Proper cleaning, Lubrication and repair of replacement of defective parts prior to a serious
malfunction will prolong the useful life of the equipments.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
CONTENTS:
1. NEPHROLOGY: DIALYSIS
2. NEUROLOGY: EEG
3. CARDIOLOGY: HEART - LUNG MACHINE
4. GASTROENTEROLOGY: ENDOSCOPES
5.RADIOLOGY: MRI,CT,X-RAY,ULTRASOUND
6.CSSD
7. OXYGEN PLANT
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
NEPHROLOGY
Dialysis:
In medicine, dialysis (from Greek "dialusis", meaning dissolution, "dia", meaning through, and
"lusis", meaning loosening) is primarily used to provide an artificial replacement for lost kidney
function (renal replacement therapy) due to renal failure. Dialysis may be used for very sick
patients who have suddenly but temporarily, lost their kidney function (acute renal failure) or
for quite stable patients who have permanently lost their kidney function (stage 5 chronic
kidney disease). When healthy, the kidneys maintain the body's internal equilibrium of water
and minerals (sodium, potassium, chloride, calcium, phosphorus, magnesium, sulfate) and the
kidneys remove from the blood the daily metabolic load of fixed hydrogen ions. The kidneys
also function as a part of the endocrine system producing erythropoietin and 1,25-
dihydroxycholecalciferol (calcitriol). Dialysis treatments imperfectly replace some of thesefunctions through the diffusion (waste removal) and convection (fluid removal). Dialysis is an
imperfect treatment to replace kidney function because it does not correct the endocrine
functions of the kidney
Principle:
Dialysis works on the principles of the diffusion and osmosis of solutes and fluid across a semi-
permeable membrane. Blood flows by one side of a semi-permeable membrane, and a dialysate
or fluid flows by the opposite side. Smaller solutes and fluid pass through the membrane. The
blood flows in one direction and the dialysate flows in the opposite. The concentrations of
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITundesired solutes (for example potassium, calcium, and urea) are high in the blood, but low or
absent in the dialysis solution and constant replacement of the dialysate ensures that the
concentration of undesired solutes is kept low on this side of the membrane. The dialysis
solution has levels of minerals like potassium and calcium that are similar to their natural
concentration in healthy blood. For another solute, bicarbonate, dialysis solution level is set at a
slightly higher level than in normal blood, to encourage diffusion of bicarbonate into the blood,
to neutralise the metabolic acidosis that is often present in these patients.
Types:
There are two primary types of dialysis, hemodialysis and peritoneal dialysisHemodialysis:
In hemodialysis,
the patient's blood
is pumped through
the bloodcompartment of a
dialyzer, exposing
it to a
semipermeable
membrane. The cleansed blood is then returned via the circuit back to the body. Ultrafiltration
occurs by increasing the hydrostatic pressure across the dialyzer membrane. This usually is
done by applying a negative pressure to the dialysate compartment of the dialyzer. This
pressure gradient causes water and dissolved solutes to move from blood to dialysate, and
allows removal of several litres of excess fluid during a typical 3 to 5 hour treatment. In the US,
hemodialysis treatments are typically given in a dialysis center three times per week (due in the
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITUS to Medicare reimbursement rules), however, as of 2007 over 2,000 people in the US are
dialyzing at home more frequently for various treatment lengths. Studies have demonstrated the
clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. These frequent long
treatments are often done at home, while sleeping but home dialysis is a flexible modality and
schedules can be changed day to day, week to week. In general, studies have shown that both
increased treatment length and frequency are clinically beneficial
Peritoneal dialysis:
In peritoneal dialysis, a sterile solution containing minerals and glucose is run through a tube
into the peritoneal cavity, the abdominal body cavity around the intestine, where the peritoneal
membrane acts as a semipermeable membrane. The dialysate is left there for a period of time to
absorb waste products, and then it is drained out through the tube and discarded. This cycle or
"exchange" is normally repeated 4-5 times during the day, (sometimes more often overnight
with an automated system). Ultrafiltration occurs via osmosis; the dialysis solution used
contains a high concentration of glucose, and the resulting osmotic pressure causes fluid to
move from the blood into the dialysate. As a result, more fluid is drained than was instilled.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITPeritoneal dialysis is less efficient than hemodialysis, but because it is carried out for a longer
period of time the net effect in terms of removal of waste products and of salt and water are
similar to hemodialysis. Peritoneal dialysis is carried out at home by the patient and it requires
motivation. Although support is helpful, it is not essential. It does free patients from the routine
of having to go to a dialysis clinic on a fixed schedule multiple times per week, and it can be
done while travelling with a minimum of specialized equipment.
Hemofiltration: Hemofiltration is a similar treatment to hemodialysis, but it makes use of a
different principle. The blood is pumped through a dialyzer or "hemofilter" as in dialysis, but no
dialysate is used. A pressure gradient is applied; as a result, water moves across the very
permeable membrane rapidly, facilitating the transport of dissolved substances, importantly
ones with large molecular weights, which are cleared less well by hemodialysis. Salts and waterlost from the blood during this process are replaced with a "substitution fluid" that is infused
into the extracorporeal circuit during the treatment. Hemodiafiltration is a term used to describe
several methods of combining hemodialysis and hemofiltration in one process
What is dialysis access?
In the context of this article, dialysis access is an
entranceway into your bloodstream that lies completely
beneath your skin and is easy to use. The access is usually in
your arm, but sometimes in the leg, and allows blood to be
removed and returned quickly, efficiently, and safely during
dialysis or, less commonly, for other procedures requiring
frequent access to your circulation. Dialysis, also called
hemodialysis, is the most common treatment for kidney
failure. A dialysis machine is an artificial kidney
designed to remove impurities from your blood. During dialysis, physicians use the dialysis
access to remove a portion of your blood to circulate it through the dialysis machine so it can
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITremove impurities and regulate fluid and chemical balances. The purified blood is then returned
to you, again through the dialysis access.
Creating the access portal is a minor surgical procedure. There are two types of portals placed
completely under the skin:
Fistula, which your vascular surgeon constructs by joining an artery to a vein.
Graft, which is a man-made tube, consisting of a plastic or other material, that your
vascular surgeon inserts under the skin to connect an artery to a vein.
For both fistulas and grafts, the connection between your
artery and vein increases blood flow through the vein. In
response, your vein stretches and becomes strengthened. This
allows an even greater amount of blood to pass through the
vein and allows your dialysis to proceed efficiently. In the
weeks after surgery, the fistula begins to mature. The vein
increases in size and may look like a cord under your skin.
The whole process of maturation, which is a beneficial feature
that permits the blood flow to increase in the fistula, typically
takes 3 to 6 months. Some fistulas may take as long as a year
or more to develop fully, but this is unusual. Once matured, a fistula should be large and strong
enough for dialysis technicians and nurses to insert the large dialysis needles easily. If it fails to
mature in a reasonable period of time, however, you may need another fistula. You can usually
begin using your graft in 2 to 6 weeks, when it is healed sufficiently. Usually fistulas are
preferred to grafts, however, because fistulas are constructed using your own tissue, which is
more durable and resistant to infection than are grafts. However, if your vein is blocked or too
small to use, the graft provides a good alternative.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
How do you prepare?
Before choosing the access site, your surgeon may ask you if you have a history or symptoms of
arm or leg artery disease. Hardening of the arteries, which reduces blood flow to your arms
or legs, often can cause these conditions. Your vascular surgeon will not place a dialysis
access site in an area of the body with reduced circulation because the blood flow will be
insufficient. For this reason, your surgeon usually places dialysis access sites in the arms
rather than in the legs because atherosclerosis is more common in the legs. Your vascular
surgeon may order a blood flow test in your arms and legs, such as an ultrasound exam, or
an x ray, such as a venogram, to determine whether your veins are large enough to use for
a fistula. Sometimes a non-invasive pulse volume recording test is used to evaluate the
flow in your arteries if this issue is a concern to your surgeon. Your vascular surgeon will
give you the necessary instructions you need to follow before the surgery, such as fasting.
Usually, your physician will ask you not to eat or drink anything 8 hours before your
procedure. Your physician will discuss with you whether to reduce or stop any
medications that might increase your risk of bleeding or other complications.
Are you eligible for dialysis access?
If you have chronic kidney failure and need long-term hemodialysis, you may require dialysis
access. You may not be a good candidate for a fistula if your veins are too small or are
scarred from frequent placement of intravenous catheters (thin, flexible tubes inserted into
veins to deliver medicine) or needles to draw blood. In that event, you may be eligible for
a graft access procedure. You also may not be a good candidate for a fistula if your arteries
are severely blocked, although they might be repairable if necessary. Your vascular
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITsurgeon will probably be reluctant to use a graft if you have an ongoing infection since the
graft itself might become infected. If this happens, the infected graft might need to be
removed in order to clear up the infection.
What happens during dialysis access?
Typically you will have the procedure on an outpatient basis. Most often, you will first be
sedated and then your surgeon will numb the area where the fistula or graft will go. In
some cases, your anesthesiologist may give you supplemental sedation or put you to sleep.
Depending upon the quality of your artery and vein, your surgeon will try to construct the
fistula with one incision using the forearm of the arm that you do not use as frequently. For
example, if you're left handed, your physician will place the fistula in your right arm, if
possible. To perform the surgery, your physician joins a large vein under the skin to an
artery nearby. The physician divides your vein and sews it to an opening made in the side
of the artery. As a result, the blood flows down the arteries into the hand, as usual, and also
some of this faster moving blood flows into the veins that lead back to your heart. The
blood that normally traveled in your divided vein goes back to the heart through other
veins, and there is usually plenty of blood remaining in your artery to supply your hand. Ifyou cannot receive a fistula because the vein is too small or blocked, your physician may
construct a graft using a tube of man-made, plastic material. Less commonly, your
physician may also choose to use a piece of a vein from your leg or a section of artery
from a cow as alternative graft materials. Your physician sews the graft to one of your
veins and connects the other end to an artery. Your physician may place the graft material
straight or form a loop under the skin either in your lower arm, upper arm, or less
commonly in your leg.
What can you expect after dialysis access?
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAfter the operation, you should initially keep the access area raised above your heart to reduce
swelling and pain. Your surgeon may recommend an over-the-counter painkiller to relieve
pain, if necessary. Following the suggestions below will help you keep your new access
site working properly in the weeks after the surgery:
Keep the incision dry for at least 2 days after the procedure and do not soak or scrub the
incision until it has healed.
Avoid lifting more than about 15 pounds or other activities that stress or compress the
access area, such as digging.
Report pain, swelling, or bleeding immediately to your physician, especially if these
symptoms are becoming worse. Some pain or swelling is common and not worrisome if
decreasing, but you should tell your physician if you have bleeding, drainage or a fever
higher than 101 degrees Fahrenheit
You may initially feel some coolness or numbness in the hand with the fistula. These
sensations usually go away in a few weeks as your circulation compensates for the
fistula. However, if these sensations are severe, tell your physician as soon as
possible, because the fistula may be causing too much blood to flow away from your
hand. You should perform exercises to grow and strengthen your fistula, after the pain
from the surgery decreases, to make dialysis faster and easier. Your physician may
recommend squeezing a soft object using the hand on the arm in which the fistula was
placed. Grafts may mature more quickly than fistulas depending upon the size of the
vein to which the graft is initially attached. They sometimes can be ready in 2 to 3
weeks, but many physicians recommend waiting about 4 to 6 weeks before using a
graft. Grafts have disadvantages over fistulas, however. Grafts are more likely than
fistulas to become infected. Also, grafts usually last about 1 to 2 years, which is less
than fistulas, which can often last up to 3 to 7 years. If you care properly for your
graft, however, you can help it last for many years. Sometimes access portals can take
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITweeks or even months until they are ready for dialysis use. Until the portal is ready,
you may have to use a catheter for dialysis.
Are there any complications?
Complications with dialysis access include clotting, narrowing, aneurysm formation in the
access itself, infection, and bleeding.
What can you do to stay healthy?
Protecting the dialysis access is crucial for you. The following tips will help you care for a
fistula or a graft:
Check several times each day to make sure the access is functioning. You should be able
to feel a vibration in the. Your physician or dialysis center staff will show you how to do
this.
Monitor any bleeding after dialysis. If the graft seems to bleed longer than usual from the
needle sites, you should notify your dialysis center staff. Do not carry heavy items with the arm that has the access.
Do not sleep on that arm.
Do not wear any clothing or jewelry that binds that arm.
Do not let anyone draw blood or measure blood pressure from that arm.
Do not allow injections to be given into the fistula or graft.
Keep the site of the fistula or graft clean.
After dialysis, monitor the access for signs of infection, such as swelling or redness.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
Electroencephalography
Electroencephalography (EEG) is the measurement of electrical activity produced by the brain
as recorded from electrodes placed on the scalp.
Just as the activity in a computer can be perceived on multiple different levels, from the activity
of individual transistors to the function of applications, so can the electrical activity of the brain
be described on relatively small to relatively large scales. At one end are action potentials in a
single axon or currents within a single dendrite, and at the other end is the activity measured by
the scalp EEG.
The data measured by the scalp EEG are used for clinical and research purposes. A technique
similar to the EEG is intracranial EEG (icEEG), also referred to as subdural EEG (sdEEG) and
electrocorticography (ECoG). These terms refer to the recording of activity from the surface of
the brain (rather than the scalp). Because of the filtering characteristics of the skull and scalp,
icEEG activity has a much higher spatial resolution than surface EEG.
Source of EEG Activity: Scalp EEG measures summated activity of post-synaptic currents. An
action potential in a pre-synaptic axon causes the release of neurotransmitter into the
synapse. The neurotransmitter diffuses across the synaptic cleft and binds to receptors in apost-synaptic dendrite. The activity of many types of receptors results in a flow of ions into
or out of the dendrite. This results in compensatory currents in the extracellular space. It
is these extracellular currents which are responsible for the generation of EEG voltages.
The EEG is not sensitive to axonal action potentials.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITWhile it is post-synaptic potentials that generate the EEG signal, it is not possible to determine
the activity within a single dendrite or neuron from the scalp EEG. Rather, surface EEG is
the summation of the synchronous activity of thousands of neurons that have similar
spatial orientation, radial to the scalp. Currents that are tangential to the scalp are not
picked up by the EEG. The EEG therefore benefits from the parallel, radial arrangement
of apical dendrites in the cortex. Because voltage fields fall off with the fourth power of
the radius, activity from deep sources is more difficult to detect than currents near the
skull.Scalp EEG activity is composed of multiple oscillations. These have different
characteristic frequencies, spatial distributions and associations with different states of
brain functioning (such as awake vs. asleep). These oscillations represent synchronized
activity over a network of neurons. The neuronal network underlying some of theseoscillations are understood (such as the thalomocortical resonance underlying sleep
spindles), while many others are not (e.g., the system that generates the posterior basic
rhythm is not yet fully understood).
Method: In conventional scalp EEG, the recording is obtained by placing electrodes on the
scalp with a conductive gel or paste, usually after preparing the scalp area by light abrasion to
reduce impedance due to dead skin cells. The technique has been advanced by the use of carbon
nanotubes to penetrate the outer layers of the skin for improved electrical contact. The sensor is
known as ENOBIO. however, this technique is not in common research or clinical use. Many
systems typically use electrodes, each of which is attached to an individual wire. Some systems
use caps or nets into which electrodes are embedded; this is particularly common when high-
density arrays of electrodes are needed.
Computer ElectroencephalographNeurovisor-BMM 40
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITElectrode locations and names are specified by the International 1020 system for most clinical
and research applications (except when high-density arrays are used). This system ensures that
the naming of electrodes is consistent across laboratories. In most clinical applications, 19
recording electrodes (plus ground and system reference) are used. A smaller number of
electrodes are typically used when recording EEG from neonates. Additional electrodes can be
added to the standard set-up when a clinical or research application demands increased spatial
resolution for a particular area of the brain. High-density arrays (typically via cap or net) can
contain up to 256 electrodes more-or-less evenly spaced around the scalp.Each electrode is
connected to one input of a differential amplifier (one amplifier per pair of electrodes); a
common system reference electrode is connected to the other input of each differential
amplifier. These amplifiers amplify the voltage between the active electrode and the reference(typically 1,000100,000 times, or 60100 dB of voltage gain). In analog EEG, the signal is
then filtered (next paragraph), and the EEG signal is output as the deflection of pens as paper
passes underneath. Most EEG systems these days, however, are digital, and the amplified signal
is digitized via an analog-to-digital converter, after being passed through an anti-aliasing filter.
Analog-to-digital sampling typically occurs at 256-512 Hz in clinical scalp EEG; sampling rates
of up to 10 kHz are used in some research applications.The digital EEG signal is stored
electronically and can be filtered for display. Typical settings for the high-pass filter and a low-
pass filter are 0.5-1 Hz and 3570 Hz, respectively. The high-pass filter typically filters out
slow artifact, such as electrogalvanic signals and movement artifact, whereas the low-pass filter
filters out high-frequency artifacts, such as electromyographic signals. An additional notch filter
is typically used to remove artifact caused by electrical power lines (60 Hz in the United States
and 50 Hz in many other countries).As part of an evaluation for epilepsy surgery, it may be
necessary to insert electrodes near the surface of the brain, under the surface of the dura mater.
This is accomplished via burr hole or craniotomy. This is referred to variously as
"electrocorticography (ECoG)", "intracranial EEG (I-EEG)" or "sub-dural EEG (SD-EEG)".
Depth electrodes may also be placed into brain structures, such as the amygdala or
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIThippocampus, structures which are common epileptic foci and may not be "seen" clearly by
scalp EEG. The electrocorticographic signal is processed in the same manner as digial scalp
EEG (above), with a couple of caveats. ECoG is typically recorded at higher sampling rates
than scalp EEG because of the requirements of Nyquist theoremthe sub-dural signal is
composed of a higher predominance of higher frequency components. Also, many of the
artifacts which affect scalp EEG do not impact ECoG, and therefore display filtering is often
not needed.A typical adult human EEG signal is about 10V to 100 V in amplitude when
measured from the scalp and is about 1020 mV when measured from subdural
electrodes.Since an EEG voltage signal represents a difference between the voltages at two
electrodes, the display of the EEG for the reading encephalographer may be set up in one of
several ways. The representation of the EEG channels is referred to as a montage.
Bipolar montage
Each channel (i.e., waveform) represents the difference between two adjacent electrodes.
The entire montage consists of a series of these channels. For example, the channel "Fp1-
F3" represents the difference in voltage between the Fp1 electrode and the F3 electrode.
The next channel in the montage, "F3-C3," represents the voltage difference between F3
and C3, and so on through the entire array of electrodes.
Referential montage
Each channel represents the difference between a certain electrode and a designated
reference electrode. There is no standard position at which this reference is always
placed; it is, however, at a different position than the "recording" electrodes. Midline
positions are often used because they do not amplify the signal in one hemisphere vs. the
other. Another popular reference is "linked ears," which is a physical or mathematicalaverage of electrodes attached to both earlobes or mastoids.
Average reference montage
The outputs of all of the amplifiers are summed and averaged, and this averaged signal is
used as the common reference for each channel.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITLaplacian montage
Each channel represents the difference between an electrode and a weighted average of
the surrounding electrodes.
Limitations: EEG has several limitations. Most important is its poor spatial resolution. EEG is
most sensitive to a particular set of post-synaptic potentials: those which are generated in
superficial layers of the cortex, on the crests of gyri directly abutting the skull and radial to the
skull. Dendrites which are deeper in the cortex, inside sulci, are in midline or deep structures
(such as the cingulate gyrus or hippocampus) or produce currents which are tangential to the
skull have far less contribution to the EEG signal.The meninges, cerebrospinal fluid and skull
"smear" the EEG signal, obscuring its intracranial source.It is mathematically impossible toreconstruct a unique intercranial current source for a given EEG signal, as some currents
produce potentials that cancel each other out. This is referred to as the inverse problem.
However, much work has been done to produce remarkably good estimates of, at least, a
localized electric dipole that represents the recorded currents.
Advantages: EEG has several strong sides as a tool of exploring brain activity; for
example, its time resolution is very high (on the level of a single millisecond). Other
methods of looking at brain activity, such as PET and MRI have time resolution between
seconds and minutes. EEG measures the brain's electrical activity directly, while other
methods record changes in blood flow (e.g., SPECT, MRI) or metabolic activity (e.g.,
PET), which are indirect markers of brain electrical activity. EEG can be used
simultaneously with MRI so that high-temporal-resolution data can be recorded at the
same time as high-spatial-resolution data, however, since the data derived from each
occurs over a different time course, the data sets do not necessarily represent the exact
same brain activity. There are technical difficulties associated with combining these two
modalities, including the need to remove RF pulse artifact and ballistocardiographic
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITartifact (a results from the movement of pulsed blood) from the EEG. Furthermore,
currents can be induced in moving EEG electrode wires due to the magnetic field of the
MRI.EEG can be recorded at the same time as MEG so that data from these
complimentary high-time-resolution techniques can be combined.
Normal activity: The EEG is typically described in terms of (1) rhythmic activity and (2)
transients. The rhythmic activity is divided into bands by frequency. To some degree, these
frequency bands are a matter of nomenclature (i.e., any rhythmic activity between 8-12 Hz
can be described as "alpha"), but these designations arose because rhythmic activity
within a certain frequency range was noted to have a certain distribution over the scalp or
a certain biological significance.Most of the cerebral signal observed in the scalp EEG
falls in the range of 1-20 Hz (activity below or above this range is likely to be artifactual,
under standard clinical recording techniques).
Comparison table
Comparison of EEG bands
TypeFrequency
(Hz)Location Normally Pathologically
Delta up to 3 frontally in
adults,
posterior in
children;
high
adults slow
wave sleep
in babies
subcortical lesions
diffuse lesions
metabolic
encephalopathy
hydrocephalus
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amplitude
waves
Deep midline
lesions.
Theta 4 - 7 Hz
young
children
drowsiness or
arousal in
older children
and adults
focal subcortical
lesions
metabolic
encephalopathy
deep midline
disorders
some instances of
hydrocephalus
Alpha 8 - 12 Hz
Posterior
regions of
head, both
sides, higher
in amplitude
on dominant
side. Central
sites (c3-c4)
at rest.
Closing the
eyes and by
relaxation.
coma
Beta 12 - 30 Hz both sides,
symmetrical
distribution,
most evident
frontally;
low
amplitude
active, busy or
anxious
thinking,
active
concentration
benzodiazepines
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
waves
Gamma 26100
certain
cognitive or
motor
functions
Wave patterns:
Delta is the frequency range up to 3 Hz. It tends to be the highest in amplitude and the
slowest waves. It is seen normally in adults in slow wave sleep. It is also seen normally in
babies. It may occur focally with subcortical lesions and in general distribution with
diffuse lesions, metabolic encephalopathy hydrocephalus or deep midline lesions. It is
usually most prominent frontally in adults (e.g. FIRDA - Frontal Intermittent Rhythmic
Delta) and posteriorly in children e.g. OIRDA - Occipital Intermittent Rhythmic Delta).
Theta is the frequency range from 4 Hz to 7 Hz. Theta is seen normally in young
children. It may be seen in drowsiness or arousal in older children and adults; it can also
be seen in meditation. Excess theta for age represents abnormal activity. It can be seen as
a focal disturbance in focal subcortical lesions; it can be seen in generalized distribution
in diffuse disorder or metabolic encephalopathy or deep midline disorders or some
instances of hydrocephalus.
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Alpha is the frequency range from 8 Hz to 12 Hz. Hans Berger named the first rhythmic
EEG activity he saw, the "alpha wave." This is activity in the 8-12 Hz range seen in the
posterior regions of the head on both sides, being higher in amplitude on the dominant
side. It is brought out by closing the eyes and by relaxation. It was noted to attenuate with
eye opening or mental exertion. This activity is now referred to as "posterior basic
rhythm," the "posterior dominant rhythm" or the "posterior alpha rhythm." The posterior
basic rhythm is actually slower than 8 Hz in young children (therefore technically in the
theta range). In addition to the posterior basic rhythm, there are two other normal alpha
rhythms that are typically discussed: the mu rhythm and a temporal "third rhythm". Alpha
can be abnormal; for example, an EEG that has diffuse alpha occurring in coma and is
not responsive to external stimuli is referred to as "alpha coma".
Mu rhythm is alpha-range activity that is seen over the sensorimotor cortex. It
characteristically attenuates with movement of the contralateral arm (or mental imagery
of movement of the contralateral arm).
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Beta is the frequency range from 12 Hz to about 30 Hz. It is seen usually on both sides in
symmetrical distribution and is most evident frontally. Low amplitude beta with multiple
and varying frequencies is often associated with active, busy or anxious thinking andactive concentration. Rhythmic beta with a dominant set of frequencies is associated with
various pathologies and drug effects, especially benzodiazepines. Activity over about 25
Hz seen in the scalp EEG is rarely cerebral (i.e., it is most often artifactual). It may be
absent or reduced in areas of cortical damage. It is the dominant rhythm in patients who
are alert or anxious or who have their eyes open.
Gamma is the frequency range approximately 26100 Hz. Because of the filtering
properties of the skull and scalp, gamma rhythms can only be recorded from
electrocorticography or possibly with magnetoencephalography. Gamma rhythms are
thought to represent binding of different populations of neurons together into a network
for the purpose of carrying out a certain cognitive or motor function.
HEART LUNG MACHINE
The coronary arteries supply blood to the heart. The most common cause of death for is heart
attack which is usually caused by blockages in arteries. When the condition cannot be
effectively treated with medicines or catheter-based angioplasty and stents(blood flows through
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITstents after opening clogged arteries), a form of open-heart surgery called coronary artery
bypass grafting is recommended which usually takes 3 to 5 hours.. Coronary artery bypass
grafting (CABG) uses arteries and/or veins from other parts of the body to bypass the blocked
coronary arteries on the surface of the heart. This technique and technology make operations
more effective and safer for patients.
Open-Heart Surgery: For Open-Heart surgery, patient is made unconscious and various
parameters like heartbeat, blood pressure, oxygen levels, breathing etc are monitored. A
breathing tube is placed in lungs through throat and connected to a ventilator and surgeon
makes a 6- to 8-inch incision in the center of chest wall. Then the chest bone is cut and rib cage
is opened to access heart. Then a medicine is given to thin blood and keeps it from clotting. A
heart-lung bypass machine is connected to heart and takes over for heart by replacing the heart's
pumping action. The bypass machine allows the surgeon to operate on a heart that isn't moving
and full of blood. Then medicines are given to stop the heartbeat once patient is connected to
the heart-lung machine. A pipe is placed in heart to drain blood to the machine which removes
carbon dioxide from blood, & adds oxygen, and then pumps the blood back into body. Tubes
are then inserted into chest to drain fluid. Once the machine begins to work, the surgeon
performs the surgery to repair heart problem.
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At the end of the surgery, heart is restarted using mild electric shocks. The pipes and tubes are
removed from heart, and the heart-lung machine is stopped. Then again a medicine is given to
allow the blood to clot and chest bone is closed with wires. Stitches or staples are used to close
the incision. The breathing tube is removed. An advantage of open-heart surgery is that it's
easier for the surgeon to operate for long and complex surgeries.
Applications: Heart surgery is done to repair or replace valves that control blood flow through
the heart, repair structures in the heart, implant devices to regulate heart rhythms, or replace a
damaged heart with a healthy heart from a donor, bypass blocked arteries, treat arrhythmiasrepairaneurysms, treat angina (chest pain or discomfort) etc.
Sarns 8000 Heart Lung Machine: Cardiothoracic surgical program is the most important goal
of open-heart program. The Sarns 8000 is a modular heart lung machine that is available in a
variety of configurations. It has 4 pumps units that are available with built-in centrifugal pump
and power input is 220-240VAC, 50Hz,/440 V 3 Phase as appropriate fitted.
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Equipment consist of following :
5- Pump Console
Temperature Control Module (Hypo-Hyper thermia unit)
Monitors: a) Pressure monitor arterial and cardioplegia with transducers
b) Time
c) Temperature Monitor with probes
d) Display of total volume of each infusion with delivery time
Air- Oxygen Blender with hoses and Flow meter
Safety Devices
Ultrasonic air sensor
Level Sensor
Technical Specifications:
A. 5- Pump Console:
1. It has 5-pump console compactly arranged with separate power supply and control modules
with easy access connectors for interchanging the pump.
2. Each individual roller pump is capable of running independently on 220 V/50Hz supply
with a spill proof base. The unit is supplied with a Battery backup for at least two pumps
& all safety systems for a minimum of 15 minutes. Switch over from main power to battery
backup is automatic and immediate.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT3. Individual pump heads have Harvey Roller pumps with facility for tubing to be used
adjustable from to 5/8 through 3/8 & by easily changeable mechanism. The total
infusion volume in litres and delivery time, the flow rates in LPM and in RPM.
4. Each Pump has easy mechanism for occlusion setting for different thickness of tubes with
unidirectional hand crank facility as a critical safety feature.
5. The Console has a compact base mount for the entire pump heads together, with pole and
handles and variable, changeable tubing holders in each pump head.
6. It has a movable oxygenator holder and roller pump has a self diagnostic circuit with
provision to detect and display critical alarm conditions and optional pulsatile module
which can be mounted on any of the blood pump.
7. It has a venous control module with single pole mast with electronic venous line occluder,a monitor mount with adjustable monitoring arm and an instrument tray positionable with
long monitoring arm.
B. Temperature Control Module: Temperature control and monitor system with Cardioplegia
supply and remote temperature display has following features:
1. Simultaneous delivery of water for arterial and cardioplegia heat exchangers and to
thermal blankets and works with a power supply of 220 20 V 50 Hz.
2. Pressure regulated blanket ports maintain the temperature of arterial port with
temperature display range of 0- 50 Celsius and remote accuracy of 0.3 Celsius.
3. Microprocessor based unit control, cool, rewarm and maintains temperature. Water outlet
temperature of heat exchanger and blanket range 0-42 C.
4. Maximum flow performance of heat exchanger port 15 22 LPM; 480mmHg maximum
pressure; Blanket 1.5 to 2.5 LPM at zero head.5. Ice generation and rewarming facility with venous difference mode settable at 6 to 10 C
gradients to hold the water bath at higher than venous blood temperature.
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6. Temperature probe module for the operating ranges of 0-50 C. and temperature probes
to fit in standard oxygenators (bubble / membrane).
C. Monitors: They have optional capability for computer interface to retrieve perfusion data.
1. Pressure Monitor: It can monitor one arterial line pressure and two cardioplegia line
pressures (total 3); along with necessary pressure transducers, cables and domes reusable,
with accurate digital display and alarms.
2. Time Monitor: 4 time displays -- 2 for arterial and 2 for cardioplegia delivery with stop,
reset and start function.
3. Temperature: 6 displays- 3 for patient monitoring & 3 for cardioplegia monitoring with
digital display in Celsius with 6 necessary compatible temperature probes with 3 of them
for nasal, rectal and esophageal use.
D. Air-Oxygen Blender: Works at 50-60 PSI for membrane oxygenator with water trap
attached with hoses & connections of min. of 5 meters length and triple flow glass flow meters.
E. Safety and monitoring devices:
1. Ultrasonic Air Sensor: It detect bubbles to work equally well with crystalloid and blood
and can fit anywhere in the circuit easily.
2. Level Sensor System: Ultrasonic transducers to work well with crystalloid and blood
with adhesive pads & with alarm settings.
F. Environmental factors:
The unit is capable of operating continuously in ambient temperature of 10 -400 C and relative
humidity of 15-90% and is capable of being stored continuously in ambient temperature of 0
-500 C and relative humidity of 15-90% with general requirements of safety for Electromagnetic
Compatibility.
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VENTRICULAR ASSIST DEVICES
Ventricular assist devices are innovative external pumps that temporarily support the circulation
inpatients who are believed to have reversible heart failure or who are candidates for heart
transplantation. The Cardiothoracic Surgeons use the Abiomed BVS 5000 Blood Pump, which
can take over pumping action for the right, left, or both ventricles. Ventricular assist devices are
used relatively rarely and are very expensive for the hospital, but are mandatory for any
comprehensive cardiac program. They provide support for prolonged heart recovery and, in
addition, can be an effective bridge to further therapy including transplantation.
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ENDOSCOPE
INTRODUCTION:
Endoscopy is a minimally invasive diagnostic medical procedure that uses tube like instruments
(called endoscopes) to assess interior surfaces of an organ. This procedure is different from
imaging tests, such as X-Rays, which also look inside of the body but usually do not place
instruments inside the body.
An endoscope is a device that uses fibre optics and powerful lens system s to provide lighting
and visualization of the interior of a joint. The portion of the endoscopes inserted into the body
may be rigid or flexible, depending upon the medical procedure. The rigid or flexible tube not
only provide an image for visual inspection and photography, but also enable taking biopsies
and retrieval o foreign objects.
Endoscopes uses two fibre optic lines. A light fibre carries light into the body cavity and an
image fibre carries the image of the body cavity back to the physicians viewing lens. There is
also a separate port to allow for administration of drugs, suction, and irrigation. This port may
also be used to introduce small folding instruments such as forceps, scissors, brushes, snares
and baskets for tissue incision (removal), sampling or other diagnostic and therapeutic work.
Endoscopes may be used in conjunction with a camera or video recorder to document images of
the inside of the joint or chronicle an endoscopic procedure. New endoscopes have digital
capabilities for manipulating and enhancing the video images.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITMany endoscopic procedures are considered to be relatively painless and, at worst, associated
with mild discomfort; for eg. As in esophagogastroduodenoscopy, most patients tolerate the
procedure with only topical anaesthesia of the oropharynx using lignocaine spray
Complications are not common (only 5% of all operations ) but can include perforation of the
organ under inspection with the endoscope or biopsy instrument. If that occurs open surgery
may be required to repair the injury
ENDOSCOPE
There are many different kinds of endoscopes, or scopes. Some are hollow, allowing the
doctor to see directly into the body, while others use fibre optic (flexible glass or plastic fibers
that transmit light). Still others have small video camera on some endoscopes are stiff while
others are flexible. Endoscopes also vary in length. Each type is specially designed for looking
at a different part of the body. Depending on the area of the body being looked at, the
endoscope may be inserted through an opening like the mouth, anus, or urethra. In some cases,
endoscope is inserted through small incision.
TYPES OF ENDOSCOPES:
Type of Endoscope Inserted into or
through
Body area
Examined
Name of procedures
Bronchoscope mouth or nose Trachea
(windpipe) and
bronchi (tubes
inside the lungs)
Bronchoscopy,
flexible
bronchoscopy
Colonoscope Anus Colon (large
intestine)
Colonoscopy, lower
endoscopy
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
Cystoscope Urethra Urinary bladder Cystoscopy,
cystourethroscopy
Esophagogastroduode-
noscope
Mouth Esophagus,
stomach and
duodenum
Esophagogastro-
uodenoscopy (EGD),
panendoscopy,
upper endoscopy
gastroscopy
Hysteroscope Vagina Inside of uterus Hysteroscopy
Laproscope Incision in
abdomen
Space inside
abdomen and
pelvis
Laproscopy,
peritoneal endoscopy
Laryngoscope Mouth or nose Larynx (voice
box)
Layngoscopy
Mediastinoscope Incision above
sternum (breast
bone)
Mediastinum
(space between
lungs)
Mediastinoscopy
Sigmoidoscope Anus Rectum and
sigmoid colon
Sigmoidoscopy,
flexible
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(lower part of
large intestine)
sigmoidoscopy,
proctosigmoidoscopy
Thoracoscope Incision Space between
lungs and chest
wall
Thoracoscopy,
pleuroscopy
Gastroscopy viewing of the stomach. Used to check for ulcers, bleeding or tumours.
Colonoscopy and Sigmoidoscopy viewing of the colon. Used to check for tumours or
polyps (small growths).
Bronchoscopy viewing of the airways and lung tissue. Used to remove foreign bodies,
take samples to diagnose lung cancer or other lung diseases and to assess the condition of
the airways following smoke inhalation.
Cystoscopy viewing of the bladder. Used to check for tumors, stones and other
abnormalities.
Hysteroscopy viewing of the uterus. Used to check for adhesions or polyps and to
investigate excessive menstrual bleeding.
In other types of endoscopy, the skin is opened to allow the scope to enter an area:
Arthroscopy to look into a joint such as the knee. Used to check for torn ligaments or
damaged cartilage.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITmicroscope or tested in other ways to know for sure whether or not cancer is present. A biopsy
is the best way to find out if a growth is cancer or something else.
In some cases endoscopes are used to help find out how far a cancer may have spread.
Thoracoscopy and laparoscopy can be especially useful in finding out whether certain cancershave spread into one of the body cavities (thorax or abdomen). They let the surgeon look at
these spaces without making a large incision in the skin.
Some types of endoscopy can help make imaging tests more accurate. This can e especially
helpful when trying to find the stage (extent) of cancer within the body. Most people are
familiar with ultrasound, an imaging test in which a transducer is moved over the skin. It sends
sound waves into the body, which bounce back in a pattern that creates an image of the inside
of the body.
ENDOSCOPIC ULTRASOUND (ESU) is a procedure in which a small transducer on the tip of
an endoscope is inserted into the mouth or rectum. By putting the transducer on the tip of the
endoscope, it can get closer to the area where the tumor is to take pictures. It is used to get
information about problems in the digestive tract and surrounding organs. Because the
transducer is close to the organ being studied, it can make very detailed pictures. EUS can be
used to see how deeply a tumor may have penetrated into the rectum or esophagus, or into an
organ like the pancreas. It can also help show whether certain lymph nodes are enlarged. EUS
can also help a doctor guide a needle into a lymph node or other suspicious area to do biopsy.
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TREATING CANCER:
Endoscopes can be used to remove or destroy small cancers. Small instruments passed through
an endoscope can be used to cut out small growths. Some forms of endoscopy allow doctors to
use a cautery or laser through the tip of the endoscope to burn or vaporize growths.
Over the last decade or so, a wide variety of endoscopic tools have been developed that allow
doctors to perform minimally invasive surgery. This type of surgery is sometimes called
keyhole surgery or when used for the abdomen, is called laparoscopic surgery. Instead of
using one long surgical incision, it involves making several small incisions in the skin usually inthe chest or abdomen. Long, thin instruments are then inserted through the holes to reach the
inside of the body. A video endoscope is placed through one of the holes to allow the surgeon to
see inside during the operation.
This type of surgery was first used for fairly minor procedures such as gall bladder removal, but
in recent years have begun using it to treat some types of cancer. It is also used to treat early
cancers of the lung, colon, prostate, and some other organs.
There are pros and cons to keyhole surgeries. There is generally less blood loss during the
operation, and patients often recover faster and with less pain because the incisions are smaller
than in regular surgery. Some forms of keyhole surgery use robotic arms, which a surgeon
controls from a console. This technique allows for better magnification of the area and more
precision in working with the delicate surgical instruments.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAFTER THE ENDOSCOPY PROCEDURE:
After the procedure the patient will be observed and monitored by a qualified individual in the
endoscopy or a recovery area until a significant portion of the medication has worn off
Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles
or a feeling of distention from the insufflated air that was used during the procedure. Both
problems are mild and fleeting. When fully recovered, the patient will be instructed when to
resume his/her usual diet (probably within a few hours) and will be allowed to be taken home.
Because of the use of sedation, most facilities mandate that the patient is taken home by another
person and not to drive on his/her own or handle machinery for the remainder of the day.
RISKS
Infection
Punctured organs
Allergic reactions due to Contrast agents or dyes (such as those used in a CT scan)
Over-sedation
COMPONENTS OF ENDOSCOPE:
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAn endoscope can consist of
a rigid or flexible tube
A light delivery system to illuminate the organ or object under inspection. The light
source is normally outside the body and the light is typically directed via an optical fibresystem
a lens system transmitting the image to the viewer from the fiberscope
an additional channel to allow entry of medical instruments or manipulators
DISTAL END PART OF ENDOSCOPE
A distal end part of an endoscope including an end cap provided with a nozzle for spouting a
fluid in a predetermined direction. The end cap is detachable with respect to a distal end block
which is provided at the distal end of an insert part of the endoscope. Engagement portions are
provided on the end cap and the distal end block to regulate the condition in which the end cap
is fitted to the distal end block. The engagement portion of the end cap and the engagement
portion of the distal end block are formed such that, among different models of endoscopes in
which the distal end blocks have approximately the same outer diameter, the engagementportion of the end cap off one model cannot be engaged with
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITA system of different models of endoscopes, each endoscope having a distal end part, each
distal end part comprising:
an end cap provided with a nozzle for spouting a fluid in a predetermined direction, said end
cap being detachable with respect to a distal end block which is provided at a distal end of an
insert part of an endoscope; and
engagement means provided on said end cap and said distal end block to regulate a condition in
which said end cap is fitted to said distal end block, said engagement means including mating
portions which are engageable with each other, said mating portions also positioning the end
cap with respect to said distal end block in a direction of rotation,
said engagement means provided on said end cap and said engagement means provided on said
distal end block being formed such that, among said different models of endoscopes in said
system in which distal end blocks have approximately the same outer diameter, said
engagement means provided on said end cap of one model cannot be engaged with said
engagement means provided on said distal end block of another model.
Distal endoscope part having light emitting source such as light emitting diodes as
illuminating means
A substrate having a plurality of light emitting diodes united therewith lies on a plane
containing the longitudinal axis of an insertion unit of an endoscope and its neighborhood.
Likewise, part of a first objective surface lies on the plane containing the longitudinal axis of
the insertion unit of the endoscope and its neighborhood. As long as the diameter of the
insertion unit remains unchanged, the plane containing the longitudinal axis of the insertion unit
of the endoscope and its neighborhood provides the largest area for the light emitting diodes.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITThe light emitting diode sub-assembly is therefore placed on the plane, whereby the outer
diameter of a distal endoscope part can be made as small as possible.
BRONCHOSCOPE
BRONCHOSCOPY is a medical procedure where a tube is inserted into the airways, usually
through the nose or mouth. This allows the practitioner to examine inside a patients airway for
abnormalities such as foreign bodies, bleeding, tumors, or inflammation. The practitioner often
takes samples from inside the lungs: biopsies, fluid (bronchoalveolar lavage), or endobronchial
brushing. The practitioner may use either a rigid bronchoscope or flexible bronchoscope.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
Rigid Bronchoscopy:
A rigid bronchoscope is a straight, hollow, metal tube. Doctors perform rigid bronchoscopy less
often today, but it remains the procedure of choice for removing foreign materials, as its
increased thickness allows instruments to be more easily inserted through it. Rigid
bronchoscopy also becomes useful when bleeding interferes with viewing the examining area
and allows for more interventions, such as cautery to stop the bleeding.
Flexible Bronchoscopy:
A flexible bronchoscope is a long tube that contains small clear optical fibers that transmit light
images as the tube bends. Its flexibility allows this instrument to reach further into the airway.
The procedure can be performed easily and safely under local anesthesia. As flexible
bronchoscopes become more advanced, it is likely that they will replace rigid bronchoscopes for
most procedures.
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GASTROSCOPE
GASTROSCOPY is an examination of the inside of the gullet, stomach and duodenum. It is
performed by using a thin, flexible fibre optic instrument that is passed through the mouth and
allows the doctor to see whether there is any damage to the lining of the oesophagus (gullet) or
stomach, and whether there are any ulcers in the stomach or duodenum.
Gastroscope
The gastroscope is a flexible plastic tube approximately four feet long and one half inch wide
The gastroscope contains optic fibers with a light source that allow the gastroscope to function
like a video camera.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITThe use of the gastroscope is esophagogastroduodenoscopy or EGD. An EGD is done when the
doctor suspects that there is a problem with the swallowing tube, stomach, or small intestine. In
the ICU, the two most common reasons for the using the gastroscope are to evaluate a patient
suspected of bleeding from the stomach or intestines and to help place a gastrostomy tube.
Occasionally, a special gastroscope is used for patients who may have an inflamed pancreas or
blocked gallbladder drainage system.
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RADIOLOGY
MAGNETIC RESONANCE IMAGING
Medical Imaging has created a revolutionary change in the field of medicine, the imaging of the
human body is very much useful in determining the diseases and used for all the treatments.
The magnetic resonance phenomenon can be described by both classical and quantum
mechanical approaches. Magnetic resonance imaging is based on the techniques of nuclear
magnetic resonance. MRI scanner uses powerful magnets to polarize and excite hydrogen
nuclei (singleproton) in water molecules in human tissue, producing a detectable signal which
is spatially encoded resulting in images of the body. MRI involves the use of three kinds of
electromagnetic field: Avery strong (of the order of units of teslas) static magnetic field to
polarize the hydrogen nuclei, called the static field, A weaker time-varying (of the order of 1
kHz) for spatial encoding, called the gradient fields, A weak radio-frequency (RF) field for
manipulation of the hydrogen.
The scanner first aligns the nuclear spins of hydrogen atoms in the patient and starts rotating
them in a perfect concert. The nuclei emit maximum-strength electromagnetic waves at the
start, but over time the rotating spins get out of synch, simply due to small differences in localmagnetic fields. The unsynchronized spins cause the combined electromagnetic signal to decay
with time, a phenomenon called relaxation. A slice is selected applying a gradient in a particular
direction (X, YorZ). Magnetic resonance signals are then formed by means of the application of
magnetic field gradients along three different directions. Finally, the signals are acquired and
Fourier transformed to form a two-dimensional or three-dimensional image.
MRI Construction and operation
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Magnet: The imaging magnet is the most expensive component of the magnetic resonance
imaging system. Most magnets are of the superconducting type. A superconducting magnet is
an electromagnet made of superconducting wire. Superconducting wire has a resistance
approximately equal to zero when it is cooled to a temperature close to absolute zero (-273.15 o
C or 0 K) by immersing it in liquid helium. Once current is caused to flow in the coil it will
continue to flow as long as the coil is kept at liquid helium temperatures. The length of
superconducting wire in the magnet is typically several miles. The coil of wire is kept at a
temperature of 4.2K by immersing it in liquid helium. The coil and liquid helium is kept in a
large dewar. The typical volume of liquid Helium in an MRI magnet is 1700 liters. In early
magnet designs, this dewar was typically surrounded by a liquid nitrogen (77.4K) dewar which
acts as a thermal buffer between the room temperature (293K) and the liquid helium. In later
magnet designs, the liquid nitrogen region was replaced by a dewar cooled by a refrigerator.
This design eliminates the need to add liquid nitrogen to the magnet. It is expected that
cryocoolers for the helium reservoir will soon be available
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITAn imaging coil must resonate, or efficiently store energy, at the Larmor frequency. All
imaging coils are composed of an inductor, or inductive elements, and a set of capacitive
elements. The resonant frequency, of an RF coil is determined by the inductance (L) and
capacitance (C) of the inductor capacitor circuit.
.
RF Coil for 4.7T Magnet
There are many types of imaging coils. Volume coils surround the imaged object while surface
coils are placed adjacent to the imaged object. An internal coil is one designed to record
information from regions outside of the coil, such as a catheter coil designed to be inserted into
a blood vessel. Some coils can operate as both the transmitter of the B 1 field and the receiver of
the RF signal. Other coils are designed as only the receiver of the RF signal. When a receive
only coil is used, a larger coil on the imager is used as the transmitter of RF energy to producing
the 90o and 180o pulses.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRIT
Slice selection
A single frequency RF pulse is applied to the whole sample; only a narrow plane perpendicular
to the longitudinal axis at the centre of the sample will absorb the RF energy. Everywhere else
in the sample is receiving the wrong frequency of excitation for resonance to occur. This
technique allows a slice, with thickness determined by the magnetic field gradient strength, to
be selected from a sample.
Technical Specifications
Tim
Up to 76 seamlessly integrated coil elements with up to 18 RF channels
205 cm FoV. Whole Body
PAT. Unlimited
Workflow automation
Examples are: Phoenix, Auto Align, Inline Technology
Compact magnet
Ultra compact 1.5T magnet (length: 120 cm)
Wide, patient-friendly inner bore diameter (70 cm)
Magnet weight including Helium only approx. 3,800 kg
Unique CT-like 70 cm Open Bore diameter, with high homogeneity over 30 cm
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Computer
syngo-speaking user interface syngo is the common software platform for all imaging
modalities. Enhanced productivity with minimized user interactions per operation step. Based
on a powerful Pentium 4/3 GHz Panoramic Recon Image Processor reconstructing up to 3,226
images per second (256 x 256, 25% recFoV) in combination with a Pentium 4-based Host
Computer with two CPUs/3 GHz and 2 GB RAM capacity.
Cost-effective siting
30 qm/325 sq. ft. floor space only
No computer room required for a total of just two electronic cabinets (water-cooled).
Computer tomography(ct scan)
CT scanningsometimes called CAT scanningis a noninvasive medical test that helps
physicians diagnose and treat medical conditions.
CT scanning combines special x-ray equipment with sophisticated computers to produce
multiple images or pictures of the inside of the body. These cross-sectional images of the areabeing studied can then be examined on a computer monitor, printed or transferred to a CD.
CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and
reveal more details than regular x-ray exams.
Using specialized equipment and expertise to create and interpret CT scans of the
body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease,
infectious disease, appendicitis, trauma and musculoskeletal disorders.
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CT-SCAN MACHINE
The CT scanner is typically a large, box like machine with a hole, or short tunnel, in the center.
You will lie on a narrow examination table that slides into and out of this tunnel. Rotating
around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a
ring, called a gantry. The computer workstation that processes the imaging information is
located in a separate room, where the technologist operates the scanner and monitors your
examination.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITIn many ways CT scanning works very much like other x-ray examinations. X-rays are a form
of radiationlike light or radio wavesthat can be directed at the body. Different body parts
absorb the x-rays in varying degrees.
In a conventional x-ray exam, a small burst of radiation is aimed at and passes through the
body, recording an image on photographic film or a special image recording plate. Bones
appear white on the x-ray; soft tissue shows up in shades of gray and air appears black.
With CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate aroundyou, measuring the amount of radiation being absorbed throughout your body. At the same
time, the examination table is moving through the scanner, so that the x-ray beam follows a
spiral path. A special computer program processes this large volume of data to create two-
dimensional cross-sectional images of your body, which are then displayed on a monitor. This
technique is called helical or spiral CT.
CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin
slices. When the image slices are reassembled by computer software, the result is a very
detailed multidimensional view of the body's interior.
Refinements in detector technology allow new CT scanners to obtain multiple slices in a singlerotation. These scanners, called "multislice CT" or "multidetector CT," allow thinner slices to
be obtained in a shorter period of time, resulting in more detail and additional view capabilities.
BENEFITS AND RISKS OF CT-SCAN
Benefits
CT scanning is painless, noninvasive and accurate.
A major advantage of CT is its ability to image bone, soft tissue and blood vessels all at the
same time.
Unlike conventional x-rays, CT scanning provides very detailed images of many types of
tissue as well as the lungs, bones, and blood vessels.
CT examinations are fast and simple; in emergency cases, they can reveal internal injuries
and bleeding quickly enough to help save lives.
CT has been shown to be a cost-effective imaging tool for a wide range of clinical
problems.
CT is less sensitive to patient movement than MRI.
CT can be performed if you have an implanted medical device of any kind, unlike MRI. A diagnosis determined by CT scanning may eliminate the need for exploratory surgery and
surgical biopsy.
No radiation remains in a patient's body after a CT examination.
X-rays used in CT scans usually have no immediate side effects.
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The equipment typically used for bone x-rays consists of an x-ray tube suspended over a table
on which the patient lies. A drawer under the table holds the x-ray film orimage recording
plate. Sometimes the x-ray is taken with the patient standing upright, as in cases of knee x-rays.
A portable x-ray machine is a compact apparatus that can be taken to the patient in a hospital
bed or the emergency room. The x-ray tube is connected to a flexible arm that is extended over
the patient while an x-ray film holder or image recording plate is placed beneath the patient.
PROCEDURE
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects,
including the body. Once it is carefully aimed at the part of the body being examined, an x-ray
machine produces a small burst of radiation that passes through the body, recording an image
on photographic film or a special digital image recording plate.
Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of
the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass
through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of
gray and air appears black.
Until recently, x-ray images were maintained as hard film copy (much like a photographic
negative). Today, most images are digital files that are stored electronically. These storedimages are easily accessible and are frequently compared to current x-ray images for diagnosis
and disease management.
The technologist, an individual specially trained to perform radiology examinations, positions
the patient on the x-ray table and places the x-ray film holder or digital recording plate under
the table in the area of the body being imaged. When necessary, sandbags, pillows or other
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CSSD EQUIPMENT
Sterilizers:
We manufacture a wide array of medical sterilizer and hospital sterilizer that are
available with different features to facilitate the process of sterilizing which is one of
the most important aspects of medical practice. These are made of superior quality
material like stainless steel that makes them hygienic by preventing them from being
prey to rust. The different variety includes, Triple Chamber Autoclave, Double
Drum Autoclave SS, Single Drum Autoclave Aluminum etc.
Horizontal Rectangular High Pressure Steam Sterilizer
In our medical sterilizer horizontal autoclave is available in
triple-walled (jacketed). Triple-walled execution is preferably
used in hospitals for sterilization of all goods, suitable for the
dressing drums size up to 12x15 Inches especially of infectious
garbage & laboratory waste. The garbage sacks are sterilized inbuckets, which are placed one above the other. Our medical
sterilizer hasinner and outer wall made of heavy gauge of stainless steel and
Construction of the unit totally made of 304 stainless steel heavy gauge sheet middle
jacket made of brass or stainless steel and gun metal
Technical Data:
Steam Working Pressure 1.26 kgf/cm2 (2.2 kgf/cm2 in case High speed
sterilizer
Steam Working Temperature 121oC
Operating Voltage 240, single phase, AC supplies, 50 Hz.
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITabove the other. In hospital sterilizer inner and outer wall made of heavy gauge of
stainless steel and middle jacket made of brass and gun metal
Technical Data:
Steam Working Pressure 1.26 kgf/cm2 (2.2 kgf/cm2 in case High speed
sterilizer
Steam Working Temperature 121oC
Operating Voltage 240, single phase, AC supply, 50 Hz.
Sterilization Period 45 to 50 minutes.
Radiant locking system, cold water drainage system Steam
Exhaust:
5 to 7 provided with timer from 1 to 60 Min with double safety valve, steam
releasing valve, pressure gauge for the pressure inside the chamber, and one pressure
gauge to show the pressure of outer chamber both the chamber made of stainless
steel lid of the unit made of heavy duty gun metal piece for extra safety, gasket,
water level indicator to see the water inside, heavy duty power plug with socket
provided with the unit
Accessories:
One spare element, and two gaskets, our common size 400x1200 mm
Vertical Sterilizer
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MINI PROJECT BIOMEDICAL ENGINEERING BVRITSterilization accessories:
Auto claves
Ultra sonic cleaners
Autoclave racks
Instrument Trays
Autoclave Chemicals
Autoclave supplies and testing
The main objectives of the Central Sterile Supply Department are: To provide sterilized material from a central department where sterilizing
practice is conducted under conditions, which are controlled, thereby
contributing to a reduction in the incidence of hospital infection.
To take some of the work of the Nursing staff so that they can devote more
time to their patients.
To maintain record of effectiveness of cleaning disinfections and sterilization
process.
To monitor and enforce controls necessary to prevent cross infection
according to infection control policy.
To maintain an inventory of supplies and equipment.
To stay updated regarding developments in the field in the interest of
efficiency, economy, accuracy and provision of better patient care.
To provide a safe environment for the patients and staff.
Technical Data:
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Steam
Working
Pressure
1.26 kgf/cm2 (2.2 kgf/cm2 in case High
speed sterilizer
Steam
Working
Temp
121oC (134o in case of High speed
sterilizer)
Hyd. Tested at Jacket-Twice the working pressure.
Chamber-One & half time the working
pressure.
Operating
Voltage
400/440, 3 phase, AC supply, 50c/s.
Sterilization
Period
20 to 25 minutes(in case of High speed
sterilizer 5 to 7 minutes).
Steam Exhaust 5 to 7 minutes (in case of High speed
sterilizer 1 minute)
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INDICATORS
In the process of sterilization of medical instruments a indicator is used by the
operator to find out weather the material in the sterilizer is completely sterile or not. A paper like
substance which is applied with some chemical is used as an indicator. Initially the tape will be
yellow in color, after sterilization it turns black.
It is called AUTO CLAVE. This indicator is attached to the
material to be sterilized and verified after sterilization process.
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