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Figure 13.1 Block diagram of an asynchronous cardiac pacemaker © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.2 Two of the more commonly applied cardiac pacemaker electrodes (a) Bipolar intraluminal electrode. (b) Intramyocardial electrode. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.3 A demand-type synchronous pacemaker Electrodes serve as a means of both applying the stimulus pulse and detecting the electric signal from spontaneously occurring ventricular contractions that are used to inhibit the pacemaker's timing circuit. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.4 An atrial-synchronous cardiac pacemaker, which detects electric signals corresponding to the contraction of the atria and uses appropriate delays to activate a stimulus pulse to the ventricles. Figure 13.5 shows the waveforms corresponding to the voltages noted. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.5 Block diagram of a rate-responsive pacemaker © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.6 A transcutaneous RFpowered electric stimulator Note that the implanted circuit of this stimulator is entirely passive and that the amplitude of the pulse supplied to the electrodes is dependent on the coupling coefficient between the internal and external coils. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.7 A stimulator system for use on stroke patients suffering from gait problems associated with drop foot. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Speech processor Stimulus controller External coil Internal coil Stimulator circuit Electrode array Microphone External unit Implanted unit Figure 13.8 Block diagram of cochlear prosthesis © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.9 (a) Basic circuit diagram for a capacitive–discharge type of cardiac defibrillator. (b) A typical waveform of the discharge pulse. The actual waveshape is strongly dependent on the values of L, C, and the torso resistance RL. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.10 Electrodes used in cardiac defibrillation (a) A spoon-shaped internal electrode that is applied directly to the heart. (b) A paddle-type electrode that is applied against the anterior chest wall. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.11 A cardioverter The defibrillation pulse in this case must be synchronized with the R wave of the ECG so that it is applied to a patient shortly after the occurrence of the R wave. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.12 Connection of a pump oxygenator to bypass the heart A disk-type oxygenator is used with a roller pump. Venous blood is taken from a cannula in the right atrium, and oxygenated blood is returned through a cannula in the femoral artery. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.13 An artificial kidney The dialysate delivery system in this unit mixes dialysate from a concentrate before pumping it through the exchange chamber. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.14 In extracorporeal shock-wave lithotripsy, a biplane x-ray apparatus is used to make sure the stone is at the focal point of spark-generated shock waves from the ellipsoidal reflector. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.15 An instrumentation system for recording pressure, temperature, and percentage of O2 in inspired air coming from a continuous-positive-airway-pressure apparatus. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Thermistor Bridge Power line Amplifier 1 Comparator Set-point resistor 1-Hz sawtooth generator 2 3 Gate pulse generator 4 Siliconcontrolled switch 5 Heater Figure 13.16 Block diagram of a proportional temperature controller used to maintain the temperature of air inside an infant incubator. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.17 Block diagram of the electronic control system for a fluid or drug delivery pump © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Power supply Reservoir Electronic controller Pump Control valve Sensor To tissue Figure 13.18 A block diagram of an implantable artificial pancreas showing the major components of the system. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.19 (a) Block diagram for an electrosurgical unit. High-power, highfrequency oscillating currents are generated and coupled to electrodes to incise and coagulate tissue. (b) Three different electric voltage waveforms available at the output of electrosurgical units for carrying out different functions. © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998. Figure 13.20 Block diagram of a typical electrosurgical unit © From J. G. Webster (ed.), Medical instrumentation: application and design. 3rd ed. New York: John Wiley & Sons, 1998.