com
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An Overview . . .
Measurement of blood pressure
Cardiac output
Cardiac rate
Heart sound
Respiratory rate
Gas volume
Flow rate of Co2, o2 in exhaust air
pH of blood,
ESR, GSR measurements
Plethysmography.
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Cardiac Output
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It is the amount of blood delivered by the heart to the aorta per minute
For normal adults it is 4 -6 litres / minute
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Ficks Method :
Based on analysis of gas - keeping of the organism
Cardiac output can be calculated by continuously
infusing oxygen into the blood or removing it from the
blood and measuring the amount of oxygen in the blood
before and after its passage
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Oxygen uptake
by Ventilation
Q2
Heart Catheter
Vena
Cava
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Aorta
Q
Heart
and
Lungs
Arterial Blood
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It is equal to the difference between the amounts in the blood arriving at and
departing from the site of measurement
I = CAQ CVQ
Q=
I
CA CV
where
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Principle
A known amount of dye or radioisotope is introduced as an indicator in the
blood circulation
The concentration of the indicator is measured with respect to time and the
volume of blood flow is estimated
Let M mg of an indicator be injected into a large vein or preferably into the
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dM
dt
= c dV
dt
But
dV
dt
= Q
Therefore
dM
= Q c dt
M
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Q c dt
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Q c dt
0
(or)
M
t
0
c dt
curve gives directly the value of the denominator in the above equation
Thus
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M
Area of the curve
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Timer/Control
Linearity
Amplifier
Integrator
Linearising
Amplifier
Microcomputer
Thermistor for
Blood Temperature
Thermistor for
Thermoindicator
Temperature
Preset Adjustment
Control
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Cardiac
Output
Display
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Potential Electrodes
A1
Oscillator
f = 100kHz
Amplifier and
Demodulator
Current
Electrodes
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A2
Differentiator
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Electrodes 2 and 3 are used to pick up the voltage across the thorax
If
(or)
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V =
pL
A
pL2
R
pL2
AL
pL2
V
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- pL2
R2
dR
dV =
Taking
dZ = t
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- pL2
Z2
dZ
dt
dZ
max
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where,
dZ
dt
Thus
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dV =
- pL2
Z2
t.
dZ
dt
max
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Spirometer
Linkage
o
VOL
VBB
kR
+
r
VOUT
-
Patient
air into
Bellows
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Spirometer
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These bellows are mechanically articulated to a biased potentiometer such that the wiper voltage is proportional
to volume of the bellows
If k is the proportionality constant giving the fractional position of the wiper arm on the potentiometer R such
that
k = Vout = VOL
VBB
Therefore
VOLmax
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Gas Analysers
Used to
Determine the quantitative composition of inspired and expired gas
Assess the lung function
Types
Infrared Gas Analyser based on infrared absorption of carbon dioxide
Paramagnetic Oxygen Analyser - based on paramagnetic behaviour of
oxygen
Thermal Conductivity Gas Analyser based on thermal conductivity of
carbon dioxide
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Infra red
Source
Mirror
Sample Tube
Reference Tube
Motor
Sample
Cell
Detector Unit
Diaphragm
Amplifier
Panel Meter
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Recorder
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By means of mirror assembly two infrared beams with same intensity are produced
A high speed rotating chopping disc is present which occludes each beam twice per motion
The chopped lights pass through the reference and sample tubes
When the opaque portions of the choppers are not in the way, the beam falls on the balanced
condenser microphone detector after passing the gas
The sample beam falling on the detector will be weaker than the reference beam since there is
absorption in the sample cell by the component of interest
The heating of the gas in the detector situated in the reference beam side will cause rise in
pressure
Thus, the change in position of the diaphragm produces a periodic change in the capacity of the
capacitor
This change is amplified and demodulated and the output is displayed on a meter or a recorder
in terms of concentration of the wanted component
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SCALE
MIRROR
DUMB CELL
O2
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If the gas surrounding the dumb shell is also nitrogen there will be
no force acting on the dumb shell
If oxygen is added to the gas, the oxygen molecules experience a
force, displacing the diamagnetic dumb shell
The resulting rotation of the suspension turns a small mirror and
deflects a small beam of light over a scale calibrated in percentages
by volume of oxygen or partial pressure of oxygen
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Sample Gas
Flow
Reference Gas
Flow
S1
R1
uA
S2
R2
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Digital pH Meter
-Er
( From Reference )
+
EIN
( From Solution )
Reference
Electrode
Electrical
Conductor
Buffer Solution
o
YT
-10 mV / oC
From
Temperature
Sensor
Glass Membrane
VOUT = Er EIN - YT
Analyzed
Solution
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VOUT
Digital
Voltmeter
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Plethysmography
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Used to measure the volume changes in any part of the body that result from the
pulsations of blood occurring with each heart beat
Consists of a rigid cup or chamber placed over any part of the body in which the
volume changes are to be measured
The changes in the volume reflect the pressure changes of air inside the chamber
Capacitance Plethysmograph
Impedance Plethysmograph
Photoelectric Pltehysmograph
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Since the patient is made to sit inside an air tight chamber whose
temperature is constant,
P * (VOL) = constant
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d (P VOL)
(or)
(PVOL)
VOL dP
+
dP
dVOL
dP
P dVOL
= -
(PVOL)
VOL
=
dVOL
P
VOL
Now the door of the air tight chamber is sealed with the patient
inside and the valve on the mouthpiece is closed
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The patient cannot breathe with the valve closed, so the air
pressure in the mouthpiece is equal to the lung pressure PT
d TLC
In the body,
where
d PT
PT
In the chamber,
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= -
TLC
= Thorax Pressure
d (VOLC)
d PC
= -
VOLC
PC
where
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= Chamber Pressure
d PT
= - d (TLC)
= -
VOLC
PC
d PC
TLC
= - VOLC
d PC
d PT
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Procedure
the formula,
TLC
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VOLC
d PC
d PT
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Blood Pressure
Blood pressure (BP) is a force exerted by circulating blood on the walls
of blood vessels
The term blood pressure usually refers to the pressure measured at a
person's upper arm.
For each heartbeat, BP varies between systolic and diastolic pressures.
Systolic pressure is peak pressure in the arteries, which occurs near the end
of the cardiac cycle when the ventricles are contracting.
Diastolic pressure is minimum pressure in the arteries, which occurs near
the beginning of the cardiac cycle when the ventricles are filled with blood.
A person's BP is usually expressed in terms of the systolic pressure and
diastolic pressure, for example 120/80 millimetres of mercury (mmHG)
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Measurement
Noninvasive measurement
Palpation method
Auscultatory method
Oscillometric method
White-coat hypertension
Home monitoring
Invasive measurement
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Auscultatory method
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Comprises an inflatable (Riva-Rocci) cuff placed around the upper armat roughly the
same vertical height as the heart, attached to a mercury or aneroid manometer
A cuff of appropriate size is fitted smoothly and snugly, then inflated manually by
Listening with the stethoscope to the brachial artery at the elbow, the examiner
slowly releases the pressure in the cuff
When blood just starts to flow in the artery, the turbulent flow creates a "whooshing"
The pressure at which this sound is first heard is the systolic BP.
The cuff pressure is further released until no sound can be heard (fifth Korotkoff
sound), at the diastolic arterial pressure.
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Mercury manometer
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Invasive measurement
Arterial blood pressure (BP) is most accurately measured invasively
displayed
Regularly employed in human and veterinary intensive care
medicine, anesthesiology, and for research purposes
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systolic, mmHg
Hypotension
< 90
< 60
Normal
90 120
and 60 80
Prehypertension
121 139
or 81 89
Stage 1 Hypertension
140 159
or 90 99
Stage 2 Hypertension
160
or 100
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diastolic, mmHg
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Heart sounds
The heart sounds are the noises (sound) generated by the beatingheart and the
resultant flow of blood through it.
In healthy adults, there are two normal heart sounds often described as a lub and
a dub (or dup), that occur in sequence with each heart beat. These are produced by
the closing of the AV valves and semilunar valves respectively
Heart murmurs are generated by turbulent flow of blood, which may occur inside or
outside the heart.
Abnormal murmurs may also occur with valvular insufficiency which allows
backflow of blood when the incompetent valve closes with only partial effectiveness
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