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Medical Signal

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Laborator 6 EIM ELECTROCARDIOGRAMA ŞI ÎNREGISTRAREA PULSULUI PERIFERIC AL SÂNGELUI
1. Scopul lucrării: lucrarea îşi propune următoarele obiective experimentale: familiarizarea principiile pletismografiei şi a utilităţii acesteia în analiza calitativă a schimbărilor care apar în volumul de sânge la nivel periferic; observarea şi înregistrarea schimbărilor care apar în volumul de sânge la nivel periferic şi a pulsului în diferite condiţii, atât experimentale cât şi fiziologice; determinarea aproximativă a vitezei undei pulsului de la inimă la deget (periferie); ilustrarea activităţii electrice asociate cu activitatea ritmului cardiac normal şi a relaţiei cu circulaţia sângelui prin corp.

2. Introducere. Concepte fiziologice
Ciclul cardiac reprezintă o secvenţă ritmică de evenimente electrice, a cărei înregistrare se numeşte ECG (electrocardiogramă), care iniţiază o secvenţă ritmică de evenimente mecanice numite “sistolă” şi “diastolă”. „Sistola” reprezintă contracţia muşchiului cardiac, iar „diastola” reprezintă relaxarea acestuia. Deoarece ventriculul stâng este cel care pompează sânge în sistemul circulator arterial, producând astfel un puls de presiune periferic, în continuare se va descrie acţiunile ventricului stâng. (pentru mai multe detalii vezi Laborator 4) În timpul ciclului cardiac activitatea electrică a ventriculului, reprezentată de complexul QRS din ECG, produce evenimentul mecanic de contracţie a muşchiului ventricular (sistolă). Pentru frecvenţe normale ale pulsului (bătăilor inimii), sistola începe cu vârful undei R şi se termină la sfârşitul undei T. Unda T, ce reprezintă repolarizarea ventriculelor, apare în timp ce ventriculele se află în sistolă. Diastola ventriculară, perioada de relaxare a muchiului, începe la sfârşitul sistolei şi durează pană la următorul vârf al undei R. Deoarece ciclul cardiac conţine o sistolă ventriculară urmată imediat de o diastolă ventriculară, durata unei bătăi a inimii poate fi măsurată ca timpul dintre două unde R succesive.

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Contracţia ventriculelor împinge un volum de sânge (puls de sânge) în artere. Ventriculul stâng pompează sânge în aortă şi prin intermediul ramficaţiilor aortei sângele ajunge în tot corpul. Fiecare volum de sânge se „izbeşte” de cel pompat anterior şi astfel se facilitează curgerea sângelui. Aorta şi celelalte vase de sânge au pereţii elastici, ce permit acestora să se „dilate” pentru a primi volumul de sânge şi apoi se restrâng pentru a ajuta la „împingerea” sângelui în tot sistemul circulator cât timp ventriculul se află în diastolă. Presiunea arterială din timpul ciclului cardiac este principala forţă ce ajută la curgerea sângelui. Acţinuea de pompare a ventriculelor iniţiază de asemenea o undă de presiune ce e transmisă prin intermediul pereţilor arteriali. Presiunea creşte în timpul sistolei şi scade în timpul diastolei. Rigiditatea pereţilor vaselor ajută la transmiterea undei de presiune; cu cât pereţii sunt mai rigizi cu atât mai rapidă este transmisia undei de presiune, dar este nevoie si de un efort mai mare al inimii pentru a mişca acelaşi volum de sânge din cauza elasticităţii reduse a pereţilor arteriali. Notă: viteza de curgere a sângelui este mai mică decât transmiterea undei de presiune. Aorta are viteza cea mai mare de curgere a sângelui de aproximativ 40-50cm/s, în timp ce viteza undei de presiune este mult mai mare. Viteza de transmitere a undei de presiune de la inimă la periferie este determinată de mulţi factori intercorelaţi, incluzând abilitatea inimii de a se contracta puternic, presiunea sângelui, elasticitatea relativă a arterelor, diametrul vaselor de sânge etc. Unii dintre aceşti factori sunt dependenţi de poziţia corpului, de activitatea sistemului nervos simpatic, emoţii, boli etc. De exemplu, s-a demonstrat că viteza de transmitere a undei de presiune este corelată cu acitivtatea sistemului nervos simpatic şi preisunea sistolică a sângelui. Când unda de presiune este transmisă spre periferie (ex. la vârful degetelor), există un puls generat de o creştere a volumului de sânge. Ţesuturile şi organele îşi schimbă volumul când vasele de sânge se dilată sau contractă ,deci când pulsurile de sânge trec prin vasele de sânge în timpul unui ciclu cardiac. Astfel atunci când presiunea sângelui creşte, pereţii vasului de sânge sunt mai întinşi şi viteza undei puls creşte, deci dacă timpul de transmitere a pulsului creşte rezultă că presiunea sângelui scade. Schimbările care apar în volumul de sânge al organelor pot fi generate de sistemul nervos autonom ce acţionează asupra sistemului cardiovascular, de factori de mediu (cum ar fi temperatura), acitvitatea metabolică a unui organ, si o varietate de alte variabile. De exemplu, regularea temperaturii implică controlul curgerii sângelui la nivelul pielii. Când temperatura trebuie conservată, circulaţia sângelui la nivelul pielii

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este minimizat, în schimb atunci când este generată căldură în exces, ciruclaţia sângelui la nivelul pielii creşte cu scopul de a disipa căldura. Studiul schimbărilor ce apar în volumul de sânge, dintr-un organ sau organism, se numeşte pletismografie. Atfel de schimbări pot fi detectate mecanic sau fotoelectric, şi semnalul poate fi transformat într-un curent electric, ce poate fi amplificat şi înregistrat în timp. Detecţia şi înregistrarea semnalului se realizează cu un dispozitiv numit pletismograf şi înregistrarea schimbărilor de volum în timp se numeşte pletismogramă. Un exemplu de traductor folosit în pletismografie este un cirstal piezoelectric (familiar celor pasionaţi de radio sub numele de „cristal radio”). Cristalul piezoelectric este sensibil la presiune, emiţând un semnal electric slab atunci când stuctura cristalului este deformată. Dacă cristalul este fixat pe suprafaţa degetului arătător, schimbările în volumul de sânge din deget asociat cu fiecare ciclu cardiac distorsionează d.p.d.v mecaninc suprafaţa cristalului sensibilă la presiune, determinând generarea unui semnal electric ce poate fi amplificat şi înregistrat mecanic. Un al tip de traductor folosit în pletismografie funcţionează prin conversia energiei luminoase în energie electrică (traductor foto-electric). Traductorul foto-electric generează un fascicul de lumină prin piele şi măsoară cantitatea de lumină reflectată. Cu cât densitatea de sânge este mai mare cu atât este absorbită mai multă lumină şi deci mai puţină lumină se reflectă. Traductorul foto-electric converteşte lumina reflectată în semnal electric, care apoi poate fi procesat şi afişat. În acest laborator se va folosi traductorul foto-electric cuplat la sistemul Biopac pentru a înregistra pletismograma şi pentru a observa cum pletismografia poate contribui la întelegerea factorilor ce înfluenţează distribuţia periferică a sângelui.

3. Desfăşurarea lucrării
3.1 Componente hardware necesare:
• • • • • • • unitatea de achiziţie MP150; modulul UIM100C; 1 amplificator ECG100C; 1 amplifiactor PPG100C; 110W/R/B cabluri pentru conectarea amplificatoarelor la electrozii plasaţi pe corp electrozi de unică folosinţă; gel pentru electrozi; 3

• •

MEC110C cablu prelungitor; TSD200 traductor foto-electric.

3.2 Conectarea componentelor hardware:
• se conectează modulele UIM100C, ECG100C, PPG100C la unitatea de achiziţie MP150; • se selectează adresele canalelor pentru amplificatoarele ECG100C şi PPG100C; • se conectează traductorul TSD200 la amplificatorul PPG100. Senzorul trebuie să se afle pe buricul degetului. Traductorul nu trebuie strâns foarte tare pe deget pentru a nu bloca circulaţia sângelui; • se conectează cablurile 110W/R/B/ la amplificatorul ECG100C; • se conectează cablurile 110W/R/B/ la electrozii plasaţi pe corp;

3.3 Conectarea electrozilor:
Electrozii se plasează pe corp astfel încât să se măsoare derivaţia II pentru ECG(conform laboratorului 4).

3.4 Setări software:
• • • din meniu MP150, se alege Set up Channels şi se selectează canalele corespunzătoare adreselor amplificatoarelor; se etichetează canalele cu ECG, respectiv PPG; de asemenea se setează 4 canale de calcul: o C0 - Peak Time pentru canalul A1 (ECG) din opţiunea RATE; o C1 - Peak Time pentru canalul A2 (PPG)din opţiunea RATE; o C2 - Peak Time Delta (C1-C0) din opţiunea MATH; o C3 - Timpul de transmitere al pulsului (maximum C2) din opţiunea RATE. din meniu MP150, se alege Set up Aquisition şi se setează frecvenţa de eşantionare la 1000Hz, iar timpul de achiziţie la 2 minute.



3.5 Achiziţionarea datelor:
Se vor realiza 3 aplicaţii în care se va înregistra ECG si pulsul pletismografic în diferite condiţii: Aplicaţia 1 ‐ subiectul este aşezat relaxat pe un scaun; ‐ se apasă butonul Start, după ce subiectul se află în corespunzătoare, şi se achiziţionează date timp de 15 de secunde; poziţia

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Aplicaţia 2. ‐ ‐ ‐ ‐ subiectul este aşezat relaxat pe un scaun; subiectul introduce mâna pe care NU este plasat nici un electrod / traductor într-un recipient (care nu este metalic) cu apă rece; se apasă butonul Start, după ce subiectul se află în poziţia corespunzătoare, şi se achiziţionează date timp de 30 de secunde; după ce s-a încheiat achiziţia subiectul îşi va usca mâna şi va aştepta 5 minute pentru ca temperatura la nivelul mâinii să revină la normal.

Aplicaţia 3 ‐ subiectul este aşezat relaxat pe un scaun; ‐ subiectul trebuie să ridice mâna pe care este plasat traductorul fotoelectric deasupra capului şi să menţină poziţia fără să se mişte; ‐ se apasă butonul Start, după ce subiectul se află în poziţia corespunzătoare, şi se achiziţionează date timp de 60 de secunde;

3.6 Analiza datelor: A. Date ECG şi Puls de Presiune
a) se setează căsuţele de măsurători astfel Canal ECG ECG PPG PPG PPG Măsurătoare Delta T BPM Delat T BPM P-P

b) se măreşte patru sau cinci cicluri cardiace corespunzătoare Aplicaţiei 1; c) se selectează porţiunea dintre două unde R. Se introduc valorile pentru Delta T şi BPM (canal ECG) în Tabel 6.1. Se repetă măsurătorile pentru încă două cicluri cardiace; d) se selectează porţiunea de semnal dintre două vârfuri succesive ale pulsului din Aplicaţia 1. Se introduc vaolorile Delta T şi BPM (canal PPG) în Tabel 6.1. e) se selecteză un vârf al unui puls individual şi se determină amplitudinea ce se trece în Tabel 6.1; f) se repetă paşii b) - e) pentru Aplicaţia 2 şi respectiv Aplicaţia 3.

B. Calculul vitezei undei de presiune
a) se selectează intervalul dintre un vârf R si vârful pulsului următor. Se introduce valoare Delta T în Tabel 6.2. Acest timp va fi folosit pentru a calcula viteza pulsului de la inimă până la vârful degetului. Unda R aproximeanză sistola ventriculară, adică momentul

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când pulsul a fost generat. Vârful pulsului de presiune înregistrat cu traductorul fotoelectric la nivelul degetului aproximează timpul la care de sosire a undei. b) Cu ajutorul unei rigle se măsoară distanţa de la sternul subiectului la umărul drept şi se trece în Tabel 6.2; c) Se măsoară distanţa de la umărul drept la deget şi se trece în Tabel 6.2; d) Se adună datele de la punctele b) şi c) şi se trec în Tabel 6.2;

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Laborator 6 EIM ELECTROCARDIOGRAMA ŞI ÎNREGISTRAREA PRESIUNII PERIFERICE A SÂNGELUI

Fişă de evaluare

I.

Date şi calcule:
Nume_______________________________ Vărstă______ Sex : M / F Înălţime_______ Greutate______

Profilul subiectului:

A. Tabelul 6.1.
Aplicaţie Măurătoare Delta T BPM Canal ECG ECG PPG PPG PPG ECG ECG PPG PPG PPG ECG ECG PPG Ciclu 1 Ciclu 1 Ciclu 1 Mean

1.

Delta T BPM P-P Delta T BPM

2.

Delta T BPM P-P Delta T

3.

BPM Delta T

7

BPM P-P

PPG PPG

B. Tabelul 6.2.
Distanţa dintre sternul subiectului şi umărul drept Distanţă Distanţa dintre umărul drept şi deget Distanţa totală de la sternul subiectului la deget Timp Viteza Timpul dintre unda R şi următorul vârf al pulsului Viteza=distanţă/time = ..............cm/.................sec cm cm cm sec cm/sec

C. Întrebări 1. Sunt valorile din Tabelul 6.1 ale frecvenţei bătăilor inimii similare cu cele ale frecvenţei pulsului pentru fiecare aplicaţie? Argumentaţi 2. Comparaţi amplitudinea pulsului din Tabelul 6.1 pentru cele trei aplicaţii. Cu cât la sută diferă amplitudinea pulsului din Aplicaţia 2 respectiv 3 faţă de amplitudinea pulsului din Aplicaţia 1? 3. Sunteţi de părere că vitezele undei puls pentru ceilalţi studenţi diferă sau este foarte aproape cu cea măsurată? Argumentaţi 4. Explicaţi schimbările amplitudinii undei puls şi / sau a frecvenţei acesteia atunci când mâna este ridicată deasupra capului. 5. Care este componenta ciclului cardiac ce iniţiază pulsul?

8…...

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...SIGNALS Wireless Signals xxxxxxxx IT/242 xxxxxxxxx xxxxxxxxx Wireless Signals There are many different types of wireless technologies accomplishing a wide variety of solutions as we trend toward a wireless world. The electromagnetic spectrum is being exploited like no other time in history. With so many choices of wireless technologies to discuss, it is difficult to narrow them down to four. The four different types of wireless technologies to be discussed are cellular, satellite, Radio Frequency Identification, and Wireless Fidelity. Cellular communications are rapidly changing as more wireless applications are realized. The potential for cellular use has transcended mere phone communication use as developers delve into other cellular applications. Cellular technology works on the premise of radio communications through lower power base stations known as cells (Brain, Tyson, & Layton). The world has built an extensive and reliable cellular infrastructure and is now midst of significant improvement. With third generation (3G) and forth generation (4G) cellular communication, it is now possible to have mobile broadband technology. Other applications include WAN backup and alarm system transmission. An example of this is the use of 3G backup devices used in all State Farm agencies. This device is connected to the router in lieu of a dial backup. Satellite is another form of wireless technology. This digital signal......

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Wireless Signals

...Individual: Wireless Signals Erwin Pancho IT/242 June 17, 2012 Wireless Signals First of all lets define what a wireless signal is. Wireless internet/technology creates a network by sending radio-frequency signals between your computers to share information. This allows wireless networking technology to happen without the use of wires and makes it easier for other computers on the same network to communicate with one another. In wireless networking, a peer-to-peer or in other words point-to-point wireless network means that each computer can communicate with every other computer on that same network. Wireless networks that use client/servers have an access point. An access point is a wired controller that receives and transmits data to the wireless adapters installed in each of the computers. There are four main types of wireless technologies which include but not limited too are Bluetooth, IrDA, HomeRF, and Wi-Fi (wireless Fidelity). Bluetooth wireless technology allows users to enable links between their mobile computers, mobile phones, portable handheld devices, and Internet connectivity, which require no wires to be involved or that is needed. It is mostly used for devices such as cell phones, PDAs, wireless headsets, computer hardware, headphones, MP3 players, etc. Bluetooth technology is supported by application and product development in a broad range of market subdivisions, which include software......

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...Wireless Signals June 29, 2011 IT242 Wireless Signals There are four different types of wireless signals in the spectrum. These are radio signals, microwave, satellite, and infrared signals. Each of these types has their proper uses as well as limitations. Radio frequencies include VHF, UHF, and shortwave radio. These are used to get a station on your car radio or to tune into a television station. Limitations of radio frequencies include distance degradation compared to bandwidth space in low frequencies. High frequencies tend to need a direct line-of-sight to get a good signal. Electrical equipment can interfere with all frequencies of radio signals. Microwave signals use electromagnetic energy to send signals at a higher frequency than radio. These signals are used in telecommunication, WIFI, and Bluetooth technology. As with radio communication, microwaves are also susceptible to interference from other electrical equipment. Satellite signals are relatable to microwave transmissions. A satellite is in orbit that sends and receives signals to receivers. The most common use for people are television, internet, and mobile telephone services. A major limitation that I run into is stability. When a storm comes through we can loose our signal due to line-of-sight issues. The final wireless transfer style is Infrared. IR systems use light to send signals. This type is used in remote controls, Palm devices, and laptops. The......

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