Instrumentasi

medis
& Teknologi
Kedokteran
Dr. Alfian Hasbi
Dr. Budi Santoso
Bagian Fisiologi-Fisika Medik FK Unsri

Diagnosis

The interdependence of our organ

systems can sometimes make it difficult to
pinpoint the source of a medical problem.

Diagnosis

The interdependence of our organ

systems can sometimes make it difficult to
pinpoint the source of a medical problem.
Doctors are trained to look for symptoms
that are characteristic of specific
problems.

Diagnosis

The interdependence of our organ

systems can sometimes make it difficult to
pinpoint the source of a medical problem.
Doctors are trained to look for symptoms
that are characteristic of specific
problems (e.g. swollen lymph nodes are a
symptom of infection).

Tools of the Trade

To collect information about whats
going on inside the body, doctors
may use devices like the
stethoscope (to listen to the heart
and lungs)

Tools of the Trade

To collect information about whats
going on inside the body, doctors
may use devices like the
stethoscope (to listen to the heart
and lungs) and a
sphygmomanometer (to measure
blood pressure).

Tests of the Trade

Doctors may also order tests of
material collected from the body
(such as blood and urine) which may
be analyzed by a separate lab.

Tests of the Trade

Doctors may also order tests of
material collected from the body
(such as blood and urine) which may
be analyzed by a separate lab.
E.g. Blood may be tested to determine the
levels of red blood cells, white blood cells,
sugar, and hormones the chemicals that
carry messages through the body to
regulate the functioning of organs.

Medical Imaging
Technologies
Diagnostic imaging tests can provide
doctors with even more information:
an actual visual picture of the
structure and functioning of organs.
However, these technologies are often
expensive, and the effectiveness of
each technology is limited by its
properties.

Endoscopy
An endoscope is a thin, flexible tube
that has a bright light and a video
camera that can be used to image
the digestive tract, as in a
colonoscopy.

Endoscopy
An endoscope is a thin, flexible tube
that has a bright light and a video
camera that can be used to image
the digestive tract, as in a
colonoscopy.

Thermography
In thermograms, infrared light
cameras are used to diagnose
problems with circulation.
Normal

Raynauds syndrome

X-Rays
X-rays are high-energy
electromagnetic radiation that can
easily penetrate soft tissues but
cannot easily penetrate bone.

X-Rays
X-rays are used to check for cancers
(e.g. mammograms), to diagnose
problems in the circulatory and
respiratory systems, and to check for
broken bones.
They are quick, painless, and noninvasive but exposure to x-rays can
damage cells and increases cancer
risk.

Body Scanners
Note that this is also true for the body
scanners that are used at airports,
especially the new naked body
scanners.

Body Scanners
Since the radiation emitted by these
body scanners is absorbed at the
level of the skin, it is your skin
cancer risk that is most increased
and the scans cannot find anything
concealed in any body cavity.

Body Scanners
Since the radiation emitted by these
body scanners is absorbed at the
level of the skin, it is your skin
cancer risk that is most increased
and the scans cannot find anything
concealed in any body cavity.
Also, like most x-rays, they do not
show contrast that may be used to
identify soft materials (like plastics
and chemical explosives).

Body Scanners
Since the radiation emitted by these
body scanners is absorbed at the
level of the skin, it is your skin
cancer risk that is most increased
and the scans cannot find anything
concealed in any body cavity.
Also, like most x-rays, they do not
show contrast that may be used to
identify soft materials (like plastics
and chemical explosives).

PRINSIP KERJA X RAY

MACHINE
X-Ray

seperti

dengan

cahaya

biasa

yang

merupakan

gelombang elektromagnetik, tetapi X-Ray memiliki energy

yang lebih besar

yang dapat menembus banyak bahan/

material pada kadar yang berbeda. Ketika sinar X menumbuk

film, sinar X akan terhambur seperti

yang terjadi pada

cahaya biasa. Tulang, Lemak, otot , tumor dan semua benda

yang

menyerap

X- Ray pada level yang berbeda-beda,

gambar pada film menampakkan perbedaan struktur-struktur

di

dalam

tubuh

karena

dihamburkan oleh film.

perbedaan

level-level

yang

Prinsip Kerja ( Cont )

Mesin

Ray
bekerja
dengan
mengaplikasikan pengontrolan tegangan
dan arus listrik ke tabung X-Ray, yang
menghasilkan sinar X-Ray. Sinar ini
diproyeksikan ke bahan . Beberapa sinar Xray akan melewati objek, sementara
beberapa diserap. Pola radiasi yang
dihasilkan kemudian akhirnya
dideteksi
oleh media pendeteksi
termasuk layar
rare earth ( sekeliling fotografi film ),
detector semikonduktor atau X-Ray image.

 Gambar yang dihasilkan oleh X-Ray machine pada

bidang kedokteran berdasarkan perbedaan tingkat

penyerapan dari organ-organ. Kalsium pada tulang
menyerap sinar X paling banyak, sehingga tulang
kelihatan putih pada sebuah film perekam

dari

gambar X-Ray, yang disebut Radiograph. Lemak dan

beberapa organ lembut lainnya menyerap lebih sedikit
dan tampak abu-abu. Udara menyerap paling sedikit
sehingga paru-paru terlihat hitam pada radiograph.

PERANGKAT-PERANGKAT
Sistem X-Ray imaging terdiri atas sebuah
sumber atau generator X-Ray dan system
pendeteksian gambar yang dapat digunakan
film ( teknologi analog ) atau pada system
penangkapan digital (seperti penyimpanan
foto dan komunikasi system).

APPLIKASI
X Ray Machine dipakai pada Aplikasi

kedokteran dan kesehatan, contohnya :

Pada bidang sekurity contohnya pada security

bandara

Computed Tomography
Computed
tomography (CT)
scans, also called
computer-assisted
tomography (CAT)
scans, use x-rays to
produce images at
different angles
through the body so
that a 3D image can

Computed Tomography
CT scans may be used to diagnose
cancers, skeletal abnormalities and
vascular diseases (affecting blood
vessels).
But since CT scans use x-rays, they
also increase your cancer risk.

Fluoroscopy
Fluoroscopy is a technique in which a
continuous beam of x-rays is used to
produce moving images.
It is used to show movement in the
digestive system (which may require
ingestion of a high-contrast liquid
such as barium) and the circulatory
system (angiograms).

Ultrasound
Ultrasound is high-frequency sound
waves produced by a device called a
transducer that are reflected back to
the transducer by internal body
structures.

Ultrasound
Ultrasound is high-frequency sound
waves produced by a device called a
transducer that are reflected back to
the transducer by internal body
structures.

Ultrasound
Ultrasound is used to study soft
tissues and organs, especially the
heart (echocardiograms) and
especially during pregnancy.
Because the presence of gas can
distort images, ultrasound is not
often used for imaging the
respiratory or digestive systems.

Magnetic Resonance
Imaging (MRI)
Magnetic Resonance Imaging (MRI) is
a technique that uses strong
magnets and radio waves that
interact with the hydrogen atoms in
your body (esp. in water). A
computer is used to construct an
image from the signal received from
the atoms.

Magnetic Resonance
Imaging (MRI)
MRI is used to image the structure
and function of the brain, heart, soft
tissue, and the inside of bones; to
diagnose cancers, brain diseases,
and problems with the circulatory
system.
But it is also extremely expensive and
the availability of
machines/technicians is limited.

Positron Emission
Tomography (PET)
PET scans are a type of nuclear
medicine is which a patient is given
a radioisotope that emits positron
radiation; the radioisotope is
attached to a chemical absorbed by
certain tissues or organs.
It is used to detect cancers,
heart disease,
and some brain disorders
(such as Alzheimers).

Diagnostic tools
Personal Health monitoring in the home:
Blood pressure, pulse, temperature, glucose

Home diagnostic challenges

Clearly, these systems need to be reliable,
accurate, and secure (beware wireless links).
The inference done on this data needs to be robust
as well, minimizing false positives and negatives.
Many simple tests today (e.g. blood pressure)
require non-trivial skill the accuracy reports by
customers are wildly different suggesting there is
a big range in skill.
Usability of home medical tests is going to be a big
issue for the foreseeable future.

In-vivo diagnostics
Some types of monitoring, e.g. glucose monitoring
for diabetes, must be invasive.
But tiny implanted sensors are a new option.
E.g. the Grimes group at Penn State builds
magneto-elastic sensors that measure glucose
levels under the skin.
Other groups, e.g. Intel Seattle, are working on
modified RFID tags that produce a few bits of
sensing (WISPs).

Diagnostic tools
Activity accelerometers, pedometers, heart rate
and GPS
e.g. Suuntos T6, Footpod and X9i

Fitsense pacer and bodylan

Diet
A few university projects have looked at estimating
caloric input using sensed data:
Jen Mankoff at UCB: used PDAs to scan receipts
Kay Connelly at Indiana: used
product barcodes
The goal is to guide users
toward better dietary choices.

Telemedicine
Telemedicine is an attractive alternative to visits to
the hospital or doctors surgery.
Telemedicine typically involves teleconferencing in
conjunction with some remote diagnosis sensors.
It can also support continuous patient monitoring.
e.g. the Health Buddy:

Telemedicine Health Buddy

http://www.healthhero.com/products_services/health_buddy_demo.h
tml

Medical Monitoring

Figure2 Wireless Body Area Network of Intelligent Sensors for Patient Monitoring
taken from [5]
41

Medical Monitoring

The figure below illustrates an example of

information flow in an integrated WBAN
system.

Figure 3 taken from [5]

42

Medical Monitoring

An example of a WBAN activity sensor worn on a persons

ankle with symbolic representation of acceleration
components is depicted below.

Figure 4 taken from [5]

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Medical Monitoring

CodeBlue [6] which is a wireless infrastructure intended to

provide common protocol and software framework in a disaster
response scenario.
Architecture developed at Harvard University which allows
wireless monitoring and tracking of patients and first
responders.
This system integrates low-power wireless wearable vital sign
sensors, handheld computers and location tracking tags.
CodeBlue software framework provides protocols for:

Resource naming and discovery;

Publish/subscribe multi-hop routing
Authentication and encryption provisions
Credential establishment and handoff
Location tracking
In-network filtering and aggregation of sensor-produced data.

A simple query interface allows emergency medical technicians

to request data from groups of patients
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Medical Monitoring

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Remote Surgery

The SOCRATESTM [12 ]links both sites with a PolyCom FX: PolyCom FX has four
ISDN lines with 512 kilo-bits per second (Kbps). The PolyCom FX was chosen
because it independently bridges up to four sites, and has the capability to
utilize H.320 (i.e., ISDN or T-1 lines) or H.323 (i.e., internet) protocols.
This helps each site provide video teleconferencing over the internet, which
would be of great value if any of these sites decide to implement an intranetbased video teleconferencing system within their institutions. It is also
supported for mobile use and PolyCom Viewstations.

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Instrumen Bedah

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