Lecture – 1
أ ,م /عباس هادي حميدي الشكراوي – جامعة اوروك
إن األجهزة الطبية ضرورية للوقاية والتشخيص وعالج وتأهيل المرضى بعد اإلصابة باألمراض
Medical Instruments and Tools
بمأمونية وفعالية .وتحقيق المرامي اإلنمائية ذات العالقة بالصحة بما في ذلك األهداف اإلنمائية لأللفية
يعتمد على التصنيع والتنظيم والتخطيط والتقييم والحيازة واإلدارة واالستعمال السليم لألجهزة الطبية
الجيدة والمأمونة والمتوافقة مع المرافق التي تستخدم فيها وعلى النحو المبين في قرار جمعية الصحة
في إدارة ) (DIMالعالمية ج ص ع 29-60فإن فريق التصوير التشخيصي واألجهزة الطبية
في منظمة الصحة العالمية يسعى إلى ضمان تحسين إتاحة ) (EHTالتكنولوجيات الصحية األساسية
وجودة واستخدام أجهزة طبية مأمونة ومناسبة بما يتمشى مع إصالح نظام الرعاية الصحية األولية الذي
يشمل صياغة التكنولوجيا الصحية )" (GIHTإن "مشروع المبادرة العالمية للتكنولوجيات الصحية
وأدوات إدارتها واختيار التكنولوجيا االبتكارية وكذلك مشروع أولويات األجهزة الطبية واالستبيان
المتعلق بوضع األجهزة الطبية في الدول تمثل احدى االستراتيجيات الرئيسية .
1- Stethoscope:
The stethoscope ( Fig. 1 ) is an acoustic medical device for auscultation, or listening
to the internal sounds of an animal or human body. It typically has a small disc -
shaped resonator that is placed against the chest, and two tubes connected to
earpieces. It is often used to listen to lung and heart sounds. It is also used to listen
to intestines and blood flow in arteries and veins. In combination with
a sphygmomanometer, it is commonly used for measurements of blood pressure.
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Fig.-1 Medical Stethoscope.
2- Sphygmomanometer:
A sphygmomanometer, also known as a blood pressure meter, blood pressure
monitor, or blood pressure gauge, is a device used to measure blood pressure,
composed of an inflatable cuff to collapse and then release the artery under the
cuff in a controlled manner and a mercury or mechanical manometer to measure
the pressure. It is always used in conjunction with a means to determine at what
pressure blood flow is just starting, and at what pressure it is unimpeded.
Manual sphygmomanometers are used in conjunction with a stethoscope.
A sphygmomanometer consists of an inflatable cuff , a measuring unit (the mercury
manometer, or aneroid gauge), and a mechanism for inflation which may be a
manually operated bulb and valve or a pump operated electrically.
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Types of Sphygmomanometer:
1-Manual:
1.1 - Mercury sphygmomanometers ( Fig.- 2 ) are considered the gold
standard.
Fig.- 2 Mercury Sphygmomanometer.
1,2- Aneroid sphygmomanometers (mechanical types with a dial) ( Fig.3 & 4 )
are in common use; they may require calibration checks, unlike mercury
manometers. Aneroid sphygmomanometers are considered safer than mercury
sphygmomanometers, although inexpensive ones are less accurate.
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Fig.-3 Aneroid sphygmomanometer with an adult cuff.
Fig.- 4Aneroid sphygmomanometer dial, bulb, and air valve.
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2-Digital:
Digital sphygmomanometer : They use manual or automatic inflation, but both types
are electronic, easy to operate without training, and can be used in noisy
environments. They measure systolic and diastolic pressures by oscillometric
detection, employing either deformable membranes that are measured using
differential capacitance, or differential piezoresistance, and they include
a microprocessor. They accurately measure mean blood pressure and pulse rate,
while systolic and diastolic pressures are obtained less accurately than with manual
meters. Digital instruments use a cuff placed of around the upper arm, the wrist, or a
finger.
Fig.- 5 Electronic sphygmomanometer.
Operation : With a manual instrument , listening with a stethoscope to
the brachial artery at the elbow, the examiner slowly releases the pressure in the
cuff. As the pressure in the cuffs falls, a "whooshing" or pounding sound is heard
when blood flow first starts again in the artery. The pressure at which this sound
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began is noted and recorded as the systolic blood pressure . The cuff
pressure is further released until the sound can no longer be heard. This is recorded as
the diastolic blood pressure.
3-Medical Syringe:
A syringe ( Fig.-6& 7 ) is a simple reciprocating pump consisting of
a plunger (a piston) that fits tightly within a graduated cylindrical tube called
a barrel . The plunger can be linearly pulled and pushed along the inside of the tube,
allowing the syringe to take in and expel liquid or gas through a discharge orifice at
the front (open) end of the tube.
Fig.- 6 Sterilized Medical Syringe.
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Fig.- 7 Components of a Medical Syringe
4-Medical Thermometers
A medical thermometer is used for measuring human or animal body temperature.
The tip of the thermometer is inserted into the mouth under the tongue (oral or sub-
lingual temperature), under the armpit (axillary temperature), or into the rectum via
the anus (rectal temperature).
Types of Thermometers:
4,1- Mercury thermometer as seen in figure- 8 is a capillary glass tube with
a bulb at one end containing a liquid such as mercury which expands in a uniform
manner with temperature. The tube itself is narrow (capillary) and has calibration
markings along it. The liquid is often mercury, but alcohol thermometers use a
colored alcohol. Medically, a maximum thermometer is often used, which indicates
the maximum temperature reached even after it is removed from the body.
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Fig.- 8 Mercury thermometers.
4,2-Acohol thermometers use a colored alcohol are used mainly in laboratory
experiments (fig- 9).
Fig, - 9 Alcohol thermometers.
4,3-Electronic or digital thermometers:
Since compact and inexpensive methods of measuring and displaying temperature
became available, electronic thermometers (often called digital, because they display
numeric values) have been used. Many display readings to great precision (0.1 °C or
0.2 °F ) .
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4,3,1 - Resistance temperature detectors (RTDs):
RTDs are wire windings or thin film serpentines that exhibit changes in resistance
with changes in temperature. They measure temperature using the positive
temperature coefficient of electrical resistance of metals. The hotter they become, the
higher the value of their electrical resistance. Platinum is the most commonly used
material because it is nearly linear over a wide range of temperatures, is very accurate,
and has a fast response time. RTDs can also be made of copper or nickel.
4,3,2 – Thermocouples thermometers:
Thermocouples are accurate, highly sensitive to small temperature changes, and quickly
respond to changes to the environment. They consist of a pair of dissimilar metal wires
joined at one end, they work according to the following principles.
4,3,3 – Thermistor thermometers:
Thermistor elements are the most sensitive temperature sensors available. A
thermistor is a semiconductor device with an electrical resistance that is proportional
to temperature.
4,3,4 - Contact thermometers: Some electronic thermometers work by contact
(the electronic sensor is placed in the location where temperature is to be measured,
and left long enough to reach equilibrium.
4,3,5- Remotely controlled thermometers : Other electronic thermometers
work by remote sensing: an infrared sensor responds to the radiation spectrum emitted
from the location.
Fig.-10 Digital thermometers.
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Figure – 11 Digital temperatures with monitor probe.
Fig.- 12 BC-DQ02 Smart Medical Thermometer Bluetooth 4.0 Wireless 24HR
Continuous Fever Monitoring with Mobile Alerts for Baby.
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4 , 4 – Liquid crystal thermometer , it is a type of thermometer that contains
heat-sensitive (thermo chromic) liquid crystals in a plastic strip that change color
to indicate different temperatures as seen in fig.- 13.
Fig.- 13 Liquid Crystal Forehead Thermometer
Diabetes Test Strips
These are small disposable strips of plastic may look insignificant but they provide a
very important role in helping people with diabetes to monitor and control their
diabetes.
How does diabetes test strip work?
When blood is placed onto the test strip, it reacts with a chemical called glucose oxidase
producing gluconic acid from the glucose in the blood. At the other end of the test strip, the meter
transfers a current to the test strip. The test strip has electric terminals which allow the meter to
measure the current between the terminals.
The current between the terminals changes depending on the level of gluconic acid that has been
produced. The blood glucose meter then uses an algorithm to work out the blood glucose level
based upon the difference in current.
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Fig.- 14 Portable glucose meter.
Hemoglobin Test Strips
The Hemoglobin Test Strips, Hb (Whole Blood) are firm plastic strips onto which a
multilayer dry reagent is affixed and are intended to be read on Hb Hemoglobin
Meter. The test strips function by lysing erythrocytes and converting the released
hemoglobin into methemoglobin. This test is for the quantitative determination of
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hemoglobin (Hb) and calculated hematocrit (Hct) in capillary and venous whole
blood. The test strips are for professional use only.
Hemoglobin is the main component of red blood cells whose main function is to
transport oxygen. The determination of hemoglobin concentration in whole blood is
useful in the clinical diagnosis of diseases such as anemia and polycythemia. The
measurement range of the Hb Hemoglobin Testing System is 5 – 25.6 g/dL.
Erythrocytes in the specimen are lysed to release hemoglobin. The hemoglobin is
converted to methemoglobin. The intensity of the color produced from this reaction is
proportional to the hemoglobin concentration. Reference values are listed in table-1
Table-1 Reference values of hemoglobin men, women and children.
13.0 – 17.0 g/dL (130 – 170
Men
g/L, 8.1 – 10.5 mmol/L)
12.0 – 15.0 g/dL (120 – 150
Women
g/L, 7.4 – 9.3 mmol/L)
11.0 – 14.0 g/dL (110 – 140
Children
g/L, 6.8 – 8.7 mmol/L)
Fig. - 15 Hb test strips.
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Fig.- 16 Hb meter with Hb test strips.
Urine test strip
A urine test strip or dipstick test is a basic diagnostic tool used to
determine pathological changes in a patient’s urine in standard urinalysis.
A standard urine test strip may comprise up to 10 different chemical pads
or reagents which react (change color) when immersed in, and then removed from,
a urine sample. The test can often be read in as little as 60 to 120 seconds or more
after dipping in urine sample. Routine testing of the urine with urine strips is the first
step in the diagnosis of a wide range of diseases such as presence
of proteins, glucose, ketones, haemoglobin, bilirubin, urobilinogen, acetone, nitrit
e and leucocytes as well as testing of pH and specific gravity or to test for infection
by different pathogens.
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Fig.- 15 urine test strips.
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