Gwangju Institute of Science and Technology Lecture 8 PDF

Lecture 8 (10/8/2024) Diagnostic Devices: Part Three Digestive System and Sensory Organs Introduction to Medical Engineering Euiheon Chung [email protected] , X 2735 Department of BioMedical Science and Engineering Gwangju Institute of Sciences and Technology Co...

Lecture 8 (10/8/2024) Diagnostic Devices: Part Three Digestive System and Sensory Organs Introduction to Medical Engineering Euiheon Chung [email protected] , X 2735 Department of BioMedical Science and Engineering Gwangju Institute of Sciences and Technology Copyright. Most figures/tables/texts in this lecture are from the textbook “Introduction to Biomedical Engineering Technology by Laurence Street 2016” and this material is only for those who take this class and cannot be distributed to anyone without the permission from the lecturer.  Prelude REF ONLY Blood flow through the capillary bed: https://www.youtube.com/ watch?v=4yBMY9Wj7z0 Capillary Blood Flow in Frog Web https://www.youtube.com/ watch?v=pwmlP1hLJf0 Blood Thur Veins2 Microscopy blood circulating flowing capillaries corpuscles vessel Fig. 7. Various capillaries from guinea-pig muscle. (Vita injection.) https://www.youtube.com/ watch?v=wu01vlf4ORM August Krogh - Nobel Lecture (December 11, 1920) 2  Reversible Control of Microvascular Flow by Optogenetic Stimulation of Pericytes Photostimulation of Pericytes and Reversible Capillary Stall Stimulation (1040 nm): 100 ms at 300 mW, Vascular imaging: Cy5.5-dextran (1250nm) Reversible capillary stalling achieved with a single pulse stimulation on to a pericyte  Optogenetic stimulation of a pericyte body in a capillary network for microvascular occlusion FOV: (164 um)2 optogenetic stimulation blood plasma pericytes Stimulation at 1040 nm: 30 mW for 100 ms with duty cycle of 50% until stalling occurs A single capillary can be temporarily occluded by optogenetic stimulation of a neighboring pericyte in the cerebral microvascular network  Contents DIGESTIVE SYSTEM (Endoscopes) Types of Endoscopes Components of Endoscope System SENSORY ORGANS Oto/Laryngo/Ophalmoloscopes REPRODUCTION SKIN, BONE, MUSCLE, AND MISCELLANEOUS Acknowledgment: Dr. Ibrhim AlMohimeed’s slides from http://slideplayer.com/slide/4492154/ 5 Endoscope: A Key Tool for Minimally Invasive Procedures Endoscopic Surgery Endoscope Equipment Setup Flexible Endoscope Tube with Light Source in Action Meaning: endo+scopy, “looking inside” from Greek Definition: an optical, tubular instrument used to examine the interior of a hollow organ or cavity of The insertion tip of an the inside body endoscope https://en.wikipedia.org/wiki/Endoscope 6  Basic Terminology: Proximal vs. Distal Understanding Relative Position in Anatomy Proximal: Toward the point of attachment to the body Distal: Away from the point of attachment to the body Example: In surgical procedures, such as joint replacements, surgeons must work with the proximal and distal ends of bones to secure implants. * distal: 말초(말단)의, proximal: 기부(基部)에 가까운, 근칭의 7  Types of Endoscopes: Rigid Type (Part 1 – Components) Components of rigid endoscope (경성내시경): A stainless-steel tube: Provides structural integrity and rigidity to the endoscope. Fiber-optics: Transmits light to illuminate the area being examined. A series of lenses: Focus and transmit the visual image from the inside of the body to the external eyepiece or camera. One or more open passages: Allows for the insertion of other instruments for surgeries or biopsies. http://vet.uga.edu/mis/exotics/equipment/rigid.php 8  Types of Endoscopes: Rigid Type (Part 2 – Functional Components) Distal End Section: An objective lens (대물렌즈): Captures and focuses the image from the observation site. Telescope Section: Lenses separated by spacers Open Passage in the Scope Section: Irrigation (세척) and suction of the observation site Entry of special tools: excising (절개) tissue or cauterizing (소작) bleeding structures https://www.aviva.co.uk/health-insurance/home-of-health/medical-centre/medical-encyclopedia/entry/procedure-rigid-endoscopy/ 9  Types of Endoscopes: Flexible Type (Part 1 – Structural Components) Flexible endoscope (연성내시경): Light guide tube: Transmits light to the observation site. Bending section: Enables flexibility to navigate through curved anatomy (e.g., GI tract) Control body: Manages the movement of the bending section and operation of instruments. (https://www.educationaldimensions.com/eLearn/endoscope/bigScope.html) 10  Types of Endoscopes: Flexible Type (Part 2 – Functionality and Distal End Anatomy) Both illumination and visualization are achieved through fiber- optics, allowing for the transmission of light and image capture from the distal tip to the control body. Special mechanisms allow for precise manipulation of the bending section at the distal end, enabling navigation through the body’s curved pathways (e.g., colon, esophagus) Distal end of an endoscope: Light: Provides illumination to the observation site. Viewing: Transmits the image back to the eyepiece or video system. Irrigation: Allows for the cleaning of the observation area. Insuf lation: Supplies air or gas to in late organs like the colon for better visibility. Suction: Removes luid or debris from the observation site. 11 f f f  Endoscope Types based on Applications (Part 1 – Greek Etymology) Bronchoscope: Greek bronkh- meaning ‘windpipe (기관지),’ used for examining the airways and lungs. Gastroscope: Greek gaster meaning ‘stomach (위),’ for examining the stomach and upper gastrointestinal tract. Thorascope: Greek thōrax meaning ‘chest (흉곽),’used for examining the pleural cavity or thoracic region. Laparoscope: Greek lapara meaning ‘flank’ or ‘side (복부, 옆구 리),’ typically used for abdominal surgeries and diagnostic procedures. Arthroscope: Greek arthron meaning ‘joint (관절),’ used for examining and treating joint conditions. 12  Endoscope Types based on Applications (Part 2 – Greek Etymology) Colonoscope: Greek kōlon meaning ‘colon,’ used to examine the entire large intestine (결장(結腸)). Sigmoidoscope: Greek from sigma, referring to the sigmoid colon (S상 결장(結腸)), used for examining the lower part of the colon. Colposcope: Greek kolpos ‘womb or uterus (자궁),’ used for examining the cervix. Cystoscope: Greek kustis ‘bladder (방광),’ used for examining the bladder and urethra.’ proctoscope: Greek prōktos ‘anus (항문),’ used to examine the rectum and anus 13  Bronchoscope (기관지경): A Procedure for Visualizing the Bronchi A exible, ber-optic cable inserted into the windpipe (trachea) to visualize the bronchi for diagnostic or therapeutic purposes Indications: Why a bronchoscopy is performed? (e.g., to diagnose lung diseases, investigate persistent coughs, or take tissue samples). Risks: Potential risks involved in the procedure? (e.g., bleeding, infection, or discomfort). Illustration of a bronchoscopy procedure, showing the insertion of the bronchoscope through the trachea and into the bronchi for visualization of the airways. 14 http://www.qmedicine.co.in/top%20health%20topics/B/Bronchoscopy.html) fl fi  Thoracoscope (흉강경): A Minimally Invasive Procedure for Examining the Pleural and Thoracic Cavity Thoracoscopy is a minimally invasive medical procedure used to examine, biopsy, or remove diseased tissues or masses from the pleural (흉막강) and thoracic (흉강) cavities. VATS (video-assisted thoracoscopic surgery) Indications: Conditions that might require thoracoscopy, such as lung cancer or pleural effusion. Risks: Potential risks of thoracoscopy, such as bleeding, infection, or lung injury. Illustration of a thoracoscopy procedure, showing the insertion of the thoracoscope into the pleural cavity for biopsy http://www.peggerrity.com/ngg_tag/peggerrity-com/nggallery/page/3/slideshow 15 Thoracoscopy with lung resection https://www.youtube.com/watch?v=Lfhk90dRI9Q 16  Laparoscope (복강경腹腔鏡): A Minimally Invasive Procedure for Abdominal and Pelvic Examination Laparoscopy is a minimally invasive surgery that uses a thin, lighted tube inserted through a small incision in the abdomen to examine abdominal organs or the female pelvic organs Indications: For diagnosis or treatment of conditions like endometriosis (자궁내막증), appendicitis, or pelvic inflammatory disease. Risks: Infection, bleeding, or injury to surrounding organs. Illustration of a laparoscopic procedure showing the insertion of the laparoscope and surgical tools into the abdomen https://www.mskcc.org/cancer-care/patient-education/laparoscopy 17  Arthroscope (관절경): A Minimally Invasive Procedure for Joint Inspection and Surgery An instrument through used to inspect, diagnose, and treat joint issues through a minimally invasive procedure. Indications: cartilage Arthroscopy for repairing torn meniscus, removing loose cartilage, or diagnosing joint pain. Risks: Infection, bleeding, or injury to surrounding organs. Lateral meniscus 〔해부〕 반월판(半月瓣) located between thigh bone (femur 대퇴 골, above) and shin bone 정강이 뼈(tibia 경 골, below). An arthroscopic procedure in the knee joint, showing The tibial cartilage 연골 displays a ssure the insertion of instruments and the arthroscope for 균열 (tip of teaser instrument) inspection and repair. http://www.mendmyknee.com/knee-pain/knee-surgery-rehabilitation.php) Wikipedia 18 fi  Colonoscope (결장경結腸鏡): A Procedure for Examining the Large Intestine (Part 1) a flexible fiber-optic instrument inserted through the anus in order to examine the colon, helping to detect abnormalities such as polyps, inflammation, or cancer. Indications: Colonoscopy is often used to screen for colorectal cancer, investigate symptoms like abdominal pain, or remove polyps. Preparation: Patients must undergo bowel preparation to clear the intestines for better visibility during the procedure. Illustration showing the insertion of a colonoscope through the rectum to examine the large intestine https://www.niddk.nih.gov/health-information/diagnostic-tests/colonoscopy) 19  Colonoscope (결장경結腸鏡): Techniques and Anatomy (Part 2) Colonoscopy involves not only examining the colon but also the removal of abnormal growths, such as polyps, using techniques like snare polypectomy * snare: 덫, 올가미 Snare polypectomy is a common procedure used during colonoscopy to remove polyps from the colon wall Large intestine with path of colonoscope as it moves through the rectum and colon Indications: Colonoscopy with polypectomy is recommended for screening for colon cancer and removing pre-cancerous polyps. Risks: Risks of polypectomy include bleeding, perforation, or infection, although these are rare. 20 https://thecolorectalcenter.com/for-patients/colonoscopy/  Sigmoidoscope (S상 결장경): A Diagnostic Tool for Examining the Sigmoid Colon examination of the sigmoid colon by means of a flexible tube inserted through the anus. Indications: Sigmoidoscopy is used to screen for colorectal cancer, detect polyps, or investigate rectal bleeding and other symptoms. The sigmoidoscope contains a camera lens for visualizing the colon, an instrument channel for biopsies or polyp removal, irrigation for cleaning, and a light source to illuminate the area Endoscopic view of the sigmoid colon showing the interior lining of the colon Illustration of a sigmoidoscope examining the sigmoid colon, showing the exible tube and the camera lens http://www.hopkinsmedicine.org/gastroenterology_hepatology/clinical_services/basic_endoscopy/ exible_sigmoidoscopy.html) 21 fl fl  Colposcope (질(확대)경): A Diagnostic Tool for Examining the Cervix and Vagina A colposcope is a diagnostic instrument used to magnify and examine the cervix, vagina, and vulva for signs of disease or abnormalities Indications: Colposcopy is typically recommended after an abnormal Pap test result or to investigate symptoms like unusual bleeding. Biopsy: During a colposcopy, if any abnormal areas are seen, a The colposcope is positioned outside the vagina, providing biopsy may be taken for a magni ed view of the cervix without making contact further analysis. https://www.webmd.com/cancer/cervical-cancer/abnormal-pap-and-colposcopy) 22 fi  Cystoscope (방광경): A Tool for Examining the Urinary Bladder A cystoscope is a thin instrument inserted into the urethra to examine the interior of the bladder for abnormalities such as tumors, stones, or inflammation Rigid cystoscope Flexible cystoscope Indications: Cystoscopy is used to diagnose bladder conditions such as bladder cancer, stones, or infections. Preparation: Patients are typically instructed to empty their bladder before the procedure and may receive local or general Illustration showing the insertion of a anesthesia depending on the type of cystoscope into the bladder through the cystoscope used. urethra for internal examination https://www.netterimages.com/cystoscopy-cystoscope-design-unlabeled-urology-frank-h-netter-64734.html https://www.scripps.org/articles/1969-cystoscopy 23  Proctoscope (직장경直腸鏡): A Tool for Examining the Rectum and Lower Anus a medical instrument with a built-in light used to examine the rectum and lower part of the anus for abnormalities, such as hemorrhoids, polyps, or in ammation Indications: Proctoscopy is used to diagnose hemorrhoids (치질, 치핵), rectal bleeding, and other conditions of the lower rectum. Comparison: The proctoscope is longer than an anoscope, which only examines the anus, and shorter than a rectoscope, Comparison of different scopes used in rectal examinations, which is used to examine including the anoscope, proctoscope, and rectoscope, varying in higher up in the rectum and length and application sigmoid colon. https://en.wikipedia.org/wiki/Proctoscopy) https://www.youtube.com/watch?v=8aM_STIxhE0 24 fl  Summary DIGESTIVE SYSTEM (Endoscopes) Types of Endoscopes Components of Endoscope System SENSORY ORGANS Oto/Laryngo/Ophalmoloscopes REPRODUCTION SKIN, BONE, MUSCLE, AND MISCELLANEOUS 25