Pressure-balanced telemetric pressure sensing method

• US 4,206,761 A
• Filed: 04/13/1978
• Issued: 06/10/1980
• Est. Priority Date: 06/21/1976
• Status: Expired due to Term

• Current Assignee: Radionics, Inc. (Integra LifeSciences Holdings Corporation)
• Original Assignee: Eric R. Cosman
• Inventors: Cosman, Eric R.
• Primary Examiner(s): Howell, Kyle L.
• Application Number:
  US05/895,955
• Time in Patent Office: 789 Days
• Field of Search: 128/673, 128/675, 128/748, 128/660, 73/701, 73/708, 73/716-719, 73/722
• US Class Current: 600/438
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/031 Intracranial pressure
• CPC Class Codes: A61M 27/006 Cerebrospinal drainage; Accessories therefor, e.g. valves

Abstract

A differential pressure sensing device is fully implanted in the body of a patient to monitor internal pressure such as intracranial pressure. A movable element in the sensor communicates on one side with the internal pressure to be measured and on the other side with an external pressure which is applied by an external pressurizer-control system and which is communicated to the sensor through the intact skin. An imbalance of the two opposing pressures causes a displacement of the movable element which changes a physical characteristic of the sensor, such as the resonant frequency of a tuned L-C circuit. This change is detected outside the body by an external detection system, such as a frequency swept radio frequency oscillator. The external pressure is varied until the external detector senses that the pressures are balanced on the movable element, at which point the external pressure equals the internal pressure, and the former is measured and read out.

Claims

1. A method for measuring an in vivo pressure, said method comprising the steps of:

(a) implanting in a living body a differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in

pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in

pressure communication with an external variable pressure from a controllable pressure source external to said living body

and is in mechanical pressure communication with the interior side of a portion of skin whereby the motion of said flexible diaphragm means is responsive to the changes in the difference in said internal bodily pressure and said external variable pressure and the pressure sensor is compensated for atmospheric pressure that is external to the body and in communication with the exterior side of said portion of skin;

(3) means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means, said mechanical contact reference position corresponding to a predetermined pressure relationship between said internal bodily pressure and said external variable pressure;

(4) means having a preselected, detectable parameter that is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter having a predetermined value at said mechanical contact reference position and said preselected, detectable parameter changing with a displacement from said mechanical contact reference position of said corresponding to a change in said pressures from said predetermined pressure relationship;

3. The method of claim 1 further comprising the step of enabling bodily fluid from an internal bodily region to communicate with one side of said flexible diaphragm means such that pressure of said bodily fluid is sensed.

5. The method of claim 3 wherein said flexible diaphragm means comprises a multiplicity of pressure responsive diaphragms that are incompressibly motion coupled together, and further comprising the step of implanting said sensor in the living body so that at least one side of one of said pressure responsive diaphragms is in pressure communication with said internal bodily pressure to be measured, and at least one side of one of said pressure responsive diaphragms is in mechanical contact with said interior side of said portion of skin.

6. The method of claim 3 in which said means for defining a mechanical contact reference position comprises a mechanical stop for at least a portion of said flexible diaphragm means relative to said housing, and further comprising the step of varying said known external variable pressure until said flexible diaphragm means is driven against said mechanical stop.

7. The method of claim 3 wherein said reference position corresponds to the balance of pressures in communication with said first and said second sides of said flexible diaphragm and wherein said known external variable pressure is varied while detecting said preselected, detectable parameter until said parameter equals said predetermined value at which point, said known external variable pressure and said internal bodily pressure are balanced.

8. The method of claim 3 wherein said controllable pressure source means includes a pressure cuff means adapted to be put in contact with said exterior side of said portion of skin, said method further comprising the steps of placing said pressure cuff in contact with the exterior side of said portion of skin and applying said known external pressure to the skin through said pressure cuff.

9. The method of claim 7 wherein at least a portion of said external detection means and said pressure cuff means comprise an integral unit so that when said pressure cuff means is placed in contact with the exterior side of said portion of skin, said portion of the external detection means is positioned in proximity to said portion of skin.

10. The method of claim 3 wherein said controllable pressure source means includes a mechanical force applicator means that can apply a known, variable force to the exterior side of said portion of skin, said variable force being relatable to an equivalent variable pressure on said sensor, and said method further comprising the step of placing said mechanical force applicator means in contact with the exterior side of said portion of skin whereby a variable force can be transmitted through the skin to the sensor.

11. The method of claim 9 wherein at least a portion of said external detection means and said mechanical force applicator means comprise an integral unit so that when said mechanical force applicator means is placed in contact with the exterior side of said portion of skin, said portion of the external detection means is positioned in proximity to said portion of skin.

12. The method of claim 3 wherein said external controllable pressure source means includes an automatic pressure control and readout means which comprises means for automatically varying said external pressure and cooperating automatically with said external detection means, said method further comprising the step initiating the automatic variation of said external pressure whereby when said predetermined value of said detectable parameter at said reference position has been reached, said pressure control means will automatically give a readout of said internal bodily pressure to be measured.

13. The method of claim 3 wherein said means having a preselected detectable parameter comprises electronic circuit means, said preselected, detectable parameter being a characteristic response parameter of said electronic circuit means and detecting said characteristic response parameter by electromagnetic coupling said electronic circuit means to an electronic apparatus means located external to said living body.

14. The method of claim 12 wherein said electronic circuit means comprises a resonant electronic circuit, and said preselected, detectable parameter being a parameter of the resonant frequency response of said resonant circuit and detecting the parameter of the resonant frequency of said resonant circuit.

15. The method of claim 13 wherein said resonant electrical circuit is a parallel resonant circuit and said preselected detectable parameter is the resonant frequency of said parallel resonant circuit and detecting the resonant frequency of said parallel resonant circuit.

16. The method of claim 3 wherein said means having a preselected detectable parameter includes an effective scatterer of ultrasonic waves which moves with said flexible diaphragm means, said external detection means comprises a source of ultrasonic radiation and a detector of ultrasonic radiation whereby differences in frequencies of source and detected radiation can be detected, and said preselected detectable parameter is the shift in frequency of radiation scattered off said scatterer, said value of said frequency shift being zero when said flexible diaphragm is driven against said mechanical stop and said frequency shift being non-zero upon changes in displacement of at least a portion of said flexible diaphragm means with respect to said housing in response to changes in said pressures in communication with said diaphragm means, said method further comprising the steps of irradiating said scatterer with ultrasonic radiation and detecting the differences in frequencies of the irradiated and scattered ultrasonic radiation.

17. The method of claim 3 further comprising the step of precalibrating said predetermined value of said preselected, detectable parameter at said reference position prior to implantation of said sensor in said living body.

18. The method of claim 3 wherein said preselected, detectable parameter is a variable parameter, the variable parameter changing as a known function of said pressures in communication with said flexible diaphragm and further comprising the step of detecting the value of said variable parameter.

2. (b) applying a known external variable pressure to said flexible diaphragm means by said controllable pressure source, and varying said known external pressure while detecting said preselected, detectable parameter until said parameter equals said predetermined value at which point said known external variable pressure and said internal bodily pressure have said predetermined pressure relationship.

4. A method for measuring an in vivo pressure, said method comprising the steps of:

(a) implanting in a living body a differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in

pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in

mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from a controllable pressure source means external to said living body that is adapted to apply mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to the changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means, said mechanical contact reference position corresponding to a predetermined relationship between said pressures in communication with said first and said second sides of said flexible diaphragm means;

(4) means having a preselected, detectable parameter that is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter having a predetermined value at said mechanical contact reference position, and said preselected;

detectable parameter changing with a displacement from said mechanical contact reference position of said flexible diaphragm means corresponding to a change in said pressures from said predetermined pressure relationship;

(b) varying said known external variable pressure while detecting said preselected, detectable parameter until said parameter equals said predetermined value at which point said known external variable pressure and said internal bodily pressure have said predetermined pressure relationship.

19. A method for measuring an in vivo pressure and of calibrating a differential pressure sensor in vivo, said method comprising:

(a) implanting in a living body the differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in

pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm is in

pressure communication with an external variable pressure from a controllable pressure source external to said living body

and is in mechanical pressure communication with the interior side of a portion of skin whereby the motion of said flexible diaphragm means is responsive to the changes in the difference in said internal bodily pressure and said external variable pressure and the pressure sensor is compensated for atmospheric pressure that is external to the body and in communication with the exterior side of said portion of skin;

(3) means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means, said mechanical contact reference position corresponding to a predetermined pressure relationship between said internal bodily pressure and said external variable pressure;

(4) means having a preselected, detectable parameter that is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter changing upon at least a displacement from said mechanical contact reference position of said flexible diaphragm means, said displacement corresponding to a change in said pressures from said predetermined pressure relationship;

(b) manipulating said sensor by applying a mechanical pressure to the exterior side of said portion of skin to cause said flexible diaphragm means to assume said mechanical contact reference position;

(c) remotely detecting the value of the preselected, detectable parameter when said flexible diaphragm means is at said mechanical contact reference position without any connection to the sensor that requires a break in the skin;

(d) applying a known external variable pressure to said flexible diaphragm means by said controllable pressure source and varying said external variable pressure until the value of said preselected, detectable parameter equals the previously detected value at the mechanical contact reference position at which point said external pressure and said internal bodily pressure have said predetermined pressure relationship.

21. The method of claim 19 wherein said flexible diaphragm means comprises a multiplicity of pressure responsive diaphragms that are incompressibly motion coupled together, and further comprising the step of implanting said sensor in the living body so that at least one side of one of said pressure responsive diaphragms is in pressure communication with said internal bodily pressure to be measured, and at least one side of one of said pressure responsive diaphragms being in mechanical contact with said interior side of said portion of skin.

22. The method of claim 19 in which said means for defining a mechanical contact reference position comprises a mechanical stop for at least a portion of said flexible diaphragm means relative to said housing, and further comprising the step of varying said known external variable pressure until said flexible diaphragm means is driven against said mechanical stop.

23. The method of claim 19 wherein said mechanical contact reference position corresponds to the balance of pressures in communications with said first and second sides of said flexible diaphragm means, and wherein said known external variable pressure is varied while detecting said preselected, detectable parameter until said parameter equals said predetermined value at which point said known external variable pressure and said internal bodily pressure are balanced.

24. The method of claim 19 wherein said controllable pressure source means includes a pressure cuff means adapted to be put in contact with said exterior side of said portion of skin, said method further comprising the steps of placing said pressure cuff in contact with the exterior side of said portion of skin and applying said known external pressure to the skin through said pressure cuff.

25. The method of claim 19 wherein said controllable pressure source means includes a mechanical force applicator means that can apply a known, variable force to the exterior side of said portion of skin, said variable force being relatable to an equivalent variable pressure on said sensor, and said method further comprising the step of placing said mechanical force applicator means in contact with the exterior side of said portion of skin whereby a variable force can be transmitted through the skin to the sensor.

26. The method of claim 23 wherein at least a portion of said external detection means and said pressure cuff means comprise an integral unit so that when said pressure cuff means is placed in contact with the exterior side of said portion of skin, said portion of the external detection means is positioned in proximity to said portion of skin.

27. The method of claim 24 wherein at least a portion of said external detection means and said mechanical force applicator means comprise an integral unit so that when said mechanical force applicator means is placed in contact with the exterior side of said portion of skin, said portion of the external detection means is positioned in proximity to said portion of skin.

28. The method of claim 19 wherein said external controllable source means includes an automatic pressure control and readout means which comprises means for automatically varying said external pressure and cooperating automatically with said external detection means, said method further comprising the step of initiating the automatic variation of said external pressure whereby when said detected value of said detectable parameter at said reference position has been reached said pressure control means will automatically give a readout of said internal bodily pressure to be measured.

29. The method of claim 19 wherein said means having a preselected, detectable parameter comprises electronic circuit means, said preselected, detectable parameter being a characteristic response parameter of said electronic circuit means and detecting said characteristic response parameter by electromagnetic coupling said electronic circuit means to an electronic apparatus means located external to said living body.

30. The method of claim 28 wherein said electronic circuit means comprises a resonant electronic circuit, and said preselected detectable parameter being a parameter of the resonant frequency response of said resonant circuit and detecting the parameter of the resonant frequency of said resonant circuit.

31. The method of claim 29 wherein said resonant electrical circuit is a parallel resonant circuit and wherein said preselected, detectable parameter is the resonant frequency of said parallel resonant circuit and detecting the resonant frequency of said parallel resonant circuit.

32. The method of claim 19 wherein said means having a preselected, detectable parameter is an effective scatterer of ultrasonic waves which moves with such flexible diaphragm means, said external detection means comprises a source of ultrasonic radiation and a detector of ultrasonic radiation, whereby differences in frequencies of source and detected radiation can be detected, and said preselected detectable parameter is the shift in frequency of radiation scattered of off said scatterer, said value of said frequency shift being zero when said flexible diaphragm is driven against said mechanical stop and said frequency shift being non-zero upon changes in displacement of at least a portion of said flexible diaphragm means with respect to said housing in response to changes in said pressures in communication with said diaphragm means, said method further comprising the steps of irradiating said scatterer with ultrasonic radiation and detecting the differences in frequencies of the irradiated and scattered ultrasonic radiation.

33. The method of claim 19 further comprising the step of enabling bodily fluid from an internal bodily region to communicate with one side of said diaphragm means such that pressure of said bodily fluid is sensed.

34. The method of claim 19 further comprising the step of precalibrating said predetermined value of said preselected, detectable parameter at said reference position prior to implantation of said sensor in said living body.

35. The method of claim 19 wherein said preselected, detectable parameter is a variable parameter, the variable parameter changing as a known function of said pressures in communication with said flexible diaphragm and further comprising the step of detecting the value of said variable parameter.

20. A method for measuring an in vivo pressure and of calibrating in vivo a differential pressure sensor, said method comprising:

(a) implanting in a living body the differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in

pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in

mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from a controllable pressure source means external to said living body that is adapted to apply a mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means said mechanical contact reference position corresponding to a predetermined relationship between said pressures in communication with said first and second sides of said flexible diaphragm means;

(4) means having a preselected, detectable parameter that is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter having a predetermined value at said mechanical contact reference position, and said preselected, detectable parameter changing with a displacement from said mechanical contact reference position of said flexible diaphragm means corresponding to a change in said pressures from said predetermined pressure relationship;

(b) manipulating said sensor by applying a mechanical pressure to the exterior side of said portion of skin to cause said flexible diaphragm means to assume said mechanical contact reference position;

(c) remotely detecting the value of the preselected, detectable parameter when said flexible diaphragm means is at said mechanical contact reference position without any connection to the sensor that requires a break in the skin;

(d) applying a known external variable pressure to said flexible diaphragm means by said controllable pressure source and varying said external variable pressure until the value of said preselected, detectable parameter equals the previously detected value at the mechanical contact reference position at which point said external pressure and said internal bodily pressure has said predetermined pressure relationship.

36. A method for remotely detecting in vivo pressure, said method comprising the steps of:

(a) implanting in a living body a balanced differential pressure sensor comprising;

(1) a housing having means defining an opening extending therethrough;

(2) flexible diaphragm means extending across said housing opening and being secured with respect to said housing, said flexible diaphragm means communicating mechanically with pressures in two separate regions external to the sensor that are separated by the flexible diaphragm means with the pressure in one of the regions being an internal bodily pressure when the sensor is implanted in a living body;

(3) means for defining a reference position of said flexible diaphragm means with respect to said housing for a predetermined pressure relationship between the pressures in said regions; and

,

(4) means having a preselected, detectable parameter that changes with displacement of said flexible diaphragm means from the reference position, upon a change from said predetermined pressure relationship;

(b) mechanically manipulating the sensor through the intact skin of the body to change the pressure in one of said separate regions thereby causing the sensor to assume the reference position;

(c) remotely detecting the value of the parameter when the sensor is in the reference position without any connection to the sensor which requires a break in the skin; and

,

(d) applying a known variable pressure to the sensor through the intact skin while remotely detecting said preselected, detectable parameter until the value of said parameter equals the previously detected value at the reference position at which point the known variable pressure and the internal bodily pressure have said predetermined pressure relationship.

37. A method for remotely detecting in vivo pressure, said method comprising the steps of:

(a) implanting in a living body a balanced differential pressure sensor comprising;

(1) a housing having means defining an opening extending therethrough;

(2) flexible diaphragm means extending across said housing opening and being secured with respect to said housing, said flexible diaphragm means communicating mechanically with pressures in two separate regions external to the sensor that are separated by the flexible diaphragm means with the pressure in one of the regions being an internal bodily pressure when the sensor is implanted in a living body;

(3) means for defining a reference position of said flexible diaphragm means with respect to said housing for a predetermined pressure relationship between the pressures in said regions; and

,

(4) means having a preselected, detectable parameter that changes with displacement of said flexible diaphragm means from the reference position upon a change from said predetermined pressure relationship;

(b) mechanically manipulating the sensor to cause the sensor to assume the reference position;

(c) remotely detecting the value of the parameter when the sensor is in the reference position without any connection to the sensor which requires a break in the skin; and

,

(d) applying a known variable pressure to the sensor while remotely detecting the variable parameter until the value of the parameter equals the previously detected value at the reference position at which point the known variable pressure and the internal bodily pressure have said predetermined pressure relationship.

38. A method for measuring an in vivo pressure, said method comprising the steps of:

(a) implanting in a living body a differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from a controllable pressure source means external to said living body that is adapted to apply mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to the changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means, said mechanical contact reference position corresponding to a predetermined relationship between said pressures in communication with said first and said second sides of said flexible diaphragm means, and said mechanical contact reference position defining means including electrode contacts that touch at the mechanical contact reference position;

(4) electrical circuit means positioned within said sensor and cooperative with said electrode contacts to produce a detectable characteristic response of said electrical circuit means when said electrode contacts touch;

(b) varying said known external variable pressure while detecting for said detectable characteristic response and terminating the varying of said known external variable pressure upon detection of said detectable characteristic response at which point said known external variable pressure and said internal bodily pressure have said predetermined pressure relationship.

39. A method for measuring an in vivo pressure, said method comprising the steps of:

(a) implanting in a living body a differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from a controllable pressure source means external to said living body that is adapted to apply mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to the changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) mechanical stop means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means, said mechanical contact reference position corresponding to a predetermined relationship between said first and said second sides of said flexible diaphragm means;

(4) means having a preselected, detectable parameter that is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter varying with variations in the differences in said pressures on the first and second sides of said flexible diaphragm means and said preselected, detectable parameter ceases to vary when said flexible diaphragm means has been driven against said mechanical stop means by an excess of said known external variable pressure beyond said predetermined pressure relationship in one direction;

(b) monotonically varying said known external variable pressure to drive said flexible diaphragm means against said mechanical stop means to produce a transition from variation to non-variation of said preselected variable parameter so that the value of said known external variable pressure at the point of said transition will be in said predetermined pressure relationship with said internal bodily pressure to be measured.

40. A method for measuring an in vivo pressure, said method comprising the steps of:

(a) implanting in a living body a differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from a controllable pressure source means external to said living body that is adapted to apply mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to the changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means, said mechanical contact reference position corresponding to a predetermined relationship between said pressures in communication with said first and said second sides of said flexible diaphragm means;

(4) means having a preselected, detectable parameter that is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter having a predetermined value at said mechanical contact reference position, and said preselected, detectable parameter changing with a displacement from said mechanical contact reference position corresponding to a change in said pressures from said predetermined pressure relationship;

(b) increasing said known external variable pressure with time until the time rate-of-change of said preselected, detectable parameter reaches zero, at which time said known external pressure and said internal bodily pressure have said predetermined pressure relationship.

41. A method for measuring an in vivo pressure and of calibrating in vivo a differential pressure sensor, said method comprising:

(a) implanting in a living body the differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from controllable pressure source means external to said living body that is adapted to apply a mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means, said mechanical contact reference position corresponding to a predetermined relationship between said pressures in communication with said first and second sides of said flexible diaphragm means, and said mechanical contact reference position defining means including electrode contacts that touch at the mechanical contact reference position;

(4) electrical circuit means positioned within said sensor and cooperative with said electrode contacts to produce a detectable characteristic response of said electrical circuit means when said electrode contacts touch;

(b) manipulating said sensor by applying a mechanical pressure to the exterior side of said portion of skin to cause said flexible diaphragm means to assume said mechanical contact reference position;

(c) varying said known external variable pressure while detecting for said detectable characteristic response, said detection being performed remotely from said sensor and without any connection to the sensor that requires a break in the skin;

(d) terminating the varying of said known external variable pressure upon detection of said detectable characteristic response at which point said known external variable pressure and said internal bodily pressure have said predetermined pressure relationship.

42. A method for measuring an in vivo pressure and of calibrating in vivo a differential pressure sensor, said method comprising:

(a) implanting in a living body the differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being secured with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from a controllable pressure source means external to said living body that is adapted to apply a mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) mechanical stop means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means said mechanical contact reference position corresponding to a predetermined relationship between said pressures in communication with said first and second sides of said flexible diaphragm means;

(4) means having a preselected, detectable parameter that is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter varying with variations in the differences in said pressures on the first and second sides of said flexible diaphragm means and said preselected, detectable parameter ceasing to varying when said flexible diaphragm means has been driven against said mechanical stop means by an excess of said known external variable pressure beyond said predetermined pressure rlationship in one direction;

(b) monotonically varying said known external variable pressure; and

,

(c) applying the monotically varying pressure to the exterior side of said portion of skin to drive said flexible diaphragm means against said mechanical stop means to produce a transition from variation to non-variation of said preselected variable parameter so that the value of said known external variable pressure at the point of said transition will be in said predetermined pressure relationship with said internal bodily pressure to be measured.

43. A method for measuring an in vivo pressure and of calibrating in vivo a differential pressure sensor, said method comprising:

(a) implanting in a living body the differential pressure sensor comprising;

(1) a housing having an opening therein;

(2) a flexible diaphragm means having a first side and a second side, said flexible diaphragm means extending across said housing opening and being securred with respect to said housing so that when the sensor is implanted in the living body, the first side of said flexible diaphragm means is in pressure communication with an internal bodily pressure to be measured and the second side of said flexible diaphragm means is in mechanical pressure communication with the interior side of a portion of skin and thereby in pressure communication across the intact skin with a known variable pressure from a controllable pressure source means external to said living body that is adapted to apply mechanical pressure to the exterior side of said portion of skin whereby the motion of said flexible diaphragm means is responsive to changes in the difference in said internal bodily pressure and said known external variable pressure;

(3) mechanical stop means for defining a mechanical contact reference position with respect to said housing of said flexible diaphragm means said mechanical contact reference position corresponding to a predetermined relationship between said pressures in communication with said first and second sides of said flexible diaphragm means;

(4) means having a preselected, detectable parameter this is detectable by detection means external to said living body, said means having a preselected, detectable parameter being at least in part cooperatively connected to and movable with said flexible diaphragm means so that said preselected, detectable parameter will change with movement of said flexible diaphragm means, said preselected, detectable parameter varying with variations in the differences in said pressures on the first and second sides of said flexible diaphragm means and said preselected, detectable parameter ceasing to vary when said flexible diaphragm means has been driven against said mechanical stop means;

(b) increasing said known external variable pressure with time; and

(c) applying, as a mechanical pressure, said increasing with time known external pressure to the exterior side of said portion of skin until the time rate-of-change of said preselected, detectable parameter reaches zero, at which time said known external pressure and said internal bodily pressure have said predetermined pressure relationship.