Threaded chestpiece drum permits the use of five interchangeable chestpiece fittings - an adult and pediatric diaphragm, and threee bells (1 1/4", 1", 3/4") - for complete diagnostic capability in most patients. Latex-free extra thick "y" tubing. Proprietary valve mechanism eliminates acoustic leakage. Adjustable chrome-plated brass binaurals. Complete with an accessory pouch containing the bell chestpieces, chestpiece key, 2 spare diaphragms, one pair of mushroom eartips, and one pair of silicon eartips. Inspected and packaged in the U.S.A.