Compact imaging instrument system

An imaging instrument includes a compact hand-held housing having an electronic imaging element supported within a housing, and a plurality of interchangeable instrument heads separably attachable to the housing. Each of the instrument heads includes an optical system disposed in alignment with the electronic imaging element along an instrument viewing axis. Preferably, the instrument further includes an integral display for displaying at least one captured or real-time video image as viewed through the instrument head of choice. The instrument includes a controller with sufficient programmable logic to capture and store a plurality of imaging images which can be transferred along with audio and/or annotation data relating to a captured image. Corresponding video and audio data can be then transferred using a receiving cradle to a computer which contains software which organizes the stored data for further processing. In a preferred example, the audio files can be transcribed through a network utilizing voice recognition software.

FIELD OF THE INVENTION 
This invention relates to the field of imaging instruments, and 
particularly to an imaging instrument system having interchangeable 
instrument heads selectively used with a single instrument body or a 
family of instrument bodies. The instrument can allow image, audio, and 
other forms of data (multimedia) to be selectively captured, stored, and 
utilized. 
BACKGROUND OF THE INVENTION 
A number of hand-held diagnostic instruments are commonly known in the 
medical field for examining a patient, such as those which are used during 
routine physician office visits. These instruments include, among others, 
skin surface microscopes which are used for diagnosing skin disorders, 
otoscopes permitting examination of the ear canal and tympanic membrane, 
and ophthalmoscopes for examining the eyes. Each of the above instruments 
have uniquely inherent features to allow an effective examination of the 
area of interest. Skin surface microscopes, for example, include a distal 
optical element having a relatively large diameter (e.g. approximately 15 
mm) for direct placement onto a wart, lesion, or other skin disorder. 
Otoscopes, on the other hand, include a frusto-conical insertion portion, 
including a safety speculum, which prevents insertion beyond a 
predetermined distance into the ear canal. 
It has since become desirable for a patient to be able to witness a primary 
care or other examination along with the physician. Therefore, videoized 
versions of the above diagnostic instruments have been developed, such as 
those described in U.S. Pat. No. 5,363,839, issued to Lankford, U.S. Pat. 
No. 5,239,984, issued to Cane, et al, and U.S. Pat. No. 4,947,245, issued 
to Ogawa, et al. In each of the referenced instruments a miniature video 
camera, such as a CCD or other electronic sensor, is positioned either 
within the interior of the instrument or adjacently coupled thereto. The 
electronic sensor includes a light receiving surface or substrate which 
receives a focused optical image of a target of interest through a 
specifically designed viewing system, such as a rod lens, objective or 
other form of lens positioned, typically in the distal end of the 
instrument. 
A separately disposed light box or other source of illumination, provides 
white light through a sheathed cable tethered to the proximal end of the 
instrument. The cable includes an optical fiber bundle for directing the 
light specifically to the distal tip of the instrument, as well as 
electrical conductors for powering the electronic sensor. The electronic 
sensor, in turn, creates an analog or digital electrical signal which is 
remotely transmitted to a processor containing appropriate circuitry for 
converting the transmitted electrical signal into a video monitor-ready 
(, NTSC) format. The processed video signal is then separately 
displayed on a remote monitor. The use of videoized systems has become 
increasingly popular and has since taken on the term "telemedicine". 
Videoized diagnostic instrument systems, like those described above, are 
quite expensive, with each system requiring a separate diagnostic 
instrument, along with dedicated cabling, light source, signal processor 
and video peripheral device(s). In addition, each system also requires a 
significant space allocation, posing a separate problem considering that 
space is already at a premium in physician's offices and other 
environments where such systems would be typically be used. It is 
therefore desirable to provide a diagnostic instrument system which is 
capable of performing multiple examinations. 
It is another perceived desire in the field to make such telemedicine 
systems sufficiently portable; for example, to allow examinations to take 
place outside the "normal doctor's office". Along with this need, is a 
similarly recognized need to allow portions of the system to be compactly 
arranged without the need for separate peripherals or connecting devices. 
Improved organization of patient records is yet another current need in the 
medical field. To date, creation and maintenance of patient files has been 
largely a manually managed activity. Data which can form a part of the 
overall patient record, however, can take on a number of different forms. 
For example, it has been known that data can be accumulated in a number of 
forms, particularly with the advent of telemedicine involving image 
capture, such as using the above described videoized instrument systems. 
In addition, physicians, such as family practitioners, surgeons, etc., 
invariably record notes during a patient visit and examination. In some 
instances, of course, the physician may write information directly into 
the patient's file. The course of usual practice, however, is to record 
events of an examination using a hand-held recording device. The taped 
notes are then later transcribed and then added to the patient's file. 
Throughout the course of a single day, however, it is possible that a 
physician may see as many as 40 patients. This kind of volume makes the 
task of compiling and transcribing notes difficult, or at a minimum time 
consuming, either for the physician or for the physician's staff. The 
creation of patient records incorporating several types of data, including 
audio and video data, is even more difficult. 
To date, though there are a number of transcripting apparatus available, 
none conveniently combine audio data with other forms of collected data, 
such as captured images, sketches by the physician, or data obtained from 
other instruments to be retained and used in compiling and assembling 
complete examination records which can then be effectively stored and 
maintained. 
SUMMARY OF THE INVENTION 
Accordingly, it is a primary object of the present invention is to improve 
the present state of the art of diagnostic or other suitable instrument 
systems. 
Another primary object of the present invention is to provide a single or 
family of convertible diagnostic devices which allow varied clinical, as 
well as industrial uses, to be performed. 
It is yet another primary object of the present invention to provide 
greater flexibility to a physician or other care-giver by providing a 
video instrument which is versatile, simple to modify, and utilizes less 
space than other known systems. 
It is yet another primary object of the present invention to provide a data 
management system, for medical or other records, such as inspection, etc, 
using an instrument which is capable of capturing and storing multiple 
forms of data input which can be effectively transferred into a central 
network capable of linking the data into accumulated data records which 
can be updated and maintained automatically. 
Yet another primary object of the present invention is to provide an 
instrument capable of storing various forms of data (i.e.: multimedia), 
that can be adaptively interconnected with a plurality of output devices 
to allow transfer and subsequent processing of a plurality of stored data 
inputs. 
It is yet another primary object of the present invention to provide a data 
or records management system in which a plurality of captured data files, 
such as digital audio files, can be subsequently transferred and 
transcribed, the results of the transcription being transferrable directly 
into a patient record. 
Therefore and according to a preferred aspect of the present invention, 
there is provided a hand-held video instrument capable of performing 
multiple examination tasks, said system comprising: 
an instrument body including an interior; 
a plurality of instrument heads interchangeably mounted to said instrument 
body, without requiring disassembly thereof; 
means for releasably mounting each of said instrument heads to said 
instrument body; 
optical viewing means for viewing a target of interest, said optical 
viewing means including at least one optical element in at least one of 
said instrument body and said plurality of instrument heads, said viewing 
means having a defined viewing axis; and 
electronic imaging means including an electronic sensor disposed along said 
viewing axis for receiving an optical image of said target from said 
optical viewing means. 
According to a preferred embodiment, each of the instrument heads include 
viewing optics which focus an optical image onto an electronic sensor, the 
sensor being situated adjacent the front or distal face of the instrument 
body. The instrument head can similarly, however, be mounted to other 
interface surfaces of the instrument body. 
Each instrument head is releasably attachable to the instrument body using 
a latch mechanism, wherein the electrical contacts for an illumination 
assembly and/or imaging assembly are disposed in the mechanism and are not 
enabled until the latch has secured the instrument head of choice to the 
front face of the instrument body. 
A light source is provided, either in the instrument head or in the 
instrument body, to illuminate the target of interest. According to one 
preferred embodiment, the instrument heads include the illumination 
source, while in another embodiment, a lamp assembly or other light source 
is provided in the instrument body. 
In yet another preferred embodiment, the CCD or other electronic sensor can 
be retained with the instrument body to be mainly used with the family of 
instrument heads. In another embodiment, the imager can be positioned 
directly within at least one instrument head, with the instrument body 
having suitable electrical contacts for powering the imager, as well as 
the illumination source. 
Other instrument bodies can additionally be provided which serve as camera 
platforms to provide additional versatility for clinical and/or industrial 
applications, such as for borescopes and the like. 
According to another preferred aspect of the present invention, there is 
provided a hand-held imaging instrument comprising: 
a compact housing including an interior; 
at least one instrument head mounted to said housing; 
means for viewing a target of interest, said viewing means including at 
least one optical element in at least one of said instrument body and said 
at least one instrument head, said viewing means having a defined viewing 
axis; 
image capture means including an electronic sensor disposed along said 
viewing axis for receiving an optical image of said target from said 
viewing means; and 
display means integral with said instrument housing for displaying at least 
one image of the target of interest captured by said image capture means. 
Preferably, the instrument body further includes means for storing at least 
one image and for capturing, storing and playback of audio data 
corresponding to at least one captured and stored image. Alternately, a 
particular instrument can include means for selectively utilizing data 
other than videoized data, such as obtained from stethoscopes, etc., 
and/or other forms of data, wherein the data can selectively be linked to 
other data input, including but not limited to video data. 
More preferably, the described instrument can include a plurality of 
interchangeable instrument heads which are releasably mountable to the 
instrument, each of the instrument heads having a unique viewing system 
for allowing multiple types of examination to be performed using the same 
instrument. 
More preferably, the instrument is part of an overall data or records 
management system in which the instrument is interconnected with a 
receiving cradle. The receiving cradle acts as a docking station having 
means for allowing data transfer between the instrument and an external 
source to allow transfer of audio, video and other data files stored in 
the instrument or the external source which can, for example, be part of a 
single computer or computer network. In this manner, protocols, operating 
instructions, etc., as well as data can be transferred directly to the 
instrument according to one embodiment or data and the like can be 
transferred from the instrument. 
Preferably, the data is transferred, according to a particular aspect of 
the present invention, to an immediate or local computer or PC utilizing 
software which arranges the data into a script template, such as a patient 
chart of convenient architecture, including allocation for voice, video 
and annotation data; for example, as part of a local database. The local 
database, would for example, contain patient files for a specific 
physician's office. 
In addition, the transferred voice or WAV files can be further transferred 
into a central data network (e.g. a server) utilizing a global database 
for tying in a plurality of similar diagnostic or other suitable 
instruments. The central database, for example, can handle raw voice data 
from a particular instrument communicated remotely and transfer a 
transcribed report back to the local physician. 
According to a preferred feature of the described data management system 
includes software which is capable of discriminating a captured video 
image for known 1D or 2D barcode symbology or for pattern recognizable 
data. This allows the instrument to tag data files automatically without 
requiring separate manual input from the user. 
According to a preferred embodiment, each of the instrument heads include 
separate and unique viewing optics which focus an optical image onto an 
electronic sensor, the sensor being preferably situated adjacent the front 
face of the instrument body. 
Preferably, each instrument head is releasably attachable to the instrument 
housing using a latching mechanism, in which attachment automatically 
transmits power to the instrument head, such as for activating a contained 
illuminating lamp, for example. According to one preferred embodiment, the 
instrument heads include a source of illumination though alternately the 
illumination source can also be a contained part of the instrument. 
Preferably, the instrument heads are removably attachable to a single and 
compact instrument housing having both image capture means as well as an 
integral display element for allowing the operator to uniquely view a 
target of interest as perceived through the instrument head. More 
preferably, the instrument includes other features, such as allowing 
annotation data to be added to a displayed image of interest as well the 
capability of storing and transmitting stored forms of data, including 
audio data. 
According to yet another preferred aspect of the present invention, there 
is described a record management system comprising: 
a diagnostic instrument including a plurality of instrument heads, each of 
said instrument heads having an optical system for directing an image onto 
an electronic sensor disposed in said instrument and display means for 
displaying at least one directed image and data capture means for 
capturing audio and video data; 
means for transferring data files from said instrument and for moving said 
files to a processing means, said processing means including means for 
transcribing notes from said audio files; and for accumulating data from 
said instrument into a record format. 
According to a preferred aspect, there is described a method for 
transcribing a plurality of record notes, comprising the steps of: 
storing data using a diagnostic instrument, said instrument having digital 
camera means and display means contained therein, as well as means for 
taking audio data corresponding to a displayed video image; 
placing the instrument into a docking station, said docking station being 
capable of extracting audio data files from the diagnostic instrument 
moving the audio data files to a central processing station; and 
using voice recognition software to process the transcription notes, the 
program preferably being able to recognize and utilize learn technology 
based on a given voice being recognized for processing; 
creating transcriptions which can be associated with a patient file having 
at least one video image attributed thereto. 
An advantage of the present invention is that an examination room videoized 
system is provided which allows multiple types of examination to be 
performed in a simple and efficient manner using a single instrument body 
and interchangeable instrument heads. 
Another advantage of the present invention is that multiple instrument 
heads can be selectively and simply interchanged with a single instrument 
body to provide versatility and to provide the advantages of multiple 
videoized systems without a significant impact beyond that of a dedicated 
videoized diagnostic system. 
Another advantage of the present invention is that a system as described 
allows multiple videoized examinations to be performed in the space 
envelope used by a single videoized system, allowing the physician to more 
efficiently improve the capabilities of the office. 
Yet another advantage of the present invention is that a system as 
described can be easily expanded, is easier to replace in the case of 
breakage of one of the instrument heads, and is much more inexpensive than 
furnishing multiple diagnostic systems. 
Still another advantage of the present invention is that an examination 
room videoized system is provided allowing multiple types of examinations 
to be efficiently performed using a single instrument body having a 
plurality of interchangeable instrument heads. 
More advantageous is that a multiple of instrument heads, each having 
capability of performing a different type of examination, can be 
selectively and simply interchanged on a single instrument for use. The 
system, therefore, dramatically increases versatility while maximizing use 
of space. Moreover, the instrument is portable, meaning that examinations 
are not confined to a dedicated location, such as a doctor's office. 
Still another advantage of the present invention is that the described 
system allows multiple examinations to be performed in a space envelope 
which is smaller than conventionally known videoized systems. The 
instrument also includes an integral display and means for compactly 
storing a series of images, or of displaying real or stored images and 
playback of captured audio-related data. This capability allows the 
physician to more efficiently improve the capabilities of the office. In 
addition, the instrument is preferably linkable to a PC, a PC network or 
other peripherals capable of using data retrieved from the instrument. 
Yet, the physician or other user of the instrument can use the videoized 
instrument from literally any location without restriction, for example, 
to an office setting. 
Yet another advantage is that the described instrument includes an integral 
display element. More preferably, annotation notes relating to at least 
one captured videoized image can be made using the display, the annotation 
data being stored along with corresponding video and/or audio data 
relating to a patient. 
Yet another advantage of the present invention is that the described system 
can be easily expanded, allows simple replacement or updating of 
components, and is much more inexpensive than furnishing multiple 
diagnostic or other systems. 
Still another advantage of the present system is that numerous types of 
data including imaging data, audio data, and annotation data can be easily 
stored, transferred, and utilized. This storage allows the creation of a 
"multi-media" data file and allows efficient creation and maintenance of 
records provided in a useful format which incorporates each data type 
within the confines of a specific record. 
Yet another advantage is that the above described system can be easily 
adapted into a multimedia data management system. According to one 
specific example, a transcription service can be created allowing audio 
data captured and stored by the instrument(s) to be added into a central 
network having voice processing software using a cradle or dictating 
station which is tied to a local PC and the PC network. In a preferred 
embodiment, transcribed data can then be processed and returned to the 
physician without tedious review of previous data records, providing 
improved reliability and accuracy of records, and time saving for the 
physician. As will become apparent, however, local use of the audio data 
provides a more efficient means for locally performing transcription as 
well, such as by a member of a physician's staff. 
Yet another advantage of the described data management system is that 
overall transcription time can be reduced in that the doctor can 
immediately place the patient, physiology, notes, and transcription. 
These and other objects, advantages, and features will be described in the 
following Detailed Description of the Invention which should be read in 
conjunction with accompanying drawings.

DETAILED DESCRIPTION OF THE INVENTION 
The following discussion describes the present invention according to a 
number of specific embodiments. As will be apparent from the following 
discussion, however, there are many other modifications and variations 
which can be employed by those of skill in the field embodying the 
concepts which are described herein. In addition, though the presently 
described embodiments relate specifically to the medical field, it should 
be readily apparent that other applications utilizing numerous forms of 
data input including manufacturing, quality control, inspection, 
engineering, and inventory, among others, can effectively utilize the 
concepts presented herein. 
Turning to FIG. 1, there is shown a video medical diagnostic instrument 
system in accordance with the prior art. The instrument system 10 includes 
a medical diagnostic instrument 14, an endoscope (ie: a video laparoscope) 
being shown, defined by an elongate instrument body 16 having a distal end 
18 and an opposite proximal end 17 attached to a handle section 20. An 
electronic sensor or element (not shown), such as a CCD (charge coupled 
device), is disposed within the instrument body 16 and receives an optical 
image of a target of interest through an imaging system, such as a relay 
lens system (not shown) or other known arrangement, in a conventional 
manner. The electronic sensor includes support electronics which convert 
the optical signal into an electrical signal which is transmitted along a 
sheathed cable 22 depending from the proximal end 24 of the handle section 
20. 
According to the above-described system, a video processing module 28 forms 
the proximal end of the sheathed cable 22, the module containing 
processing electronics for converting the transmitted electrical signal 
into a video monitor-ready (, NTSC, etc.) signal. The video processing 
module 28 is attached into a receiving cavity 29 of a light/power box 32 
containing a high output light source, such as an arc lamp (not shown) or 
other source of white light. The light from the high-intensity light 
source is transmitted from the light box 32 through an optical fiber 
bundle (not shown) contained within the sheathed cable 22, and guided into 
the diagnostic instrument body 16 to the distal end 18 thereof. The 
light/power box 32 also serves to furnish power to the diagnostic 
instrument 14 through electrical connectors, also contained within the 
sheathed cable 22, the power/light box being operated by a control panel 
30. 
In use, a processed video signal of the target of interest is displayed by 
an interconnected video monitor 34 which is connected to the light/power 
box 32 to allow viewing, by a physician and patient(s). Other peripheral 
devices, (not shown) such as a video printer, a video tape recorder, a PC, 
etc., can also be substituted into the above described instrument system. 
As recognized, the above diagnostic instrument system 10 introduces a 
number of discrete components and requires a significant spatial footprint 
typically restricting the use of the system to a dedicated area, such as a 
physician's office, an emergency room, etc. Though the above laparoscopic 
system is dedicated to a particular target of surgical interest, in this 
case, the abdominal cavity, other types of diagnostic instruments, such as 
otoscopes, colposcopes, and dermatoscopes, among others, are required for 
performing other types of examinations that are typically done during a 
patient visit. That is, it is not uncommon that a variety of different 
examinations, (ear, eye, throat, skin) could be performed in a single 
family practitioner visit. The ability to electronically capture and 
archive images for each type of examination would be desirable, allowing 
the patient and the physician to both view a target of interest, but as 
noted above, typically a separate dedicated system is required for each 
instrument. 
According to FIG. 2, there is provided a diagrammatic view of a medical 
diagnostic instrument system 40 according to a first preferred embodiment 
of the present invention including a primary instrument body or housing 42 
having a front or distal face 44 and a proximal end 46. A plurality of 
instrument heads 48, 50, 52 and 54 are interchangeably and releasably 
mountable to the front face 44, the details of which will be described in 
greater detail below. 
The instrument body 42 according to this embodiment is tethered by known 
means at the proximal end 46 to one end of an umbilical cable 56, the 
remaining end of which is attached to an interface box 58. The interface 
box 58, in general, acts as a conduit to supply electric power to the 
described system 40 from a transformer 60 connected to a conventional wall 
outlet 70, though it is conceivable that other electric power sources, 
such as batteries and the like, could be alternately utilized. A battery 
powered instrument is described in a succeeding embodiment of this 
invention. 
The interface box 58 includes a number of attachment ports 62 to enable 
interconnection to a number of video peripheral devices. For purposes of 
this embodiment, a video monitor 64, a video printer 66, and a personal 
computer 68 are shown, each of which is capable of receiving a processed 
video signal from the diagnostic instrument, as is described in greater 
detail below. Preferably, the interface box 58 includes additional ports 
(not shown), allowing a plurality of instrument bodies 42A, 42B to be 
similarly interconnected by umbilical cables 56A, 56B. Details relating to 
the method of interconnection are well known in the field and require no 
further discussion for purposes of the present invention. 
According to this embodiment, a conventional wall mount 71 is preferably 
provided for receiving and retaining an instrument body 42 or bodies 42A, 
42B when the instrument is not in use. The wall mount 71 may also be 
suitably equipped to provide a signal to turn the illumination and video 
mechanism off upon engagement therewith; that is, to shut the unit off 
automatically when the instrument is no longer in use. 
Referring now to FIG. 3(a), the instrument body 42 according to this 
embodiment includes a substantially hollow interior 72 defined by a 
hand-holdable section 74 and an instrument section 76. The hand-holdable 
section 74 assumes the shape of a pistol grip, though other convenient 
shapes or designs can alternately be used. Each of the two sections 74, 76 
are integral, the instrument body 42 having a separable two-part housing 
78 which is attached using threaded fasteners 80 through holes 81 provided 
at either end. The interior 72 of the instrument section 76 is sized for 
containing a miniature video camera, such as a charge coupled device 
(CCD), CMOS, or other electronic sensor 82, having a substrate 84 defining 
an image plane for receiving an optical signal along a viewing axis 85, 
extending to the front face 44, FIG. 2, of the instrument body 42. For 
purposes of this specifically described embodiment, a compact Hitachi 
VK-C25A color video camera is provided. An infrared filter 86 and plano 
lens 87, each shown in phantom, are disposed in front of the electronic 
sensor 82, and aligned with the viewing axis 85. 
A series of transmission lines 88 are soldered or otherwise connected to a 
series of connector pins (not shown) extending from the rear of the 
electronic sensor 82, by known means, to an integrated circuit board 92 
disposed in the hand-holdable portion 74. The circuit board 92 contains 
video processing circuitry (not shown) for converting the electrical 
signal from the electronic sensor 82 into a video signal which is then 
transmitted from the circuit board along the transmission lines 83 
extending through the umbilical cable 56 to the video peripheral devices 
64, 66, 68, FIG. 2, through the interface box 58, FIG. 2. The umbilical 
cable 56, as partially shown in FIG. 3(a), includes a flexible covering 90 
and is sized for also containing additional transmission lines 94 for 
transmitting electric power from the transformer 60, FIG. 2, to the 
instrument section 76. 
The instrument body 42 also contains a power ON/OFF switch 95 comprising a 
depressible portion extending through a slot (not shown) in the two-part 
housing 78, as well as a similarly disposed white balance button 98, the 
purpose of which will be described below. 
Still referring to FIG. 3(a), one of the instrument heads; in this instance 
an otoscopic instrument head 48, is shown which is releasably attachable 
to the front face 44 of the instrument body 42. The instrument head 48 has 
an illumination assembly including a supported halogen lamp or other 
suitable light source, and an imaging system retained therein. A major 
feature of the present invention relates to the powering of the 
illuminating assembly using a latching mechanism described in detail 
below. Additional details also follow pertaining to features of each 
interchangeable instrument head 48, 50, 52, 54, as well as the operation 
of the diagnostic system 40 of this embodiment. 
Referring now to FIG. 3(b), the front face 44 of the instrument body 42 
includes a base portion 100 defined by an open ended distally extending 
section 104 having a circular metal alignment plate 108 mounted therein, 
the plate having a substantially flat contact surface 110. The alignment 
plate 108 also includes a centrally disposed and substantially circular 
cavity 112 having a defined bottom planar surface 116. As noted, the 
cavity 112 is substantially circular, with the exception of a pair of 
diametrically opposed tab sections 120. 
A cylindrical pilot section 124 projects distally from the planar surface 
116, the section comprising a circular cross section and an open end 128 
centrally disposed about a center aperture 132. The center aperture 132 is 
centrally disposed on the front face 44 of the instrument body 42 and 
communicates with the interior of the instrument section 76, FIG. 3(a). 
Furthermore, the center aperture 132 is aligned with the viewing axis 85, 
FIG. 3(a). 
The metal alignment plate 108 is securely fastened to the base portion 100 
by engagement of a pair of threaded fasteners (not shown) into 
corresponding diametrically opposed holes 136. The holes 136 are 
preferably countersunk to ensure the planarity of the contact surface 110. 
A pair of electrical contacts 140 connected to the power transmission lines 
83, FIG. 3(a), are provided in a pair of openings 144 provided on the 
planar recessed surface 116. According to this embodiment, the openings 
144 are also diametrically opposed, and are disposed adjacent the tab 
sections 120. The contacts 140 are preferably flush with the planar 
surface 116. A pair of stops (not shown) are provided within respective 
annular slots 148, shown in phantom, extending radially from the tab 
sections 120, the purpose of which is described below. 
As noted above, and depicted in FIG. 2, a number of instrument heads 48, 
50, 52, and 54 are releasably attachable to the front face 44 of the 
instrument body 42, the description of which is now attended to. Each of 
the above instrument heads include an identical latching mechanism for 
releasable attachment to the front face 44 of the instrument body 42. The 
following discussion specifically refers to the latch mechanism related to 
the otoscopic instrument head 48. Similar features are present in the 
attachment of the remaining instrument heads 50, 52, 54. 
LATCHING MECHANISM 
In passing and prior to describing the present latching mechanism, it 
should be noted that though the front facing surface of the instrument and 
the rear surface of the instrument heads, respectively, are the 
interfacing surfaces, mechanisms embodying the concepts prescribed herein 
can be provided using other surfaces thereof. For example, and though not 
shown, the instrument heads could be attached to the top of a suitable 
instrument body for use (e.g. a side-viewing instrument head, etc). 
Referring to FIG. 4(b), the rear or proximal face 152 of the otoscopic 
instrument head 48 includes a ring-shaped latching member 156 having a 
substantially circular configuration with the exception of a pair of 
diametrically opposite ear portions 160. The latching member 156 is 
disposed within a correspondingly shaped cavity 164 provided in a flat 
ring 158 which is fixedly secured to the rear face 152 using a plurality 
of evenly spaced threaded holes 168. The threaded holes 168 are sized for 
receiving a corresponding number of threaded fasteners (not shown). As 
shown in FIG. 4(a), each of the fastener holes 168 extend into an interior 
wall 170 of the instrument head 48. A single pin hole 172 similarly 
extends into the latching member 156 and into the interior wall 170. A pin 
(not shown) inserted into the pin hole 172 prevents rotation of the 
latching member 156. 
Still referring to FIG. 4(b), the latching member 156 is a cylindrical 
member having a pair of open ends 157 centrally disposed relative to a 
center opening or aperture 177 communicating with the interior of the 
instrument head 48. A pair of diametrically opposed cylindrical electrical 
contact elements 192 are slidingly attached to the latching member 156 
through openings extending therethrough into the interior of the 
instrument head 48 for allowing axial movement thereof. A plastic 
insulator 200 surrounds each the contact element 192, as shown in FIG. 
4(a). 
As more clearly shown in FIG. 4(a), the latching member 156 is preferably 
made from a stainless steel and includes an inner annular shoulder portion 
176 disposed within a cavity 180 formed in the interior of the rear face 
152. An O-ring 184 is also disposed within the cavity 180 between the 
annular shoulder portion 176 and the interior surface of the flat ring 
158. 
Referring to FIGS. 4(a), 4(b), and 4(c), the latching member 156 is 
intentionally biased rearwardly relative to the rear face 152 by the 
O-ring 184 to a first axial position. This position is most clearly shown 
in FIG. 4(a). The leaf springs 183 each include an engagement portion 188 
at one end which is aligned with the inwardly extending end of a contact 
member 192 so as to supply a bearing force thereupon. 
In use, the rear side 152 of the instrument head 48 is brought into 
engagement with the front face 44 of the instrument body 42, FIG. 3(b). 
The latching member 156 is aligned with the cavity 112, and more 
specifically the ear portions 160 are aligned with the tab portions 120. 
Preferably, the cavity 112, including the tab portions 120 closely match 
the profile or contour of the latching member 156. The engagement of the 
cylindrical pilot portion 124 causes the latching member 156 to be 
directed forwardly toward the interior of the instrument head 48 against 
the bias of the O-ring 184, ensuring significant contact between the flat 
ring 158 and the contact surface 110. 
Rotation of the entirety of the instrument head 48 in a clockwise manner; 
that is, clockwise as perceived looking at the front face 44 of the 
instrument body 42, advances the ear portions 160 into the annular slots 
148 until engagement with the stops (not shown). The described rotational 
movement causes the contact members 192 to align with and engage with the 
corresponding electrical contacts 140 in the instrument body 42, thereby 
supplying electric power to the supported lamp assembly 101. 
To initiate release, a user reverses the above procedure by grasping and 
rotating the instrument head in the opposite (counterclockwise) direction 
until the ear portions 160 are aligned with the tab portions 120 in the 
instrument body 42. The instrument head 48 is then pulled axially away 
from the front face 44 of the instrument body 42, causing the latching 
member 156, as biased by the O-ring 184, to be moved back into the initial 
axial position. 
As noted above and as depicted in the accompanying FIGS. 5(a), 6(a), 6(b), 
6(c), 7(a), and 7(c), each of the remaining instrument heads 50, 52, and 
54 according to the present embodiment include an identical latching 
mechanism for releasable engagement with the front face 44 of the 
instrument body 42. An actual engagement therebetween is also illustrated 
in FIG. 6(c). 
OTOSCOPIC INSTRUMENT HEAD 
Referring now to FIGS. 4(a)-4(d), a number of additional details pertaining 
to the otoscopic instrument head 42 of this embodiment are herein 
described. The instant instrument head 42 is defined by a substantially 
frusto-conical configuration including a rear housing portion 202, an 
intermediate housing portion 204, and an front housing or insertion 
portion 206 distally arranged therefrom. The insertion portion 206 
includes overlapping and conically shaped inner and outer tip housings, 
210, 214, each having a respective distal tip opening 218, 222. A safety 
speculum 226 made from a plastic material and having a distal tip opening 
228 is mounted onto the conical periphery of the outer tip housing 214, 
also in overlapping relation thereto. A linear lens tube 230 is retained 
within the interior of the inner tip housing 210 extending rearwardly from 
the tip opening 218. A series of objective lens assemblies 234 are 
retained within each of the lens tubes 230. 
As most clearly seen in FIGS. 4(a) and 4(c), the illumination assembly 101 
includes a miniature halogen lamp 238 which is disposed within the rear 
housing portion 202 and press-fitted within a spring-metal receptacle 242 
placed in a spaced enclosure 244 formed by a pair of supporting plates 246 
mounted to a rear wall 248. The spring metal receptacle 242 forms a pocket 
sized for retaining the lamp 238 from one of a pair of flat sections 252, 
which are mounted to the exterior of the supporting plates 246. 
The remaining flat spring-metal section 254 includes a curved section 256 
which is disposed behind the lamp 238 and into engagement with the lamp 
contacts 258. Each of the flat spring metal sections 252, 254 support the 
leaf springs 183 such that when the contacts 192 engage the contacts 140 
in the instrument body 42, FIG. 3(a), that the electrical circuit is 
completed, allowing the lamp 238 to be powered. 
Referring to FIGS. 4(a) and 4(d), light from the halogen lamp 238 is 
directed to one end of a bundle of optical fibers 262 (partially shown in 
FIG. 4(a)) which are fanned out into an annular space 264 formed between 
the lens tube 230 and the interior wall of the inner tip housing 210. The 
bundle of fibers 262 terminate at the distal tip opening 218 of the inner 
tip housing 210 as a polished light emitting end 266. 
Still referring to FIGS. 4(a) and 4(d), an insufflation port 250 is 
provided in the intermediate housing portion 204 and sized to receive a 
fitting 268, shown only in FIGS. 3(a) and 4(a). The insufflation port 250 
defines one end of a passageway extending into the interior of the 
insertion section 206. The fitting 268 allows a known depressible 
pneumatic bulb (not shown) to be connected thereto for directing air (or 
creating a vacuum) through the path 270 which is defined through an 
opening in an interior wall 272 into an annular space 260 between the 
inner and outer tip housings 210, 214. The air then passes out the distal 
tip opening 222 of the outer tip housing 214 and into another annular 
space 274 defined between the inner tip housing 210 and the interior of 
the safety speculum 226. The directed air exits through the distal tip 
opening 228 of the safety speculum 226. A rear wall 278 seals the 
assembly, along with the mounted safety speculum 226 from air leakage 
other than through the distal tip opening 228, as shown in FIG. 4(d). 
The safety speculum 226 is releasably attached to the outer tip housing 214 
using a bayonet attachment as described in commonly owned U.S. Pat. No. 
4,380,998 issued to Kieffer, et al, the entire contents of which are 
herein incorporated by reference. In use, the otoscopic instrument head 48 
is attached as previously described and as shown in FIG. 3(a). The 
described latching mechanism allows the instrument head 48 to be locked 
into engagement with the front side 44 of the instrument body 42. 
Referring to FIG. 4(a), this engagement allows the proper electrical 
interconnection to power the lamp assembly 101 which directs light through 
the optical fiber bundle 262 to the distal tip opening of the insertion 
portion 206. In addition, insufflation capability is provided through the 
port 250 to allow stimulation of the tympanic membrane. 
The target of interest (the interior of the ear canal) is viewed by the 
objective lens assembly 234 through the aligned tip opening 226, 218 which 
then projects the optical image along the viewing axis 85, FIG. 3(a), 
focusing the image onto the electronic sensor 82, FIG. 3(a). Though 
described as an otoscope embodiment, it is conceivable that an instrument 
head of the above or similar design could be used in cavities having 
narrow or shaped openings in-addition to the ear canal. 
SURFACE MICROSCOPE HEAD 
Referring to FIGS. 5(a)-5(c), a surface microscope head 50 according to the 
instant embodiment includes an elongated housing 280 having a hollow 
interior 288 and respective proximal and distal ends 284, 296. The housing 
280 has a substantially frusto-conical configuration with the proximal end 
284 being wider than the distal end 296 to provide adequate space 
allocation for an illumination assembly 282 disposed therein. 
The proximal end 284 of the instrument head 50 is defined by a cylindrical 
base portion 290 having a cavity 291 sized for retaining a shoulder 
portion 177 of a latching member 156. The cavity 291 is formed between a 
flat ring 158 mounted by threaded fasteners (not shown) through 
countersunk holes 168 to an interior wall 302. The remainder of the 
latching member 156 extends through an opening 164, FIG. 4(b), on the flat 
ring 158, and is biased into a first axial position by a pair of leaf 
springs 304, 306 mounted to the inside surface of the interior wall 302 
and engaged into biasing contact with a pair of contact members 192, only 
one being shown in FIG. 5(c), extending through the latching member 156 
and the interior wall 302 into the hollow interior 288 of the housing 280. 
For purposes of discussion, the latching member 156 is identical to that 
previously described which releasably engages the front face 44, FIG. 
3(a), of the instrument body 42, FIG. 3(a). Therefore, no further 
discussion is required except as needed. 
A releasably attachable lens holder 292 is disposed at the distal end 296 
thereof The lens holder 292 accommodates a viewing window 300 having a 
measuring reticle (not shown) for providing a frame of reference or means 
of measuring a target of interest. For purposes of this embodiment, the 
viewing window 300 provides a field of view of approximately 15 mm, and is 
releasably attachable to allow cleaning and/or sterilization. The viewing 
window 300 according to this embodiment is made from a plate glass, though 
any optical grade material including light plastics such as acrylic, or 
polycarbonate are suitable. 
As most clearly seen in FIGS. 5(a) and 5(c), the illumination assembly 282 
includes a light source, such as a miniature halogen lamp 298, which is 
retained within a spaced enclosure 305 formed by a pair of parallel 
supporting plates 310 extending from the interior of the wall 302. As with 
the other illumination assemblies described herein, other suitable light 
sources, such as low-power surface-mounted or bulb-type white LEDs, can 
also be substituted. The spaced enclosure 305 further includes a spring 
metal receptacle 314 into which the lamp 298 is press-fitted, the 
receptacle being formed from one of a pair of leaf springs 304 having a 
substantially flat portion attached to the interior of the wall 302. The 
remaining leaf spring 306 includes a flat extending portion 320 for 
contacting the rear electrical contacts (not shown) of the halogen lamp 
298 when fitted into the spaced enclosure 305. A first polarizer 308 is 
provided at the light emitting end of the lamp 298 and attached to the 
corresponding end of the supporting plates 310. The first polarizer 308 is 
angled relative to the axis formed between the viewing window 300 and a 
lens assembly 316 including a plano lens 318, an aperture plate 322, and 
an objective lens 326 respectively disposed within the interior of the 
base portion 290. According to this embodiment, a second polarizer 312 is 
also provided between the viewing window 300 and the lens assembly 316, to 
assist in minimizing glare presented by the illumination assembly 282. The 
polarizer 308, 312 also combine to minimize specular glare from the target 
(e.g. skin) surface. 
In use, the instrument head 50 is mounted in the previously described 
manner such that the latching member 156 inwardly deflects when engaged 
with the front face 44, FIG. 3(a), of the instrument body 42. This 
deflection causes the cylindrical contact members 192 to bear against 
respective engagement portions 330 of the leaf springs 304, 306, as 
illustrated in FIGS. 5(a) and 5(c). Subsequent twisting of the instrument 
head 50 as described above, also aligns the contacts 192 with the 
corresponding contacts 140, FIG. 3(b), provided in the instrument body 42, 
FIG. 3(b), and completes an electrical connection causing the lamp 298 to 
illuminate upon locking of the instrument head 50 in place. 
The illumination assembly 282, and particularly the first polarizer lens 
308, being angled relative to the viewing axis 85 causes light to 
indirectly strike the viewing window 300 in order to minimize reflective 
glare from the inside surface thereof, and to prevent an image of the 
illuminating assembly to be reflected optically through the lens assembly 
316. When assembled, the lens assembly 316, including the second polarizer 
312, and the viewing window 300 are each aligned along the viewing axis 
85, FIG. 3(a), to allow a focused optical image to be transmitted to the 
electronic sensor 82, FIG. 3(a). The lens assembly 316 allows focusing of 
an optical image of the target (a wart, lesion, or other skin disorder) 
when the viewing window 300 is placed in direct contact therewith. 
The preceding embodiment relates specifically to skin-surface examinations. 
It will be readily apparent, however, to one of sufficient skill in the 
field, that other non-medical applications requiring similar analysis can 
utilize instruments suitably configured. 
GENERAL VIEWING INSTRUMENT HEAD 
Referring now to FIGS. 6(a)-6(c), the general viewing instrument head 52 
according to the present embodiment includes a cylindrical base section 
340 similar in construction to the dermatological instrument head 50 
previously described. An adjustable lens assembly 344 is securely mounted 
within a lens holder 354 which is threaded or otherwise attached through 
an opening 352 provided in a distal end 348 thereof. The adjustable lens 
assembly 344 includes at least one objective lens (not shown) and an 
aperture plate (not shown), wherein the objective lens has sufficient 
power to provide an enhanced field of view. The lens assembly 344 is 
movable along a defined axis 362 and allows an optical image to be focused 
onto the electronic sensor 82, FIG. 3(a). The optical axis 362 is aligned 
with viewing axis 85, as shown in FIG. 6(c). 
The instant instrument head 52 includes a latching member 156 as previously 
described for releasably engaging the front face 44, FIG. 2, of the 
instrument body 42, as shown in FIG. 6(b). Because an illumination 
assembly is not present, however, the described instrument head can have a 
compact construction. 
MAGNIFYING INSTRUMENT HEAD 
Referring to FIGS. 7(a)-7(c), the magnifying instrument head 54 is defined 
by a cylindrical housing 380 including an integral depending portion 384 
used to retain an illumination assembly 385. The illumination assembly 385 
includes a halogen lamp 388, or as noted above, another suitable light 
source, and a reflector 392 which are retained within a pocket 387 formed 
by a triad of spring fingers 396 extending from a rear wall 389, as most 
clearly shown in FIG. 7(b). 
The halogen lamp 388 includes a rear electrical contact 400 which engages a 
sheet metal plate (not shown) when the lamp is press-fitted into the 
spring fingers 396. A set of wires 402 extend from the metal plate and the 
spring fingers 396 to respective leaf springs 404 mounted at one end to a 
rear interior wall 406 of the housing 380. The remaining end 415 of the 
leaf springs 404 is cantilevered for movement and is aligned with the ends 
of cylindrical contact members 192 passing through the latching member 156 
and the rear interior wall 406. For purposes of this embodiment, the 
latching member 156 is identical to that described above. To avoid 
redundancy, a recitation of these features, shown in FIGS. 7(a)-7(c), is 
not repeated. Therefore, when the latching member 156 is engaged, the 
electrical connection is completed and the lamp 388 is illuminated. 
The housing 380 also includes an adjustable lens assembly 408 defined by a 
mushroom-shaped housing 412 having a necked portion 416 which is fitted 
into an opening 420 in the front side of the housing. At least one 
objective lens assembly 425 and an adjacent aperture plate (not shown) are 
contained therein. The lens assembly 408, according to this embodiment, is 
received within the opening 420 and is rotatably and axially movable 
therein to permit focal adjustment. A shoulder portion 430 having a width 
dimension which is wider than the opening in the front side of the housing 
380 provides an adjustment limit. 
In use, and when the instrument head 54 is assembled to the front side 44, 
FIG. 3(b), of the instrument body 42, FIG. 3(a), in the manner previously 
described above, an image perceived by the optics contained in the 
adjustable lens assembly 408 is transmitted along the viewing axis 85, 
FIG. 3(a), to the electronic sensor 82. 
As noted, the depending portion 384 of the housing 380 is built in two 
pieces. Removal of the rear wall 389 allows the lamp 388 to be removed for 
replacement as needed. Finally, the lamp 388 is oriented such that the 
defined illumination axis 424 is angled relative to the viewing axis 85. 
A second embodiment of a video diagnostic instrument system according to 
the present invention is herein described with reference to FIGS. 8-10(b). 
Similar parts are herein labeled with the same reference numerals for the 
sake of convenience. 
As shown in the cross-sectional view of FIG. 8, an instrument base unit 460 
is illustrated having a hollow interior 464 and within which an imaging 
assembly 470 and an illumination assembly 498 are each provided. The 
imaging assembly 470, as in the preceding embodiment, includes a CCD or 
other electronic sensor 82 having an image plane or substrate 84 which is 
aligned with a viewing opening 468 of the base unit 460, thereby defining 
a viewing axis 85. A video processing board 472 having circuitry for 
converting an electronic signal from the electronic sensor 82 to a 
monitor-ready video signal is also disposed within the interior 464 of the 
base unit 460 and is interconnected by transmission lines (not shown) 
through an umbilical cable 56 partially shown). The illumination assembly 
498 includes a halogen lamp 502 positioned within a reflector 506, the 
lamp having electrical contacts (not shown) which are interconnected to 
the transmission in the umbilical cable 56. 
As in the preceding embodiment, a plurality of instrument heads (not shown) 
can be releasably mounted to the front face of the instrument base unit 
460, in a manner similar to that described above. For purposes of the 
present embodiment, an exemplary instrument head is shown in FIG. 9, which 
is a surface microscope head 520 similar to that described as 50 above, 
having a housing 522, including an engagement or locking member 524 
projecting from the rear side 528 for attachment within a defined cavity 
530 of the distal face of the instrument base unit 460. 
The instrument head housing 522 includes a viewing window 526 mounted in a 
releasably attachable circular lens holder 527 which is mounted on the 
distal end 532 of the housing oppositely disposed from the locking member 
524. 
The housing 522 further includes an expanded interior 533 sized for 
retaining a light pipe 534 for transmitting light from the illumination 
assembly 498 to the viewing window 526. 
Referring to FIGS. 9, 10(a) and 10(b), the light pipe 534 is made from a 
transparent (light-transmissive) material, such as acrylic or 
polycarbonate, including a light receiving end 542 which is positioned in 
alignment with the light emitting end 500 of the illumination assembly 
498, which as noted earlier, is disposed above the imaging assembly 470. 
The light receiving end 542 is part of a cylindrical light emitting 
portion 538 which is curved to allow the light pipe 534 to extend into the 
expanded portion of the interior 533. The pipe 534 includes a cylindrical 
light emitting portion 538 at the remaining end having a through opening 
546 to enable an optical image from the viewing window 526 to be 
transmitted along the viewing axis 85 without interference. In the 
meantime, light from the illumination assembly 498 is transmitted through 
the length of the light pipe 534 where the light is transmitted in a 
circular area through the viewing window 526 from the cylindrical light 
emitting portion 538. 
The location of the electronic imager 82 in the described system is not 
limited to the interior of the instrument body. Referring to FIGS. 11 and 
12, a diagnostic instrument system in accordance with a third embodiment 
of the present invention is herein described. 
An instrument body 560 includes a hand-holdable portion 564 shaped 
similarly like a pistol grip which includes a hollow interior 568 sized to 
retain a number of components. Preferably, the body 560 is a two-part 
housing connected by fasteners inserted through spaced holes 640. A number 
of depressible buttons and/or switches (not shown) are included on the 
exterior of the body 560 to control a number of functions including an 
ON/OFF power switch 572, a white balance switch 576, and an electronic 
zoom control switch (not shown). 
At least one instrument head 584 is mountable to the front face 588 of the 
instrument body 560, the instrument head including an electronic imager 
assembly 590 and an illumination assembly 592 disposed within a 
substantially hollow interior 593. The imager assembly 590 includes an 
electronic sensor 82 disposed adjacent to a rear wall 600 and includes a 
number of spring-loaded contacts 608 on the exterior of the rear wall 600, 
which can be subsequently brought into engagement with corresponding 
contacts 604 provided on the front face surface 588 of the instrument body 
560. 
The illumination assembly 592 includes a halogen lamp 612 positioned above 
the imager assembly. An opening 638 in the rear wall 600 allows the lamp 
to be accessed for replacement, while the imager assembly 590 is 
accessible by means of a removable cover 639. 
The engagement interface between the instrument head 584 and the instrument 
body 560 is structurally different than the latching mechanisms previously 
described. In this embodiment, the rear wall 600 of the instrument head 
584 includes a peripheral slot 628 covering at least three sides of the 
periphery for engaging a correspondingly sized annular shoulder 630 
provided in the front face 588 of the instrument body 560. 
The instrument head 588 is fitted by sliding the head onto the body 560 in 
the direction of arrow 634, as shown in FIG. 11. 
Referring to the sectional view of FIG. 13, there is shown a diagnostic or 
other suitable instrument 1100 according to a fourth embodiment of the 
present invention. The instrument 1100 includes a body section 1104 and an 
instrument head 1108 which is releasably attachable to a distal face 1112 
thereof. 
The instrument head 1108 according to the present embodiment includes a 
housing 1116 having a distal receptacle 1120 sized for accommodating a 
lens assembly 1124 having a series of linearly arranged optical elements 
disposed along an optical axis 1128 in an adjustable lens cell 1126. 
An electronic imager 1132, such as a miniature CCD or CMOS vide camera, is 
attached to an interior surface 1140 of a rear wall 1136 of the instrument 
head 1108. The imager 1132 includes a light receiving surface (not shown) 
which is aligned with the optical axis 1128 to receive any focused image 
of a target of interest from the adjustable lens cell 1126. 
A polarizer element 1 144 is disposed between the electronic imager 1132 
and the receptacle 1120. The polarizer element 1144 is preferably attached 
to a slide mechanism 1148 externally connected to the housing 1116 through 
a slot 1152, allowing selective positioning of the polarizer element 
relative to the optical axis 1128. 
An adjustable lamp assembly 1156 includes a low-power miniature halogen 
lamp or other suitable light source to an external portion of the 
instrument head housing 1116. According to the present embodiment, the 
lamp assembly 1156 is pivotally attached to the housing 1116, the housing 
having a series of circumferentially disposed detents 1160 for 
accommodating toothed sections 1164 of the lamp assembly 1156 so as to 
orient the lamp until the illumination axis 1157 is aligned with and 
intersects the optical axis 1128. Other suitable automatic or manual 
assembly mechanisms (not shown) for rotating or otherwise shifting the 
location of the lamp assembly 1156 can easily be imagined. 
The body section 1104 of the instrument 1100 includes a handle 
configuration having an interior sized for accommodating a number of 
components. The interior 1170 includes a battery compartment 1174 for at 
least one contained rechargeable battery 1178. 
An RF (radio frequency) antenna 1180 is attached by conventional means and 
extends from an upper part of the body section 1104. Electrical connectors 
1182 extending from the RF antenna 1180 are connected to a conventional RF 
circuit board 1184. Another set of electrical connectors 1188 extend from 
opposite sides of the battery compartment 1174 in alignment with the 
terminals of the battery 1178 to a power modifying printed circuit board 
1194 disposed adjacent the distal face 1112 of the instrument head and 
having appropriate regulators and drivers for setting the voltage and 
wattage for powering the imager 1132 and the adjustable lamp assembly 1156 
of the instrument head 1108. 
A series of spring loaded contacts 1200 extend from the front of the power 
modifying printed circuit board 1194 for engaging female contacts 1202 
located on the exterior side of the rear wall 1136 of the instrument head 
1108. 
The circuit board 1194 is interconnected by known means to a set of 
switches located on the exterior of the body section 1104 of the 
instrument 1100. More particularly, these switches include an ON/OFF power 
switch 1216, an electronic zoom switch 1218, and a white balance switch 
1220, wherein the power modifying circuit board 1194 is connected in a 
known manner order to support the above switches. 
As noted, the lens cell 1126 is adjustable via a threaded portion 1212 
which engages a threaded opening 1214 of the lens assembly 1124. In 
assembly, the distal receptacle 1120 includes a groove 1122 for 
accommodating an O-ring 1208 on the lens assembly 1124 used to seal the 
lens assembly into position. 
In operation, engagement of the corresponding contacts 1200, 1202 during 
attachment of the instrument head 1108 to the distal face 1112 of the body 
section 1104 powers the adjustable lamp assembly 1156 and the electronic 
imager 1132 by connection with the power modifying printed circuit board 
1194, as powered by the battery 1178. 
Selective depression of the power ON/OFF switch 1216 can also be used to 
control the lamp assembly 1156 and imager 1132 after the instrument head 
1108 has been attached. 
Preferably, and according to this embodiment, the latching mechanism used 
to retain the instrument head 1108 is similar to that described in FIG. 12 
in which the rear wall 1136 of the instrument head 1108 includes a 
peripheral slot 1222 for engaging a corresponding annular shoulder 1226 of 
the distal face 1112 of the body section 1104, though other means could 
similarly be employed. When engaged, the output of the electronic imager 
1132 can be transmitted using the RF circuitry and antenna 1180 to a video 
processor, video printer or other peripheral device (not shown) having 
suitable means for receiving and decoding the RF signal and obviating the 
need for cabling. 
A charger port 1224 extends from the bottom of the body section 1104 to 
allow recharging of the battery 1178 without having to remove the battery 
from the compartment 1174. 
MULTIMEDIA DIAGNOSTIC INSTRUMENT 
Referring now to FIG. 14, a diagnostic instrument system 730 according to a 
further preferred embodiment of the present invention comprises a compact 
diagnostic instrument 732 including a housing or body 734 having a front 
interface 736 with means for allowing selective releasable attachment 
thereto of a plurality of instrument heads. According to this embodiment, 
the instrument heads include a general purpose instrument head 738, a 
dermatological instrument head 740, a high magnification instrument head 
742, and an otological instrument head 746. Other instrument heads such 
for ophthalmoscopes employing optical systems such as described in 
commonly assigned U.S. Pat. Nos. 4,526,449 and 4,998,818, for example, 
incorporated by reference herein, can also be utilized. Details relating 
to each of the instrument heads 738, 740, 742, 746 and the attachment of 
each to the diagnostic instrument 732 are described in greater detail 
below. In passing, however, it should be noted that the instrument heads 
described in the first embodiment could be substituted for those about to 
be described and vice versa. Still further, other suitable heads for the 
same or other purposes, e.g. ophthalmoscopic could be envisioned. 
Referring to FIGS. 15 and 16, the diagnostic instrument 732 for purposes of 
the described system 730, FIG. 14, is a compact digital camera having a 
defined interior 748. The interior 748 is appropriately sized to retain a 
plurality of components including an electronic imaging element 750, such 
as a charge coupled device (CCD), disposed adjacent a window 752 or clear 
covering at the front interface 736. The digital camera used in the 
described embodiment is a "COOLPIX 300" sold by the Nikon Corporation, 
though it will be apparent that other known compact digital cameras having 
similar or other features can be similarly configured for use in the 
described diagnostic instrument system. 
The electronic imaging element 750, as is known to those of skill in the 
field, includes a light receiving surface having a two dimensional array 
of pixels (not shown), for receiving an optical image along a viewing axis 
753 from a target of interest. Processing electronics (not shown) also 
retained within the interior 748 allow the optical image to be converted 
into an electrical signal and subsequently converted into a digital 
signal. According to the present embodiment, the electronic imaging 
element 750 is a progressive scanning CCD color camera with a 1/3" 330,000 
square-pixel array having a resolution of 640 (horizontal) .times.480 
(vertical) dots. Other types of imaging elements, such as CMOS imager 
including those manufactured by Omnivision, Inc., among others, having 
other processing circuitry (not shown) could alternately be utilized. 
Reference is made here to FIG. 34 which illustrates an architecture for 
the described embodiment. 
Still referring to FIGS. 15 and 16, a controller, such as a microprocessor 
with sufficient memory and programmable logic is contained within the 
interior of the instrument housing 734 and is interconnected to the 
retained components, including an integral touch-sensitive TFT liquid 
crystal display (LED) 754, provided at the rear side 756 of the instrument 
housing 734. Alternately, an eyepiece (Kopin) type of display (not shown) 
could be used. The processed digital video signal is outputted to the 
display 754 by the microprocessor for viewing by the user. A protective 
cover 755, slidingly attached to the rear side 756 of the housing 734 by 
known means, allows selective access to the display 754. Preferably, the 
rear side 756 of the instrument housing 764 is angled, as shown in FIG. 15 
by reference numeral 760, relative to the vertical axis 762 and orthogonal 
to the viewing axis 753 of the instrument 732 to facilitate viewing of the 
display 754 for the user. According to the embodiment, an angle, 
represented in FIG. 16 as --A--, of approximately 15 degrees is suitable. 
Referring to FIGS. 14-18, the programmable logic and internal memory of the 
microprocessor allows various forms of data to be captured and stored in 
conjunction with image (video) information. An internal condenser 
microphone 764 disposed on the top exterior of the instrument housing 734 
allows audio information to be captured and stored selectively into the 
memory of the microcontroller (not shown), while an integral speaker 766 
disposed on the rear side 756 of the housing allows playback of the stored 
audio information in conjunction with a stored video image. 
A plurality of control switches located on the exterior of the instrument 
housing 734 includes a POWER ON/OFF switch 768, as well as a 
RECORD/PLAYBACK switch 770 controlling the audio recording and playback 
features of the camera. A series of indicating lamps are also provided, 
more specifically a power lamp 772, a ready lamp 773, and a recording lamp 
774. 
The described digital camera used as the diagnostic instrument 732 includes 
other salient and specific features relating to image capture, such as 
programmed auto-exposure control, including an electronic single-frame 
shutter and automatic gain control. The specific teachings of these 
features do not specifically form a part of the present invention. 
Therefore, no further discussion is required. 
Activation of the diagnostic instrument 732 using POWER ON switch 768 
activates the imager and processing circuitry so as to allow a real time 
video image to be viewed on the TFT display 754. The viewed image can be 
selectively captured using a shutter release button provided on the 
instrument housing 734 (not shown), causing the image to be stored into 
the internal memory of the controller. Activation of the switch 770 allows 
the microphone 764 to be enabled to allow audio data to be captured 
corresponding to the video image which is being currently displayed. The 
camera includes a MENU feature controlled by the programmable logic of the 
controller which allows the length of the sound clip to be controlled. 
Alternately, other modes are provided for recording sound without use of 
the video capture mechanisms, if desired. Audio data is stored in a WAV 
format, though other formats with varying degrees of compression may also 
be used. In the present embodiment, approximately 17 minutes of sound data 
memory are provided though this quantity can easily be varied. 
Referring briefly to FIGS. 18 and 19, the TFT display 754 according to the 
present embodiment includes a main window 776 and a plurality of 
selectable keys disposed about the periphery thereof, including a key for 
accessing a main menu 778, an ENTER key 780, a CANCEL key 782, and a 
DELETE key 784. Keys 786 are also provided to allow scrolling in either 
vertical direction. The main window 776 can be selectively divided into 
separate image fields for allowing multiple stored digital images to be 
displayed simultaneously, and to allow annotation relating to a displayed 
image(s). Exemplary image fields 788 and 790 and an annotation field 792 
are shown in FIG. 19, though preferably the microprocessor allows 
literally any number of separate fields to be made available. For example, 
a plurality of miniature captured images (not shown) can be displayed in a 
sequential manner as a slide show presentation on the main window 776. A 
stylus pen (not shown) selectively allows notes to be added in the 
illustrated annotation field 792. The notes are also stored into the 
internal memory of the instrument 432. 
For reasons which are apparent below, the programmable logic of the 
controller of the described instrument 732 also includes an internal 
calendar, including a date and time stamp which automatically provides an 
entry which is stored with each corresponding video and/or audio image 
captured by the camera. In an alternate embodiment, not shown, the 
multimedia instrument could conceivably link forms of data input 
selectively or not at all. For example, video may not be required for 
certain applications which may require only annotation and audio data, 
etc. 
Image data in internal memory are stored in the presently described 
instrument using JPEG compression to reduce the amount of memory they 
consume. Image quality can be enhanced by adjusting of a menu setting in 
order to produce either high quality photographs or normal (compressed) 
photographs which increases the compression ratio and reduces the amount 
of memory needed to store each photograph. In the described camera, the 
high quality mode allows 66 images to be stored using a compression ratio 
of 10:1 and 132 photographs to be stored using a compression of 20:1 in 
the normal mode. 
Additional detail relating to certain specific features, including use of 
the menus of the display of the herein described digital camera are 
provided in the COOLPIX 300 User's Manual, the entire contents of which 
are incorporated by reference. The theory of operation relating to each of 
these features, except as indicated, do not form an inventive part of the 
present invention. Therefore, no further discussion is required, except as 
pertinent to the present invention. 
Preferably, the instrument housing 734 includes a compartment 794, FIG. 17, 
accessible from the rear side 756 thereof for retaining a set of 
rechargeable batteries (not shown) for powering the instrument 732. 
Alternately, a separate adapter cord (not shown) can supply power from a 
suitable AC outlet (not shown). 
The instrument 732 further includes a serial port (not shown) and an SCSI 
port (also not shown in this embodiment) allows selective interconnection 
to a computer (not shown) or to a docking station or cradle 796, FIG. 34, 
which is similarly linked to a PC or PC network, according to a preferred 
embodiment described in greater detail below. Alternately, the stored 
audio and video data can also be transmitted to a video printer, or other 
suitable peripheral device(s) (not shown). 
LATCHING MECHANISM 
With reference to FIGS. 15, 16(a) and 16(b), the front interface 736 of the 
herein referred to multimedia diagnostic instrument 732 provides 
releasable but locking engagement with latching members provided on the 
rear side of each of the instrument heads 738, 740, 742, 746, FIG. 14. 
Furthermore, engagement also allows electrical contact to be made with 
illumination sources (if any) provided in the attached instrument head of 
choice, without interfering with the optical path to the electronic 
imaging element 750. Attachment of an instrument head of choice using the 
described latching mechanism also aligns the optical components of the 
instrument head with the instrument viewing axis 753. 
The latching mechanism is nearly identical to that described in the first 
embodiment above. In brief, the front interface 736 includes an open-ended 
distally extending section 798 having a centrally disposed and 
substantially circular cavity 800 with a defined planar mounting surface 
802. As noted, the cavity 800 is substantially circular, with the 
exception of a pair of diametrically opposed tab sections 804. 
A cylindrical pilot section 806 projects distally from the planar surface 
802, the section comprising a circular cross section and an open end 808 
centrally disposed about an aperture 810 which directly communicates with 
the interior 748, FIG. 16(a), of the diagnostic instrument 732. 
Specifically, the aperture 810 is coaxial with the viewing axis 753, FIG. 
16(a), and extends directly into the instrument 732 to the imaging 
substrate (light receiving surface) of the electronic imaging element 750, 
FIG. 16(a), as supported within the housing 734, FIG. 16(a). Though not 
shown in this embodiment, a lens element could be supplied within the 
pilot section and aligned with the imaging element 750 in lieu of or in 
combination with any of the instrument heads. That is to say, a general or 
other optical system can be alternately supplied in the instrument 
interface. 
A pair of electrical contacts 812 connected at an interior end thereof (not 
shown) to a series of power transmission lines (not shown), each include 
an opposite exposed end, which is preferably flush with the planar 
mounting surface 802. According to this embodiment, the electrical 
contacts 812 are diametrically opposed from one another, and are disposed 
adjacent the tab sections 804. A pair of stops 814 (only one being shown 
in FIG. 16(b)) is provided within respective annular slots 816, each 
extending radially from one side of each tab section 804. 
The front interface 736 engages the rear or proximal face of a 
corresponding instrument head of choice. For purposes of explanation, the 
following description relates to the otoscopic instrument head 746, though 
each instrument head includes similar features for releasable attachment 
to the diagnostic instrument 732. 
Referring to FIGS. 20-23, the otoscopic instrument head 746 of this 
embodiment includes a latching member 818 similar to that described in 
FIGS. 4(a)-4(d) above, the member having a rounded configuration, with the 
exception of a pair of diametrically opposite ear portions 820 and a pair 
of flat edges 822. The latching member 818 is disposed within a 
correspondingly shaped cavity 824 provided in a flat ring 826 fixedly 
secured to the rear face of the instrument head 746 by known means. 
The latching member 818 is a cylindrical member having a pair of open ends 
centrally disposed relative to a center opening or aperture 828 
communicating with the interior of the instrument head 746. A pair of 
diametrically opposed cylindrical electrical contact elements 830 are 
slidingly attached to the latching member 818 for axial movement thereof 
adjacent the ear portions 820 through openings extending into the interior 
of the instrument head 746. According to this embodiment, the contact 
elements 830 are made from metal, though other materials may be 
substituted. 
Preferably, the latching member 818 is made from plastic (although other 
non conducting materials can be used), and includes an inner annular 
shoulder (not shown) disposed within a cavity formed in the interior of 
the rear face thereof. 
Still referring to FIGS. 20-23, the latching member 818 is intentionally 
biased rearwardly of the flat ring 826 by a pair of internal spring 
fingers 827 to a first or home axial position. A pair of contact springs 
834 are fixedly attached to the interior facing side 836 of a rear support 
839 and includes a depending spring end portion aligned with the inwardly 
extending end of a contact member 830 so as to supply a bearing force 
thereupon. 
In use, the rear support 839 of the otoscopic instrument head 746 is 
brought into engagement with the front interface 736 of the instrument 
body 734. The latching member 818 is aligned with the cavity 800, and more 
specifically the ear portions 820 are aligned with the tab portions 804. 
Preferably, the cavity 800, including the tab portions 804 closely match 
the profile or contour of the latching member 818. The engagement of the 
cylindrical pilot portion 806 causes the latching member 818 to be 
directed forwardly toward the interior of the instrument head 746 against 
the bias of the internal spring fingers 827. 
Rotation of the entirety of the instrument head 746 in a clockwise manner; 
as perceived looking at the front interface 736, advances the ear portions 
820 into the annular slots 816 until engagement with the stops 814. The 
described rotational movement causes the contact members 830 to align with 
and engage with the corresponding electrical contacts 812 in the interface 
736, thereby supplying electric power to a supported lamp assembly 840, as 
described below. 
To initiate release, a user reverses the above procedure by grasping and 
rotating the instrument head 746 in the opposite (counterclockwise) 
direction until the ear portions 820 are aligned with the tab portions 804 
in the interface 736. The instrument head 746 is then pulled axially away 
from the interface 736, causing the latching member 818, as biased by the 
internal spring fingers 827, to be moved back into the initial axial 
position. 
As noted, each of the instrument heads are similarly attached and detached 
from the front interface 736 of the instrument 732. Other salient features 
of each of the instrument heads used in the present embodiment will now be 
described. 
OTOSCOPIC INSTRUMENT HEAD 
Referring first to FIGS. 14 and 20-24, the otoscopic instrument head 746 of 
this specific embodiment includes a substantially cylindrically shaped 
rear or proximal housing portion 839, an intermediate portion 842, and a 
frusto-conical front or distal insertion portion 847. The distal insertion 
portion 847 includes an interior which includes overlapping and conically 
shaped inner and outer tip housings, 848, 850, each having a respective 
distal tip opening 852, 854. As clearly illustrated in FIG. 23, the inner 
tip housing 848 extends distally from the tip opening 854 of the outer tip 
housing 850. A hollow safety speculum 846, made from a plastic material 
and having a distal tip opening 906, is mounted onto the conical periphery 
of the front insertion portion 847, also in overlapping relation thereto. 
Each of the tip openings 850, 848, 906 are coaxial with one another along 
a defined optical axis 856, the tip openings of the mounted speculum 846 
and the front insertion portion 847 being slightly displaced from the tip 
opening 852 of the inner tip housing 848. 
Referring to FIGS. 23 and 24, the optical system of the otoscopic 
instrument head 746 is comprised of a series of axially interconnected 
lens tubes 858, 860, 862 arranged within the interior of the instrument 
head 746 along an optical axis 856. A negative lens element 864 is 
disposed in a first lens tube 858 adjacent the distal opening 852 of the 
inner tip housing 848, FIG. 23. A plano glass section 866 is disposed 
directly in front of the negative lens 864. Preferably, the interior wall 
of the first lens tube 858 defines a shoulder 868 for supporting and 
positioning the two optical elements 864, 866. The proximal end 870 of the 
first lens tube 856 is wider than that of the remainder of the tube and is 
sized for receiving the distal end 872 of the attached second lens tube 
860. An aperture plate 874 and a second lens element 876, are retained 
within the widened proximal end 870 of the first lens tube 858 prior to 
the distal end 872 of the second lens tube 860. The second lens element 
876 is a positive lens of sufficient power. A proximal end of the second 
lens tube 860 is retained within a cavity 878 of the distal end 880 of a 
third lens tube 862, wherein a third lens element 882 is attached at the 
proximal end of the second lens tube 860. The third lens element 882 is a 
doublet containing a concave and convex lens of an appropriate size. 
Finally, a fourth singlet lens element 884 is disposed in a cavity 886 at 
approximately the midpoint of the length of the third lens tube 862. In 
use, an optical signal is channeled through the above disposed lens 
elements and is ultimately focused at the imaging substrate of the 
electronic sensor of the diagnostic instrument upon assembly. It should be 
readily evident that the fourth lens element 884 could alternately be 
disposed within the pilot section 806, FIG. 16(b), of the instrument 732. 
When attached, the optical axis 856 of the otoscopic instrument head 746 is 
coaxial with the viewing axis 753, FIG. 16(a), of the instrument 732, each 
of the above described lens elements being spaced to allow the optical 
signal to be focused onto the imaging substrate (not shown) of the 
electronic imaging element 750. 
As most clearly seen in FIGS. 21 and 23, the otoscopic instrument head 746 
includes a miniature halogen lamp 888 disposed conveniently within the 
rear housing portion 839 and press-fitted within a spring-metal receptacle 
890. The receptacle 890 is defined by a spaced enclosure 892 which is 
preferably formed by a pair of metal supporting ribs 894, 896 mounted to 
the interior side of a rear support 898. The spring metal receptacle 890 
forms a pocket sized for retaining the halogen lamp 888, which is 
preferably angled relative to the optical axis 856. 
One of the metal supporting ribs 894 extends behind the lamp 888 while the 
second supporting rib 896 extends to the front and sides thereof Each of 
the supporting ribs 894, 896 include sections 900 (only one being shown) 
extending along the rear support 898, and thereby defining the previously 
described flat springs 834, such that when the contacts 830 engage the 
contacts 812 in the instrument body 734, an electrical circuit is 
completed, allowing the lamp 888 to be powered automatically. 
Referring to FIG. 23, light from the halogen lamp 888 is directed to one 
end of a bundle 902 of optical fibers. The bundle of fibers 902 are fanned 
out into an annular space 904 formed between the exterior of the lens 
tubes 858, 860, 862 of the optical system and the interior wall of the 
inner tip housing 848 so as not to interfere with the transmission of 
optical data. The bundle of fibers 902 terminate at the distal tip opening 
852 as a polished light emitting end. 
As noted, the safety speculum 846 is preferably attached in a releasable 
manner to the exterior of the front insertion portion 847 using a bayonet 
attachment as described in commonly owned U.S. Pat. No. 4,380,998 issued 
to Kieffer, et al, the entire contents of which are herein incorporated by 
reference. In use, the previously described latching mechanism allows the 
instrument head 746 to be locked into engagement with the front interface 
736 of the instrument body 734. This engagement allows a proper electrical 
interconnection to power the lamp 888 which directs light through the 
optical fiber bundle 902 to the distal tip opening 906 of the insertion 
portion 846. In addition, insufflation capability can be provided through 
a separate port (not shown) to allow stimulation of the tympanic membrane. 
The target of interest (the interior of the ear canal) is viewed through 
the aligned tip openings, allowing an optical image along the aligned axes 
856,753. The lens elements of the optical system are preferably spaced so 
as to focus the image directly onto the electronic imaging element 750. 
GENERAL PURPOSE INSTRUMENT HEAD 
Referring now to FIGS. 14, 25 and 26, the general purpose or 
general-viewing instrument head 738 according to the present multimedia 
instrument embodiment includes a cylindrical housing 908 having a rear 
plate 910 and a defined hollow interior. An adjustable lens assembly 912 
is securely mounted within a lens holder which is threaded or otherwise 
attached through an opening provided in a distal end 914 thereof. The 
adjustable lens assembly 912 includes at least one objective lens and an 
aperture plate of sufficient size to provide an enhanced field of view for 
the diagnostic instrument 732 when assembled thereto. According to the 
present embodiment, a field of view of approximately 40 degrees is 
provided, but this parameter can be easily varied depending on the 
application. The lens assembly 912 of the present embodiment is movable 
along a defined axis 916 so as to focus at a wide range of distances, 
allowing a formed optical image to be focused onto the electronic imaging 
element 750, FIG. 15, while varying the object distance. As noted, the 
instrument head 738 is attached to the front interface 736 of the 
instrument 732, in the manner previously described above. 
This particular instrument head design does not include an illumination 
assembly although one could be added, depending on the application. 
However, the latching member 918 includes a pair of non-electrical contact 
members 922 extending through the rear plate 910. Each contact member 922 
includes an interior end for separately engaging a pair of flat springs 
924 fixedly attached to the interior side of the rear plate 910. The 
springs 924 provide a bias for engaging and locking the instrument head 
738 in place with the front interface 736 of the instrument 732. 
In use, the optical path proceeds in an uninterrupted manner through the 
interior of the instrument head 738 and the opening defined in the 
latching member 918, which is focused at the electronic imaging element 
750, FIG. 15. 
SURFACE MICROSCOPE HEAD 
Referring to FIGS. 27-30, the surface microscope head 740 of the instant 
embodiment includes a two-piece construction comprising a cylindrical 
housing shell 930 having a hollow interior 932 with open distal and 
proximal ends 934, 936. A second section 938 is fitted into the interior 
932 of the housing 930. As most clearly shown in FIG. 28, the second 
section 938 includes a base portion 940 and a curved side wall 942 which 
is sized to fit within the interior 932 of the housing 930, the curved 
side wall being fitted within an axial slot 944. A protruding portion 946 
of the side wall 942 adjacent the distal end 934 of the instrument head 
740 is used for retaining a miniature halogen lamp 948. 
The base portion 940 includes a cavity 950 sized for retaining a latching 
member 952. The latching member 952 operates nearly identically in 
principle to those previously described above. The miniature halogen lamp 
948 is retained in a pocket 949 formed by a spring metal receptacle 956 
located within the protruding portion 946 of the side wall 942. As noted 
previously, such lamps are well known in the field and do not form an 
essential part of the present invention. That is to say, other suitable 
light sources can be substituted, as noted previously herein. 
The receptacle 956 is defined by one of a pair of contacting plates 958, 
960. The first plate 958, as shown in FIG. 28, forms a spring loaded 
sleeve for the miniature lamp 948 while the second plate 960 includes a 
flat portion 962 in contact with the rear portion of the lamp and the 
electrical contacts (not shown) thereof. Each of the contacting plates 
958, 960 is manufactured from a spring metal extending in parallel 
configurations along the interior side or wall 956 of the rear portion 
940. A portion of each plate 958, 960 is fixedly attached with a depending 
spring end 963 of each being cantilevered into biasing contact with 
axially movable contact members 964 extending through the rear portion 
940. 
In an unattached condition, the latching member 952 is biased by the 
depending spring ends 962 into a first axial position directed outward or 
rearward of the proximal end 936, as shown most particularly in FIGS. 27 
and 29. 
As in the preceding, attachment of the instrument head 740 to the front 
interface 736 of the instrument body 734 causes the latching member 952 to 
overcome the bias of the springs 962 and causes intimate contact, 
completing an electrical circuit with the miniature lamp 948 and causing 
illumination thereof. 
Referring to FIG. 29, a releasably attachable lens holder 964 is disposed 
at the distal end 934 thereof. The lens holder 964 accommodates a direct 
skin contacting window 966 having a measuring reticle (not shown) for 
providing a frame of reference of a target of interest. For purposes of 
this embodiment, the skin contacting window 966 provides a field of view 
of approximately 15 mm, and is releasably attachable to allow cleaning 
and/or sterilization. The skin contacting window 212 according to this 
embodiment is made from a plate glass, though any optical grade material 
including light plastics such as acrylic, or polycarbonate are suitable. 
Referring to FIGS. 29 and 30, a pair of crossed, linear polarizer elements 
968, 970 are disposed on a support assembly 972, aligning a first 
polarizer element 968 with the illuminating end of the halogen lamp 948, 
and angled thereto. The support assembly 972 includes a three point mount 
fitted within the center opening defined by the lens holder 964 and having 
a second polarizing lens or element 970 disposed proximally from the skin 
contacting window 966. The support assembly 972 is preferably rotatable 
relative to the skin contacting window 966 (the viewing axis) to polarize 
incoming light as needed in order to minimize glare. In current practice, 
glare from the skin surface is removed by applying a layer of oil to 
eliminate the air/tissue interface. Oil could still be applied, but the 
crossed linear polarizers eliminate much of the specular glare from the 
surface. 
Still referring to FIG. 29 and 30, the first polarizer element 968, being 
angled relative to the viewing axis 753, FIG. 16(a), causes light to 
indirectly strike the viewing window 966 in order to minimize reflective 
glare from the inside surface thereof, and to prevent an image of the 
miniature lamp 948 to be reflected optically through. The support assembly 
972 is preferably attached to the lens holder 964 by known means. 
In use, the instrument head 740 is mounted to the front interface 736 of 
the diagnostic instrument 732 in the manner previously described such that 
the latching member 952 inwardly deflects when engaged therewith. This 
deflection causes the cylindrical contact members 964 to bear against the 
respective depending spring ends 963 of the supporting plates 958, 960. 
Subsequent twisting of the instrument head 740, as described above, also 
aligns the projecting ends of each of the contact members 964 with the 
contacts 812, FIG. 16(b), located in the front interface 736 of the 
instrument 732. This alignment completes an electrical connection, causing 
the lamp 948 to automatically illuminate, upon locking of the instrument 
head 740 in place. 
When assembled, the skin-contacting window 966 and the second polarizing 
element 970, are each aligned with the viewing axis 753 to allow a focused 
optical image to be transmitted to the electronic sensor 750. In use, a 
target (such as a wart, lesion, or other skin disorder) is viewed when the 
skin-contacting window 966 is placed in direct contact therewith. 
Alternately, the reticle (not shown) can be spaced from the target of 
interest by recessing the optical window using an adapter. This allows the 
image to be viewed, such as a lesion or wart, without compression thereof. 
MAGNIFYING INSTRUMENT HEAD 
Referring to FIGS. 14 and 31-33, the magnifying instrument head 742 is 
defined by a two part housing 974 defining an interior sized for 
supporting an illumination assembly 976 and adjacent supporting fixture 
978 including a rear support 980. 
In brief, the illumination assembly 976 includes a halogen lamp (not shown) 
or other suitable light source which is supported therein as described in 
greater detail above in the preceding embodiment. The lamp is supported by 
a set of spring fingers retaining the back end of the lamp and providing 
electrical contact. A pair of supporting plates (not shown) made from a 
spring material extend therefrom, at least one of the plates having a 
portion engaged with the lamp's electrical contacts (not shown). The 
plates extend therefrom and are supported at the interior side 982 of the 
rear support 980, each of the plates having a depending spring end 984 
(only one of which is shown in FIG. 33). 
As noted, the supporting fixture 978 includes a rear support 980 including 
a latching member 986 supported in a cavity 988 of a flat floating ring 
990. The latching member 986 is biased by the depending spring ends 984 
(one shown in FIG. 33), attached to the interior side 982 of the rear 
support 980 (partially shown), also in the manner previously described. 
The latching member 986 includes a center opening 988 extending into the 
interior of the housing 974 of the instrument head 742. As in the 
preceding, the latching member 986 is similar to that described above and 
having a depending spring ends which bias a pair of fixedly attached 
electrical contact members 991 having ends extending through openings in 
the rear portion 980. Hence, and when the latching member 986 is engaged 
with the front interface 736, FIG. 15, of the instrument 732, FIG. 15, an 
electrical connection is completed and the halogen lamp of the 
illumination assembly 976 is automatically illuminated. 
A focusing lens assembly 992 defined by a cylindrical lens housing 994 is 
fixedly supported by the interior wall 982 of the rear support 980. The 
proximal end of the lens assembly 992 is coaxial with the center openings 
defined by the rear support 980 and the latching member 986. A distal 
portion 996, FIG. 14, of the lens housing 984, extends through an opening 
998 in the front or distal side of the assembled housing 974. At least one 
objective lens assembly (not shown) and an adjacent aperture plate (not 
shown) are contained therein, the details being provided in the preceding 
embodiment with reference to FIGS. 7(a)-7(c). The lens assembly 992 is 
preferably rotatably and axially movable therein to permit focal 
adjustment. 
In use, and when the instrument head 742 is assembled to the instrument 
body 732, FIG. 15, an image perceived by the optics contained in the 
adjustable lens assembly 992 is transmitted along an axis aligned with the 
viewing axis 753, FIG. 16(a), to direct an incoming optical signal to the 
electronic imaging element 750, FIG. 16(a). The lamp is oriented such that 
a defined illumination axis is angled relative to the viewing axis 753, 
FIG. 16(a). 
The arrangement of the reflectorized lamp system gives a substantially 
coaxial illumination to the viewing path, such as for imaging anatomy 
within a cavity. 
The described embodiment does not provide an optical system for the 
electronic imaging element 750, FIG. 16(a), when an instrument head is not 
attached to the front interface 736, FIG. 16(a). In an alternate 
modification, shown in FIG. 36(a), one of the instrument heads, in this 
case, the general view instrument head 738, can slide relative to the 
front side of the instrument body 732 adjacent the front interface 736. 
Each of the remaining instrument heads (not shown in this view) can be 
attached selectively to the front interface 736, as needed using the afore 
mentioned latching mechanism in the manner previously described. The 
general view instrument head 738, on the other hand, can translate into 
and out of position with the viewing axis 753 (not shown in this FIG.) of 
the instrument 732 by sliding the head 738 laterally along a pair of 
parallel rails 1002. When moved into alignment, the general view 
instrument head 738, having the latching member 820 (not shown in this 
FIG.), can engage the front interface 736, also in the manner previously 
described. Alternately, a single lens element (not shown) can be supplied 
in the pilot section adjacent the electronic imaging element to provide a 
general view with a limited field of view. 
According to another alternate arrangement, FIG. 36(b), each of the above 
described or other instrument heads 1003 can be circumferentially disposed 
on a rotatable turret assembly 1006, which can be fixedly or removably 
mounted to the front side of the diagnostic instrument 732. The turret 
assembly 1006 allows each of the instrument heads to be selectively 
rotated into position relative to the front interface 736 and into 
alignment with the electronic imaging element 750, FIG. 16(a). Preferably, 
the turret assembly 1006 includes detent means (not shown) based, 
according to this embodiment, on a 90 degree rotation thereof The turret 
assembly 1006 provides a means for storing those instrument heads that are 
currently not in use. 
The above diagnostic instrument can contain other salient features, 
including an audible or vibratory alarm (not shown), which can be preset 
for a predetermined period of time (e.g. 10-15 minutes) to assist the 
physician to stay on schedule. 
DATA MANAGEMENT SYSTEM 
A description of a preferred medical data management program is herein 
described in accordance with the previously described instrument 732 of 
the preceding embodiment and with reference to FIGS. 34, 35 and 38-43. 
Prior to a discussion of the present embodiment, reference is first made to 
FIG. 38 and 39, which broadly describes a transcription procedure in 
accordance with the prior art. 
Initially and prior to an examination, a patient chart is taken from the 
office files and given to the physician. The physician then examines the 
patient, adding his or her notes to the file and dictating as needed 
during the course of examination, typically using a hand-held tape 
recorder. The physician identifies the patient and adds a time and date 
stamp at the start of each dictation session. Usually, a single tape will 
contain dictation relating to a plurality of patients seen over the course 
of a typical working day or shift. Often the dictation will be done at the 
end of the day, when details of the patient visit are sketchy. The doctor 
must usually rely upon memory, and whatever notes made during the course 
of examination. As noted, however, a doctor will often see many patients 
during the day, obscuring the details of a specific visit. 
The tape is then sent to a transcriptionist, who listens to the tape, as 
best understood, and manually types the chart notes. The notes are either 
into typed into a computer record or onto paper for each patient record on 
the tape. In any event, a copy of the chart notes are then printed and 
forwarded to the physician for review. The physician fills in any data 
which could not be successfully interpreted by the transcriptionist, and 
otherwise edits the chart notes which are then typed in accordance with 
the corrections. After again reviewing the chart notes, as necessary, the 
physician signs off the transcribed record. The record is then added to 
the patient's file. 
A number of potential problems can occur from the above procedure. First, 
if the tape(s) is faulty or lost, the physician will be required to create 
the chart records from memory and/or consultation of any written notes 
which may have been taken during the examination. A similar problem occurs 
if the tape is prematurely and accidently erased. The audio tape is the 
primary source of information, which both the transcriptionist and the 
physician must rely upon for both creating the draft chart notes and for 
reviewing purposes. The end result is a heightened probability that the 
records will be incomplete or inaccurate. 
In a similar vein, the printed notes could also be lost or misplaced, 
potentially delaying the reviewing process. Delays obviously will increase 
the probability that incorrect or incomplete records will be generated. If 
video diagnostic instruments of the type previously referred to as being 
typical of the prior art, FIG. 13, are used, the data obtained from each 
must also be labeled and separately attached to the file. Based on the 
amount of time taken, it could be difficult to correctly place this data 
correctly with the transcribed data, if any. As should be apparent, a 
myriad of different combinations using various types of data are possible. 
A number of the above problems are minimized by the record management 
system, having the major features which are illustrated in FIG. 35. For 
purposes of the discussion, similar features will be described using the 
same reference numerals. In brief, a diagnostic instrument 732A, similar 
to the instrument 732 described above, with a different body 734A is used 
in conjunction with a cradle 796 which provides a data transfer function 
to allow downloading of stored audio and video data from the internal 
memory of the instrument 732A. The cradle 796 is interconnected to a local 
computer station 1012 which incorporates the downloaded data into a local 
database. In the described embodiment, audio (WAV) files are arranged with 
corresponding video data in a template which forms the basis for a patient 
record data sheet, the files being separated by identifiers (for example, 
patient and doctor names) as described in greater detail below. 
The audio data files are transmitted to a central network server 1014 which 
includes a number of computer stations 1016 which utilize human 
transcriptionists and voice recognition software, as described below, to 
create a transcription record which is downloaded back to the local 
computer in the generated template format. Reports can then be generated 
which can be stored in the local database, and can be printed for 
creating, maintaining and updating of patient files. 
As noted, the diagnostic instrument 732A includes those features as the 
instrument 732A described above. That is, the instrument 732A is a compact 
digital camera which has been configured for use with a plurality of 
selectively interchangeable instrument heads. Each of the instrument heads 
includes a specific optical system which allows an optical image of 
interest to be focused onto an electronic imaging element. The instrument 
732A includes an instrument housing 734A having an integral display 754, 
and support electronics (not shown) for converting the optical signal into 
a video signal which is captured and displayed. A microprocessor within 
the instrument 732A contains programmable logic which allows a real-time 
image to be continuously displayed and also allows a predetermined number 
of images to be captured and stored into memory, selectively or otherwise, 
along with corresponding audio and/or annotation data added using an 
integral microphone and the display, which is preferably touch-sensitive 
and includes a number of controls on the instrument housing 734A and keys 
located on the TFT display 754, as previously described. In another 
embodiment, the instrument can selectively utilize data, such as to 
combine audio and annotative data, without reliance on video data for 
those applications which do not necessarily require this form of input. 
Still referring to FIG. 35, and according to this specific embodiment, the 
instrument 732A includes a pinned data exchange (SCSI) connector 1018 
configured for engagement with a corresponding port (not shown) located in 
the receiving cavity 1020 of the cradle 796. As should be apparent, the 
form of data transfer is not critical, for example, the data exchange 
connector can also be USB or serial. The cradle 796 is linked by 
conventional means to a local personal computer (PC) 1012 located in the 
physician's office, while the physician's computer is, according to this 
embodiment, connected either through phone lines through dial-up 
networking, a LAN connection, or alternately via the Internet to a central 
computer network 1014 to which other individual remote PC stations 1016 
are also connected. 
As shown in FIG. 35, the cradle 796 includes a supporting base portion 1028 
having the receiving cavity 1020 appropriately sized for retaining the 
diagnostic instrument 732A, shown partially. Preferably, the base portion 
1028 can also include a separate storage cavity (not shown) or other means 
for retaining any of the loose interchangeable instrument heads. 
A control section 1030 of the cradle 796 includes a number of controls 
including an actuatable synch button or switch 1032, which when activated 
automatically downloads the stored digital video, audio and annotation (if 
any) data contained within the internal memory of the supported diagnostic 
instrument 732A into the local PC 1012. 
The control section 1030 further includes a plurality of indicator lamps 
1035 which indicate specific operational features of the cradle 796, such 
as to indicate the extent of charging of the instrument batteries, the 
status of data transfer, and overall powering of the station. For purposes 
of the present discussion, and upon proper attachment, activation of the 
synch button 1032 causes all audio, annotated and video data to be 
automatically downloaded to the local PC 1012. 
The cradle 796 according to the present embodiment is capable of performing 
additional functions. For example, means are provided for recharging the 
batteries contained in the compartment 794, FIG. 17, of the instrument 
732A while nested. Additionally, the instrument 732A can also be powered 
(for example, when battery power is low) while attached to the cradle 796, 
through interconnection to a wall outlet or other source of electrical 
power. The control section 1030 can also be configured with additional 
switches (not shown) which interconnect with the controller through the 
data transfer connector of the instrument 732A to allow the instrument to 
be operated directly from the cradle 796. An advantage realized by this 
from of control is that the instrument 732A can be made capable of 
receiving data from other instruments, such as a clinical vital signs 
monitor, for storage as part of a patient protocol. 
Still referring to FIG. 35, the cradle 796 also preferably allows 
connection to a separate video monitor 1034 or other peripheral device for 
viewing of the captured images, such as with other doctors, patients or 
interested parties. Alternately, the instrument 732A, such as the above 
described Nikon COOLPIX E300 digital camera, also allows direct connection 
to a video monitor without requiring direct use of a cradle 796, if 
desired. Corresponding audio and annotation data can be similarly 
transferred with the video data in a manner known in the field. Techniques 
for transferring of this data is already known in the art and does not 
form a part of the present invention, therefore no further discussion is 
required. 
Referring to the flowcharts of FIGS. 37 and 40-41, the preferred record 
management system is herein described. The description relates 
specifically to an office visit by a patient, though it will be readily 
apparent that the above could also apply to a typical round or hospital 
shift or other suitable setting in which a single patient or plurality of 
patients are to be examined. 
First, the patient chart is pulled from the files for the physician. The 
physician then initiates the examination by utilizing the diagnostic 
instrument 732A by removing the instrument from the cradle 796 and 
attaching the general purpose instrument head 738 to the front interface 
46 of the instrument in the manner described previously. Preferably, the 
cradle 796 recharges the batteries of the instrument 732A sufficiently to 
allow several hours of typical use. 
Depending on the particular protocol of the local database (that is, the 
template of the patient data folder created by the database), a patient ID 
and doctor ID are first captured. One way of obtaining either ID is by 
capturing and storing video image(s) of the printed patient chart. The ID 
may or may not include barcode information. Alternately, a video image of 
the patient can be taken and the appropriate data can be added via 
annotation, using the TFT display 754. Alternately, doctor and patient 
information can be captured via a menu in the controller software. As in 
the preceding, images are captured and stored by first activating the 
instrument 732A using switch 768, FIG. 18, and framing the image to be 
captured into memory in the integral display 754. Actuation of the shutter 
control button (not shown) of the instrument 732A allows each digital 
image of interest to be stored into the internal memory of the contained 
controller. Vital sign and other pertinent patient data would also be 
added, either as a captured video image or be entering the data directly 
into the internal memory of the instrument. Data from other instruments or 
from other measurements can be entered into the instrument 732A by a 
number of known methods. For example, data could be sent using RF or other 
wireless technologies. Data could also be entered using the keyboard of 
the local PC 1012, through buttons, or other known input devices on the 
instrument itself. 
The physician is then ready to begin examinations, such as done on a daily 
basis in the office, for example. As described above, each patient visit 
is initialized by capturing a video image of the patient ID and storing 
the image into the internal memory of the microprocessor. Additional 
patient data can then be captured using the instrument and selectively any 
of the interchangeable instrument heads which may be required. The 
physician can also capture audio data pertaining to each captured video 
image of interest using the microphone 764, FIG. 18, through activation of 
the switch 770, FIG. 18, the video and audio data being available for 
playback using speaker 766, FIG. 18, also using switch 770, FIG. 18, at 
any point during the examination. The instrument according to the present 
embodiment utilizes an internal calendar with date stamping to identify 
the date and time of each captured image. Alternately, this data could be 
entered separately or other data could be entered, such as from an 
external source, including operating instructions, protocol, height and 
weight data, as well as other pertinent information which can be added 
using the local computer or the network, for example. Each new patient 
requires identification of the new patient ID, as described above. During 
the exam, after the exam, after examining several patients, or at the end 
of the day, the physician can perform his dictation in the usual manner. 
At the end of the day, or after a determinate number of examinations, the 
instrument 732A is loaded into the receiving cavity 1020 of the cradle 
796. The software contained within the instrument 732A further preferably 
allows additional data entry for an earlier patient, if desired, such as 
to include later obtained data from another external source, etc. 
Upon loading the diagnostic instrument 732A into the receiving cavity 1020 
of the cradle 796, the synch button 1032 is actuated, automatically 
transferring the stored audio (WAV), video, and annotation data files (if 
any) to the physician's local PC 1012. The software provided in the local 
PC loads the raw data into a specific template, an example of which is 
shown in FIG. 43. Preferably, a confirmation indication is provided on the 
display of the local PC 1012 to indicate that all images and audio clips 
have been removed from the instrument 732A. 
During the data transfer to the local database, the doctor and patient IDs 
are first located and identified. In the case of use of bar codes, the 
local PC 1012 preferably includes recognition software which allows 
identification of the doctor and patient IDs and loads the data into an 
already existing or newly created patient file. Most preferably, the 
software includes pattern recognition or bar code recognition programs 
which can detect the existence of a barcode or other pattern from an 
existing and captured video image and then decode the bar code or pattern 
if such information is present. In the present embodiment, the doctor ID 
or the patient ID may contain a 1D or 2D bar code pattern, the 
determination of which engages the following transcription routine. 
Details relating to the software for detecting barcode from a digitally 
captured video image is described in greater detail in U.S. application 
Ser. No. 60/030,360 [Attorney Docket 283-213, filed Nov. 5, 1996], the 
entire contents of which is herein incorporated by reference. The barcode 
recognition software can also be used to control the instrument 732A. For 
example, the software can be used to indicate the type of instrument head 
being used or which anatomy type a physician is examining or imaging. 
Upon identifying the doctor and patient, the software creates a new data 
folder in the event of a previously unlisted patient, or accesses an 
already existing patient folder by comparison to a list stored in memory. 
Preferably, a security feature is loaded into the logic of the local 
computer 1012 prompting a user identification window and requiring a 
password be entered prior to allowing access to the raw data for review or 
prior to transferring the data to the central data network 1014. The 
software automatically stores images and other associated data input to a 
tagged file having the ID number or name attributed to it. As such, the 
files can be automatically stored without requiring human intervention or 
assistance. In addition, the files can also be tagged for action, such as 
additional tests, follow-up visits, inoculations, prescriptions, or other 
procedures. 
After all of the stored data (video, audio, etc.) has been downloaded onto 
the local database and reviewed, an election is made to send all or part 
of the data, in this embodiment the digital audio files (WAV) files, such 
as through phone lines as part of a LAN connection , by dial-up 
networking, e-mail transfer or alternately over the Internet by known 
means to the central data network 1014. Prior to transmitting this data, 
the WAV files are first previewed, such as by the physician at the local 
PC 1012, if desired by selection of the appropriate entry queued at the 
patient template. Alternately, other image data can be archived to the 
central network location 1014 while the audio data is being transmitted. 
Preferably, the local PC 1012 encrypts the data prior to transferring the 
data to the central data network 1014, where the data will be decrypted 
using techniques known in the field. The details of encryption/decryption 
do not form an essential part of the present invention and therefore 
require no further discussion. The data is transferred between the local 
PC 1012 and the central data network 1014 using the template originally 
created at the local PC. Because the data is transferred in this format, 
it is not necessary to sent the corresponding video data to the central 
data network 1014. However, image files may be transferred for data 
storage (warehousing) or for sending referring letters via e-mail or other 
purposes. 
At the central data network 1014, the audio digital (WAV) files can be 
transcribed after being loaded into a server or other hardware, the center 
having a plurality of linked computer stations 1016 using human 
transcriptionists in combination with an automatic voice recognition 
(hereinafter referred to as VR) software system, such as Dragon Systems 
Naturally Speaking to develop a database of a doctor's vocabulary. 
Preferably, the VR software contains an adaptation or learning mode which 
improves the general efficiency of transcription as related to specific 
physician(s). That is, as the number of transcriptions using the dedicated 
physician necessarily improves more efficiently over time by updating of a 
specific dedicated physician file. However, unlike traditional uses of 
voice recognition software, the training would be done by 
transcriptionists rather than the physicians themselves. 
According to the flowchart of FIGS. 40 and 41, and upon receipt of the raw 
audio data from the local PC 1012, the physician's ID is retrieved from 
memory at the central database and the training file (if existing) is 
accessed. Otherwise, a new doctor's training file is created. An original 
version of the transcription is then automatically created, the results of 
which are then subsequently transmitted, also automatically, to a separate 
PC station 1016 for review by a human transcriptionist. 
Using the WAV files obtained from memory by accessing the training folder, 
the transcriptionist can effect any changes which may be required based on 
a review of the created transcription, the changes being directly inputted 
into the record and also into the VR software into the training file. The 
above procedure can then be iterated until the training using the VR 
software has progressed to a given level and a suitable transcription is 
produced. The number of iterations (edits) will significantly decrease 
with an increasing number of transcription files, based on the learning 
mode, and assuming the physician performs an initial vocabulary building 
exercise typically required of presently known VR software. This 
improvement creates an increase in efficiency and accuracy after an 
initial learning curve for each physician. At the PC station 1016, the 
transcriptionist can also access the video and annotation files, if 
transmitted and as needed, to further improve the reviewing process. The 
chief benefit of this sort of training method is that the difficult job of 
training VR software is done by lower paid personnel which is more 
efficient, thereby freeing the physicians to perform the jobs they were 
trained for. 
Following the transcription procedure at the central network center, a copy 
of the transcription is removed from the training file and is attached to 
the specific patient data file in the appropriate location prompted by the 
incoming template. The data file is then transferred to the local PC 1012 
in the template format having the transcribed information added as shown 
in FIG. 43 in the vicinity of the corresponding video image. Data transfer 
is performed either through a LAN connection, dial-up networking, or other 
suitable means either through telephone lines or via the Internet 
(http/ftp) . At the local PC 1012, the transcription can then be reviewed 
by the physician where the information can be reviewed for accuracy and 
additional editing, if needed. At the physician's local PC 1012, the 
physician can also access the image and audio portions of the patient 
chart while reviewing the transcription. A finalized copy can be approved 
or signed off by the physician prior to adding a hardcopy of the file to 
the patient record. 
The appropriate files are originally combined using a data file accumulated 
prior to transcription which is presented using a script template. The 
template can be reviewed and the audio information can be accessed by 
cursor, mouse or keyboard control to icons presented adjacent to the video 
images. The icons access the audio files with the annotation files being 
presented along with the video files. After the transcription has been 
completed, a hardcopy with the transcription record added appropriately 
with the images in place of the icons can be printed for placing in the 
patient file. 
The video images, once received into the system are scanned. Subsequent 
changes, such as cropping or airbrushing, etc may be detected to prevent 
distortion or falsification of records. Further, the system preferably 
contains appropriate encryption programs for preventing access to the 
records by unauthorized persons. 
The data can also be transmitted over the telephone lines in any known 
manner or via the Internet to an EMR or other remote site, with the 
central network station 1014 also allowing receipt of information 
therefrom from other sources, etc. to aid in networking. For example, 
information from an instrument at a remote site relative to the local PC 
1012 can be transmitted into the local database or be unlinked by known 
means through the cradle 796 to the instrument 732A. 
Though the preceding data management system described in detail, a 
technique of remotely transcribing using a central bank of computers, it 
should be realized that the transcription could certainly be done locally. 
That is to say, the immediate benefit is the ability of the instrument of 
the present invention to incorporate multiple forms of data which can be 
linked, including audio, video, annotation, etc., to allow data management 
to be better coordinated. The features, though pertaining to the medical 
profession in the preceding embodiment, are clearly applicable to other 
service providers, including attorneys, insurance agents, and the like, as 
well as a myriad of other suitable applications.