Abstract:
A device for converting acoustic data collected by a stethoscope into digital data for transmission to a processor for storage and/or comparison with data stored in a database, and to optionally provide computer generated suggestions for diagnosis, is provided in the form of an in-line device interposable between a head of the stethoscope and an acoustic transmission portion of the stethoscope, or is integral with the head, and advantageously has the appearance of an icon of pleasing appearance, for example, a butterfly, in which are incorporated the structural requisites of a functioning stethoscope and/or capabilities for receiving and transmitting to a diagnostician, audio signals gathered from patient examination, and optionally also other data collected at examination and/or following the examination. The butterfly-shaped device, includes a central body advantageously serving as a conduit for transmitting sound received from the patient to the physician or a remote system for analysis and diagnosis.

Description:
TECHNICAL FIELD 
       [0001]    The present invention relates to a stethoscope. More particularly, the invention relates to a stethoscope and an attachment portion for a stethoscope providing improved analysis capabilities, and advantageously being embodied in a structure presenting enhanced appearance and function, in a form particularly well suited for use in pediatric medicine. 
       BACKGROUND ART 
       [0002]    The acoustic stethoscope remains the most widely used auscultation device in both developed and developing medical economies. The basic design references the 1978 Patent held by 3M for production of the Littmann Stethoscope. 
         [0003]    Developments over the well accepted acoustic stethoscope design have been suggested, including electronic stethoscope designs. However, the international adoption of heretofore-suggested electronic stethoscopes has been slow and cumbersome, their general failure points being cost, required change of habit and potential distortion of the acoustic auscultation process. 
         [0004]    While effective as a monitoring and diagnostic tool, the stethoscope relies upon the analysis of the diagnostician listening to the sound collected by the stethoscope, i.e., the subjective judgement of the physician, himself or herself. Attendant with this drawback is the possibility that the physician listening to the sounds detected by the stethoscope may mis-diagnose, or miss entirely, an ailment from which the patient is suffering. 
         [0005]    Additionally, while quite effective as a monitoring and diagnostic tool, the well known stethoscope of conventional design projects a somewhat cold and clinical appearance that may trigger anxiety in a patient, especially in a young patient undergoing medical care and/or observation. 
         [0006]    An object of the invention is to provide a low cost alternative to an electronic stethoscope, by applying a synergistic utilization of current technologies, to develop a novel audio capturing device, advantageously interfacing through a device agnostic communication protocol, that can be easily integrated with available mobile and stationary diagnostic equipment. 
         [0007]    It is a further object of the invention to provide the above features in a manner which is supported by proprietary mobile and desktop dashboard applications used for the interpretation of diagnostic queries and the consumption of Rich Diagnostic Content (RDC) 
         [0008]    A still further object of the invention is to provide a stethoscope, at least a portion of which having an appearance which is reassuring to the patient, particularly a pediatric patient, such that a calming effect is achieved during patient examination, and which optionally concomitantly provides multiple functions with coordinated synergistic benefits and effects, to aid in diagnostic evaluation. 
       SUMMARY OF INVENTION 
       [0009]    These and other objects of the invention are achieved by utilizing a system operable to augment, inform and optionally automate diagnostic processes performed with any stethoscope, an optionally usable in combination with a basic stethoscope of conventional design. 
         [0010]    The objects are further implemented in a stethoscope design embodied broadly in a device having a stethoscope head or in-line audio capture and analog/digital conversion device presenting a general appearance, at least suggestive of, an animal, character or icon of pleasing appearance and impression, advantageously one with wing-like structure, for example, a butterfly, in which are incorporated the structural requisites of a functioning stethoscope and optionally, auxiliary capabilities for receiving and transmitting to a diagnostician, audio signals gathered from patient examination, and/or other data collected at examination and/or following the examination. 
         [0011]    According to a feature of the invention, an acoustic fingerprint or signature of the sound sensed by a stethoscope probe is matched against an existing database of stored acoustic fingerprints associated with known conditions. The communication between the source and the database is optionally platform agnostic, or could be tied to proprietary transmission technology. The system disclosed herein would advantageously use, for example, a three step process to record, query, then report or “tag” any given acoustic passage. 
         [0012]    A multi-party system comprising hardware, proprietary software applications, and a proprietary database server application is advantageously utilized. In a particularly advantageous embodiment, an in-line electronic recording device is presented, which captures sound from along a conventional stethoscope tube during diagnostic procedures. The recording device would further optionally allow for the recording of examiner audio notes and the capturing of patient subject photos or videos for identity verification and further diagnostic studies as part of an integrated patient record. The construction of the in-line device according to an embodiment of the invention advantageously allows for a customizable fit, making it suitable as a simple enhancement for the majority of conventional acoustic stethoscopes. The in-line device is also optionally equipped with a low-power wireless transceiver, which allows it to offload its data to a device upstream. 
         [0013]    The aforementioned upstream device can be any mobile or stationary computing node capable of connecting to a database server application, for example, over TCP/IP network. The device is also advantageously configured to be capable of presenting rich digital media and displaying interactive analytical reports. 
         [0014]    In accordance with an embodiment of the invention, recorded audio data from the stethoscope is processed by proprietary software running on both the local computing node and at the server level, in order to determine information relevant to diagnosis. A response is then returned from the server to the local computing node, where the basic diagnostic result can be augmented by the presentation of Rich Diagnostic Content, also pulled from the networked database. Rich Diagnostic Content may, for example, include video, audio, images, documents, hyperlinks, or other digital media of relevance to a medical diagnosis made with the enhanced stethoscope system. Captured, classified and diagnostic content is presented in a unique digital patient record for use in multi-format viewing. 
         [0015]    A verified database is provided as part of the system, and differs, for example, from a known music database, in that a music track&#39;s audio fingerprint is implicit, and is only affected by ambient noise during the recording phase. In the case of this invention, a large sampling of patient auscultation sounds, normal and abnormal, advantageously needs to be aggregated, classified and enhanced through ongoing learning. The invention includes, but is not exclusive to, the design of a learning algorithm for the diagnostic classifier, utilizing machine learning code to interpret and expand the database functionality using successfully logged audio “fingerprints.” 
         [0016]    In accordance with a particularly advantageous embodiment of the invention, the head of the stethoscope (chestpiece) will assume the general shape or suggested appearance of an appealing animal or character, for example, a butterfly, with the “central body” of the animal representation advantageously serving, inter alia, as a conduit for transmitting sound received from the patient to the physician for analysis and diagnosis, as described above herein. 
         [0017]    In accordance with this embodiment, one end of the central body can be optionally connected to electronic ear phones (buds) or to an input of another device (digital analysis version) or to the ear piece of a regular stethoscope (analog version). 
         [0018]    In an embodiment in which the animal depiction for the stethoscope head has wings, the wings would serve advantageously to house structural components in a convenient manner. The wings could be structurally configured to further facilitate handleablility by the user. For example, in the example of a butterfly, upper ones of the wings (larger ones closer to the head) could be configured to advantageously flip upward to facilitate grasping of the device. The wings could optionally have a built-in space within them for receiving other components. For example, they may be used as a small storage space for batteries, to accommodate a small radiation (Geiger-like) detector, and/or to display a logo, a name, an ID, an animated light, etc., via an appropriate visual output device, such as an LCD display. 
         [0019]    The rear ones of the wings (smaller ones closer to a rear of the central body) are advantageously configured to accommodate one or more sound detectors. These wings advantageously remain flat, so as to rest against the body part being monitored (chest, heart area, abdomen, etc.). 
         [0020]    In an analog version of the stethoscope according to an embodiment of the invention, the underside of these rear and upper wings advantageously carry, or include, a high frequency membrane and a low frequency membrane, respectively (alternatively, the rear wings can carry the low frequency membrane and the upper wings can carry the high frequency membrane. In that case, the upper wings will also remain flat, and the device can be held with a ring device or other suitable structural adaptation carried or attached to, for example, an anterior part of the central body). The sound would then, for example, be transmitted directly from the rear wings to the body from the lateral sides of the body. 
         [0021]    Alternatively, in accordance with a digital embodiment, the listening device would comprise one or more microphones having suitable sensitivity and frequency ranges, which capture the patient sounds as electronic audio signals. 
         [0022]    It is contemplated that the stethoscope according to an embodiment of the invention can be suitably configured as an in-line device for use with an acoustic earpiece of a standard (conventional) acoustic stethoscope, in which case, if the sounds are captured by electronic means, such as with a microphone, the in-line device will additionally include a speaker or other digital-to-audio convertor, for reproducing the electronic data into audio so that the physician can hear the sounds, while advantageously simultaneously recording and/or sending the electronic data for analysis and/or storage for future use. 
         [0023]    Alternatively, a specially configured butterfly (or any generic animal/character-shaped) audio sensor assembly can send electronic information to ear buds which convert the data to audible sound. 
         [0024]    An embodiment of the invention will be exemplified with reference to a butterfly shaped stethoscope with novel and advantageous symmetric chamber design, as described below. This will act as a passthrough sound device preserving an original acoustic signal. The signal is advantageously recorded with a stereo MicroElectrical-Mechanical System (MEMS) microphone unit on either side of the sound path. 
         [0025]    The components advantageously comprise the following, alternatively or in selective combination (described relative to the butterfly example): 
         [0026]    Sound Chambers 
         [0027]    High Frequency (Traditionally Cold Ring and Membrane) 
         [0028]    The rear “wing” structures (smaller wings of the butterfly form) advantageously form a continuous cold ring and membrane structure that has a concave surface facing towards the patient contact area. The membranes are vibrated in stereo as sound is pushed to the sound path past the MicroElectrical-Mechanical System (MEMS) microphones and into the plastic tubing leading to the physician&#39;s or diagnostician&#39;s ears. 
         [0029]    The MEMS microphone, which is advantageously employed in the preferred practice of the invention at the present state of the art, is also called a microphone chip or silicon microphone. The pressure-sensitive diaphragm is etched directly into a silicon chip, and can advantageously be accompanied with an integrated pre-amplifier. An advantage of MEMS microphone technology is that built in analog-to-digital converter (ADC) circuits can be incorporated on a common CMOS chip, providing the function of a digital microphone, thereby permitting facilitated integration with other digital circuitry. 
         [0030]    Low Frequency (Traditionally Hollow Metal Cup, Skin Forms Membrane) 
         [0031]    The rear of the rear and/or upper wing structures will advantageously contain geometry to allow for low frequency auscultation. The low frequency sound path merges with the main sound path from where the signal is recorded, and the sound wave transmitted to the consultants ears. 
         [0032]    Sound Path 
         [0033]    The sound path is shaped and/or adapted to connect to either a stethoscope tube (analog type) or, conveniently to, for example, a  3 . 5 mm headphone jack (digital type). This requires a pass through chamber around the headphone jack to alleviate air pressure and allow for versatility of sound review. The headphone jack is optionally connected to an on-chip amplifier and built-in recorded storage, allowing for instant replay and wireless transmission. The sound path can exit on the rear end, or the front of the butterfly structure, as shown in the alternative diagrams. 
         [0034]    Battery 
         [0035]    Dual batteries are advantageously housed within the larger front wings. These can be, for example, standard lithium ion batteries or rechargeable lithium polymer batteries. Charging pins are provided in the case of rechargeable batteries in a suitable position, for example, located on the underside of the body. These will allow for convenient recharging of the device, for example, on a desktop stand or by connection with a portable adapter. 
         [0036]    Camera 
         [0037]    Optionally, a small digital camera is provided on the underside of the butterfly “belly” that allows for documentation and storage of time stamped patient photographs for verification and Electronic Medical Record (EMR) tie-in purposes. 
         [0038]    It is believed that the camera represents a major advance, and it is contemplated that it may one day become mandated as a basis for any documentation in any EMR. For this reason, this advance is considered to be a particularly advantageous option of the invention. 
     
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
         [0039]      FIG. 1  is a perspective view of a first embodiment directed to an in-line device for reception between a stethoscope head and rubber tubing leading to the earpieces; 
           [0040]      FIG. 2  is an upright perspective view of the first embodiment of  FIG. 1 ; 
           [0041]      FIG. 3  is an exploded view of the first embodiment of  FIGS. 1 and 2 ; 
           [0042]      FIG. 4  is a system schematic operational flowchart of the first embodiment; 
           [0043]      FIG. 5  is an exploded view of a stethoscope according to another embodiment of the invention having the appearance of a butterfly; 
           [0044]      FIG. 6  is a perspective underside view of the stethoscope of  FIG. 5 ; 
           [0045]      FIG. 7  is a perspective top view of the stethoscope of  FIGS. 5 and 6 ; 
           [0046]      FIGS. 8   a  and  8   b  are bottom plan and side elevational views, respectively, of the stethoscope of  FIGS. 5-7 ; 
           [0047]      FIGS. 9   a  and  9   b  are top plan and rear elevational views, respectively, of the stethoscope of  FIGS. 5-7 ; 
           [0048]      FIG. 10  is a perspective top view of another embodiment according to the invention which incorporates a low frequency bell alternative; 
           [0049]      FIGS. 11   a  and  11   b  are perspective views of another embodiment directed to a clip-on camera for attachment to a conventional stethoscope; 
           [0050]      FIGS. 12   a  and  12   b  are a top plan view and a perspective view of another embodiment which includes clip-on camera for attachment to a conventional stethoscope embodied in a form of a butterfly. 
           [0051]      FIG. 13  is a plan view of another embodiment of the device according to the invention having a butterfly form; 
           [0052]      FIG. 14  is a side elevational view of the embodiment of  FIG. 13 ; 
           [0053]      FIG. 15  is an explanatory view of the embodiment of  FIGS. 13 and 14 ; 
           [0054]      FIGS. 16   a  and  16   b  are respective depictions exemplifying alternative forms of a stethoscope incorporating the embodiment of  FIGS. 13 and 14 ; 
           [0055]      FIG. 17  illustrates examples of a few possible representations that can be adopted in configuring a stethoscope head or in-line device in accordance with an embodiment of the invention; 
           [0056]      FIG. 18  is a plan view of another embodiment of the device according to the invention directed to a heart-shaped icon form; 
           [0057]      FIG. 19  is a side perspective view of the embodiment of  FIG. 18 ; 
           [0058]      FIG. 20  is an explanatory view of the embodiment of  FIGS. 18 and 19 ; 
           [0059]      FIGS. 21   a  and  21   b  are respective depictions exemplifying alternative forms of a stethoscope incorporating the embodiment of  FIGS. 18 and 19 . 
       
    
    
     DESCRIPTION OF EMBODIMENTS 
       [0060]    An advantageous feature of the invention is to capture acoustic data during the auscultation process by transforming data collected by a standard acoustic stethoscope, advantageously without altering the enclosed sound pipe and resulting wave-based transmission from the membrane to the examiner&#39;s or diagnostician&#39;s ears. 
         [0061]    A second advantageous feature provides the ability to capture patient identification and examiner&#39;s audio notes during consultation through optionally externally facing sensors on the unit housing. 
         [0062]    A third advantageous feature is that the diagnostic system remains agnostic of specific types of communication protocol, except that it favors a process of lightweight data transfer with minimized interference, and low power consumption 
         [0063]    Referring now to  FIGS. 1-3 , an in-line electronic recording device example according to a first embodiment of the invention comprises an upper housing part  10  and a lower housing part  18  together defining a housing within which is received an internal and external high dynamic range, low profile microphone  16  with acoustic noise cancelling, a CMOS fixed lens camera  21  (with lens  20 ), a short range wireless transceiver  14 , a Solid State Disk (SSD) storage  9 , an SSD interface  15 , a top and bottom acoustic channel  17  and  22 , a rechargeable battery  19 , status LEDs  7 , and power and activation buttons  8 . 
         [0064]    The device couples to the stethoscope in-line between the head  1  and the rubber tubing  3  leading to the conventional Y-split and earpiece (not shown). The device makes use of the internal high dynamic range, low profile microphone  16  to capture sound traveling through the stethoscope tube. The in-line construction advantageously has minimal impact on the acoustic properties of the stethoscope. 
         [0065]    The in-line device (shown, for example, between the head  1  and the acoustic rubber tubing  3  in  FIGS. 1 and 2 ) advantageously uses the external high dynamic range, low profile microphone  16  to capture sound clips from the head  1 . 
         [0066]    The device also optionally employs the low profile fixed lens CMOS camera  21  to capture subject photos. 
         [0067]    The device is optionally equipped with an internal Solid State Disk (SSD) storage  9  and slot for removable storage. The recording device can also be equipped with a power source (for example, at least one rechargeable battery  19 ) and a low-power RF transceiver operating  14 , for example, in the 2.4 GHz ISM band. Wireless communication is achieved, for example, using a standard protocol, such as BLUETOOTH, to enable the recording device to communicate with other electronic equipment. In order to conserve power, the device is advantageously activated by, for example, a pushbutton interface, allowing the user to control when segments of data are recorded and uploaded. 
         [0068]    Adjustable or interchangeable rings on the recording device housing (acoustic rubber adapter  4 , interface cap  5 , interface cap  11 , and acoustic rubber adapter  12 ) facilitate customized coupling to most common stethoscope head and tubing attachments. For example, acoustic rubber adapter  4  couples with a head connector  2  on the stethoscope head  1 . 
         [0069]    An audio microphone opening  6  is also advantageously provided in a convenient position communicative with a microphone  13  mounted within the space between top and bottom housing parts  10 ,  18 , for example on the top housing part  10 , as depicted, for allowing recording of voice or ambient sound data by the physician. 
         [0070]    Referring to  FIG. 4 , a rich computing platform such as a mobile smartphone or laptop  23  (serving as part of a local computing node  24 ) communicates with the recording device using the 2.4 GHz wireless link, storing segments of audio data transmitted from the stethoscope. Local computing node  24  plays host to proprietary application software, which processes the recorded audio data. The processing at this level includes tagging  25 , feature extraction  26 , pre-classification of an acoustic fingerprint  27 , and encryption  28 . 
         [0071]    Using a TCP/IP network  29 , the local computing node  24  uploads secure encrypted data to a remote analysis server  30  running a classification engine  31 . This software associates the acoustic fingerprint with a specific diagnosis, if possible. Based on the results, the local computing node  24  also links to the content server  32 , which stores a database of RDC that may be pertinent to a diagnosis. 
         [0072]    The diagnostic report  33  from the analysis server and the RDC  34  from the content server are sent back to the local computing node  24 , where they are displayed in an interactive format. 
         [0073]    Ambiguous results can be handled by displaying several different options and the statistical confidence levels  35  associated with each of them. RDC for several different medical conditions can also be aggregated in this type of report. Rather than relying on a machine algorithm with a single obscure output, the ability to display pertinent RDC inherently encourages the user to work iteratively to increase the level of confidence in the diagnosis. The fact that the RDC database is automatically indexed by recorded data sent from the stethoscope, means that diagnostic cues can also be delivered much more quickly than conventional methods. 
         [0074]    In the case of a positive diagnosis verified by a registered physician, the local computing node  24  can be used to quickly update  37  the classification server. If desired, the associated audio fingerprint and raw audio signal can be integrated into the classification model as training data. Also, pertinent media  38  recorded by the physician at the time of diagnosis can optionally be added to the RDC database. 
         [0075]    An advantageous embodiment of this invention functions as an acoustic pass-through, recording high dynamic range sound without altering the diagnostic integrity of the acoustic stethoscope&#39;s sound transmission. The device according to the embodiment captures sound through the unique arrangement of either an MEMS capacitive microphone, a piezoelectric microphone, or any other low profile, high dynamic range recording sensor. 
         [0076]    Advantageously, the device in accordance with embodiment of the invention remains brand agnostic through use of a novel adaptor connector head on both the sound inlet and outlet, allowing for easy connectivity to virtually any acoustic stethoscope 
         [0077]    A distributed analysis system for automated delivery of Rich Diagnostic Content to conventional stethoscope users is also contemplated. The mechanism for distributed analysis offers unique and novel advantages in the mechanisms through which data is recorded, transmitted, classified and presented. The machine learning algorithm developed allows for a constantly updated or organic database and classification model, whereby the statistical relevance of the diagnostic response increases as a result of recurring feedback. The additional matching and delivery of the RDC further enhances the diagnostic process and patient experience. 
         [0078]    During the capturing process, and advantageously as a direct benefit of the recent commercial introduction of MEMS microphones, fine sensing of high dynamic range sound (wherein the stethoscope produces mid to high frequency sound from the membrane, and low frequency from the bell) is achieved. The transmission part conveniently uses an existing wireless protocol and fingerprint recognition 
         [0079]    A diagnostic platform or database that “learns” through a unique algorithm and feedback mechanism is also contemplated, as discussed above with reference to  FIG. 4 . 
         [0080]    The FDA regards this product as a Class I medical device, since its operation at no point affects, or has a life supporting role in, the patient treatment process. This makes time to market much faster, and hurdles to global expansion less strenuous. 
         [0081]    The system contemplated herein advantageously requires three basic component elements, i.e., a suitable in-line recording and/or data capturing head, a classification database, and a computing node interface as either desktop or mobile application. While a specialized in-line recording and/or head can be developed by suitable known or future technologies for optimal performance, existing acoustic or electronic stethoscopes can be used to implement the method herein. 
         [0082]    To build a suitable database for use with the disclosed system, the acoustic fingerprints required should advantageously be mapped in a controlled study within a research hospital, ideally by medical students. A diagnostic list needs to be formulated, and then sets of patients with known conditions at various ages advantageously need to be recorded. Every sample is then tagged with unidentifiable patient data, condition, and source location. After the base recordings are completed, a classification algorithm will be built using this data. This can be done in-house with the assistance, for example, of programmers, a sound engineer, and a UI/web designer. 
         [0083]    Once the database is in place, the UI (user interface) and software design for a computing node can be developed to leverage this classification engine in the three product use cases previously mapped out. The interface should present the patient photo, digital medical record, acoustic signature, classification response and variations (if applicable, rich diagnostic content, doctors audio note and commentary) and/or video. 
         [0084]    Licensing of the database to other diagnostic product companies, future sale of database, subscription for database use—tiered pricing for urban, rural, academic and the developed world, is also contemplated within the scope of the invention. 
         [0085]    A further embodiment is directed to another type processing device-equipped stethoscope, advantageously connectable with the acoustic rubber tube  3  of a standard acoustic stethoscope, and integrates an in-line device along the lines of the previously described device embodiment and a head. Such embodiment is shown by way of example in  FIGS. 5-8 , wherein such device assumes the general form of a butterfly so as to be particularly well suited for use in pediatric medicine, as will be described in detail below. 
         [0086]    An example of the invention according to such embodiment will be described with reference to  FIGS. 5-9   b . A stethoscope embodied to resemble a butterfly is generally designated by the numeral  30 . A head of the stethoscope  30  includes a central body  126 , within which a circuit substrate having a MEMS microphone  116  mounted thereto along with any required circuitry (digital processing, amplification means, etc.). A wing casing  110  (defining a pair of front, larger wings) extends from the central body  126 , within which one or more batteries  114  are housable. A pair of display screens  111  (OLED, LCD or the like) can optionally be provided to face outward of the wing casing  110  to allow display of visual effects, information, pictures, logos or data, etc. A wing lower closure  117  encloses a chamber within the wing casing  110 , in which the one or more batteries are housable. 
         [0087]    A pair of rear, smaller wings defined by a rear wing casing  129  enclose a sound chamber  120  which adjoins a membrane  122  for detecting patient sounds in the manner of a conventional stethoscope head membrane, and which delimits the sound chamber at a side thereof facing a patient when the stethoscope  30  is being used to collect patient data. The sound camber is in direct communication with an interior chamber of the central body, in which is housed the aforementioned MEMS microphone  116 , thereby allowing accurate recording of the sounds collected by the membrane  122 . 
         [0088]    In an embodiment having analog acoustic capabilities, such as that shown in the depicted example, a stethoscope acoustic tube adapter  121  is provided in a rear position of the butterfly-shaped structure to which an acoustic tube  123 , leading to the ears to the physician (for example, in a conventional manner), is receivable. 
         [0089]    An audio microphone  112  is also advantageously provided in a convenient position, for example on a top of the central body  126 , for allowing recording of voice or ambient sound data by the physician, for a more complete examination record. 
         [0090]    Various other features are conveniently provided at the central body  126 . For example, operation buttons and indicator LEDs  113  to allow effective user interface for selecting desired functional modes, adjusting recording levels, etc., are advantageously provided on a top position of the central body  126  to permit convenient access by the physician during use of the stethoscope  130 . A camera  118 , advantageously directed from a bottom of the central body  126 , permits the taking of patient and other relevant photos at a time of measurement (or before or after), to assemble a more complete patient history and allow better remote evaluation of audio data collected. 
         [0091]    An electronic line-out  115  is optionally provided, conveniently positioned at a forward end of the central body, for output of collected electronic data, including, but not limited to, the audio signals produced by the MEMS microphone  116 , audio data collected by the audio microphone  112 , camera images collected by camera  118 , etc. While depicted as having a phone jack type connector for stereo output of audio signals in the illustrative example, the line-out  115  can alternatively be a USB or like port for transmission of any form of digital data collected by the various components of the head of the stethoscope  30 . Such digital data is transmittable remotely of the stethoscope directly for analysis of the signals by comparison with a database of illnesses or conditions, or to a memory media for storage and later comparison with the collected data in a database. The line-out  115 , when optionally fashioned as a data connection (USB or the like), can then optionally also serve as a line-in for programing circuitry housed the head of stethoscope  30  and/or for receiving a tentative evaluation after comparison with the database, for display on the display screens  111  or as audio output to the physician via, for example, the acoustic tube  123 . 
         [0092]    Additional or alternative operation buttons  119  are optionally provided on the rear wings for ready access. 
         [0093]    Turning now to  FIG. 10 , another embodiment in which a low frequency bell  125  is provided in addition to, or in place of, some of the components described with reference to the previous embodiment, in the positional placement conveniently as shown. The an interior chamber delimited by the membrane of the bell  125  is in direct communication with (i.e., open to) the interior chamber of the central body  126  in which is housed the aforementioned MEMS microphone  116 , for accurate recording and also proper transmission of the analog acoustics through the tube  123 . 
         [0094]    Referring now to  FIGS. 11   a ,  11   b ,  12   a  and  12   b , alternative embodiments directed to a camera module receivable to a conventional stethoscope. The concept of having a camera in close reach of a physician is considered particularly advantageous, as already mentioned herein.  FIGS. 11   a  and  11   b  depict an embodiment in which a removable camera module  210  having a camera component analogous with the embodiment of  FIGS. 5-9   b , is received to an acoustic tube  23  of a conventional stethoscope  40 . In this embodiment, no special appearance is imparted to the camera  210 , such as the butterfly of the previously described examples. 
         [0095]    Another of the camera module embodiments according to the invention is shown in  FIGS. 12   a  and  12   b . This embodiment differs from that of  FIGS. 11   a  and  11   b , insofar as a structural configuration resembling a butterfly is provided in addition to the basic camera module (with the attendant advantages already mentioned, such as the wing compartment for battery, etc.), and in which it is also possible, as shown, to optionally have operation buttons ( 119 , described previously) on the rear wings for ready access by the physician. 
         [0096]      FIG. 13  illustrates a possible form of decoration which can be present on the wing casing  110  and rear wing casing  129 , in the depiction mimicking a Monarch butterfly. Such pattern is advantageously colorful, so as to elicit a response of interest and curiosity on the part of the patient being examined (for example a child) rather than one of generalized anxiety and trepidation often precipitated in a clinical environment of an examining room. 
         [0097]    As previously described, the central body of the butterfly stethoscope  30  is equipped to carry out a plurality in functions, including a flashlight, sound recognition for diagnostic modality, video recording, voice recording, memory chips, camera for identification and documentation purposes. As shown in  FIG. 13 , an optional laser pointer is included. As shown in  FIG. 14 , additionally, an optional pocket clip can be provided on the central body. 
         [0098]    One end of the central body is connected to the ear phones  131  (as shown in  FIGS. 13 and 16   b , where they appear as the antennae of a butterfly) or to the ear piece of a regular stethoscope (as shown in  FIG. 16   a ). The other end is blind, at which end can optionally be provided a laser pointer or flashlight. 
         [0099]    The wings can serve various desired functions, as depicted in  FIGS. 13-16   b . The front ones of the wings (defined by wing casing  110 ) can advantageously be configured to flip upward to facilitate grasping of the device, as depicted in  FIG. 15 . The wings can optionally display a logo, a name, an ID, an animated light, etc. 
         [0100]    The rear ones of the wings (smaller ones in the figures, as defined by rear wing casing  129 ) can accommodate sound detectors (i.e., membranes  122 ) Therefore, the wings defined by the rear wing casing  129  are advantageously always horizontally flat so as to rest against the body part (chest, heart area, abdomen, etc.). Of course, it will be recognized that alternatively, the rear wings can carry the low frequency membrane and the front wings can carry the high frequency membrane. In that case the front wings will remain flat and the device can be held with a ring device attached to anterior part of the body piece). The sound is transmitted from the rear wings to the body from the lateral sides of the body. 
         [0101]    Alternatively, the listening device can comprise one or more microphones  130  having suitable sensitivity and frequency ranges, which capture the sounds as electronic signals, as shown in  FIG. 14 . 
         [0102]    As shown in  FIG. 16   a , it is contemplated that the butterfly stethoscope can be embodied for use with an acoustic earpiece of a standard acoustic stethoscope (as shown in the depiction of  FIG. 16   a ) in which case, if the sounds are captured by electronic means, such as with a microphone, the in-line device will additionally include a speaker for reproducing the electronic data into audio, so that the physician can here the sounds while simultaneously recording and sending the digital electronic data for analysis and/or storage for future use. 
         [0103]    Alternatively, the butterfly sensor assembly can send electronic information to ear buds  131  which convert the data to audible sound, as shown in  FIG. 16   b . As also shown, the ear buds optionally include a pair of magnets  132  on a back portion thereof (advantageously shielded from the speakers in the earpieces so as not to adversely interfere with sound reproduction), so that when not in active use, the stethoscope can be worn as a necklace or hanging pendent by affixing the magnets, one to the other, behind the neck of the physician or diagnostician. 
         [0104]    While, for depiction and illustrative purposes herein, the selected examples are all butterfly likenesses, it is contemplated that any animal or other character or cartoon likeness, real or imaginary which is perceived positively, particularly by children, is employable in place of a butterfly. For example, as shown in the various depictions of  FIG. 17 , the stethoscope head (or in-line device) could be fashioned as a lizard, frog, hummingbird, clown, lion, mouse, fish, etc., or a well known cartoon or comics characters without departure from the invention. 
         [0105]    Furthermore, other representations of familiar icons can be adopted in the design appearance of a device in accordance with the invention.  FIGS. 18-21   b  depict an example in which a stethoscope head is made to resemble a heart shaped icon. Functionality and various components are analogous with those of the embodiment of  FIGS. 13-16   b , and therefore have not been repeated. 
         [0106]    For purposes herein, the term “icon” refers collectively to all shapes which bear resemblance to any familiar subject, including any of the aforementioned examples, including animals, characters and design shapes. 
         [0107]    Having described preferred embodiments of the invention with reference to the accompanying drawings, it is to be understood that the invention is not limited to those precise embodiments, and that various changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the invention as defined in the appended claims.