Patent Publication Number: US-7722542-B2

Title: Blood pressure measuring apparatus

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
   This application is a continuation in part (CIP) application of U.S. Ser. No. 09/929,501, filed Aug. 14, 2001 now U.S. Pat. No. 6,615,666 entitled: PRESSURE MEASURING DEVICE, which is a continuation in part (CIP) application of U.S. Ser. No. 09/669,474, filed Sep. 25, 2000 now U.S. Pat. No. 6,422,086 entitled: LOW PROFILE PRESSURE MEASURING DEVICE. 

   FIELD OF THE INVENTION 
   The invention relates to the field of measuring instruments, and more particularly to an electronic pressure measuring device, such as a sphygmomanometer, that is releasably attachable to a blood pressure sleeve. 
   BACKGROUND OF THE INVENTION 
   Pressure measuring devices such as sphygmomanometers, that are used to measure the arterial blood pressure of a patent, typically include a pneumatic bulb which inflates a pressure chamber of an attached sleeve that is fitted over a limb (i.e., an arm or a leg) of the patient. A diaphragm or bellows assembly, responsive to changes in fluid pressure of the pneumatic bulb and the sleeve pressure chamber, is positioned in a gage housing which is fluidly connected to the pressure chamber of the sleeve through flexible tubes or hoses. In a mechanical gage housing, a pointer of a dial indicator is interconnected to the bellows assembly through a movement mechanism that is retained within the gage housing, whereby inflation of the bellows causes corresponding circumferential movement of the pointer, enabling a blood pressure measurement procedure to be carried out by a caregiver. 
   Typically, the above referred to movement mechanisms are quite intricate and complex, and are akin in terms of their manufacture and precision to Swiss watches. For example, and in one such movement mechanism, a pair of diaphragm springs are attached adjacent opposing ends of a spindle. A bottom end of the spindle is placed in contact with the bellows assembly and a twisted bronze band perpendicularly disposed at the top end of the spindle is connected in parallel by a horizontally disposed spring bent part. As the spindle deflects axially in response to the inflation of the bellows, the bent spring part is also caused to deflect, thereby causing the band to twist. The pointer, attached to the bronze band, therefore is caused to rotate in relation to an adjacent dial face. 
   Devices, such as the foregoing, include numerous moving and relatively complex components, some or each of having numerous bearing surfaces. Therefore, such known devices must be manufactured with relatively strict tolerance margins and significant associated costs in terms of both precision and failure rate in order to minimize errors. 
   In addition, any adjustments required after assembly of the above mechanisms, such as to null the pointer or adjust the sensitivity of the device, require substantial tear down or at least some undesired disassembly. 
   Furthermore, discrete and separate elements are typically required within the instrument housing for independently supporting the movement mechanism and the bellows assembly, respectively, and for defining an expansion chamber for the bellows assembly there between. 
   A more recent and simplified movement mechanism is described in U.S. Pat. No. 5,996,829, incorporated by reference in its entirety. This mechanism includes a vertically disposed axial cartridge having a spirally wrapped ribbon spring with one end mounted to an axially movable elongate shaft and the remaining end of the spring being attached to a fixed tubular sleeve. A bottom portion of the elongate shaft is positioned relative to an expandable diaphragm or bellows, wherein subsequent axial translation of the shaft, caused by movement of the diaphragm, elongates the spirally wound ribbon spring and produces repeatable circumferential movement of a pointer supported at the top end of the shaft. The above movement mechanism is far smaller and more lightweight than those previously known due to its simplified construction. 
   A further advance, described in U.S. Pat. No. 6,168,566, also incorporated by reference in its entirety, permits the design of a housing retaining the movement mechanism described in the &#39;829 patent to be even more compact. 
   One feature common to the above pressure measuring devices is the need to fluidly interconnect the gage housing containing the movement mechanism, the dial face and the indicating member with the interior of the inflatable sleeve. This interconnection is typically done using an elongated hose that is connected to a barb or coupling located on the sleeve exterior at one end of the hose and to an inlet port disposed on one end of the gage housing. It is a general object in the field to simplify the manufacture of these devices and to better integrate the design thereof. 
   More recently, electronic versions of pressure measuring devices have become much more prevalent and conspicuous in their use in the field. These devices such as those manufactured by Omron, Inc. among others can be mounted to the arm or wrist of a patient. These devices have a battery powered electronically based device that converts the output from the sleeve into a pressure reading output to the user. There is still reliance, however, upon inflation and deflation of an inflatable sleeve and more particularly, there is a fluid interconnection between the interior of the sleeve and the interior of the gage housing. In addition and to date, all of these devices have always been part of an integrated assembly, including the sleeve, whereby replacement has required replacement of not only the sleeve, but also the tethered electronic components. 
   SUMMARY OF THE INVENTION 
   It is a primary object of the present invention to overcome the above-noted deficiencies of the prior art. 
   It is another primary object of the present invention to provide a pressure measuring assembly that permits fluid interconnection between an inflatable sleeve or cuff and a gage housing containing an electronic based or mechanical pressure gauge wherein a blood pressure sleeve or cuff can be replaced as needed or interchanged as in the case of requiring a child size of adult cuff, where appropriate, without requiring replacement of the remainder of the pressure measuring assembly. 
   Therefore and according to a preferred aspect of the invention, there is provided a blood pressure measuring apparatus comprising: 
   a flexible sleeve member sized to be fitted about the limb of a patient and having an interior; 
   at least one gage housing, said at least one gage housing containing at least one of a mechanical and an electronic pressure gauge; and 
   coupling means for adaptively enabling direct attachment of one of said at least one gage housing to said flexible member and further adapted for permitting fluid interconnection between the interior of said flexible sleeve member and contained pressure gauge without requiring a hose or tubing therebetween. 
   Preferably, the coupling means includes at least one socket or port provided on the flexible sleeve member that is sized to directly and releasably receive an engagement portion of the gage housing. The socket includes an opening that extends into the interior of the sleeve member providing a sealed connection between the components and permitting fluid communication with the attached pressure gauge. 
   The socket is configured to accept gage housings that utilize literally any form of contained mechanism, provided that the contained mechanism is responsive to changes in pressure in the sleeve interior. Gage housings that are typically interconnected to prior art sleeves through a flexible elongated hose can be therefore be reconfigured, adapted, or retrofitted so as to permit releasable attachment to the socket of the inflatable sleeve member. 
   Moreover, the attached gage housing can be attached to the flexible sleeve member so as to permit rotation thereof, either through rotation of the housing or alternately by rotation of the socket or port. This rotation permits blood pressure measurements to be carried out by either the patient or the care giver. Moreover, the sleeve member can be configured to permit left and right limb measurements to be performed using the same sleeve. An advantageous feature of the present invention is an artery marker defined on the facing side of the sleeve which aligns the brachial artery of either the left or right arm of a patient. 
   According to another preferred aspect of the invention, there is provided a sleeve for a blood pressure measuring apparatus, said apparatus including a gage housing including a gauge mechanism disposed therein that is responsive to pressure changes within the interior of said sleeve, said sleeve comprising: 
   snap-fitting means for directly attaching said gage housing to said sleeve wherein said attachment permits direct fluid communication between the interior of said inflatable sleeve and the contained gauge mechanism without requiring a hose therebetween and in which said gage housing contains at least one of a mechanical and an electronic pressure gauge. 
   According to yet another preferred aspect of the invention, there is provided a blood pressure measuring apparatus comprising: 
   a gage housing having an engagement end and an electronic pressure gauge contained within said housing; 
   a flexible sleeve member sized to be fitted about the limb of a patient, said sleeve member having an inflatable interior; and 
   coupling means for adaptively permitting direct attachment of said gage housing to said sleeve and further adapted for permitting fluid interconnection between the interior of said flexible sleeve member and the contained electronic pressure gauge without requiring a hose or tubing therebetween. 
   According to another preferred aspect of the invention, there is provided an electronic module for a blood pressure measuring apparatus, said module comprising: 
   a housing body; 
   electronic gauge means disposed within said housing body that is responsive to pressure changes; and 
   coupling means for attaching said module to an inflatable sleeve member of said blood pressure apparatus such that there is direct fluid interconnection between the electronic gauge means and the interior of said inflatable sleeve member. 
   An advantage provided by the present invention is that a blood pressure measuring apparatus is provided in which a gage housing containing an electronic or a mechanical pressure gauge can be directly and sealingly mounted to an inflatable sleeve without requiring any interconnecting hoses between the housing and the sleeve. That is to say, a sealed mechanical interconnection is provided between the contained pressure gauge and the sleeve, permitting fluid pressure changes within the sleeve to be immediately detected by mechanisms provided within the gage housing and thereby allowing a blood pressure measurement to be taken more readily than those previously known. 
   A further advantage is that literally any previously known or current gage housing can be retrofitted to the sleeve to permit their attachment to the sleeve in a hoseless manner. For example, adapters can be provided which permit suitable attachment to the sleeve socket, the adapters being attachable to an engagement portion of the housing. Such adapters can further be provided integrally with the engagement portion of the gage housing to permit use With the presently described sleeve. 
   According to another preferred aspect of the present invention, there is described an electronic blood pressure measuring assembly comprising a sleeve having a port and a compact electronic gage housing having an engagement portion that is directly engageable with the port of the sleeve so as to permit fluid communication between the interior of the sleeve and an electronic pressure gauge contained within the interior of the electronic module. The electronics module can include a user interface, including a liquid crystal display (LCD) in lieu of the indicating member as found in a typical mechanical gage mechanism in order to provide processed output. 
   According to a preferred version, the electronic module can include a wireless transmitter, such as an RF (radio frequency) or IR (infrared) based transmitter, enabling blood pressure readings to be sent remotely. The module can further include a microprocessor with adequate memory enabling a plurality of pressure readings to be stored until it is desired that the readings be transmitted to a remote location. 
   These and other objects, features, and advantages will be more readily apparent to one of ordinary skill in the field from the following Detailed Description which should be read in conjunction with the accompanying drawings. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
       FIG. 1  is a side elevation view, shown in section, of a pressure measuring device according to the present invention; 
       FIG. 2  is an enlarged sectional view of the pressure measuring device of  FIG. 1 , depicting alternate means for attaching a rotatable dial face in relation to the device; 
       FIG. 3  is a side elevation view, shown partly in section, of a pressure measuring device having a housing according to a second preferred embodiment; 
       FIG. 4  is a side elevation view, shown partly in section, of a pressure measuring device having a housing according to a third preferred embodiment; 
       FIG. 5  is a partial sectional view of a pressure measuring device made in accordance with a fourth preferred embodiment as used with an inflatable blood pressure sleeve; 
       FIG. 6  is a side elevation view, partly in section, of a pressure measuring device made in accordance with a fifth preferred embodiment of the present invention; 
       FIG. 7  is an unassembled view of the pressure measuring device of  FIG. 6 ; 
       FIG. 8  is a partially exploded view of the housing of the pressure measuring device of  FIGS. 6 and 7 ; 
       FIG. 9  is a side elevation view, in section, of a gage housing made in accordance with a sixth embodiment of the present invention; 
       FIG. 9A  is an enlarged view of the attachment of the peripheral bumper to the gage housing of  FIG. 9 ; 
       FIG. 10  is a top perspective view of the gage housing of  FIG. 9 ; 
       FIG. 11  is a side perspective view of a gage housing made in accordance with a seventh embodiment of the present invention; 
       FIG. 12  is a side elevation view, in section, of the gage housing of  FIG. 11 ; 
       FIGS. 12A and 12B  are enlarged partial sectioned views of a protective peripheral bumper as attached to the gage housing of  FIG. 12 ; 
       FIG. 13  is a top perspective view of the gage housing of  FIG. 12 ; 
       FIG. 14  is a bottom perspective view of the gage housing of  FIG. 12  having a shock resistant feature made in accordance with another embodiment of the present invention; 
       FIG. 15  is a partially exploded view of a conventional blood pressure measuring apparatus; 
       FIGS. 16 and 17  are side elevation views, partly in section, of conventional gage housings which have been configured for direct attachment to an inflatable blood pressure sleeve; 
       FIG. 18  is a top view of a blood pressure measuring apparatus in accordance with a preferred embodiment of the invention; 
       FIG. 19  is a perspective view of the inflatable sleeve of the apparatus of  FIG. 18  as used with a patient; 
       FIG. 20  is an assembled top perspective view of a blood pressure measuring apparatus in accordance with another preferred embodiment of the present invention; 
       FIG. 21  is the top perspective view of the blood pressure measuring apparatus depicted in  FIG. 20  with the electronic gage module removed from the sleeve; 
       FIG. 22  is a functional block diagram of a capacitance transducer for use in the electronic gage module of the blood pressure measuring apparatus of  FIGS. 20 and 21 ; 
       FIG. 23  is a cross sectional view of a capacitance sensor assembly used that can be used in the electronic gage module of  FIGS. 20-22 ; 
       FIG. 24  is a preferred oscillator circuit for use in the electronic gage module of  FIGS. 20-23 ; 
       FIG. 25  is a cross-sectional view illustrating the interior of another electronic gage housing in accordance with the present invention; 
       FIG. 26  is a functional block diagram of another configuration for use in the electronic gage module of  FIGS. 20-25 ; and 
       FIGS. 27 and 28  depict bottom and top perspective views, respectively, of another electronic gage module in accordance with the present invention. 
   

   DETAILED DESCRIPTION 
   The present invention is herein described with reference to several preferred embodiments, each of which specifically relates to blood pressure measuring apparatus. However, it should be evident to one of sufficient skill in the field that certain other variations and modifications could be made utilizing the inventive concepts described herein, as well as alternate applications other than blood pressure measurement, including use in barometers, pressure vessel indicators, pressure sensitive switches, valves, and literally any industrial or medical device requiring a pressure responsive element. Furthermore and throughout the course of the following discussion, terms such as “upwardly”, “downwardly”, “upper”, “lower”, “top”, “bottom”, “vertically”, “horizontally”, and the like are used to provide a frame of reference with regard to the accompanying drawings. These terms, however, should not be treated as limiting with regard to the invention as described herein. In addition, a number of terms are used herein which require definitions. “Gearless” as used herein refers to any movement mechanism disposed within a gage housing which does not include a gear or gear-like element. 
   “Hoseless” as used herein refers to a direct connection between a gage housing and an inflatable sleeve of a pressure measuring apparatus without any intermediate hose or hoses therebetween. Several preferred embodiments of hoseless attachments for a blood pressure measuring apparatus are described throughout the course of the following discussion. 
   Referring to  FIG. 1 , there is shown a blood pressure measuring device or apparatus  10  made in accordance with a first embodiment of the invention. The device  10  includes a substantially cylindrical gage housing  12  having an interior cavity  14  defined by a circumferential inner wall  16 , an open top end  18 , and a bottom end  20 . A viewing window or bubble  22 , made from glass, plastic, or other suitable transparent material is attached in a known manner to the open top end  18  of the gage housing  12 . The bottom end  20  of the gage housing  12  has a diameter which inwardly tapers down to a narrow downwardly extending portion  24  having a bottom opening  26  serving as an inlet port for admitting a fluid. Preferably, the diameter of the narrow extending portion  24  is about one third of the diameter of the major portion of the housing  12 , though it will be apparent from the following discussion that this parameter can be suitably varied depending upon the application. 
   The interior cavity  14  of the housing  12  is sized for retaining a number of component parts, including a horizontally disposed support plate  28 . The support plate  28  is a generally planar member having opposing top and bottom facing sides  30 ,  32 , and a central through opening  34 . A press-fitted or otherwise suitably attached or integral sleeve  36  attached to the top facing side  30  of the support plate  28  extends into the central through opening  34  of the support plate  28  and is used for retaining a movement mechanism  40 , described in greater detail below. 
   The circumferential inner wall  16  of the housing  12  further includes a reflexed portion  19  which is sized for supporting an outer edge  21  of the horizontal support plate  28  immediately therebeneath and at a predetermined height within the housing  12 . The central through opening  34  is shown as being substantially aligned with the bottom opening  26  of the housing  12 , but this particular alignment is not critical to the workings of the present invention and therefore can be varied. 
   Referring to  FIGS. 1 and 2 , a diaphragm subassembly  42  includes a flexible diaphragm  44  which is non-fixedly attached to the bottom facing side  32  of the horizontal support plate  28 . The diaphragm  44  is substantially horizontally planar and includes a plurality of wave-like surfaces  49 . An outer edge  47  of the diaphragm  44  is clamped by an O-ring  46  disposed on a circumferential ledge  45  extending upwardly from the bottom end  20  of the housing  12 . The O-ring  46  not only supports the diaphragm  44  in place, but also provides a fluid tight seal for the bottom of the interior cavity  14 . 
   The centermost portion of the substantially horizontally planar diaphragm  44  includes a downwardly extending section, herein after referred to as the pan  48 , which is soldered or otherwise fixed or even integral with the remainder of the diaphragm  44 . The pan  48  is a hollow cylindrical section which extends into the downwardly extending portion  24  of the housing  12  when assembled and includes a cavity  50  having a width dimension that is substantially equal to that of the press-fitted sleeve  36 . A lower end  53  of the pan  48  includes a interior contact surface  52  that is hardened. 
   Referring specifically to  FIG. 1 , the movement mechanism  40  includes an axially displaceable shaft member  54  that is wholly enclosed within a hollow tubular member  56  with the exception of protruding top and bottom ends  57 ,  55 , respectively. A thin flexible ribbon-like spring member  70  is fixedly attached at one end  61  adjacent a bottom end of the tubular member  56  to a fixed portion of the tubular member and at an opposite remaining end  59  to the axially displaceable shaft member  54  around which the ribbon spring member  70  is helically or spirally wound. The hollow tubular member  56  includes a set of external threads  73  extending over an upper portion of the length thereof that engage corresponding internal threads  75  provided in the press-fitted sleeve  36 . The ribbon spring member  70  is preferably fabricated from beryllium copper, spring steel, or other similar material. 
   The hollow tubular member  56  includes an integral top cap portion  58  having a diameter which is larger than that of the remainder of the member, the cap portion having a shoulder which bears against a biasing spring  68  disposed within an annular recess  69  of the press-fitted sleeve  36 . The top cap portion  58  and the biasing spring  68  are used to adjust the overall sensitivity of the movement mechanism  40 . 
   When correctly positioned, the majority of the movement mechanism  40  extends beneath the horizontal support plate  28  and into the cavity  50  defined in the pan  48  which is already positioned in the downwardly extending portion  24  of the housing  12 . In this position, the extending bottom end  55  of the shaft member  54  is proximate to the hardened contact surface  52 . 
   Still referring to  FIG. 1 , a dial face  63  having measuring indicia (not shown) is attached to the top facing side  30  of the horizontal support plate  28  through a center opening which is sized to fit over the press-fitted sleeve  36 . An O-ring  65  disposed in a slot  67  of the tubular sleeve  36  engages an inner edge of the dial face  63  with an indicating member  62  being mounted to the protruding top end  57  of the shaft member  54 . A preferred lightweight indicating member useful in his design is described in U.S. Ser. No. 09/471,847, the entire contents of which are herein incorporated by reference. 
   In operation, changes in the pressure of incoming fluid (in this example, air) entering the bottom opening  26  of the housing  12  cause corresponding movements of the diaphragm  44 . That is, the seal provided onto the outer edge  47  of the diaphragm  44  by the O-ring  46  clamping against the top face of the housing ridge  45  prevents air from further penetrating into the interior cavity  14 . Therefore, the increase in pressure causes axial movement of the diaphragm pan  48  with the interior contact surface  52  being caused to push upwardly against the bottom end  55  of the axially displaceable shaft member  54 . As a result of the upward movement of the diaphragm  44 , the top end of the ribbon spring member  70  is caused to extend relative to the fixed bottom end  61  of the spring member which is fixedly attached to the bottom end of the tubular member  56 . This extension causes the shaft member  54  to rotate about its linear axis. The rotation of the axially displaceable shaft member  54  therefore causes a corresponding circumferential movement of the indicating member  62  attached to the top end  57  of the shaft member  54  relative to the measuring indicia (not shown) on the dial face  63 . 
   Zero adjustment of the above pressure measuring device  10  is a relatively simple procedure, as compared with previously known devices. First, the viewing window  22  is removed from the open top end  18  of the gage housing  12 . The engagement of the O-ring  65  against the inner edge of the dial face  63  allows the dial face to be freely rotated in relation to the position of the indicating member  62 . Sensitivity adjustments can also be made at the top of the device  10  by rotating the top cap portion  58  against the biasing spring  68  within the annular recess  69  of the press-fitted sleeve  36 , so as to adjust the sensitivity of the ribbon spring member  70  for a given rotation. A similar mechanism is described in previously incorporated U.S. Pat. No. 6,168,566. 
   Variations of the above device are possible. For example and referring to  FIG. 2  and in lieu of an O-ring, either the dial face  63 A and/or the horizontal support plate  28 A can be tapered suitably adjacent their center openings relative to a shoulder  80  provided on the tubular sleeve  36 A in order to allow the dial face to be rotated without requiring removal. Alternately, the movement mechanism  40  can include a zero adjustment feature as described in U.S. Pat. No. 5,966,829 and U.S. Pat. No. 6,168,566. In passing, it should be noted that  FIG. 2  merely illustrates a portion of the overall assembly in order to distinctly facilitate the above discussion. 
   A housing design in accordance with a second embodiment is illustrated in  FIG. 3 . Similar parts are herein labeled with the same reference numerals for the sake of clarity. As in the preceding, the device includes a gage housing  12  having an interior cavity  14  sized for retaining a diaphragm assembly  42  that includes a diaphragm  44  having a series of wave-like surfaces  49 , as well as a downwardly extending portion or pan  48 . The device further includes a substantially horizontally disposed planar support plate  28 , the housing  12  further having a downwardly extending narrowed portion  24 . A movement mechanism  40  is disposed through a central opening  34  defined in the horizontal support plate  28  such that the bottom end  55  of an axially displaceable shaft  54  of the mechanism is disposed in proximity to a hardened contact surface  52  of the pan  48  of the diaphragm assembly  42 . The diaphragm  44  in the meantime is attached, but not sealed, to the bottom facing side  32  of the horizontal support plate  28 . 
   A fluid, such as air, entering the gage housing  12  through a bottom opening  26  causes deflection of the pan  48  of the diaphragm  44  against the axially displaceable shaft  54 , thereby causing rotation of the shaft by means of an attached ribbon spring member  70 , according to the manner previously described. 
   According to this particular embodiment, the device includes a docking hub  82  that is provided on the exterior of narrow downwardly extending portion  24  of the housing  12 , the hub including a circumferential groove  114  which is sized for retaining an O-ring  118  or other similar sealing element. For example, the docking hub  82  can utilize pipe or other form of known threads (not shown). The docking hub  82  provides adequate modification to allow the device to be attached to other existing pressure device housings having pressure sources, for example, those manufactured by Welch Allyn, Inc. of Skaneateles Falls, N.Y., among others. In passing, it should be noted that the position of the bottom opening  26  of the housing  12  is not essential; that is, incoming fluid can enter the housing  12  from either a horizontally or otherwise disposed port, so long as the opening is beneath the seal that is provided by the O-ring  118 . 
   To further illustrate variations and referring to  FIG. 4 , a third embodiment of a housing  12 B made in accordance with the present invention includes a diaphragm  44 B, which unlike the preceding embodiments, is a substantially vertical member having an overall width dimension that is considerably narrower than those previously described. As a result, a horizontal support plate is not required, as in the preceding. 
   As in the preceding embodiments, an outer edge  47 B of the diaphragm  44 B is sealed using an O-ring  46 B or other sealing member which effectively clamps the outer edge to a shoulder of the a press-fitted sleeve  36 B. The movement mechanism  40  is disposed essentially through a center opening in a press-fitted sleeve  36 B and threaded into engagement therewith. The majority of the movement mechanism  40  is disposed within the cavity defined by the essentially vertical diaphragm  44 B, the particular diaphragm of this embodiment having vertically disposed wave-like surfaces  49 B. Adjustments to control the sensitivity of the movement mechanism  40  using biasing spring  68 B are performed in the manner previously described. 
   Overall, the housing of the instant embodiment defines a very shallow profile for the upper portion of the gage housing  12 B. Though not shown, the bottom end  20 B of the gage housing  12 B can be used as a docking hub to secure the gage housing into other gage housings (not shown) either as a retrofitted or as a new assembly as previously described. As further described herein, this docking hub can also permit direct hose-free connection between a gage housing and an inflatable blood pressure sleeve. 
   Referring to  FIG. 5 , a gage or instrument housing  140  formed in accordance with a fourth embodiment of the present invention is herein described in combination with a blood pressure sleeve or cuff  142 . For purposes of the present embodiment, the instrument housing  140  is used with a specific blood pressure cuff that is described in greater detail in U.S. Pat. No. 6,036,718, the contents of which are hereby incorporated in its entirety. In brief, the inflatable cuff  142  is manufactured using a pair of sleeve portions  144 ,  146  that are sealed together using a series of continuous RF (radio frequency) welds to form an integral bladderless structure having an inflatable inner volume  148 . In operation, the cuff  142  is then wrapped as conventionally known about the arm  170  (partially shown) or other limb of a patient. 
   The gage housing  140  includes an upper housing portion  152 , a lower housing portion  154 , and a connecting intermediate portion  156 . The upper and lower housing portions  152 ,  154  are substantially cylindrical in cross section and have approximately the same dimensions while the intermediate portion  156  has a substantially smaller diameter that is considerably narrower than either adjoining section, thereby defining a configuration resembling a yo-yo. According to the present embodiment, the intermediate portion  156  has a diameter which is approximately one third the diameter of the remaining portions  152 ,  154 , but it will be readily apparent that this parameter can be varied depending on the relative size of the movement mechanism used therein. Each of the above portions  152 ,  154 ,  156  are interconnected and hollow, combining to form an interior cavity  158 . 
   According to this embodiment, a horizontal support plate  165  (shown in phantom), is positioned within the lower portion  154  of the housing  140  while a dial face  167  (also shown in phantom) is disposed in the upper portion  152 . A movement mechanism  171  (also shown in phantom), which is similar structurally to those previously described, interconnects the dial face  167  and the support plate  165  and is located primarily in the intermediate portion  156 . 
   According to this embodiment, a button-hole like slot  162  is cut both of the inner and outer sleeve portions  144 ,  146 . The edges of the slot  162  are sealed. The above slot  162  provides a button-like retainment for the lower portion  154  of the housing  140  as well as the intermediate portion  156 , with the upper portion  152  protruding from the exterior of the cuff  142 . A port  176  is connected via a hose  178  to the inflatable inner volume  148  of the cuff  142  which is inflated by a pneumatic bulb (not shown) in a well known manner. 
   In operation, the device operates similarly to that previously described, except that a detachable stethoscope adapter  166  can also be attached to the bottom of the lower housing portion  154 , thereby forming an integral unit. The bottom of the lower portion  154 , according to this embodiment, includes an extending attachment portion  174  sized to engage a female connector  180  or other suitable means provided on the adapter  166 . All preceding known cuffs require separation between the cuff and the stethoscope. With the overall shallow profile of the above housing  140 , use of an adapter  166  permits an interconnection which is highly advantageous. 
   The stethoscope adapter  166  is a conical member which forms the bell of the stethoscope having connecting ear pieces (not shown) attached to a port  184 . In use, the adapter  166  is freely rotatable relative to the housing  140 , allowing examination by a patient or care giver to be performed equally well. The overall workings of stethoscopes are commonly known and do not form part of the inventive concepts described hereon. 
   Referring to  FIGS. 6-8 , there is shown a blood pressure measuring device made in accordance with a fifth embodiment of the present invention. As in the preceding, similar parts are labeled with the same reference numerals for the sake of clarity. This device includes an RF-welded blood pressure sleeve  142  similar to that described in the previously incorporated &#39;718 patent including a pair of sleeve portions  144 ,  146  which are sealed together to form an integral structure and define an inflatable inner volume  148 . The sleeve  142  is sized to be wrapped around the arm or other limb of a patient (not shown) in a manner which is commonly known, and therefore requiring no further explanation. A socket  190  is disposed and fixed within an opening that is provided on the exterior of one of the sleeve portions  144 , the socket being sized to receive a mating portion of an instrument or gage housing  194 . The instrument housing  194  according to this embodiment is similar to those previously described including a narrowed bottom portion, but in which the bottom portion also includes a ball-shaped engagement or mating end  196 . When assembled, the ball-shaped engagement end  196  is fitted within the socket  190  of the sleeve in order to provide a direct fluid and sealed connection therewith, the gage housing  194  being free to pivot relative to the plane of the sleeve  142 , about the socket  190 , as shown by reference numeral  198 . 
   The engagement end  196  includes an opening  200  that permits fluid communication with the interior of the sleeve  142  wherein fluid (e.g., air) can enter the interior of the gage housing  194 , causing corresponding movement of a diaphragm and a contained movement mechanism (not shown in this view), in the manner previously described herein. 
   Preferably, the viewing window  22  of the housing  194  includes an anti-reflective coating to reduce or substantially reduce glare, with the user (physician or care giver) or patient having the ability to either rotate the housing or to pivot same in order to effectively utilize the instrument and read the dial face. As such, the gage housing  194  can effectively be used in either a right or left-armed patient measurement. A sleeve that further provides this ability with an attached gage housing is described in greater detail below. 
   Still referring to  FIGS. 6-8 , the device further includes a rubberized ring-shaped guard or bumper  202  that is press-fitted into engagement about the outer periphery of the gage housing  194 , the bumper having a ridge  206  extending a predetermined distance above the viewing window  22 . The bumper  202  performs at least two functions; first, and though the present device is ultra-lightweight, the bumper additionally absorbs shock or impact loads when the housing  194  is dropped. Second, the bumper  202  also reduces the likelihood of damage to the viewing window  22 . 
   As described in greater detail in a succeeding embodiment, it should be noted herein that the mating or engagement end of the narrowed bottom portion of the instrument or gage housing need not include a “ball-shape” for accommodation within the sleeve socket  190 . Examples are discussed below with reference to  FIGS. 9-14 . 
   Furthermore, it should also be apparent that literally any gage housings that include a pressure responsive member can be configured or retrofitted for direct engagement with a blood pressure sleeve without requiring hoses (hoseless) between the housing and the sleeve. Moreover, these housings should not be limited merely to mechanically based gage housings, as described in the foregoing, in that electronic versions can also be retrofitted to the above described sleeve if the electronic version includes or is adapted to include a suitable mating or engagement end. 
   One example of a prior art mechanical system is partially shown in  FIG. 15 , and is defined by a gage housing  296  that retains a conventional movement mechanism  292 . The movement mechanism  292  includes a threaded end  297  extending through a bottom opening  299  of the gage housing  296  and is received into the mating threaded end of a port  300  of a tubular member  305 , the input end of which includes a pneumatic bulb  307 . In use, the output end  309  of the tubular member  305  receives a hose (not shown) that extends to a coupling of a blood pressure sleeve (not shown). 
   Referring to  FIGS. 16 and 17 , respectively, a pair of known mechanical gage housings  294 ,  306  are shown that can be interconnected to a blood pressure sleeve  324  in a manner similar that previously described. Each of these conventional housings  294 ,  306 , similar to those of  FIG. 15 , are less compact than those which have been expressly detailed, mainly because of the intricacy and sizing of the movement mechanism that is contained therein. Each of the gage housings  294 ,  306 , however, do commonly contain a threaded engagement end or inlet port  298 ,  310 , that permits fluid communication between the housing interior and the pneumatic bulb  307 ,  FIG. 15 . The pneumatic bulb  307  is attached using a hose (not shown) to the inlet port. As noted previously, any gage housing having an engagement or inlet end and including literally any form of movement mechanism can be reconfigured according to the present invention for hoseless interconnection with an inflatable sleeve. A number of additional examples are now described to further illustrate this point. 
   According to the present invention and in order to retrofit the gage housings  294 ,  306 , the end of the threaded inlet port  298 ,  310  can be covered with an adapter or cap  302  which is sized for sealing engagement within a socket  320  provided in an inflatable blood pressure sleeve  324 . The cap  302  and the socket  320  each include respective openings  304 ,  308 , which as shown in  FIGS. 16 and 17  upon attachment to the inflatable sleeve  324 , permits direct fluid communication between the interior  328  of the sleeve  324  and the interior of the housing  294 ,  306 , the housing being preferably snap-fitted to the sleeve. As a result, there is no need to include the hoses which are essential to the prior art assembly of  FIG. 15 , thereby greatly simplifying the use of even conventional devices by permitting direct, hose free connection to an inflatable blood pressure sleeve. 
   Referring to  FIGS. 20-28 , another series of preferred embodiments are herein described to better depict the versatility achieved by the present invention. All of the preceding embodiments have referred to so-called mechanical hoseless connections, that is, each of the gage housings have included a movement mechanism which is mechanical in nature. As noted above, however, any form of movement mechanism that is capable of producing a result based on a change of pressure can be utilized. 
   To that end and first referring to  FIGS. 20 and 21 , a blood pressure measuring assembly  400  includes a blood pressure sleeve  404  such as previously described which is bladderless, such as described in U.S. Pat. No. 6,036,718, the sleeve including a port  408  containing a small opening  412  that maintains fluid communication with the interior (not shown) of the sleeve. The port  408  permits engagement to an electronic gage module or housing  420  having a number of interior component parts, that are described in greater detail below, as well as a proximal end  424  that is sized to permit a direct releasable connection with the port without the need or requirement of additional hoses therebetween, the proximal end including an aligned end opening  428 . The sleeve  404  is inflated by means of a pneumatic bulb  434  that is tethered by a hose  438  to a coupling  442  provided on the sleeve, the coupling having an opening extending into the interior of the sleeve. A bleed valve  446  adjacent the pneumatic bulb  434  assists in the deflation of the sleeve  404  in a manner conventionally known. The sleeve  404  is bladderless, can be securably wrapped about a limb of a patent (not shown) by means of hoop and loop fastener portions  445 . 
   Referring to  FIG. 22 , a block diagram illustrates the primary componentry, in this instance, a capacitance transducer assembly  450  of an electronic pressure gauge contained within the electronic gage module  420 . This transducer assembly  450  generally includes a capacitance pressure sensor transducer  454  that is responsive to a stimulus, (in this instance, the stimulus is the input of fluid into the interior of the electronic gage module from the sleeve  404 ,  FIG. 20 ), the transducer being operatively connected to an oscillator circuit  458 . A measurement and processing circuit  462  is connected to the output of the oscillator circuit  458 . The measurement and processing circuit  462  includes a counter circuit  466  that is connected to a data processor  470 , each of the latter being connected to a reference oscillator  474 , the data processor being connected to user I/O devices  475 . In this instance, the I/O devices  475  include an actuable button  476 ,  FIG. 20 , provided on the exterior of the module as well as a display  478 ,  FIG. 21 . 
   In terms of general operation, essentially the dynamic portion of transducer  454  is a variable capacitor. As the measured environmental parameter changes (the entering fluid pressure), the capacitance changes. The oscillator circuit  458  converts this capacitance change into an AC signal. The processor  470  converts the measured frequency into the parameter (e.g., pressure) measurement and the measured parameter is then displayed upon the display  478 . 
   Referring to  FIG. 23 , a preferred capacitance sensor transducer  454  for use in the above assembly  450  is described in greater detail for exemplary purposes, the transducer including a capacitance sensor that includes a metallic conductor layer  480  formed on a surface of a circuit board  484 . A ground conductor layer  488  is disposed on the opposite surface  492  of the circuit board  484 , that also includes a dielectric material, disposed between the conductor layer  480  and the ground conducting layer  488 . A metal ring  496  is connected to the circuit board  484  by pins  500 , that are inserted through a ring conductor  504 . The metal ring  496  receives structural support from a support plate  508  that is disposed between the circuit board  484  and the metal ring  496 . The support plate  508  causes the conductor layer  480  and the support plane of the metal ring  496  to be co-planar, thereby reducing mechanical tolerance stack-up. A metallic diaphragm  512  is coupled to the circuit board  484  as sandwiched between the metal ring  496  and an O-ring  516 . Therefore, the metallic diaphragm  512  is disposed over the circuit board  484  and is juxtaposed relative to the conductor layer  480  to form a variable capacitor. The metallic diaphragm  512  is held in place by the O-ring  516  which is pressed against the diaphragm and metal ring  496  by a snap-on cap  520 . The snap-on cap  520  includes a port  522  aligned to permit fluid to enter same as stimulus as well as multiple snaps  524  that fit over the edge of the metal ring  496 . A set of electronics; more particularly, an oscillator circuit  458  and a measurement and processor circuit  462  as well as a reference oscillator  474 , for the sensor are mounted to the underside  492  of the circuit board  484 . 
   Referring to  FIG. 24 , a schematic of a preferred oscillator circuit is herein described. This circuit  458  includes a first loop having an inverter gate  530 , inverter gate  534 , resistor  538 , and a capacitive sensor  540 , such as just described in  FIG. 23 , in series. An optional capacitor  542  is connected between the input of the inverter gate  530  and ground. An optional capacitor  544  is connected between the output of the resistor  538  and ground. The capacitor  542  and capacitor  544  are in parallel with stray capacitances resulting from the construction of the sensor  450  and the proximity of the oscillator  458  on the circuit board  492  to the ground conductor. A low-pass filter  548  is formed by the series resistor  538  in combination with the capacitor  542 , capacitor  544  and the stray capacitances referred to above. The oscillator circuit  458  also includes a second loop in parallel with the resistor  538  and capacitance transducer  540 . The second loop includes an inverter gate  552  in series with a resistor  556 . The output of the oscillator circuit  458  is connected to the measurement and processing circuit  462 . 
   This oscillator circuit  458  is a type of RC relaxation oscillator wherein the dynamic portion of the oscillator circuit  458  is the capacitance transducer  540 , as described above. Additional details concerning the above sensor and transducer assembly, including the above referred to oscillator circuit, can be found in copending U.S. Ser. No. 10/058,191 entitled: Capacitance Sensor, filed Oct. 26, 2001, the entire contents of which are herein incorporated by reference. 
   A cross-sectional view of the components as stored within the interior of another version of another suitable electronic gage module  560  are shown in  FIG. 25 . It should be readily apparent that this module is exemplary, and that modifications and variations can be found, for example, in U.S. Pat. Nos. 5,323,782 and 5,316,006. Exterior views of this module  560  are depicted in  FIGS. 27 and 28 , the module having an ovate geometry that is defined by a housing body  564  which includes a upper or major housing section  566  and a proximal engagement section  568  that is sized to be sealingly and releasably fitted into a port or socket  408  of a blood pressure sleeve  404 , such as that shown in  FIGS. 20 and 21 , and in the manner previously described. The proximal engagement section  568  includes an end opening  572  extending into the interior of the module  560  and particularly to a contained capacitance transducer sensor assembly  582 , coupled to a circuit board  586 , the sensor assembly having a metallic diaphragm (not shown in this view) and operative in a manner as previously described. The interior of the module  560  further includes relevant circuitry as well as a processor  594  interconnecting the above components including a display, such as an LCD  584  that positioned relative to a viewing window  588 . Each of the above are interconnected in the manner previously described to an input means such as an ON/OFF button  598 , disposed on the upper housing section  566  of the module  560 , each being powered by batteries  600 . 
   The exterior of the housing body  564  further includes a peripheral bumper  576 , shown in  FIGS. 27 and 28  only, that protects the upper housing section  566  when dropped. The bumper  576  is preferably raised above the LCD  584 . Within the module  560  are a number of components including the capacitance transducer sensor assembly  582 , similar to that previously described, 
   Referring to  FIG. 26 , an alternate design for an electronic gage housing or module  640  is depicted wherein fluid enters a housing body  644  as from a sleeve (not shown) regulated by a valve  648  or pneumatic bulb (not shown) attached to a pressure-sensitive switch  652 . The sensor  656 , such as the, preceding capacitive sensor is operatively connected to receive the fluid incoming stream through a port  660 , the sensor being controlled by circuitry retained with a miniature processor  666 . Blood pressure readings are then calculated by the processor  666  for either output by a display  670  or the pressure information signal is alternately converted through appropriate means into digital values that can be transmitted wirelessly by means of a RF or IR based link  674  to a remote site (not shown). 
   In passing, it should further be noted that though an RF welded or bonded inflatable sleeve is described throughout, other forms of inflatable sleeves can be utilized embodying the central concepts of the present invention, including both bladderless sleeves and sleeves having bladders. In addition, other forms of systems can be employed other than the capacitance sensor described herein. For example, a strain gage including a silicon pressure sensor could be employed in combination with an analog amplifier and an A/D converter to produce a digital signal. Alternately, a diaphragm could be employed in combination with a pair of ultrasonic transducers to produce a time delay signal. According to yet another example, an optical version could be contemplated using a laser and a diffraction grating in which interference fringe counts could be used as a determining means. 
   Still according to another alternative, a magnetic based system could be utilized in combination with a diaphragm and an LVDT. A MEMs-based version is also possible within the ambits of the invention provided the packaging is suitably convenient for sleeve attachment. Each of the foregoing can be used with a diaphragm though use of a diaphragm may also not be required. For example, a Bourdon tube could be employed in lieu of a diaphragm. Alternately, a spring and a rolling seal piston could be substituted for the diaphragm, indicating the myriad of potential uses and applications. 
   Referring to  FIGS. 9-11 , there is shown a gage or instrument housing  210  according to a sixth embodiment of the present invention. As in the preceding, the gage housing  210  is used in connection with a blood pressure measuring device and includes an upper housing portion  212  which retains a movement mechanism  214  and a narrowed lower portion  218  having a mating or engagement end  220  which is sized to engage a generally cylindrical socket  222  formed in a sleeve portion of a bladderless blood pressure cuff or sleeve  226 . Unlike the preceding embodiment, the mating end  220  of the narrowed lower portion  218  is also generally cylindrical in cross section, the end similarly including an end opening  224 , shown in  FIG. 11 , which permits fluid communication with the interior of the blood pressure cuff  226  via a corresponding opening  228  also formed in the socket  222 , thereby forming a fluid inlet port. 
   The upper housing portion  212  of the gage housing  210  and the contained movement mechanism  214  are similar to those previously described. That is, the movement mechanism  214  includes a helically wound thin ribbon spring  240  which is attached at one end to an axially displaceable shaft member and at a second end to a tubular sleeve member in the manner described above. Changes in pressure of the cuff  226  cause fluid to enter the narrowed lower housing portion  218  through the end opening  224 , affecting a contained diaphragm  246  and causing the axially displaceable shaft member to be translated upwardly, resulting in rotation of the shaft member against the biasing of the ribbon spring  240  and circumferential movement of an indicating member  248 , attached to a protruding top end of the shaft member, relative to a dial face. 
   The mating end  220  of the narrowed lower housing portion  218  can include a circumferential channel or notch  250 , that is most clearly shown in  FIG. 11 . The circumferential channel  250  provides a discontinuous path for shock and impact loads and, therefore, effectively cushions the contents of the gage housing  210  including the movement mechanism  214 , from shock or impact loads such as when the housing  210  lands on the narrowed lower portion  218 . 
   According to this embodiment and as most clearly shown in  FIGS. 9 and 10 , and to further insulate the housing  210  from damage due to shock or impact loading, a rubberized peripheral guard or bumper member  232 , sized to fit over the exterior periphery of the upper housing portion  212  is press fitted into engagement therewith. The guard member  232  is similar to that previously described above in that the entire periphery of the upper housing portion  212  is covered, the guard member including a stepped portion  234 , shown in  FIG. 9A , which extends over the top of the upper housing portion, including the viewing window, and defines an air gap  236  along the outer circumferential edge thereof. The air gap  236  provides a discontinuous path for any impact loads which can occur if the gage housing  210  lands awkwardly. 
   Variations of the above embodiment of  FIGS. 9-11  are possible. For example, and referring to  FIGS. 12-14 , there is shown a gage housing  260  according to a seventh embodiment of the present invention. The gage housing  260  also includes an upper housing portion  264  and a narrowed lower housing portion  268  having an engagement end  270  which mates with a socket  222  which is formed in blood pressure sleeve  226 . The upper housing portion  264  according to this embodiment is defined by a substantially elliptical cylindrical cross section as opposed to the preceding embodiments in which the upper housing portions are substantially circular cylinders. It should be noted that other shapes or geometries could be contemplated. According to this embodiment, a circular face groove  272  provided in the bottom surface  276  of the engagement end  270  provides a similar function to the circumferential channel  250 ,  FIG. 11 , with regard to shock or impact loads applied to the housing if dropped or otherwise acted upon. 
   Otherwise, the engagement end  270  similarly engages the socket  222  of the sleeve  226 , the gage housing  260  retaining a movement mechanism (not shown) as previously described. The engagement end  270  includes an end opening  271  which permits hoseless fluid communication with the sleeve  226 , also as previously described, through a socket opening  228  which extends to the sleeve interior. 
   According to the instant embodiment, a rubberized guard member  280  is press fitted over the exterior periphery of the upper housing portion  264 , the guard member according to this embodiment including a radially extending portion  284  which when attached extends from the outer edge of the elliptically shaped upper housing portion  264  and similarly provides a cushioning air gap  286  which creates a discontinuity, in fact a buffer, which insulates the housing  260  from impact loads when the housing is dropped. Similar air gaps  288  are provided above the viewing window as defined in an axially extending portion  290  to provide additional protection against shock or impact loads. 
   As shown in  FIG. 12B , an O-ring  289  is provided within the annular air gap  288 . Additional shock resistance between adjoining portions of the housing  264  and the interior wall surface of the guard member include an annular rubberized shim  285 . 
   Referring to  FIGS. 18 and 19 , a sleeve  344  for a blood pressure measuring apparatus  340  is herein described. 
   The sleeve  344  itself is constructed from a pair of sleeve portions  368 ,  372  made from a polyamide or other similar fluid impermeable material which are RF welded or bonded together and define an interior chamber. The interior chamber of the sleeve  344  is inflated by means of a pneumatic bulb  356  which is tethered by tubing  360  to a barb or port  352  provided on a sleeve portion  368 , the barb having an opening which is in communication with the interior chamber of the sleeve. A check valve  364  provided adjacent to the pneumatic bulb  356  permits depressurization of the interior chamber of the sleeve  344  when the valve is opened. 
   The sleeve  344  includes hook and loop fastener portions (only one of which  376  being shown) on the outward facing sides of each of the sleeve portions  368 ,  372  at opposite ends of the sleeve, thereby permitting the sleeve to be formed into a cylindrical shape and secured when wrapped about the limb of a patient  375 , as shown in  FIG. 19 . Each hook and loop fastener portion  376  is also preferably RF welded to a sleeve portion  368 ,  372 . Specific features relating to the above noted features, including the manufacture of the herein described sleeve  344 , are described in U.S. Pat. No. 6,036,718, herein previously incorporated by reference in its entirety. 
   When properly attached, the facing side of the sleeve portion  372  contacts the patient with the facing side of the sleeve portion  368  being exposed. According to the present embodiment, each facing side has a different color to assist in attaching same to the patient. According to the present embodiment, the sleeve  344  is two-toned with the facing side of the sleeve portion  372  having a black colored finish and the facing side of the exposed sleeve portion  368  having a lighter colored finish. 
   A socket or port (not shown) similar to those described above and shown for example in  FIGS. 9 and 12  is also provided in the sleeve portion  368 , the socket being sized for receiving a gage housing  348  which is releasably snap-fitted in the manner previously described and defined. The gage housing  348 , when attached, can be rotated about its vertical axis, permitting easy visual access to either the care giver and/or the patient. 
   The gage housing  348  according to this embodiment is identical to that previously shown and described in  FIG. 9 , the housing containing a bellows assembly as well as a gearless movement mechanism which operates in the manner described above to permit circumferential movement of an indicating member relative to a dial face when pressure changes within the interior chamber of the sleeve  344  cause movement to a movable surface of the bellows assembly. The gage housing  348  also preferably includes the shock/impact resistant features previously described. 
   An artery index marker  380  is provided adjacent the hook and loop fastener portion  376  on the facing side of the sleeve portion  368 . This marker  380  is used to align the sleeve with the brachial artery of the patient, the marker further including left and right limb indicators which are provided on respective lateral sides of the sleeve  344 . When the sleeve  344  is wrapped over the arm of the patient  375 , the marker is used to properly and circumferentially align the arm and the artery with the limb indicator pointing directly at the artery. The rotatability of the gage housing  348  within the sleeve  344  permits the sleeve having the attached gage housing to be used when attached regardless of orientation. 
   According to the present invention, sets of indicia  384 ,  388  are also provided on the facing side of the sleeve portion  368  designating the size of sleeve being used; that is, whether the sleeve is an adult, child or neonatal cuff. An adult sleeve is shown in the present embodiment. The gage housing  348  can be releasably attached in the manner described herein to any of the above noted sleeves, regardless of size. Moreover, the above sleeve can be used with any of the above described gage housings, including the electronic modules described in  FIGS. 20-23 . 
   
     
       
         
             
           
             
                 
             
             
               Parts list for FIGS. 1-28 
             
             
                 
             
           
          
             
                 
             
          
         
         
             
             
          
             
                10 
               blood pressure measuring device or apparatus 
             
             
                12 
               gage housing 
             
             
                12B 
               gage housing 
             
             
                14 
               interior cavity 
             
             
                16 
               circumferential inner wall 
             
             
                18 
               open top end 
             
             
                19 
               reflexed portion 
             
             
                20 
               bottom end 
             
             
                20B 
               bottom end 
             
             
                21 
               outer edge (support plate) 
             
             
                22 
               bubble or viewing window 
             
             
                24 
               downwardly extending portion 
             
             
                26 
               bottom opening 
             
             
                28 
               horizontal support plate 
             
             
                28A 
               horizontal support plate 
             
             
                30 
               top facing side 
             
             
                32 
               bottom facing side 
             
             
                34 
               central through opening 
             
             
                36 
               sleeve 
             
             
                36A 
               sleeve 
             
             
                36B 
               sleeve 
             
             
                40 
               movement mechanism 
             
             
                42 
               diaphragm subassembly 
             
             
                44 
               diaphragm 
             
             
                44B 
               diaphragm 
             
             
                45 
               circumferential ridge 
             
             
                46 
               O-ring 
             
             
                46B 
               O-ring 
             
             
                47 
               outer edge 
             
             
                47B 
               outer edge 
             
             
                48 
               pan 
             
             
                49 
               wave-like surfaces 
             
             
                49B 
               wave-like surfaces 
             
             
                50 
               cavity 
             
             
                51 
               cavity 
             
             
                52 
               contact surface 
             
             
                53 
               lower end 
             
             
                54 
               axially displaceable shaft member 
             
             
                55 
               bottom end 
             
             
                56 
               tubular member 
             
             
                57 
               top end 
             
             
                58 
               top cap portion 
             
             
                59 
               end-ribbon spring 
             
             
                61 
               end-ribbon spring 
             
             
                62 
               indicating member 
             
             
                63 
               dial face 
             
             
                63A 
               dialface 
             
             
                65 
               O-ring 
             
             
                66 
               threads 
             
             
                67 
               slot 
             
             
                68 
               biasing spring 
             
             
                68B 
               biasing spring 
             
             
                69 
               recess 
             
             
                70 
               ribbon spring member 
             
             
                72 
               one end 
             
             
                73 
               threads 
             
             
                75 
               threads 
             
             
                80 
               shoulder 
             
             
                82 
               docking hub 
             
             
               114 
               circumferential groove 
             
             
               118 
               O-ring 
             
             
               140 
               gage or instrument housing 
             
             
               142 
               cuff 
             
             
               144 
               sleeve portion 
             
             
               146 
               sleeve portion 
             
             
               148 
               inner volume 
             
             
               152 
               upper housing portion 
             
             
               154 
               lower housing portion 
             
             
               156 
               intermediate portion 
             
             
               158 
               interior cavity 
             
             
               162 
               slot 
             
             
               165 
               support plate 
             
             
               166 
               detachable stethoscope adapter 
             
             
               167 
               dialface 
             
             
               170 
               arm 
             
             
               171 
               movement mechanism 
             
             
               174 
               extending attachment portion 
             
             
               176 
               port 
             
             
               178 
               hose 
             
             
               180 
               female connector 
             
             
               184 
               port 
             
             
               190 
               socket 
             
             
               194 
               instrument or gage housing 
             
             
               196 
               ball-shaped engagement end 
             
             
               198 
               direction 
             
             
               200 
               opening 
             
             
               202 
               peripheral bumper 
             
             
               206 
               ridge 
             
             
               210 
               gage housing 
             
             
               212 
               upper housing portion 
             
             
               214 
               movement mechanism 
             
             
               218 
               narrowed lower housing portion 
             
             
               220 
               engagement or mating end 
             
             
               222 
               socket 
             
             
               224 
               end opening 
             
             
               226 
               blood pressure sleeve or cuff 
             
             
               228 
               socket opening 
             
             
               232 
               rubberized peripheral guard or bumper member 
             
             
               234 
               stepped portion 
             
             
               236 
               gap 
             
             
               240 
               ribbon spring 
             
             
               242 
               axially displaceable shaft member 
             
             
               246 
               contained diaphragm 
             
             
               248 
               indicating member 
             
             
               250 
               circumferential channel 
             
             
               260 
               gage housing 
             
             
               264 
               upper housing portion 
             
             
               268 
               narrowed lower housing portion 
             
             
               270 
               engagement end 
             
             
               271 
               end opening 
             
             
               272 
               circular face groove 
             
             
               274 
               movement mechanism 
             
             
               276 
               bottom surface 
             
             
               280 
               rubberized guard member 
             
             
               284 
               radially extending portion 
             
             
               285 
               rubberized shim 
             
             
               286 
               air gap 
             
             
               288 
               air gap 
             
             
               289 
               O-ring 
             
             
               290 
               axially extending portion 
             
             
               292 
               movement mechanism 
             
             
               294 
               gage housing 
             
             
               296 
               gage housing 
             
             
               297 
               threaded end 
             
             
               298 
               inlet port 
             
             
               299 
               bottom opening 
             
             
               300 
               port 
             
             
               302 
               cap 
             
             
               304 
               opening 
             
             
               305 
               tubular member 
             
             
               306 
               gage housing 
             
             
               307 
               pneumatic bulb 
             
             
               308 
               opening 
             
             
               309 
               output end 
             
             
               310 
               inlet port 
             
             
               320 
               socket 
             
             
               324 
               sleeve 
             
             
               328 
               interior 
             
             
               340 
               blood pressure measuring apparatus 
             
             
               344 
               sleeve 
             
             
               348 
               gage housing 
             
             
               352 
               barb or port 
             
             
               356 
               pneumatic bulb 
             
             
               360 
               tubing 
             
             
               364 
               check valve 
             
             
               368 
               sleeve portion 
             
             
               372 
               sleeve portion 
             
             
               375 
               patient 
             
             
               376 
               hook and loop fastener portion 
             
             
               380 
               artery index marker 
             
             
               384 
               indicia 
             
             
               388 
               indicia 
             
             
               400 
               blood pressure measuring assembly 
             
             
               404 
               sleeve 
             
             
               408 
               port 
             
             
               412 
               opening 
             
             
               416 
               interior, sleeve 
             
             
               420 
               gage housing 
             
             
               424 
               proximal end 
             
             
               432 
               electronic movement mechanism 
             
             
               434 
               pneumatic bulb 
             
             
               438 
               hose 
             
             
               442 
               coupling 
             
             
               445 
               hook and loop fasteners 
             
             
               446 
               bleed valve 
             
             
               450 
               capacitance transducer assembly 
             
             
               454 
               capacitance pressure sensor transducer 
             
             
               458 
               oscillator circuit 
             
             
               462 
               measurement and processing circuit 
             
             
               466 
               counter circuit 
             
             
               470 
               data processor 
             
             
               474 
               reference oscillator 
             
             
               475 
               I/O devices 
             
             
               476 
               actuable button 
             
             
               478 
               display 
             
             
               480 
               metallic conductor layer 
             
             
               484 
               circuit board 
             
             
               488 
               ground conductor layer 
             
             
               492 
               side 
             
             
               496 
               metal ring 
             
             
               500 
               pins 
             
             
               504 
               ring conductor 
             
             
               508 
               support plate 
             
             
               512 
               metallic diaphragm 
             
             
               516 
               O-ring 
             
             
               520 
               snap-on cap 
             
             
               522 
               port 
             
             
               524 
               multiple snaps 
             
             
               530 
               inverter gate 
             
             
               534 
               inverter gate 
             
             
               538 
               resistor 
             
             
               540 
               capacitance transducer 
             
             
               542 
               capacitor 
             
             
               544 
               capacitor 
             
             
               548 
               low pass filter 
             
             
               552 
               inverter gate 
             
             
               556 
               resistor 
             
             
               560 
               electronic gage module 
             
             
               564 
               housing body 
             
             
               566 
               upper or major housing section 
             
             
               568 
               proximal engagement portion 
             
             
               572 
               opening, end 
             
             
               576 
               peripheral bumper 
             
             
               582 
               capacitance transducer sensor assembly 
             
             
               584 
               LCD 
             
             
               586 
               circuit board 
             
             
               588 
               viewing window 
             
             
               594 
               processor 
             
             
               598 
               button 
             
             
               600 
               batteries 
             
             
               640 
               electronic gage housing or module 
             
             
               644 
               housing body 
             
             
               648 
               valve 
             
             
               652 
               pressure-sensitive switch 
             
             
               656 
               sensor 
             
             
               660 
               port 
             
             
               666 
               processor 
             
             
               670 
               display 
             
             
               674 
               wireless link 
             
             
                 
             
          
         
       
     
   
   It will be readily apparent to those of ordinary skill in the field that other variations and modifications are possible within the spirit and scope of the invention as defined by the following appended claims.