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The ADC Spragues feature: Threaded chestpiece drum of chrome plated zinc permits the use of five interchangeable chestpiece fittings - an adult and pediatric diaphragm, and three bells (11/4'', 1'', 3/4'') - for complete diagnostic capability in most patients Latex-free, double tube configuration Proprietary valve mechanism eliminates acoustic leakage Adjustable chrome-plated brass binaurals Complete with an accessory pouch containing the bell chestpieces, chestpiece key, 2 spare diaphragms, one pair of mushroom eartips, and one pair of silicon eartips Inspected and packaged in the U.S.A. Adscope 641 features: Convenient 22'' tubing length in choice of 29 fashion tubing colors Weighs 8 oz. / Overall length 30'' 5 Year WarrantyProduct photo may not exactly match the product offered for sale. 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