تدريب Shadowing: Ischemic Stroke - causes, symptoms, diagnosis, treatment, pathology - تعلم التحدث بالإنجليزية عبر الفيديو
اختر وضع التدريب
كل وضع يفتح غرفة تدريب بملء الشاشة.
124 جمل
إذا كانت الجمل قصيرة أو طويلة جدًا، انقر على Edit لتعديلها.
1
There are two main types of stroke.
2
An ischemic stroke, which is when there is a blocked artery that reduces blood flow to the brain,
3
and a hemorrhagic stroke, which is when there is an artery in the brain that breaks, creating a pool of blood that damages the brain.
4
Of the two, ischemic strokes are much more common, and the amount of damage they cause is related to the parts of the brain
5
that are affected and how long the brain suffers from reduced blood flow.
6
Now, if symptoms self -resolve within 24 hours, it's called a transient ischemic attack, and there are usually minimal long -term problems.
7
Okay, let's start with some basic brain anatomy.
8
The brain has a few regions.
9
The most obvious is the cerebrum, which is divided into two cerebral hemispheres, each of which has a cortex,
10
an outer region divided into four lobes including the frontal lobe, the parietal lobe, the temporal lobe, and the occipital lobe.
11
There are also a number of additional structures including the cerebellum
12
which is down below as well as the brainstem which connects to the spinal cord.
13
The right cerebrum controls muscles on the left side of your body and vice versa.
14
The frontal lobe controls movement and executive function which is our ability to make decisions.
15
The parietal lobe processes sensory information which lets us locate exactly where we are physically
16
and guides movement in a three -dimensional space.
17
The temporal lobe plays a role in hearing, smell, memory, as well as visual recognition of faces and language.
18
Finally, there's the occipital lobe, which is primarily responsible for vision.
19
The cerebellum helps with muscle coordination and balance.
20
And finally, there's the brain stem, which plays a vital role in functions like heart rate, blood pressure, breathing, gastrointestinal function and consciousness.
21
The brain receives blood from the left and right internal carotid arteries, as well as the left and right vertebral arteries,
22
which come together to form the basilar artery.
23
The internal carotid arteries turn into the left and right middle cerebral arteries, which serve the lateral portions of the frontal,
24
parietal, and temporal lobes of the brain.
25
Each of the internal carotid arteries also gives off branches called the anterior cerebral arteries
26
which serve the medial portion of the frontal and parietal lobes
27
and connect with one another with a short little connecting blood vessel called the anterior communicating artery.
28
Meanwhile, the vertebral arteries and basilar arteries give off branches to supply the cerebellum and the brain stem.
29
In addition, the basilar artery divides to become the right and left posterior cerebral artery,
30
which mainly serves the occipital lobe and some of the temporal lobe as well as the thalamus.
31
Finally, the internal carotid arteries each give off a branch called the posterior communicating artery, which attaches to the posterior arteries on each side.
32
So together, the main arteries and the communicating arteries complete what is called the circle of willis,
33
a ring where blood can circulate from one side to the other in case of a blockage.
34
The Circle of Willis offers alternative ways for blood to get around an obstructed vessel.
35
In general, the brain can get by on diminished blood flow, especially when it happens gradually, because that allows enough time for collateral circulation to develop,
36
which is where a nearby blood vessel starts sending out branches of blood vessels to serve an area that's in need.
37
But once the supply of blood flow is reduced to below the need of the tissue, it causes tissue damage, which we call an ischemic stroke.
38
There are two main ways an ischemic stroke happens.
39
One mechanism is endothelial cell dysfunction, which is when something irritates or inflames the slippery inner lining of the artery, the tunica intima.
40
One classic irritant is the toxin found in tobacco, which floats around in the blood damaging the endothelium.
41
That damage becomes a site for atherosclerosis, which is where a plaque forms.
42
This is when a buildup of fat, cholesterol, proteins, calcium, and immune cells form and start to obstruct arterial blood flow.
43
This plaque has two parts to it, the soft, cheesy, textured interior and the hard outer shell which is called the fibrous cap.
44
Branch points in arteries and particularly the internal carotid and middle cerebral arteries are the most common spots for atherosclerosis.
45
Usually though, it takes years for plaque to build up and this slow blockage only partially blocks the arteries.
46
And so even though less blood makes it to the brain tissue, there's still some blood.
47
So strokes happen when there is a sudden and complete or nearly complete blockage of the artery.
48
So let's see how that can happen.
49
Since plaques sit in the lumen of the blood vessel, they're constantly being stressed by mechanical forces from blood flow,
50
and interestingly, it's often the smaller plaques that are more dangerous.
51
Their fibrous caps are softer than the large ones, and are prone to getting ripped off.
52
Once that happens, the inner cheesy filling is exposed to the blood and is thrombogenic, which means that they tend to form clots very quickly.
53
Platelets adhere to the exposed cheesy material and they release chemicals that enhance the clotting process.
54
Within a minute, that artery can be fully blocked.
55
Another mechanism for ischemic stroke formation is an embolism.
56
An embolic stroke typically happens when a blood clot breaks off from one location, travels through the blood, and gets lodged in an artery downstream,
57
typically an artery, arterial, or capillary with a small diameter.
58
These blood clots typically emerge from atherosclerosis but they can also form in the heart.
59
For example stagnant blood flow can form a clot and blood can stagnate due to atrial fibrillation or after a heart attack.
60
If a clot forms in the left atrium it moves into the left ventricle
61
and from there it has direct route to the brain.
62
On the other hand
63
And if a clot forms in the low pressure veins or right atrium,
64
then it goes to the right ventricle and gets lodged in the pulmonary capillaries, with no way of getting to the brain.
65
An important exception is if a person has a heart defect, like an atrial septal defect, that allows blood
66
and potentially a blood clot to wander from the right side of the heart over to the left side of the heart.
67
In that situation, a venous or right atrial blood clot will have bypassed the pulmonary circulation and established a route to the brain.
68
One specific type of ischemic stroke is called a lacunar stroke,
69
and they typically involve the deep branches of the middle cerebral artery that feed the basal ganglia.
70
Lacunar refers to lake, and is called that since after a lacunar stroke,
71
the damaged brain tissue develops fluid -filled pockets called cysts that look like little lakes under a microscope.
72
Lacuna strokes classically develop as a result of highline arteriolosclerosis, which is when the arteriole wall gets filled with protein.
73
This can happen as a result of hypertension or diabetes, and can make the artery wall quite thick, reducing the size of the lumen.
74
In addition to problems specific to an artery, something like shock can lead to reduction in blood flow throughout the entire body.
75
In these cases, the tissues that are the furthest downstream are affected the most.
76
This is because healthy tissue continues to extract what it needs from the blood flowing by,
77
leaving little to no oxygen and nutrients for the tissue furthest away.
78
The furthest downstream tissues in the brain are at the border of two different blood supplies.
79
When the blood flow throughout the body is diminished for any reason, they get damaged, and this pattern of injury is called a watershed infarct.
80
Regardless of the mechanism of an ischemic stroke, it's helpful to remember that there is an ischemic core,
81
which is the brain tissue that will likely die from ischemia, and then there is the tissue around the core,
82
called the ischemic penumbra, which is preserved for a period of time by collateral circulation
83
and has a chance to survive if blood flow is restored quickly enough.
84
Regardless of the type of ischemic stroke, without a steady supply of glucose and oxygen, cells run out of energy within minutes,
85
and you get a high buildup of sodium and calcium levels in the cells.
86
High sodium levels draw water into the cell, making it swell, and this is called cytotoxic edema.
87
And high calcium leads up to the buildup of reactive oxygen radicals
88
that react with lipids in the membranes of mitochondria and lysosomes.
89
Damage to these organelles allow apoptosis inducing factors and degradative enzymes to seep out of the cell.
90
Over a period of 4 -6 hours, immune cells begin to haul away damaged cells, and the resulting inflammation damages the blood -brain barrier,
91
allowing fluids and proteins to get into the brain tissue, causing swelling or vasogenic edema.
92
Because the skull creates a fixed volume,
93
the swelling leads to a mass effect where the swollen brain tissue pushes into the unaffected side of the brain, called cingulate, or uncal herniation,
94
or slips down and out of the base of the skull,
95
called cerebellar tonsil herniation, which is particularly dangerous because it can push onto the brainstem and affect breathing and consciousness.
96
Stroke symptoms depend on the exact part of the brain that is affected.
97
For example, an interior or middle cerebral artery stroke can cause numbness and sudden muscle weakness.
98
If a stroke affects the BRCA area, which is usually the left frontal lobe, or the Wernicke's area, which is usually the left temporal lobe,
99
then it can cause slurred speech or difficulty understanding speech, respectively.
100
If there's a posterior cerebral artery stroke, then it can affect vision.
101
An acronym to remember some common stroke symptoms is FAST.
102
Facial drooping, arm weakness, speech difficulties, and time.
103
Time is obviously not a symptom,
104
but just a reminder to help as quickly as possible to minimize cell injury and maximize the chance of a full recovery.
105
To diagnose and confirm the location and size of an ischemic stroke, medical imaging with a CT or MRI can be used.
106
Also, angiography, which uses a contrast injected into the blood, can help to visualize the exact location where blood flow is blocked within an artery.
107
In addition, using flare -sequenced MRIs, it's possible to distinguish a new stroke injury from an old one.
108
In an ischemic stroke, the ultimate treatment is to re -establish blood flow as quickly as possible to prevent further cell injury, particularly in the penumbra.
109
Every minute counts.
110
So thrombolytic enzymes like tissue plasminogen activator or TPA are used to activate the blood's natural clot -busting mechanism,
111
but TPA does have a time limit of when it can be used.
112
Aspirin is also used to prevent platelets from forming additional clots.
113
If TPA is unsuccessful, surgical procedures can be used that push a wire through the artery and physically remove the clot.
114
In mechanical embolus removal in cerebral ischemia, called MERCY for short, the wire grabs onto the clot and draws it out of the artery.
115
In suction removal, the wire is used to physically break down the clot and the clot fragments are removed with suction.
116
After a stroke has occurred, there is an elevated risk of having additional strokes, so it's important to minimize risk factors,
117
the main one being quitting smoking, but others include having a healthy blood pressure, normal LDL cholesterol levels, and controlling other diseases like diabetes.
118
Occasionally, a surgery may be necessary to help clean arteries obstructed by severe atherosclerosis.
119
For example, in a carotid endarterectomy, the internal carotid artery is opened up and atherosclerotic plaque is removed.
120
Alternatively, a stent might be placed to keep the artery opened up.
121
Okay, as a quick recap, an ischemic stroke occurs when there is an acute decrease in the arterial blood supply.
122
It can be due to atherosclerosis, a thrombus, or an embolus, or a global reduction in blood flow.
123
The goal is to identify symptoms and re -establish blood flow to prevent long -term damage.
124
To remember this, a common acronym is FAST, facial drooping, arm weakness, speech difficulties, and time.
تنزيل التطبيق
كل ما تحتاجه للتحدث بطلاقة
تقييم النطق بالذكاء الاصطناعيتقييم كل جملة
تدريب IPAأتقن كل صوت
المفرداتابنِ رصيدك من الكلمات
لعبة المفرداتتعلّم أثناء اللعب
نفس القناة
C13
Pneumothorax - causes, symptoms, diagnosis, treatment, pathology
Daily ConversationUniversity Students
C14
Nitrates: Nursing Pharmacology
Daily ConversationUniversity Students
C11
Asthma
University StudentsWorking Adults
C13
Clinical Cuts: B-Cell Activation, Differentiation, & Contraction
IELTS PrepTOEFL PrepCambridge Exam Prep
C12
Myasthenia gravis
University StudentsWorking Adults
C1Gallstones (cholelithiasis)
University StudentsWorking Adults
C11
Bell palsy
University StudentsWorking Adults
C18
Emotional and mental health needs
Business EnglishUniversity StudentsWorking Adults
C17
Introduction to the immune system
IELTS PrepTOEFL PrepUniversity Students
C1Tuberculosis - causes, symptoms, diagnosis, treatment, pathology
IELTS PrepTOEFL PrepUniversity Students
FOR YOU
فيديو موصى به
C15
76 جمل
Stroke Symptoms, Risk Factors, & Prevention: What You Need to Know #stroke #strokesymptoms
Daily ConversationUniversity StudentsWorking Adults
C11
77 جمل
Retinal Artery Occlusion vs. Retinal Vein Occlusion
Daily ConversationUniversity Students
C1212
17 جمل
How exercise benefits your body
Daily ConversationUniversity StudentsWorking Adults
C13
45 جمل
Introduction to neural cell types | Organ Systems | MCAT | Khan Academy
Daily ConversationUniversity Students
C11
406 جمل
Scoliosis: How to medically classify scoliosis (the Lenke System for AIS)
Daily ConversationUniversity Students
C22
53 جمل
(English) Acute dissection of the ICA (Caresto implantation + PTA)
Daily ConversationUniversity StudentsWorking Adults
C156 جمل
ST Elevation and Depression on an EKG Rhythm Strip
Daily ConversationUniversity Students
C11
150 جمل
What it's like to have schizophrenia
Daily ConversationUniversity Students
C15
46 جمل
The Heart Structures and Agency
Daily ConversationUniversity Students
C11
72 جمل
Overview of Fluid and Electrolyte Physiology (Fluid Compartment)
Daily ConversationUniversity Students
المفردات وملاحظات التحدث لهذا الدرس
هذا الدرس في المحادثة مبني على الفيديو “Ischemic Stroke - causes, symptoms, diagnosis, treatment, pathology”. أكثر الكلمات تكرارًا في الفيديو: blood, stroke, artery, brain, arteries. يحتوي هذا الفيديو على 83 جملة و2020 كلمة للتدرب على الترديد. مدة الكلام 13:06. يتكلم المتحدث بسرعة طبيعية، نحو 154 كلمة في الدقيقة، قريبة من المحادثة اليومية. 70% فقط من الكلمات ضمن أكثر 3,000 كلمة شيوعًا في الإنجليزية، فالمفردات صعبة نسبيًا.
أهم المفردات في هذا الفيديو
15 كلمة من الفيديو تستحق التعلّم، مع النطق والمعنى:
| الكلمة | النطق | المعنى |
|---|---|---|
| artery اسم | /ˈɑɹ.təɹ.i/ | شِرْيَان |
| tissue اسم | /ˈtɪʃ.(j)u/ | مَنْدِيل, مِنْدِيل |
| cerebral صفة | /səˈɹi.bɹəl/ | مُخِّيّ |
| vessel اسم | /ˈvɛsəl/ | فُلْك |
| mechanism اسم | /ˈmɛk.ə.nɪ.zəm/ | آلِيَّة |
| symptom اسم | /ˈsɪm(p)təm/ | عَرَض, عَلَامَة |
| muscle اسم | /ˈmʌs.əl/ | عَضَلَة |
| wire اسم | /ˈwaɪɚ/ | سِلْك |
| connect فعل | /kəˈnɛkt/ | رَبَطَ |
| difficulty اسم | /ˈdɪfɪkəlti/ | صُعُوبَة |
| oxygen اسم | /ˈɑksɪd͡ʒən/ | أُكْسِجِين |
| weakness اسم | /ˈwik.nɪs/ | ضَعْف |
| calcium اسم | /ˈkælsi.əm/ | كَلْسِيُوم, كَالْسِيُوم |
| anterior صفة | /ænˈtɪɹ.i.ɚ/ | أَمَامِيّ |
| sudden صفة | /ˈsʌd.ən/ | مُبَاغِت, مُفَاجِئ |
القواعد في هذا الفيديو
أكثر التراكيب التي يستخدمها المتحدث، مع العبارات نفسها من الفيديو:
| التركيب | في الفيديو |
|---|---|
| المبني للمجهول be + اسم المفعول — التركيز على ما يحدث لا على من يفعله | are affected · is divided · is called |
| جمل الوصل who / which + جملة — معلومة إضافية عن شخص أو شيء | stroke, which is · cerebrum, which is · function which is |
| المضارع التام have/has + اسم المفعول — حدث ماضٍ ما زال له أثر الآن | have bypassed · has occurred |
نطق يحتاج إلى انتباه
- أصوات “th”: breathe /bɹiːð/, thick /θɪk/, atherosclerosis /ˌæθɚoʊskləˈɹoʊsəs/, furthest /ˈfɜː(ɹ)ðɪst/
- أصوات “sh” و“zh”: tissue /ˈtɪʃ.(j)u/, circulation /ˌsɝkjʊˈleɪʃən/, reduction /ɹɪˈdʌk.ʃən/, consciousness /ˈkɑnʃəsnəs/, recognition /ˌɹɛkəɡˈnɪʃ(ə)n/
- الكلمات الطويلة — انتبه لموضع النبر: mechanism /ˈmɛk.ə.nɪ.zəm/, difficulty /ˈdɪfɪkəlti/, communicate /kəˈmjuːnɪkeɪt/, circulation /ˌsɝkjʊˈleɪʃən/, anterior /ænˈtɪɹ.i.ɚ/
أصوات يجدها متحدثو العربية صعبة:
- /p/ — ليس /b/: انطقه مع نفخة هواء: plaque /plæk/, temporal /ˈtɛm.pə.ɹəl/, symptom /ˈsɪm(p)təm/, pocket /ˈpɑ.kɪt/, primarily /ˈpɹaɪ.mə.ɹə.li/
- /v/ — ليس /f/: مع اهتزاز الأوتار الصوتية: vessel /ˈvɛsəl/, removal /ɹɪˈmuː.vəl/, divide /dɪˈvaɪd/, respectively /ɹɪˈspɛktɪvli/, vital /ˈvaɪtəl/
- تتابع الصوامت — لا تضف حركة بينها: plaque /plæk/, symptom /ˈsɪm(p)təm/, connect /kəˈnɛkt/, downstream /ˌdaʊnˈstɹiːm/, regardless /ɹɪˈɡɑɹd.lɪs/
كيف تتدرب بهذا الفيديو
- استمع إلى الفيديو كاملًا مرة واحدة دون أن تتكلم، ودوّن الكلمات التي لا تعرفها.
- ابدأ بسرعة 0.75×، وردّد جملة جملة، ثم عُد إلى السرعة العادية عندما يصبح الأمر سهلًا.
- سجّل صوتك وقارنه بالأصل، مع الانتباه إلى كلمات مثل artery, tissue, cerebral.
ما هي تقنية التظليل الصوتي؟
التظليل الصوتي (Shadowing) تقنية تعلم لغة مدعومة علمياً، طُورت أصلاً لتدريب المترجمين الفوريين المحترفين. الطريقة بسيطة لكنها قوية: تستمع لصوت إنجليزي أصلي وتكرره فوراً بصوت عالٍ — كظل يتبع المتحدث بتأخير 1-2 ثانية. تُظهر الأبحاث تحسناً كبيراً في دقة النطق والتنغيم والإيقاع وربط الأصوات والاستماع والطلاقة.