Shadowing Practice: Retinal Artery Occlusion vs. Retinal Vein Occlusion - Learn English Speaking with Video

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Medical students hate this question, retinal artery occlusion versus retinal vein occlusion.
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The reason that this is so difficult is that both of these processes will present with acute painless monocular vision loss.
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And yes, we can kind of nitpick here and maybe say
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that retinal vein occlusion tends to be a little bit more painful, or maybe there's some temporal sparing in retinal artery occlusion,
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but the test writer knows this and they're not going to give you that.
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So in your exam, the way that you're going to get this right is
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if you can identify buzzwords and identify the picture when they show you the back of somebody's eye.
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So the way that I think you can simplify this is let's break it down and get back to basics.
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If you understand pathophysiology, this makes perfect sense.
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One of these has artery in the name.
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One of these has vein in the name.
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Artery brings the blood to something and the vein takes it away.
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So if we block the artery, blood cannot get to the retina.
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If we block the vein, blood can't get out of the retina.
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And if we keep it that stupid and that simple, this all makes perfect sense.
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So in other words, a retinal artery occlusion where your artery is blocked, therefore blood can't get to something, that's a supply problem.
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A retinal vein occlusion, meaning that the blood cannot drain out of the eye, that's a drainage problem.
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So, let's pause for a second, and I've got a really silly picture here at the bottom of the slide.
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If blood can't get in, what physical findings would you expect to see?
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And if blood can't get out, what physical findings would you expect to see so taking
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that one step further in the artery occlusion
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you see a pale fundus with a cherry red spot in the vein occlusion you see hemorrhage
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and edema now this should make sense to you
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when we look at hemorrhage and edema if blood is pooling into the eye
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and can't get out through the retinal vein there will be hemorrhage and there will be edema specifically of the optic disc.
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And if we think about the pale fundus with the cherry red spot, because this is a supply problem, part of the eye is ischemic.
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If you can't get blood to part of the eye, it will appear pale.
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And that should make sense to you.
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Now, as far as the cherry red spot goes, here's what you want to look for.
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You see the black arrow here pointing to the cherry red spot.
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And something that is important to understand here is
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that you see the reason that the cherry red spot is cherry red at the center,
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but then pale around it is because the fovea will stay red.
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And the reason that the fovea stays red is that it gets its blood supply from the posterior ciliary arteries.
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It does not get its blood supply from the central retinal artery.
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So basically anything that is supplied from the central retinal artery will become pale because it's ischemic,
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but anything that is supplied from the posterior ciliary arteries will appear well perfused because we don't have the blockage there.
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Again, in a retinal artery occlusion, the occlusion is in the retinal artery or the central retinal artery.
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And this is why the fovea will be a nice dark red color, but the surrounding tissue will be pale.
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Now, let's contrast that to what you see in a retinal vein occlusion.
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So in a retinal vein occlusion, you're looking for optic disc edema, so the optic disc would swell, and retinal hemorrhage.
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And you can see, I hope you can appreciate the very stark contrast between these two pictures.
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One is showing you hemorrhage and some swelling.
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The other shows you that cherry red spot with the pale fundus.
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And again, if you think about this as artery occlusion equals supply problem, it's ischemic, and vein equals drainage problem,
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it's buildup and swelling and hemorrhage, this really should make sense to you.
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Now on your exam, they're going to show you one of these pictures, like 90 % of the time.
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They want you to be to pick out the cherry red spot, they want you to pick out the hemorrhage, and this is kind of basic.
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So you really should commit this to memory.
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But if you're looking at causes here,
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the retinal artery occlusion typically is due to some type of thromboembolic event.
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And the retinal vein occlusion is typically due to a compressive effect of nearby central retinal arteries having atherosclerosis.
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So interestingly, in the retinal vein occlusion, it is truly that a nearby artery becomes atherosclerotic, and then that pushes up against the retinal vein,
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which prevents the retinal vein from draining properly, hence the hemorrhage, hence the edema.
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But in the retinal artery occlusion, the problem is inherent to whatever thromboembolic event takes place that occludes the actual central retinal artery itself.
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And that's really important to understand.
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So, I've gone through this video, and so far I would say
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that I've covered much of what you probably need to know for the purposes of your exam.
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Again, you want to be able to identify these pictures and know that the buzzwords pale fundus, cherry red spot equals artery occlusion,
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retinal hemorrhage, and optic discodema equals vein occlusion.
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But if you need a way to memorize this and pair these together, I always think about artery is red and vein is blue.
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That's just how it is in my head, probably from years of studying this way.
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So the way that I memorize this is when I think about a pale fundus with a cherry red spot,
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pale to me pales like a bucket.
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So I think about a bucket or a pale filled with cherries.
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And then I associate pale fundus, cherry red spot with red,
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you know, everything else by process of elimination would be a retinal vein.
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So, this was quick, really to the point, but I want you to understand if you're blocking the artery, blood can't get in.
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That's a supply problem.
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So, you're looking for ischemic symptoms.
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If the vein is occluded, blood can't get out.
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That's a drainage problem.
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You're looking for hemorrhage and edema type symptoms.
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If you can keep that straight, then when you look at these images,
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you can kind of guess based on which blood vessel looks more engorged versus which one looks more like a cherry.
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So there you go.
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Good luck.

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Vocabulario y notas de pronunciación para esta lección

Esta lección de conversación se basa en el vídeo “Retinal Artery Occlusion vs. Retinal Vein Occlusion”. Las palabras que más se repiten: retinal, artery, occlusion, vein, blood. Este vídeo tiene 77 frases y 1105 palabras para practicar shadowing. La parte hablada dura 6:33. El hablante habla a un ritmo natural de unas 169 palabras por minuto, cercano a una conversación cotidiana. Solo el 75 % de las palabras está entre las 3.000 más comunes del inglés, por lo que el vocabulario es exigente.

Vocabulario clave de este vídeo

15 palabras del vídeo que vale la pena aprender, con su pronunciación y significado:

PalabraPronunciaciónSignificado
artery sustantivo/ˈɑɹ.təɹ.i/arteria
vein sustantivo/veɪn/vena
cherry sustantivo/ˈt͡ʃɛɹi/cereza, guinda
pale adjetivo/peɪl/pálido
optic adjetivo/ˈɑp.tɪk/óptico
examination sustantivo/ɪɡˌzæm.ɪˈneɪ.ʃən/examen, examinación
disk sustantivo/dɪsk/disco
drainage sustantivo/ˈdɹeɪnəd͡ʒ/drenaje, desagüe
swell verbo/swɛl/hincharse, inflarse
contrast sustantivo/kənˈt(ʃ)ɹæst/contraste
hence adverbio/ˈhɛns/de aquí/acá/aquende
versus/ˈvɝsəs/contra, en vez de
bucket sustantivo/ˈbʌkɪt/balde, cubeta
drain sustantivo/dɹiːn/desagüe, drenaje
symptom sustantivo/ˈsɪm(p)təm/síntoma

Phrasal verbs que vas a escuchar

PalabraSignificado
get out verbosalir
get back to verboresponder / contestar (en un rato), volver / tornar a contactar
get out of verbosalirse de, ponerse fuera de
go through verboatravesar

Gramática en este vídeo

Las estructuras que más usa el hablante, con las palabras exactas del vídeo:

EstructuraEn el vídeo
Voz pasiva be + participio pasado — importa lo que ocurre, no quién lo haceis let · is blocked · is supplied
Present perfect have/has + participio pasado — una acción pasada que sigue importando ahoraI've gone · I've covered

Pronunciación a tener en cuenta

El hablante usa 20 contracciones y formas reducidas, como can't, you're, I've. Dilas en su forma corta, tal como las oyes.

  • Los sonidos de “sh” y “zh”: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, contrast /kənˈt(ʃ)ɹæst/, associate /əˈsoʊʃi.ət/, tissue /ˈtɪʃ.(j)u/, elimination /ɪlɪmɪˈneɪʃ(ə)n/
  • Palabras largas — cuida el acento: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, associate /əˈsoʊʃi.ət/, elimination /ɪlɪmɪˈneɪʃ(ə)n/, ciliary /ˈsɪl.iˌɛɹ.i/, posterior /poʊˈstɪɹ.i.ɚ/

Sonidos difíciles para hispanohablantes:

  • s + consonante al inicio — sin añadir una “e” delante: swell /swɛl/, slide /ˈslaɪ̯d/, spare /spɛɚ/, stark /stɑɹk/
  • /v/ — no es /b/: los dientes tocan el labio inferior: vein /veɪn/, versus /ˈvɝsəs/, vessel /ˈvɛsəl/, fovea /ˈfəʊ.vi.ə/, compressive /kəmˈpɹɛsɪv/
  • /z/ — sonora, no /s/: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, pause /pɔːz/, memorize /ˈmɛm.əˌɹaɪ̯z/, perfuse /pəɹˈfjuːz/

Cómo practicar con este vídeo

  1. Escucha el vídeo entero una vez sin hablar y anota las palabras que no conoces.
  2. Empieza a velocidad 0,75×, haz shadowing frase por frase y vuelve a la velocidad normal cuando te resulte fácil.
  3. Grábate y compara con el original, prestando atención a palabras como artery, vein, cherry.

¿Qué es la Técnica de Shadowing?

Shadowing es una técnica de aprendizaje de idiomas respaldada por la ciencia, desarrollada originalmente para la formación de intérpretes profesionales y popularizada por el políglota Dr. Alexander Arguelles. El método es simple pero poderoso: escuchas audio en inglés nativo y lo repites en voz alta de inmediato, como una sombra que sigue al hablante con solo 1-2 segundos de retraso. A diferencia de la escucha pasiva o los ejercicios de gramática, el shadowing obliga a tu cerebro y músculos de la boca a procesar y reproducir simultáneamente patrones de habla reales. Las investigaciones muestran que mejora significativamente la precisión de la pronunciación, la entonación, el ritmo, el habla conectada, la comprensión auditiva y la fluidez al hablar, convirtiéndola en una de las metodologías más efectivas para la preparación del IELTS Speaking y la comunicación en inglés en el mundo real.

Técnica de shadowing: lee la guía completa paso a paso →