Pratique du Shadowing: Retinal Artery Occlusion vs. Retinal Vein Occlusion - Apprendre l'anglais à l'oral avec la vidéo
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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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Vocabulaire et conseils d’expression pour cette leçon
Cette leçon d’expression orale s’appuie sur la vidéo « Retinal Artery Occlusion vs. Retinal Vein Occlusion ». Les mots qui reviennent le plus souvent : retinal, artery, occlusion, vein, blood. Cette vidéo contient 77 phrases et 1105 mots à répéter en shadowing. La partie parlée dure 6:33. Le locuteur parle à un rythme naturel d’environ 169 mots par minute, proche d’une conversation courante. Seuls 75 % des mots font partie des 3 000 mots les plus courants en anglais, le vocabulaire est donc exigeant.
Vocabulaire clé de cette vidéo
15 mots de la vidéo à retenir, avec leur prononciation et leur sens :
| Mot | Prononciation | Sens |
|---|---|---|
| artery nom | /ˈɑɹ.təɹ.i/ | artère |
| vein nom | /veɪn/ | veine |
| cherry nom | /ˈt͡ʃɛɹi/ | cerise, griotte |
| pale adjectif | /peɪl/ | pâle, hâve |
| examination nom | /ɪɡˌzæm.ɪˈneɪ.ʃən/ | examen |
| disk nom | /dɪsk/ | disque |
| drainage nom | /ˈdɹeɪnəd͡ʒ/ | drainage |
| swell verbe | /swɛl/ | gonfler, enfler |
| contrast nom | /kənˈt(ʃ)ɹæst/ | contraste |
| hence adverbe | /ˈhɛns/ | d'ici |
| versus | /ˈvɝsəs/ | contre, face à |
| bucket nom | /ˈbʌkɪt/ | seau, chaudière |
| drain nom | /dɹiːn/ | drain, bonde |
| symptom nom | /ˈsɪm(p)təm/ | symptôme |
| silly adjectif | /ˈsɪl.i/ | sot, insensé |
Les verbes à particule que vous entendrez
| Mot | Sens |
|---|---|
| get out verbe | sortir |
| pick out verbe | distinguer, faire la distinction |
| go through verbe | traverser |
La grammaire de cette vidéo
Les structures que le locuteur utilise le plus, avec les mots exacts de la vidéo :
| Structure | Dans la vidéo |
|---|---|
| Voix passive be + participe passé — l’accent est mis sur ce qui arrive, pas sur qui le fait | is let · is blocked · is supplied |
| Present perfect have/has + participe passé — une action passée qui compte encore maintenant | I've gone · I've covered |
Prononciation à surveiller
Le locuteur utilise 20 contractions et formes réduites, comme can't, you're, I've. Prononcez-les sous leur forme courte, telles que vous les entendez.
- Les sons « sh » et « zh »: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, contrast /kənˈt(ʃ)ɹæst/, associate /əˈsoʊʃi.ət/, tissue /ˈtɪʃ.(j)u/, elimination /ɪlɪmɪˈneɪʃ(ə)n/
- Mots longs — placez bien l’accent: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, associate /əˈsoʊʃi.ət/, elimination /ɪlɪmɪˈneɪʃ(ə)n/, ciliary /ˈsɪl.iˌɛɹ.i/, posterior /poʊˈstɪɹ.i.ɚ/
Les sons difficiles pour les francophones :
- /h/ — il se souffle, il n’est pas muet: hence /ˈhɛns/, inherent /ɪnˈhɪəɹənt/, hemorrhage /ˈhɛm(ə)ɹɪd͡ʒ/
- /tʃ/ et /dʒ/ — à ne pas adoucir en « ch » et « j »: cherry /ˈt͡ʃɛɹi/, drainage /ˈdɹeɪnəd͡ʒ/, hemorrhage /ˈhɛm(ə)ɹɪd͡ʒ/, blockage /ˈblɑkɪd͡ʒ/, engorge /ɪnˈɡɔːdʒ/
- /r/ anglais — langue recourbée, sans frotter la gorge: artery /ˈɑɹ.təɹ.i/, cherry /ˈt͡ʃɛɹi/, drainage /ˈdɹeɪnəd͡ʒ/, contrast /kənˈt(ʃ)ɹæst/, drain /dɹiːn/
Comment s’entraîner avec cette vidéo
- Écoutez la vidéo en entier une fois sans parler et notez les mots que vous ne connaissez pas.
- Commencez à la vitesse 0,75×, répétez phrase par phrase, puis revenez à la vitesse normale quand cela devient facile.
- Enregistrez-vous et comparez avec l’original, en faisant attention à des mots comme artery, vein, cherry.
Qu'est-ce que la technique du Shadowing ?
Le Shadowing est une technique d'apprentissage des langues fondée sur la science, développée à l'origine pour la formation des interprètes professionnels. Le principe est simple mais puissant : vous écoutez de l'anglais natif et le répétez immédiatement à voix haute — comme une ombre suivant le locuteur avec un décalage de 1 à 2 secondes. Les recherches montrent une amélioration significative de la précision de la prononciation, de l'intonation, du rythme, des liaisons, de la compréhension orale et de la fluidité.