Shadowing Practice: Surgical Anatomy 2 (Spleen) - Learn English Speaking with Video
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In part 1 of this video, we talk about the spleen, its size and size, the spleenule,
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the spleenic vessels, the vascular distribution of these vessels to segments, and so on.
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Now we are talking about the spleenic ligaments, which is a really important topic when talking about surgical anatomy,
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because these ligaments are all excised or divided in order to perform spleenectomy.
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Anatomy box speaks about eight ligaments, the gastrosplenic, the splenophenic, splenorenal,
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or the lineorenal, the ancient or the older name, pancreatic splenic, pancreatic colic, splenocolic,
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perisplenic fold, and the phrenicocolic ligament.
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But here we will just talk about five of these ligaments, which are the cardinal ligaments.
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First, the gastrosplenic, the splenophrenic, the splenorenal, also the splenocolic,
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and lastly the phrenicocolic ligament.
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We will talk first about the gastrosplenic ligament.
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Gastrosplenic ligament is a ligament between the spleen and the stomach, from its name.
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there's some information about this ligament first of all it's a
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triangular ligament you can see in this diagram this is the gastro splenic ligament
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and it's apex near the upper pool of the spleen
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and space is as a wider base
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and near the lower pool this tell us
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that says the upper pool of the spleen is really close to the stomach
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so when performing the section in this area you may injure either the stomach or the spleen.
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So be careful in the section in this area.
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Also the section actually is easier in the wider base of the ligament.
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This ligament also have two important structures passing in it which is, you can see here,
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the short gastric vessels this is the excised
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or divided gastrosplenic ligament the short gastric vessels and near the upper pool
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and the gastroepiploic the left gastroepiploic vessels near the lower pool
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so this is a vascular structure actually it should be excised between clamps
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or using a harmonic
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or whatever appropriate to ensure hemostasis in this ligament the second
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ligament is the splenophenic ligament number two this one this is a splenophenic ligament between the spleen
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and the diaphragm it's important to know
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that this some authors thought this is not a true ligament
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it's just a part we can condense about from the gastrosplenic ligament also it may be containing a fleshy part
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or sling of fiber of muscular fibers from the diaphragm
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so the section here also must be meticulous
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because it may be may need a lot of hemostasis traction
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of the spleen downwards may cause a valgian of this area
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so take care
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when you are tracked performing traction of the spleen not to cause a valgian of the splenic capsule
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and this area and cause marked pleading the third ligament
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and third important ligament is a splenorenal
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or the lino -renal as we said it's between the spleen
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and the kidney actually this this diagram can show it more
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comprehensively this is the spleen this is the kidney it is a cross -section of course stomach
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and this is the gastrosplenic ligament containing the short gastric vessels and this is This brittoneal flexion is the splenorenal ligament.
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As we can see here, it's connected to the kidney,
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and it contains the splenic artery and vein and the tail of pancreas.
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So this is a very vascular port, and actually it covers all the hilum of the spleen, so this section here is important.
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You can encounter during splenectomy this ligament from two approaches.
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Either if you are dissecting in this direction,
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dissecting the gastrosplenic ligament, you will approach the hilum of the spleen from the front side
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and you will start your dissection like this.
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Or you can approach it from other side
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if you are retracting the spleen to the right to deliver
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spleen outside the incision you are you are inserting your hand in this space and grabbing the spleen we're moving it
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to the right in this direction so you can imagine
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if this structures are reflected to the side
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so you will encounter this ligament from the posterior side
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and you will also encounter the tail of the pancreas
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and both the splenic vessels take care this is a vascular ligament you can perform finger dissection
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or plant dissection but it contains very important vessels
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which is the splenic artery and vein and also the tail of the pancreas
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so take care
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while performing the section in this area the pancreatic splenic ligament actually is not a true ligament it means
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if the tail the pancreas doesn't reach the hilum it will be connected with a small part
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which is the pancreatic splenic ligament it may be not found if the pancreas is long enough to reach the hilum
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pancreatic colic ligament actually number five this one is a part of the transverse mesocolon
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here's a splenocolic ligament which another important ligament we will talk about So,
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it may be containing polar vessels, it's number 6, right here,
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it's between the spleen and the, I'll remove the picture, yes,
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to be more comprehensive, this is the splenocolic ligament,
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it connects the lower pole of the spleen to the splenic flexure.
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actually it may contain, as we said, a polar vessel so take care while dissecting here and also
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when you are performing a left hemicolectomy you are also incising this ligament to mobilize the colon
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actually also traction in this direction may cause avulsion of the capsule of the spleen
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and may cause a marked bleeding so take care while performing traction in this area Perisplenic ligament,
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actually it's not obvious in this diagram It's here, behind the gastrosplenic ligament
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Number 1 is gastrosplenic and number 7 is perisplenic fold
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And at last the phrenicocolic ligament Actually the phrenicocolic ligament is
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not attached to the spleen at all It's between the splenic flexure and the diaphragm
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It's the junction between the mid gut
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and the hind gut here in this part it's keeping the splenic flexure hanging in this side
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but it's important because importance because it our relation to the spleen
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because it directs the spleen in this direction when it's
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when it is enlarging actually it can be called the splenic floor the spleen is resting on this ligament and
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when the spleen is enlarged it will be enlarged this way
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not downward the downward enlargement is blocked by the phrenicocolic ligament
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so the enlarged spleen can reach up to the amperlichus
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and the mid abdomen not to the left paracolic gutter another
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importance of this ligament it prevents blood from ruptured spleen
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or any cause of bleeding in this area from entering the left paracolic gutter
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so a traumatic event in this area and the splenic rupture, the blood will be confined to this space,
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the left hypochondrium space and not propagating to the left paracolic gutter.
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So this is the most important ligament of the spleen,
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we will just remember them,
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here the gastrosplenic ligament from here it's like triangular oh
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i missed okay it's like this a triangular ligament here it contains a short gastric
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and the gastric left gastro pleuric here's the line renal ligament
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or the spleen renal ligament containing the hilum or the hyalur vessels
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and tail of the pancreas here's a splenocolic ligament in the lower pool
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and there is a splenophenic in the upper pool
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and there is a floor of the spleen
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which is formed by the colophenic or phrenocolic sorry phrenocolic ligament
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which directs the spleen in this direction this is the most important ligament regarding the spleen.
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One last information you should remember.
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that the tail of pancreas lying in this area,
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so careless division in this part may result in pancreatic fistula and it's really a nasty complication to happen,
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may take a few weeks to month to close down,
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so really take care when you are incising or dissecting in this area to make sure that the pancreas is safe.
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Thank you for listening and see you in another video.
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אוצר מילים והערות הגייה לשיעור הזה
שיעור הדיבור הזה ברמה C1 מבוסס על הסרטון “Surgical Anatomy 2”. המילים שחוזרות הכי הרבה: ligament, spleen, splenic, gastrosplenic, vessel. בסרטון הזה יש 109 משפטים ו-1327 מילים לתרגול Shadowing. הדיבור נמשך 10:41. הדובר שומר על קצב יציב של כ-124 מילים בדקה, קצב נוח לתרגול Shadowing. רק 72% מהמילים נמצאות בין 3,000 המילים הנפוצות ביותר באנגלית, כך שאוצר המילים מאתגר.
אוצר מילים מרכזי בסרטון הזה
15 המילים המתקדמות ביותר בסרטון, עם ההגייה והמשמעות שלהן:
| מילה | הגייה | משמעות |
|---|---|---|
| ligament שם עצם | /ˈlɪɡəmənt/ | רְצוּעָה |
| spleen שם עצם | /spliːn/ | טחול |
| pancreas שם עצם | /ˈpæŋ.kɹi.əs/ | לבלב |
| enlarge פועל | /ɪnˈlɑɹd͡ʒ/ | הִגְדִּיל |
| diagram שם עצם | /ˈdaɪ.ə.ɡɹæm/ | תַּרְשִׁים |
| kidney שם עצם | /ˈkɪdni/ | כִּלְיָה, כְּלָיוֹת |
| artery שם עצם | /ˈɑɹ.təɹ.i/ | עוֹרֶק |
| downward תואר הפועל | /ˈdaʊnwɚd/ | מַטָּה, לְמַטָּה |
| bleed פועל | /ˈbliːd/ | דִּימֵּם |
| vein שם עצם | /veɪn/ | וְרִיד |
| anatomy שם עצם | /əˈnætəmi/ | אנטומיה |
| downwards תואר הפועל | /ˈdaʊnwɚdz/ | מַטָּה, לְמַטָּה |
| fistula שם עצם | /ˈfɪs.tjə.lə/ | פִיסְטוּלָה |
| incision שם עצם | /ɪnˈsɪʒən/ | חֲתָךְ |
| abdomen שם עצם | /ˈæb.də.mən/ | בֶּטֶן |
דקדוק בסרטון הזה
המבנים שהדובר משתמש בהם הכי הרבה, עם המילים המדויקות מהסרטון:
| מבנה | בסרטון |
|---|---|
| סביל (Passive voice) be + past participle — הדגש הוא על מה שקורה, לא על מי שעושה את הפעולה | should be excised · are tracked · are reflected |
| משפטי זיקה (Relative clauses) who / which + clause — מידע נוסף על אדם או דבר | ligaments, which is · ligaments, which are |
הגייה ששווה לשים לב אליה
הדובר משתמש ב-3 קיצורים וצורות מקוצרות, כמו doesn't, I'll, we're. אמרו אותם בצורה הקצרה, כפי שאתם שומעים אותם.
- הצלילים של “sh” ו-“zh”: traction /ˈtɹæk.ʃən/, dissection /dɪˈsɛkʃən/, flexure /ˈflɛkʃə(ɹ)/, complication /ˌkɑm.pləˈkeɪ.ʃən/, fleshy /ˈflɛʃi/
- מילים ארוכות — שימו לב להטעמה: pancreatic /ˌpæŋ.kɹɪˈæ.tɪk/, triangular /tɹaɪˈæŋ.ɡjə.lɚ/, gastroenteritis /ˌɡæstɹəʊˌɛntəˈɹaɪtəs/, hemostasis /ˌhiːməˈsteɪsɪs/, anatomy /əˈnætəmi/
צלילים שדוברי עברית מתקשים בהם:
- /w/ — שפתיים מעוגלות, לא /v/: downward /ˈdaʊnwɚd/, downwards /ˈdaʊnwɚdz/
- /æ/ — פתוח יותר מה-“אֶ” העברית, לא כמו “a” ב-“cup”: pancreas /ˈpæŋ.kɹi.əs/, pancreatic /ˌpæŋ.kɹɪˈæ.tɪk/, gastric /ˈɡæstɹɪk/, vascular /ˈvæskjələ/, traction /ˈtɹæk.ʃən/
- /r/ — הלשון לא נוגעת בשום מקום, לא ה-“ר” הגרונית: pancreas /ˈpæŋ.kɹi.əs/, pancreatic /ˌpæŋ.kɹɪˈæ.tɪk/, gastric /ˈɡæstɹɪk/, enlarge /ɪnˈlɑɹd͡ʒ/, traction /ˈtɹæk.ʃən/
איך לתרגל עם הסרטון הזה
- הקשיבו לכל הסרטון פעם אחת בלי לדבר, ורשמו את המילים שאתם לא מכירים.
- תרגלו Shadowing משפט אחר משפט במהירות רגילה, וחזרו על כל משפט עד שהקצב שלכם תואם את הדובר.
- הקליטו את עצמכם והשוו למקור, תוך תשומת לב למילים כמו ligament, spleen, pancreas.
מהי טכניקת השאדואינג?
שאדואינג היא טכניקת למידת שפה מבוססת מדע שפותחה במקור להכשרת מתורגמנים מקצועיים ופופולרית על ידי הפוליגלוט ד"ר אלכסנדר ארגואלס. השיטה פשוטה אך עוצמתית: אתה מקשיב לאודיו באנגלית ילידית וחוזר עליו בקול רם מיד — כמו צל העוקב אחרי הדובר עם עיכוב של 1–2 שניות בלבד. בניגוד להאזנה פסיבית או תרגילי דקדוק, שאדואינג מכריח את המוח והשרירים בפה לעבד ולשחזר דפוסי דיבור אמיתיים בו זמנית. מחקרים מראים שזה משפר משמעותית את דיוק ההגייה, האינטונציה, הקצב, הדיבור המחובר, הבנת השמיעה ושטף הדיבור — מה שהופך אותו לאחת השיטות היעילות ביותר להכנה לIELTS Speaking ולתקשורת באנגלית בעולם האמיתי.