Shadowing Practice: SVINutes: Pulsatile Tinnitus - Learn English Speaking with Video
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41 משפטים
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Hello, my name is Dr. Fazeev Siddiqui.
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I'm a clinical adjunct professor at the University of Michigan at Michigan State University.
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Today, I will guide you through the evaluation of pulsatile tinnitus, a condition that can reveal critical underlying vascular abnormalities.
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Pulsed-style tinnitus is a rhythmic sound often in sync with the heartbeat.
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Unlike common tinnitus, typically a ringing sound, pulsed-style tinnitus is often caused by vascular abnormalities that create vibrations transmitted to the ear.
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Pulse slide tinnitus can be heard as whooshing, thumping, or whooping noises.
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A thorough assessment is crucial.
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The first step, always take a comprehensive history.
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Ask about the timing and onset and if it's unilateral or bilateral.
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Next, move to the physical exam.
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Pay close attention to blood pressure as hypertension can contribute.
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Don't forget to auscultate the neck and skull for any bruise, indicating turbulent blood flow pointing to an underlying vascular issue.
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If the initial assessment is concerning, the next step is imaging.
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A brain MRI with MR angiography
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or a CT angiogram is typically the first line modality to evaluate for vascular abnormalities like arteriovenous malformation or dural fistula.
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A diagnostic cerebral endogram can be performed if there is a strong suspicion on screening non-invasive imaging.
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Common causes include arteriovenous malformation, dural arteriovenous fistula, and carotid artery stenosis.
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Other less common causes include venous sinus stenosis, sigmoid diverticulum, aberrant carotid artery, and cerebral aneurysm.
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Recognizing these early can prevent severe complications like a stroke or hemorrhage.
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A dual arterial systula is an abnormal connection between arteries and veins within the dual matter.
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This bypasses the normal capillary system, forcing high-pressure arterial blood directly into the venous system.
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The result is turbulent blood flow in the dual venous sinuses.
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This turbulence generates vibrations which can be transmitted through the surrounding tissue to the cochlea, causing pulsed tinnitus.
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If left untreated, dural arterioleus fistula can lead to complications like intracranial hemorrhage or venous congestion, making early diagnosis critical.
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Another common vascular cause of pulsed tinnitus is carotid artery stenosis, which occurs when and the carotid artery narrows due to plaque buildup or other factors.
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This narrowing creates turbulent blood flow as the high-pressure blood moves through the constricted segment.
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Carotid artery stenosis is a significant risk for ischemic stroke and, if identified early, can be managed safely with carotid enderectomy or stenting.
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Venous disorders are another important cause of pustile tinnitus.
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Common conditions include venous sinus stenosis, which narrows major venous pathways like the the transfer sinus or sigmoid sinus,
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leading to turbulent blood flow and elevated venous pressure.
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Other venous causes include jugular bulb abnormalities, such as high riding bulb or diverticulum, which may create vibrations that propagate to the inner ear.
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Recognizing venous causes early is crucial, as they may contribute to symptoms of intracanial hypertension or other complications requiring targeted treatment.
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Let's look at a quick case.
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A 78-year-old man with a remote history of pulsoil tinnitus presented with headaches.
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An MRI brain revealed a cerebellar hematoma.
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A diagnostic angiogram demonstrated a high-grade complex arteriovenous fistula with multiple arterial feeders.
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Multiple arterial embolization attempts could not completely resolve the fistula.
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Hence, a coil embolization of the non-functional left transfer sinus was performed.
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A complete cure was achieved after the venous sinus sacrifice the patient did well clinically the patient did well clinically.
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To sum up, pulse light tinnitus should always prompt a careful history, physical exam, and if needed, vascular imaging.
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Early identification of vascular causes is essential for preventing complications.
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Vocabulary and speaking notes for this lesson
This video has 41 sentences and 588 words to shadow. The speech runs for 4:51. The speaker talks at a steady 121 words per minute, a comfortable pace for shadowing. Only 57% of the words are among the 3,000 most common in English, so the vocabulary is demanding.
Key vocabulary in this video
15 words from the video worth learning, with pronunciation and meaning:
| Word | Pronunciation | Meaning |
|---|---|---|
| vascular adjective | /ˈvæskjələ/ | Relating to the flow of fluids, such as blood, lymph, or sap, through the body of an animal or plant, or to the vessels that carry such fluids |
| pulse noun | /pʌls/ | A normally regular beat felt when arteries near the skin (for example, at the neck or wrist) are depressed, caused by the heart pumping blood through them; the… |
| artery noun | /ˈɑɹ.təɹ.i/ | Any of the muscular- and elastic-walled blood vessels forming part of the circulation system by which blood is conveyed away from the heart regardless of its… |
| narrow adjective | /ˈnæɹəʊ/ | Having a small width; not wide; having opposite edges or sides that are close, especially by comparison to length or depth. |
| dual adjective | /ˈdul/ | Characterized by having two (usually equivalent) components. |
| vibration noun | /vaɪˈbɹeɪʃən/ | The act of vibrating or the condition of being vibrated. |
| assessment noun | /əˈsɛsmənt/ | The act of assessing or an amount (of tax, levy or duty etc) assessed. |
| reveal verb | /ɹɪˈviːl/ | To uncover; to show and display that which was hidden. |
| contribute verb | /kənˈtɹɪb.jut/ | To give something that is or becomes part of a larger whole. |
| crucial adjective | /ˈkɹuː.ʃəl/ | Essential or decisive for determining the outcome or future of something; extremely important; vital. |
| examination noun | /ɪɡˌzæm.ɪˈneɪ.ʃən/ | The act of examining. |
| underlying adjective | Lying underneath. | |
| diagnostic adjective | /ˌdaɪ.əɡˈnɑ.stɪk/ | Of, or relating to diagnosis. |
| transmit verb | /tɹænsˈmɪt/ | To send or convey from one person, place or thing to another. |
| bulb noun | /ˈbʌlb/ | The bulb-shaped underground portion of a plant such as a tulip, consisting of a shortened stem and many fleshy scale leaves, from which the rest of the plant… |
Phrasal verbs you will hear
| Word | Meaning |
|---|---|
| sum up verb | To produce a total by adding. |
Pronunciation to watch
- The “th” sounds: thorough /ˈθʌɹoʊ/, pathway /ˈpæθˌweɪ/, rhythmic /ˈɹɪð.mɪk/, thump /θʌmp/
- The “sh” and “zh” sounds: vibration /vaɪˈbɹeɪʃən/, crucial /ˈkɹuː.ʃəl/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, tissue /ˈtɪʃ.(j)u/, evaluation /ɪˌvæljuˈeɪʃn̩/
- Long words — get the stress right: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, diagnostic /ˌdaɪ.əɡˈnɑ.stɪk/, comprehensive /ˌkɑm.pɹəˈhɛn.sɪv/, evaluation /ɪˌvæljuˈeɪʃn̩/, identification /aɪˌdɛn(t)ɪfɪˈkeɪʃn̩/
How to practise with this video
- Listen to the whole video once without speaking and note the words you do not know.
- Shadow it sentence by sentence at normal speed, repeating each one until your rhythm matches the speaker.
- Record yourself and compare with the original, paying attention to words like vascular, pulse, artery.
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.