शैडोइंग अभ्यास: Gynaecological Examination - वीडियो के साथ अंग्रेजी बोलना सीखें
पाठ बनाया जा रहा है...
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The gynecological examination.
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So continuing on our examination series, we're going to be taking a look at the gynae examination.
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So when performing any examination on the patient, we always need to have a discussion prior, explain what we're going to be doing and obtain verbal consent.
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We need to inform her that she will need to get undressed from the waist down, therefore we need to have an appropriate room where the patient will be able to get undressed in privacy
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and we should provide the sheet so that she can cover herself.
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We can ask her if she would like to empty her bladder
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and also perform a pregnancy test before proceeding with the examination.
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For this examination we will need to have a chaperone present with us.
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Finally we need to ensure we have all our equipment prepared for the examination including a Cusco speculum,
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lubricant gel, swabs used to assess for any infections and possibly a cervical smear brush.
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Now we also need to prepare the couch.
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This time we need to position the couch completely flat.
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Then we need to make sure we wear disposable gloves as you can see here.
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And then we would always start with the abdominal examination.
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So here we will assess for tenderness, rebound guarding and any masses.
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If you would like to see a detailed video on the abdominal examination, let me know in the comments.
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Okay, so now we can start off the proper gynae examination.
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So we start off by asking the patient to bend her legs and bring her heels to her buttocks, and allow her knees to fall to the sides.
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This is called the modified litotomy position, and is preferred nowadays to placing the patient's legs in stirrups.
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Now we can uncover the patient, and start off with inspection of the vulva.
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So, here we are looking for any scars,
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erythema, discoloration, masses, warts or ulcers and discharge or bleeding from the entroitis.
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We can also part the labia a bit to improve our inspection.
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At this point, we can also ask the patient to cough to assess for any prolapse.
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Again, if you'd like to see a video from me about vaginal prolapse, leave a comment down below.
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next up we've got the speculum examination
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so first let's take a look at the instrument
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so this is a cusco's speculum over here we have the blades the fixation screw and the handles
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i like to hold the speculum as you can see here with my thumb
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and index finger above the anterior blade
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and my third finger below the posterior blade this gives me good stability
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when handling the speculum and prevents the blades from opening before I want them to.
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So next we'll look at how to insert the speculum, so of course on an actual patient we'll need to lubricate the blades of the speculum.
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Then part the labia, insert the speculum on its side slowly with the blades closed
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and then rotate the speculum with the handles positioned at the top.
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I prefer this approach rather than having the handles facing downwards and having to fiddle with them close to the anus.
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Once the speculum has been inserted all the way in, we start to open the blades under direct vision until the cervix has come into view.
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Of course you must have some form of light available to see properly.
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When we are happy, we can use a fixation screw to keep the speculum in place.
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Once we have done this, we can inspect the cervix and the vaginal walls.
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First of all, looking at the cervix, we want to identify any cervical ectropion,
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any obvious masses any discharge or bleeding then we want to look at the vaginal walls
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and inspect for any vaginal tears or lacerations
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that is one advantage of using these transparent speculums as you
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can still inspect all vaginal walls during the examination now here
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i've also shown how to take a high vaginal swab
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so essentially we are guiding the swab into the posterior fornix
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which is location underneath the cervix and here we're taking a cervical smear
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so here we are using a cervical broom the tip is inserted into the cervical loss
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and is brushed in a circular motion over the cervix by
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360 degrees for five turns some pressure should be applied to make sure
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that the cells are sticking to your cervical broom for more
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information on smears i have created a video all about this subject next we need to remove the speculum
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so first we will retract the speculum slightly keeping the blades
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open until we have passed the cervix then we can close the blades
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and then we draw the speculum gently in the same position or rotate it again and withdraw it completely.
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To perform the bimanual vaginal examination, we first lubricate two fingers.
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Again, part the labia using our left hand and insert the fingers of our right hand gently into the vagina.
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Now, our left hand will be placed on the abdomen so that we can bellow the structures between our two hands.
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Starting off with the uterus, we want to assess the position, size and mobility of the uterus.
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so back to some revision here so
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when we talk about the position of the uterus we refer to version
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and flexion of the uterus but what are these
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so these refer to angles created by the curvature of the uterus
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so the first is how the long axis of the uterus
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is bent over the long axis of the vagina this refers
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to version then we've got the angle created by the long axis of uterus, bent over the long axis of the cervix,
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and this is referred to as flexion.
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So keeping these two diagrams in mind, here we have got an antiverted uterus, with the uterus bent forwards over the vagina.
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Then we have a retroverted uterus, with the uterus bent backwards over the vagina.
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an anti -flexed uterus with the uterus bent forwards over the cervix
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and a retroflexed uterus with the uterus bent backwards over the cervix.
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So during a bimanual examination from these two images, you can appreciate how the cervix will be positioned in a different direction
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and the uterus will be much harder to palpate when in a retroverted position.
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now we also want to assess ferny masses
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or cervical excitation cervical excitation refers to acute tenderness on palpation
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of the cervix these patients might literally jump off the couch
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so be careful when listing this sign some causes include pelvic inflammatory disease
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or ectopic pregnancy we will then move over to the right at nexa again feeling ferny masses or adnexal tenderness,
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a normal ovary will not be palpable in examination and will repeat the same on the left.
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When talking about adnexal tenderness, this could be secondary to an ovarian cyst accident, such as ovarian cyst structure or ovarian torsion.
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I hope you found this helpful.
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If you haven't watched my previous video on the obstetric examination, you can have a look at it here.
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Let me know what you think in the comments, like and subscribe.
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इस पाठ की शब्दावली और बोलने के सुझाव
यह स्पीकिंग पाठ वीडियो “Gynaecological Examination” पर आधारित है। सबसे ज़्यादा दोहराए गए शब्द ये हैं: uterus, examination, speculum, cervix, blade। इस वीडियो में शैडोइंग के लिए 84 वाक्य और 1203 शब्द हैं। बोला गया हिस्सा 7:37 लंबा है। वक्ता लगभग 158 शब्द प्रति मिनट की स्वाभाविक गति से बोलता है, जो रोज़मर्रा की बातचीत के करीब है। केवल 74% शब्द अंग्रेज़ी के 3,000 सबसे आम शब्दों में से हैं, इसलिए शब्दावली कठिन है।
इस वीडियो की मुख्य शब्दावली
वीडियो के 15 सीखने लायक शब्द, उच्चारण और अर्थ के साथ:
| शब्द | उच्चारण | अर्थ |
|---|---|---|
| examination संज्ञा | /ɪɡˌzæm.ɪˈneɪ.ʃən/ | परीक्षण |
| blade संज्ञा | /bleɪd/ | ब्लेड |
| bend क्रिया | /bɛnd/ | झुकाव, प्रवृत्ति |
| assess क्रिया | /əˈsɛs/ | मूल्यांकन करना |
| finger संज्ञा | /ˈfɪŋɡɚ/ | उंगली, अंगुल |
| axis संज्ञा | /ˈæksɪs/ | धुरी, अक्ष |
| vagina संज्ञा | /vəˈdʒaɪ.nə/ | योनि, बुर |
| inspect क्रिया | /ɪnˈspɛkt/ | जाँचना, जाँच करना |
| angle संज्ञा | /ˈæŋ.ɡəl/ | कोण |
| pregnancy संज्ञा | /ˈpɹɛɡnənsi/ | गर्भावस्था |
| brush संज्ञा | /bɹʌʃ/ | ब्रश, बुरुश |
| inspection संज्ञा | /ɪnˈspɛkʃən/ | निरीक्षण, जाँच |
| bleed क्रिया | /ˈbliːd/ | रक्तस्राव |
| helpful विशेषण | /ˈhɛlp.fl̩/ | मददगार |
| obtain क्रिया | /əbˈteɪn/ | प्राप्त करना, पाना |
इस वीडियो का व्याकरण
वक्ता जिन संरचनाओं का सबसे अधिक प्रयोग करता है, वीडियो के असली शब्दों के साथ:
| संरचना | वीडियो में |
|---|---|
| Passive voice be + past participle — ज़ोर इस पर कि क्या होता है, न कि कौन करता है | is called · has been inserted · is inserted |
| Present perfect have/has + past participle — बीता हुआ काम जिसका असर अभी भी है | has been inserted · have done · i've also shown |
ध्यान देने योग्य उच्चारण
वक्ता 10 बार संक्षिप्त रूपों का प्रयोग करता है, जैसे we're, we'll, we've। इन्हें वैसे ही छोटा बोलें जैसा आप सुनते हैं।
- “th” की ध्वनियाँ: underneath /ˌʌndɚˈniθ/, withdraw /wɪðˈdɹɔ/, thumb /ˈθʌm/, erythema /ˌɛɹɪˈθiːmə/
- “sh” और “zh” की ध्वनियाँ: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, brush /bɹʌʃ/, inspection /ɪnˈspɛkʃən/, essentially /ɪˈsɛnʃəli/, sheet /ʃit/
- लंबे शब्द — बलाघात सही रखें: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, essentially /ɪˈsɛnʃəli/, stability /stəˈbɪlɪti/, mobility /mə(ʊ)ˈbɪlɪti/, inflammatory /ɪnˈflæmət(ə)ɹi/
हिंदी भाषियों के लिए मुश्किल ध्वनियाँ:
- /v/ और /w/ का फ़र्क़ — /v/ में ऊपर के दाँत निचले होंठ को छूते हैं, /w/ में होंठ गोल होते हैं: vagina /vəˈdʒaɪ.nə/, backward /ˈbækwɚd/, privacy /ˈpɹaɪ.və.si/, withdraw /wɪðˈdɹɔ/, waist /weɪst/
- /z/ — इसे “ज” (/dʒ/) न बनाएँ: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, nowadays /ˈnaʊ.ə.deɪz/, disposable /dɪsˈpoʊzəbl̩/, downwards /ˈdaʊnwɚdz/
- शब्द की शुरुआत में s + व्यंजन — पहले “इ” न जोड़ें: stability /stəˈbɪlɪti/, scar /skɑɹ/, speculum /ˈspɛk.jə.ləm/, smear /smiɚ/, swab /swɒb/
इस वीडियो से अभ्यास कैसे करें
- पहले बिना बोले पूरा वीडियो एक बार सुनें और जो शब्द नहीं आते उन्हें लिख लें।
- 0.75× गति से शुरू करें, एक-एक वाक्य की शैडोइंग करें, और सहज लगने पर सामान्य गति पर लौटें।
- अपनी आवाज़ रिकॉर्ड करें और मूल से तुलना करें, ख़ासकर examination, blade, bend जैसे शब्दों पर ध्यान दें।
शैडोइंग तकनीक क्या है?
शैडोइंग (Shadowing) एक विज्ञान-समर्थित भाषा सीखने की तकनीक है जो मूल रूप से पेशेवर दुभाषिया प्रशिक्षण के लिए विकसित की गई थी। विधि सरल लेकिन शक्तिशाली है: आप मूल अंग्रेज़ी ऑडियो सुनते हैं और तुरंत इसे ज़ोर से दोहराते हैं — जैसे वक्ता की छाया 1-2 सेकंड की देरी से। शोध से पता चलता है कि यह उच्चारण सटीकता, स्वर, लय, जुड़ी हुई ध्वनियाँ, सुनने की समझ और बोलने की प्रवाहशीलता में काफ़ी सुधार करता है।