シャドーイング練習: Retinal Artery Occlusion vs. Retinal Vein Occlusion - 動画で英語スピーキングを学ぶ

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Medical students hate this question, retinal artery occlusion versus retinal vein occlusion.

The reason that this is so difficult is that both of these processes will present with acute painless monocular vision loss.

And yes, we can kind of nitpick here and maybe say

that retinal vein occlusion tends to be a little bit more painful, or maybe there's some temporal sparing in retinal artery occlusion,

but the test writer knows this and they're not going to give you that.

So in your exam, the way that you're going to get this right is

if you can identify buzzwords and identify the picture when they show you the back of somebody's eye.

So the way that I think you can simplify this is let's break it down and get back to basics.

If you understand pathophysiology, this makes perfect sense.

One of these has artery in the name.

One of these has vein in the name.

Artery brings the blood to something and the vein takes it away.

So if we block the artery, blood cannot get to the retina.

If we block the vein, blood can't get out of the retina.

And if we keep it that stupid and that simple, this all makes perfect sense.

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.

A retinal vein occlusion, meaning that the blood cannot drain out of the eye, that's a drainage problem.

So, let's pause for a second, and I've got a really silly picture here at the bottom of the slide.

If blood can't get in, what physical findings would you expect to see?

And if blood can't get out, what physical findings would you expect to see so taking

that one step further in the artery occlusion

you see a pale fundus with a cherry red spot in the vein occlusion you see hemorrhage

and edema now this should make sense to you

when we look at hemorrhage and edema if blood is pooling into the eye

and can't get out through the retinal vein there will be hemorrhage and there will be edema specifically of the optic disc.

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.

If you can't get blood to part of the eye, it will appear pale.

And that should make sense to you.

Now, as far as the cherry red spot goes, here's what you want to look for.

You see the black arrow here pointing to the cherry red spot.

And something that is important to understand here is

that you see the reason that the cherry red spot is cherry red at the center,

but then pale around it is because the fovea will stay red.

And the reason that the fovea stays red is that it gets its blood supply from the posterior ciliary arteries.

It does not get its blood supply from the central retinal artery.

So basically anything that is supplied from the central retinal artery will become pale because it's ischemic,

but anything that is supplied from the posterior ciliary arteries will appear well perfused because we don't have the blockage there.

Again, in a retinal artery occlusion, the occlusion is in the retinal artery or the central retinal artery.

And this is why the fovea will be a nice dark red color, but the surrounding tissue will be pale.

Now, let's contrast that to what you see in a retinal vein occlusion.

So in a retinal vein occlusion, you're looking for optic disc edema, so the optic disc would swell, and retinal hemorrhage.

And you can see, I hope you can appreciate the very stark contrast between these two pictures.

One is showing you hemorrhage and some swelling.

The other shows you that cherry red spot with the pale fundus.

And again, if you think about this as artery occlusion equals supply problem, it's ischemic, and vein equals drainage problem,

it's buildup and swelling and hemorrhage, this really should make sense to you.

Now on your exam, they're going to show you one of these pictures, like 90 % of the time.

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.

So you really should commit this to memory.

But if you're looking at causes here,

the retinal artery occlusion typically is due to some type of thromboembolic event.

And the retinal vein occlusion is typically due to a compressive effect of nearby central retinal arteries having atherosclerosis.

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,

which prevents the retinal vein from draining properly, hence the hemorrhage, hence the edema.

But in the retinal artery occlusion, the problem is inherent to whatever thromboembolic event takes place that occludes the actual central retinal artery itself.

And that's really important to understand.

So, I've gone through this video, and so far I would say

that I've covered much of what you probably need to know for the purposes of your exam.

Again, you want to be able to identify these pictures and know that the buzzwords pale fundus, cherry red spot equals artery occlusion,

retinal hemorrhage, and optic discodema equals vein occlusion.

But if you need a way to memorize this and pair these together, I always think about artery is red and vein is blue.

That's just how it is in my head, probably from years of studying this way.

So the way that I memorize this is when I think about a pale fundus with a cherry red spot,

pale to me pales like a bucket.

So I think about a bucket or a pale filled with cherries.

And then I associate pale fundus, cherry red spot with red,

you know, everything else by process of elimination would be a retinal vein.

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.

That's a supply problem.

So, you're looking for ischemic symptoms.

If the vein is occluded, blood can't get out.

That's a drainage problem.

You're looking for hemorrhage and edema type symptoms.

If you can keep that straight, then when you look at these images,

you can kind of guess based on which blood vessel looks more engorged versus which one looks more like a cherry.

So there you go.

Good luck.

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このレッスンの語彙とスピーキングのポイント

このスピーキングレッスンは、動画「Retinal Artery Occlusion vs. Retinal Vein Occlusion」を教材にしています。繰り返し出てくる語は次のとおりです：retinal, artery, occlusion, vein, blood。この動画には、シャドーイング用の文が77文、単語が1105語あります。音声の長さは6:33です。話す速さは1分あたり約169語で、日常会話に近い自然なペースです。英語の頻出3,000語に含まれる単語は75%だけなので、語彙は難しめです。

この動画の重要語彙

動画に出てくる覚えておきたい単語15語を、発音と意味つきで紹介します。

単語	発音	意味
artery 名詞	/ˈɑɹ.təɹ.i/	動脈
vein 名詞	/veɪn/	静脈
cherry 名詞	/ˈt͡ʃɛɹi/	チェリー, 桜ん坊
pale 形容詞	/peɪl/	青ざめた
examination 名詞	/ɪɡˌzæm.ɪˈneɪ.ʃən/	診察, 検査
disk 名詞	/dɪsk/	ディスク, 円盤
swell 動詞	/swɛl/	膨れる, 隆起する
hence 副詞	/ˈhɛns/	ここから
versus	/ˈvɝsəs/	対, バーサス
bucket 名詞	/ˈbʌkɪt/	バケツ, 桶
symptom 名詞	/ˈsɪm(p)təm/	症状, 症候
associate 名詞	/əˈsoʊʃi.ət/	提携者
silly 形容詞	/ˈsɪl.i/	馬鹿げた, 他愛ない
commit 動詞	/kəˈmɪt/	預ける, 任せる
painful 形容詞	/ˈpeɪn.fl̩/	痛い, 痛みの伴う

動画に出てくる句動詞

単語	意味
get out 動詞	出て行く

この動画の文法

話し手がよく使っている文型を、動画の実際の表現とともに紹介します。

文型	動画での表現
受動態 be + 過去分詞 — 誰がするかより、何が起きるかに焦点を当てる	is let · is blocked · is supplied
現在完了形 have/has + 過去分詞 — 過去の出来事が今も関係している	I've gone · I've covered

注意したい発音

話し手はcan't, you're, I'veなど、短縮形や弱形を20回使っています。聞こえたとおりの短い形で発音しましょう。

「sh」と「zh」の音: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, contrast /kənˈt(ʃ)ɹæst/, associate /əˈsoʊʃi.ət/, tissue /ˈtɪʃ.(j)u/, elimination /ɪlɪmɪˈneɪʃ(ə)n/
長い単語（アクセントの位置に注意）: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, associate /əˈsoʊʃi.ət/, elimination /ɪlɪmɪˈneɪʃ(ə)n/, ciliary /ˈsɪl.iˌɛɹ.i/, posterior /poʊˈstɪɹ.i.ɚ/

日本語話者が苦手な音：

/r/ と /l/ の区別 — /l/ は舌先を歯茎につけ、/r/ はどこにもつけない: temporal /ˈtɛm.pə.ɹəl/, retinal /ˈɹɛt.ən.əl/, ciliary /ˈsɪl.iˌɛɹ.i/, atherosclerosis /ˌæθɚoʊskləˈɹoʊsəs/, monocular /məˈnɑkjələɹ/
/v/ — /b/ にならないように、上の歯を下唇に当てる: vein /veɪn/, versus /ˈvɝsəs/, vessel /ˈvɛsəl/, fovea /ˈfəʊ.vi.ə/, compressive /kəmˈpɹɛsɪv/
/f/ — 「フ」ではなく、上の歯と下唇で出す: painful /ˈpeɪn.fl̩/, fundus /ˈfʌn.dəs/, fovea /ˈfəʊ.vi.ə/, perfuse /pəɹˈfjuːz/, simplify /ˈsɪmplɪfaɪ/

この動画での練習方法

まず声を出さずに動画を最後まで聞き、知らない単語をメモします。
まず0.75倍速で一文ずつシャドーイングし、慣れてきたら通常の速度に戻します。
自分の声を録音して元の音声と比べます。artery, vein, cherryなどの単語に特に注意しましょう。

シャドーイングとは？英語上達に効果的な理由

シャドーイング（Shadowing）は、もともとプロの通訳者養成プログラムで開発された言語学習法で、多言語習得者として知られるDr. Alexander Arguelles によって広く普及されました。方法はシンプルですが非常に効果的：ネイティブスピーカーの英語を聞きながら、1〜2秒の遅延で声に出してすぐに繰り返す——まるで「影（shadow）」のように話者を追いかけます。文法ドリルや受動的なリスニングと異なり、シャドーイングは脳と口の筋肉が同時にリアルタイムで英語を処理・再現することを強制します。研究により、発音精度、抑揚、リズム、連音、リスニング力、そして会話の流暢さが大幅に向上することが確認されています。IELTSスピーキング対策や自然な英語コミュニケーションを目指す方に特におすすめです。

シャドーイングのやり方: ステップ別の完全ガイドを読む →

シャドーイング練習: Retinal Artery Occlusion vs. Retinal Vein Occlusion - 動画で英語スピーキングを学ぶ

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