쉐도잉 연습: Gynaecological Examination - 영상으로 영어 말하기 배우기

레슨 만드는 중...
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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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이 레슨의 어휘와 말하기 포인트

이 말하기 레슨은 영상 “Gynaecological Examination”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: uterus, examination, speculum, cervix, blade. 이 영상에는 섀도잉할 문장 84개와 단어 1203개가 있습니다. 말하는 구간의 길이는 7:37입니다. 화자는 분당 약 158단어로, 일상 대화에 가까운 자연스러운 속도로 말합니다. 영어에서 가장 많이 쓰이는 3,000단어에 속하는 단어가 74%뿐이라 어휘가 어려운 편입니다.

이 영상의 핵심 어휘

영상에 나오는 익혀 둘 만한 단어 15개를 발음, 뜻과 함께 정리했습니다.

단어발음뜻
examination 명사/ɪɡˌzæm.ɪˈneɪ.ʃən/진찰, 검사
blade 명사/bleɪd/날
bend 동사/bɛnd/구부리다
refer 동사/ɹɪˈfɜː/언급하다
insert 동사/ɪnˈsɝt/삽입하다, 넣다
finger 명사/ˈfɪŋɡɚ/손가락
axis 명사/ˈæksɪs/축
vagina 명사/vəˈdʒaɪ.nə/보지, 질
couch 명사/ˈkaʊ̯t͡ʃ/카우치, 소파
angle 명사/ˈæŋ.ɡəl/각, 각도
pregnancy 명사/ˈpɹɛɡnənsi/임신
brush 명사/bɹʌʃ/솔, 브러시
inspection 명사/ɪnˈspɛkʃən/검사
gently 부사/ˈd͡ʒɛntli/부드럽게, 살포시
bleed 동사/ˈbliːd/피를 흘리다

이 영상의 문법

화자가 가장 많이 쓰는 문형을 영상 속 실제 표현과 함께 정리했습니다.

문형영상 속 표현
수동태 be + 과거분사 — 누가 하는지보다 무슨 일이 일어나는지에 초점is called · has been inserted · is inserted
현재완료 have/has + 과거분사 — 과거의 일이 지금도 관련이 있을 때has been inserted · have done · i've also shown

주의할 발음

화자는 we're, we'll, we've 같은 축약형과 약화된 형태를 10번 사용합니다. 들리는 대로 짧게 발음하세요.

  • “th” 소리: underneath /ˌʌndɚˈniθ/, withdraw /wɪðˈdɹɔ/, thumb /ˈθʌm/, erythema /ˌɛɹɪˈθiːmə/
  • “sh”와 “zh” 소리: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, brush /bɹʌʃ/, inspection /ɪnˈspɛkʃən/, essentially /ɪˈsɛnʃəli/, sheet /ʃit/
  • 긴 단어 — 강세 위치에 주의: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, essentially /ɪˈsɛnʃəli/, stability /stəˈbɪlɪti/, mobility /mə(ʊ)ˈbɪlɪti/, inflammatory /ɪnˈflæmət(ə)ɹi/

한국어 화자가 어려워하는 소리:

  • /f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: refer /ɹɪˈfɜː/, finger /ˈfɪŋɡɚ/, helpful /ˈhɛlp.fl̩/, infection /ɪnˈfɛkʃən/, inform /ɪnˈfɔɹm/
  • /v/ — ㅂ(/b/)과 구별하기: vagina /vəˈdʒaɪ.nə/, privacy /ˈpɹaɪ.və.si/, verbal /ˈvɜː.bəl/, revision /ɹəˈvɪʒ.ən/, glove /ɡlʌv/
  • /z/ — ㅈ이 아니라 성대를 울리는 /s/: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, nowadays /ˈnaʊ.ə.deɪz/, disposable /dɪsˈpoʊzəbl̩/, downwards /ˈdaʊnwɚdz/

이 영상으로 연습하는 방법

  1. 먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
  2. 0.75배속으로 한 문장씩 섀도잉을 시작하고, 익숙해지면 보통 속도로 돌아갑니다.
  3. 자신의 목소리를 녹음해 원본과 비교하고, examination, blade, bend 같은 단어에 특히 주의합니다.

쉐도잉이란? 영어 실력을 빠르게 키우는 과학적 방법

쉐도잉(Shadowing)은 원래 전문 통역사 훈련을 위해 개발된 언어 학습 기법으로, 다언어 학자인 Dr. Alexander Arguelles에 의해 대중화된 방법입니다. 핵심 원리는 간단하지만 매우 강력합니다: 원어민의 영어를 들으면서 1~2초의 짧은 지연으로 즉시 소리 내어 따라 말하는 것——마치 '그림자(shadow)'처럼 화자를 따라가는 것입니다. 문법 공부나 수동적인 청취와 달리, 쉐도잉은 뇌와 입 근육이 동시에 실시간으로 영어를 처리하고 재현하도록 훈련합니다. 연구에 따르면 이 방법은 발음 정확도, 억양, 리듬, 연음, 청취력, 말하기 유창성을 크게 향상시킵니다. IELTS 스피킹 준비와 자연스러운 영어 소통을 원하는 분들에게 특히 효과적입니다.

섀도잉 방법: 단계별 전체 가이드 읽기 →