쉐도잉 연습: Retinal Artery Occlusion vs. Retinal Vein Occlusion - 영상으로 영어 말하기 배우기

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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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이 레슨의 어휘와 말하기 포인트

이 말하기 레슨은 영상 “Retinal Artery Occlusion vs. Retinal Vein Occlusion”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: retinal, artery, occlusion, vein, blood. 이 영상에는 섀도잉할 문장 77개와 단어 1105개가 있습니다. 말하는 구간의 길이는 6:33입니다. 화자는 분당 약 169단어로, 일상 대화에 가까운 자연스러운 속도로 말합니다. 영어에서 가장 많이 쓰이는 3,000단어에 속하는 단어가 75%뿐이라 어휘가 어려운 편입니다.

이 영상의 핵심 어휘

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

단어	발음	뜻
artery 명사	/ˈɑɹ.təɹ.i/	동맥
vein 명사	/veɪn/	정맥
cherry 명사	/ˈt͡ʃɛɹi/	버찌, 체리
pale 형용사	/peɪl/	창백한
examination 명사	/ɪɡˌzæm.ɪˈneɪ.ʃən/	진찰, 검사
disk 명사	/dɪsk/	디스크, 원반
swell 동사	/swɛl/	부풀다, 붓다
versus	/ˈvɝsəs/	대
bucket 명사	/ˈbʌkɪt/	양동이
drain 명사	/dɹiːn/	배수구
symptom 명사	/ˈsɪm(p)təm/	증상, 증후
associate 명사	/əˈsoʊʃi.ət/	제휴자, 조합원
silly 형용사	/ˈsɪl.i/	어리석다
painful 형용사	/ˈpeɪn.fl̩/	아프다
tissue 명사	/ˈtɪʃ.(j)u/	조직

영상에 나오는 구동사

단어	뜻
get out 동사	나오다, 나가다

이 영상의 문법

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

문형	영상 속 표현
수동태 be + 과거분사 — 누가 하는지보다 무슨 일이 일어나는지에 초점	is let · is blocked · is supplied
현재완료 have/has + 과거분사 — 과거의 일이 지금도 관련이 있을 때	I've gone · I've covered

주의할 발음

화자는 can't, you're, I've 같은 축약형과 약화된 형태를 20번 사용합니다. 들리는 대로 짧게 발음하세요.

“sh”와 “zh” 소리: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, contrast /kənˈt(ʃ)ɹæst/, associate /əˈsoʊʃi.ət/, tissue /ˈtɪʃ.(j)u/, elimination /ɪlɪmɪˈneɪʃ(ə)n/
긴 단어 — 강세 위치에 주의: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, associate /əˈsoʊʃi.ət/, elimination /ɪlɪmɪˈneɪʃ(ə)n/, ciliary /ˈsɪl.iˌɛɹ.i/, posterior /poʊˈstɪɹ.i.ɚ/

한국어 화자가 어려워하는 소리:

/f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: painful /ˈpeɪn.fl̩/, fundus /ˈfʌn.dəs/, fovea /ˈfəʊ.vi.ə/, perfuse /pəɹˈfjuːz/, simplify /ˈsɪmplɪfaɪ/
/v/ — ㅂ(/b/)과 구별하기: vein /veɪn/, versus /ˈvɝsəs/, vessel /ˈvɛsəl/, fovea /ˈfəʊ.vi.ə/, compressive /kəmˈpɹɛsɪv/
/z/ — ㅈ이 아니라 성대를 울리는 /s/: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, pause /pɔːz/, memorize /ˈmɛm.əˌɹaɪ̯z/, perfuse /pəɹˈfjuːz/

이 영상으로 연습하는 방법

먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
0.75배속으로 한 문장씩 섀도잉을 시작하고, 익숙해지면 보통 속도로 돌아갑니다.
자신의 목소리를 녹음해 원본과 비교하고, artery, vein, cherry 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.

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쉐도잉 연습: Retinal Artery Occlusion vs. Retinal Vein Occlusion - 영상으로 영어 말하기 배우기

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