Prática de Shadowing: Retinal Artery Occlusion vs. Retinal Vein Occlusion - Aprenda a falar inglês com vídeo

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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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Vocabulário e dicas de fala para esta lição

Esta aula de conversação usa o vídeo “Retinal Artery Occlusion vs. Retinal Vein Occlusion”. As palavras que mais se repetem: retinal, artery, occlusion, vein, blood. Este vídeo tem 77 frases e 1105 palavras para praticar shadowing. A fala dura 6:33. O falante fala em ritmo natural, cerca de 169 palavras por minuto, próximo de uma conversa do dia a dia. Apenas 75% das palavras estão entre as 3.000 mais comuns do inglês, por isso o vocabulário é exigente.

Vocabulário principal deste vídeo

15 palavras do vídeo que vale a pena aprender, com pronúncia e significado:

Palavra	Pronúncia	Significado
artery substantivo	/ˈɑɹ.təɹ.i/	artéria
vein substantivo	/veɪn/	veia
cherry substantivo	/ˈt͡ʃɛɹi/	cereja
pale adjetivo	/peɪl/	pálido, claro
optic adjetivo	/ˈɑp.tɪk/	óptico, ótico
examination substantivo	/ɪɡˌzæm.ɪˈneɪ.ʃən/	exame
disk substantivo	/dɪsk/	disco
drainage substantivo	/ˈdɹeɪnəd͡ʒ/	drenagem
swell verbo	/swɛl/	inchar
contrast substantivo	/kənˈt(ʃ)ɹæst/	contraste
hence advérbio	/ˈhɛns/	daqui
versus	/ˈvɝsəs/	contra, vérsus
bucket substantivo	/ˈbʌkɪt/	balde
drain substantivo	/dɹiːn/	dreno, ralo
symptom substantivo	/ˈsɪm(p)təm/	sintoma

Phrasal verbs que você vai ouvir

Palavra	Significado
get out verbo	sair

Gramática neste vídeo

As estruturas que o falante mais usa, com as palavras exatas do vídeo:

Estrutura	No vídeo
Voz passiva be + particípio passado — o foco está no que acontece, não em quem faz	is let · is blocked · is supplied
Present perfect have/has + particípio passado — uma ação passada que ainda importa agora	I've gone · I've covered

Pronúncia para ficar de olho

O falante usa 20 contrações e formas reduzidas, como can't, you're, I've. Diga-as na forma curta, do jeito que você ouve.

Os sons de “sh” e “zh”: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, contrast /kənˈt(ʃ)ɹæst/, associate /əˈsoʊʃi.ət/, tissue /ˈtɪʃ.(j)u/, elimination /ɪlɪmɪˈneɪʃ(ə)n/
Palavras longas — acerte a sílaba tônica: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, associate /əˈsoʊʃi.ət/, elimination /ɪlɪmɪˈneɪʃ(ə)n/, ciliary /ˈsɪl.iˌɛɹ.i/, posterior /poʊˈstɪɹ.i.ɚ/

Sons difíceis para falantes de português:

Consoante final — sem acrescentar um “i” depois: optic /ˈɑp.tɪk/, disk /dɪsk/, contrast /kənˈt(ʃ)ɹæst/, bucket /ˈbʌkɪt/, associate /əˈsoʊʃi.ət/
/l/ final — a língua toca o céu da boca, não vira “u”: pale /peɪl/, swell /swɛl/, vessel /ˈvɛsəl/, temporal /ˈtɛm.pə.ɹəl/, retinal /ˈɹɛt.ən.əl/
/h/ — um sopro suave, diferente do “r”: hence /ˈhɛns/, inherent /ɪnˈhɪəɹənt/, hemorrhage /ˈhɛm(ə)ɹɪd͡ʒ/

Como praticar com este vídeo

Ouça o vídeo inteiro uma vez sem falar e anote as palavras que você não conhece.
Comece na velocidade 0,75×, faça shadowing frase por frase e volte à velocidade normal quando ficar fácil.
Grave a sua voz e compare com o original, prestando atenção a palavras como artery, vein, cherry.

O que é a Técnica de Shadowing?

Shadowing é uma técnica de aprendizado de idiomas com base científica, originalmente desenvolvida para o treinamento de intérpretes profissionais. O método é simples, mas poderoso: você ouve áudio em inglês nativo e repete imediatamente em voz alta — como uma sombra seguindo o falante com 1-2 segundos de atraso. Pesquisas mostram melhora significativa na precisão da pronúncia, entonação, ritmo, sons conectados, compreensão auditiva e fluência na fala.

Técnica de shadowing: leia o guia completo passo a passo →

Prática de Shadowing: Retinal Artery Occlusion vs. Retinal Vein Occlusion - Aprenda a falar inglês com vídeo

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