Prática de Shadowing: SVINutes: Pulsatile Tinnitus - Aprenda a falar inglês com vídeo
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Hello, my name is Dr. Fazeev Siddiqui.
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I'm a clinical adjunct professor at the University of Michigan at Michigan State University.
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Today, I will guide you through the evaluation of pulsatile tinnitus, a condition that can reveal critical underlying vascular abnormalities.
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Pulsed-style tinnitus is a rhythmic sound often in sync with the heartbeat.
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Unlike common tinnitus, typically a ringing sound, pulsed-style tinnitus is often caused by vascular abnormalities that create vibrations transmitted to the ear.
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Pulse slide tinnitus can be heard as whooshing, thumping, or whooping noises.
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A thorough assessment is crucial.
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The first step, always take a comprehensive history.
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Ask about the timing and onset and if it's unilateral or bilateral.
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Next, move to the physical exam.
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Pay close attention to blood pressure as hypertension can contribute.
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Don't forget to auscultate the neck and skull for any bruise, indicating turbulent blood flow pointing to an underlying vascular issue.
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If the initial assessment is concerning, the next step is imaging.
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A brain MRI with MR angiography
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or a CT angiogram is typically the first line modality to evaluate for vascular abnormalities like arteriovenous malformation or dural fistula.
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A diagnostic cerebral endogram can be performed if there is a strong suspicion on screening non-invasive imaging.
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Common causes include arteriovenous malformation, dural arteriovenous fistula, and carotid artery stenosis.
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Other less common causes include venous sinus stenosis, sigmoid diverticulum, aberrant carotid artery, and cerebral aneurysm.
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Recognizing these early can prevent severe complications like a stroke or hemorrhage.
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A dual arterial systula is an abnormal connection between arteries and veins within the dual matter.
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This bypasses the normal capillary system, forcing high-pressure arterial blood directly into the venous system.
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The result is turbulent blood flow in the dual venous sinuses.
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This turbulence generates vibrations which can be transmitted through the surrounding tissue to the cochlea, causing pulsed tinnitus.
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If left untreated, dural arterioleus fistula can lead to complications like intracranial hemorrhage or venous congestion, making early diagnosis critical.
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Another common vascular cause of pulsed tinnitus is carotid artery stenosis, which occurs when and the carotid artery narrows due to plaque buildup or other factors.
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This narrowing creates turbulent blood flow as the high-pressure blood moves through the constricted segment.
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Carotid artery stenosis is a significant risk for ischemic stroke and, if identified early, can be managed safely with carotid enderectomy or stenting.
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Venous disorders are another important cause of pustile tinnitus.
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Common conditions include venous sinus stenosis, which narrows major venous pathways like the the transfer sinus or sigmoid sinus,
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leading to turbulent blood flow and elevated venous pressure.
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Other venous causes include jugular bulb abnormalities, such as high riding bulb or diverticulum, which may create vibrations that propagate to the inner ear.
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Recognizing venous causes early is crucial, as they may contribute to symptoms of intracanial hypertension or other complications requiring targeted treatment.
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Let's look at a quick case.
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A 78-year-old man with a remote history of pulsoil tinnitus presented with headaches.
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An MRI brain revealed a cerebellar hematoma.
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A diagnostic angiogram demonstrated a high-grade complex arteriovenous fistula with multiple arterial feeders.
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Multiple arterial embolization attempts could not completely resolve the fistula.
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Hence, a coil embolization of the non-functional left transfer sinus was performed.
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A complete cure was achieved after the venous sinus sacrifice the patient did well clinically the patient did well clinically.
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To sum up, pulse light tinnitus should always prompt a careful history, physical exam, and if needed, vascular imaging.
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Early identification of vascular causes is essential for preventing complications.
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Vocabulário e dicas de fala para esta lição
Este vídeo tem 41 frases e 588 palavras para praticar shadowing. A fala dura 4:51. O falante mantém um ritmo estável de cerca de 121 palavras por minuto, confortável para o shadowing. Apenas 57% 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 |
|---|---|---|
| vascular adjetivo | /ˈvæskjələ/ | vascular |
| pulse substantivo | /pʌls/ | pulso |
| artery substantivo | /ˈɑɹ.təɹ.i/ | artéria |
| narrow adjetivo | /ˈnæɹəʊ/ | estreito, estreita |
| dual adjetivo | /ˈdul/ | dual |
| vibration substantivo | /vaɪˈbɹeɪʃən/ | vibração |
| assessment substantivo | /əˈsɛsmənt/ | contabilização |
| reveal verbo | /ɹɪˈviːl/ | revelar |
| contribute verbo | /kənˈtɹɪb.jut/ | contribuir |
| crucial adjetivo | /ˈkɹuː.ʃəl/ | crucial |
| examination substantivo | /ɪɡˌzæm.ɪˈneɪ.ʃən/ | exame |
| underlying adjetivo | implícito, subjacente | |
| diagnostic adjetivo | /ˌdaɪ.əɡˈnɑ.stɪk/ | diagnóstico |
| bulb substantivo | /ˈbʌlb/ | bulbo |
| cerebral adjetivo | /səˈɹi.bɹəl/ | cerebral |
Pronúncia para ficar de olho
- Os sons de “th”: thorough /ˈθʌɹoʊ/, pathway /ˈpæθˌweɪ/, rhythmic /ˈɹɪð.mɪk/, thump /θʌmp/
- Os sons de “sh” e “zh”: vibration /vaɪˈbɹeɪʃən/, crucial /ˈkɹuː.ʃəl/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, tissue /ˈtɪʃ.(j)u/, evaluation /ɪˌvæljuˈeɪʃn̩/
- Palavras longas — acerte a sílaba tônica: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, diagnostic /ˌdaɪ.əɡˈnɑ.stɪk/, comprehensive /ˌkɑm.pɹəˈhɛn.sɪv/, evaluation /ɪˌvæljuˈeɪʃn̩/, identification /aɪˌdɛn(t)ɪfɪˈkeɪʃn̩/
Como praticar com este vídeo
- Ouça o vídeo inteiro uma vez sem falar e anote as palavras que você não conhece.
- Faça shadowing frase por frase na velocidade normal, repetindo cada uma até o seu ritmo ficar igual ao do falante.
- Grave a sua voz e compare com o original, prestando atenção a palavras como vascular, pulse, artery.
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.