Практика Shadowing: Retinal Artery Occlusion vs. Retinal Vein Occlusion - Изучайте разговорный английский по видео

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Medical students hate this question, retinal artery occlusion versus retinal vein occlusion.
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The reason that this is so difficult is that both of these processes will present with acute painless monocular vision loss.
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And yes, we can kind of nitpick here and maybe say
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that retinal vein occlusion tends to be a little bit more painful, or maybe there's some temporal sparing in retinal artery occlusion,
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but the test writer knows this and they're not going to give you that.
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So in your exam, the way that you're going to get this right is
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if you can identify buzzwords and identify the picture when they show you the back of somebody's eye.
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So the way that I think you can simplify this is let's break it down and get back to basics.
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If you understand pathophysiology, this makes perfect sense.
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One of these has artery in the name.
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One of these has vein in the name.
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Artery brings the blood to something and the vein takes it away.
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So if we block the artery, blood cannot get to the retina.
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If we block the vein, blood can't get out of the retina.
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And if we keep it that stupid and that simple, this all makes perfect sense.
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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.
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A retinal vein occlusion, meaning that the blood cannot drain out of the eye, that's a drainage problem.
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So, let's pause for a second, and I've got a really silly picture here at the bottom of the slide.
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If blood can't get in, what physical findings would you expect to see?
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And if blood can't get out, what physical findings would you expect to see so taking
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that one step further in the artery occlusion
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you see a pale fundus with a cherry red spot in the vein occlusion you see hemorrhage
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and edema now this should make sense to you
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when we look at hemorrhage and edema if blood is pooling into the eye
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and can't get out through the retinal vein there will be hemorrhage and there will be edema specifically of the optic disc.
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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.
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If you can't get blood to part of the eye, it will appear pale.
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And that should make sense to you.
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Now, as far as the cherry red spot goes, here's what you want to look for.
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You see the black arrow here pointing to the cherry red spot.
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And something that is important to understand here is
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that you see the reason that the cherry red spot is cherry red at the center,
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but then pale around it is because the fovea will stay red.
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And the reason that the fovea stays red is that it gets its blood supply from the posterior ciliary arteries.
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It does not get its blood supply from the central retinal artery.
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So basically anything that is supplied from the central retinal artery will become pale because it's ischemic,
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but anything that is supplied from the posterior ciliary arteries will appear well perfused because we don't have the blockage there.
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Again, in a retinal artery occlusion, the occlusion is in the retinal artery or the central retinal artery.
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And this is why the fovea will be a nice dark red color, but the surrounding tissue will be pale.
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Now, let's contrast that to what you see in a retinal vein occlusion.
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So in a retinal vein occlusion, you're looking for optic disc edema, so the optic disc would swell, and retinal hemorrhage.
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And you can see, I hope you can appreciate the very stark contrast between these two pictures.
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One is showing you hemorrhage and some swelling.
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The other shows you that cherry red spot with the pale fundus.
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And again, if you think about this as artery occlusion equals supply problem, it's ischemic, and vein equals drainage problem,
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it's buildup and swelling and hemorrhage, this really should make sense to you.
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Now on your exam, they're going to show you one of these pictures, like 90 % of the time.
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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.
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So you really should commit this to memory.
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But if you're looking at causes here,
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the retinal artery occlusion typically is due to some type of thromboembolic event.
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And the retinal vein occlusion is typically due to a compressive effect of nearby central retinal arteries having atherosclerosis.
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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,
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which prevents the retinal vein from draining properly, hence the hemorrhage, hence the edema.
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But in the retinal artery occlusion, the problem is inherent to whatever thromboembolic event takes place that occludes the actual central retinal artery itself.
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And that's really important to understand.
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So, I've gone through this video, and so far I would say
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that I've covered much of what you probably need to know for the purposes of your exam.
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Again, you want to be able to identify these pictures and know that the buzzwords pale fundus, cherry red spot equals artery occlusion,
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retinal hemorrhage, and optic discodema equals vein occlusion.
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But if you need a way to memorize this and pair these together, I always think about artery is red and vein is blue.
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That's just how it is in my head, probably from years of studying this way.
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So the way that I memorize this is when I think about a pale fundus with a cherry red spot,
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pale to me pales like a bucket.
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So I think about a bucket or a pale filled with cherries.
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And then I associate pale fundus, cherry red spot with red,
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you know, everything else by process of elimination would be a retinal vein.
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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.
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That's a supply problem.
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So, you're looking for ischemic symptoms.
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If the vein is occluded, blood can't get out.
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That's a drainage problem.
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You're looking for hemorrhage and edema type symptoms.
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If you can keep that straight, then when you look at these images,
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you can kind of guess based on which blood vessel looks more engorged versus which one looks more like a cherry.
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So there you go.
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Good luck.

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Лексика и советы по произношению к этому уроку

Этот урок разговорной практики построен на видео «Retinal Artery Occlusion vs. Retinal Vein Occlusion». Чаще всего повторяются слова: retinal, artery, occlusion, vein, blood. В этом видео 77 предложений и 1105 слов для шедоуинга. Речь длится 6:33. Говорящий говорит в естественном темпе, около 169 слов в минуту, близком к повседневной речи. Только 75% слов входят в 3000 самых частых слов английского языка, поэтому лексика сложная.

Ключевая лексика этого видео

15 слов из видео, которые стоит выучить, с произношением и значением:

СловоПроизношениеЗначение
artery существительное/ˈɑɹ.təɹ.i/арте́рия
vein существительное/veɪn/ве́на, жи́ла
cherry существительное/ˈt͡ʃɛɹi/чере́шня, ви́шня
pale прилагательное/peɪl/бле́дный
optic прилагательное/ˈɑp.tɪk/оптический
examination существительное/ɪɡˌzæm.ɪˈneɪ.ʃən/прове́рка, иссле́дование
disk существительное/dɪsk/диск
drainage существительное/ˈdɹeɪnəd͡ʒ/дрена́ж
swell глагол/swɛl/раздува́ться, набуха́ть
contrast существительное/kənˈt(ʃ)ɹæst/контра́ст
hence наречие/ˈhɛns/отсю́да
versus/ˈvɝsəs/про́тив
bucket существительное/ˈbʌkɪt/ведро́, ведёрко
drain существительное/dɹiːn/дрена́ж, водосто́к
symptom существительное/ˈsɪm(p)təm/симпто́м, при́знак

Фразовые глаголы, которые вы услышите

СловоЗначение
pick out глаголвыковы́ривать, вы́ковырять

Грамматика в этом видео

Конструкции, которые говорящий использует чаще всего, с точными словами из видео:

КонструкцияВ видео
Пассивный залог be + причастие прошедшего времени — важно, что происходит, а не кто это делаетis let · is blocked · is supplied
Present Perfect have/has + причастие прошедшего времени — прошлое действие, важное сейчасI've gone · I've covered

Произношение, на которое стоит обратить внимание

Говорящий использует 20 сокращённых и редуцированных форм, например can't, you're, I've. Произносите их коротко, так, как слышите.

  • Звуки «sh» и «zh»: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, contrast /kənˈt(ʃ)ɹæst/, associate /əˈsoʊʃi.ət/, tissue /ˈtɪʃ.(j)u/, elimination /ɪlɪmɪˈneɪʃ(ə)n/
  • Длинные слова — следите за ударением: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, associate /əˈsoʊʃi.ət/, elimination /ɪlɪmɪˈneɪʃ(ə)n/, ciliary /ˈsɪl.iˌɛɹ.i/, posterior /poʊˈstɪɹ.i.ɚ/

Звуки, трудные для русскоязычных:

  • /h/ — лёгкий выдох, а не русское «х»: hence /ˈhɛns/, inherent /ɪnˈhɪəɹənt/, hemorrhage /ˈhɛm(ə)ɹɪd͡ʒ/
  • Звонкие согласные в конце слова — не оглушайте их: drainage /ˈdɹeɪnəd͡ʒ/, slide /ˈslaɪ̯d/, pause /pɔːz/, surround /səˈɹaʊnd/, hemorrhage /ˈhɛm(ə)ɹɪd͡ʒ/

Как заниматься с этим видео

  1. Прослушайте всё видео один раз молча и выпишите незнакомые слова.
  2. Начните со скорости 0,75×, повторяйте предложение за предложением и вернитесь к обычной скорости, когда станет легко.
  3. Запишите себя и сравните с оригиналом, обращая внимание на такие слова, как artery, vein, cherry.

Что такое техника Shadowing?

Shadowing — это научно обоснованная техника изучения языка, изначально разработанная для подготовки профессиональных переводчиков и популяризированная полиглотом доктором Александром Аргуэльесом. Метод прост, но эффективен: вы слушаете аудио на английском от носителей языка и немедленно повторяете вслух — как тень, следующая за говорящим с задержкой в 1–2 секунды. В отличие от пассивного прослушивания или грамматических упражнений, Shadowing заставляет мозг и мышцы рта одновременно обрабатывать и воспроизводить реальные речевые паттерны. Исследования показывают, что это значительно улучшает точность произношения, интонацию, ритм, связную речь, понимание на слух и беглость речи — что делает его одним из самых эффективных методов для подготовки к IELTS Speaking и реального общения на английском.

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