ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Introduction to CT Chest - Anatomy and Approach

เลือกโหมดฝึก

แต่ละโหมดจะเปิดห้องฝึกแบบเต็มจอ

335 ประโยค

หากประโยคสั้นหรือยาวเกินไป กดที่ Edit เพื่อปรับแก้

This interactive video series is designed to get you comfortable reading CT scans of the chest.

By interactive, I mean that you'll be able to scroll through full CT cases on your phone

or computer as you follow along.

In this first video, we'll cover basic anatomy and an approach to reading CT of the chest.

In future videos, we'll cover how to read a CT pulmonary angiogram, or CTPA, including how to diagnose acute and chronic pulmonary emboli,

and then cover basic patterns of lung disease like consolidation, ground glass, nodules, septal thickening,

etc., and the associated differentials that you need to know.

To open up the CT chest that we're looking at, you can use your phone camera to scan the QR code on the screen

and then scroll through the case on your phone

while you follow along or

if you're on a computer you can click the link in the description

and open up the case in a separate browser alongside the video.

The cases will look something like this

and you can access the different series on the left or

if you're on your phone you'll see an icon in the top left

that you can click to bring up the various series.

Before watching this, I strongly suggest watching our video, A Practical Introduction to CT.

Also, if you want to support the channel,

join our Patreon at patreon .com slash navigating or become a member of our YouTube channel by clicking join in the description.

Here you'll have access to case -based courses that we are building, including an abdominal and pelvic MRI course,

and other scrollable CT and MRI teaching cases.

Alright, so let's get started.

So this is a CT scan of the chest, and again, if you'd like to follow along,

you can open up the case via QR code or the link in the description.

So this CT scan of the chest was performed with IV contrast with a routine protocol,

but there are a number of ways that you can image the chest with CT.

So there are multiple protocols and we won't get into too much detail,

but for now you should understand the basics of contrast timing and how that affects what the images look like.

So you can have a non -contrast CT chest, i .e no IV contrast was administered.

Notice that there's no contrast here in the heart or vessels.

If we give IV contrast, how long we wait after injection, practically speaking, is going to determine the phase of contrast.

After we inject contrast into a vein,

it travels to the right heart and then into the pulmonary arteries.

So if we image really, really early at that stage, about 15 seconds or so after injection,

the pulmonary arteries would be filled with contrast and look very, very bright.

This would be a CTPA or CT pulmonary angiogram protocol, the scan that we want when we're looking for pulmonary emboli.

If we waited a little bit longer, about 20 seconds after injection or so, contrast moves from the pulmonary arteries into the lungs,

back to the pulmonary veins in the left heart, and then into the aorta and other arteries.

If we image then, it would be a CTA

or CT angiogram of the chest with the aorta and other arteries very bright.

We use this to assess the arterial vasculature, for example when ruling out an aortic dissection.

If we waited even longer, the contrast would distribute further and we'll have more optimal enhancement of soft tissues around 60 to 70 seconds or so.

This is a routine contrast enhanced CT of the chest.

Now we've intentionally oversimplified things here for now

and left out protocols like low dose CT chest

and high resolution CT chest but that's the basic principle

that you want to understand for now and we'll get to the rest later.

For now let's get back to this CT and start looking at the anatomy in detail.

So when we scroll through these axial images of the chest, most of what we're interested in here is within the thoracic cavity.

And the thoracic cavity is this entire cavity that is surrounded by chest wall,

which includes the bones and muscles that surround the cavity.

The thoracic cavity extends all the way up to this opening at the top of the thoracic cavity called the thoracic inlet.

Basically it's the hole at the top bordered by the first ribs which are here.

and the manubrium, and the thoracic cavity extends all the way down to the thoracic outlet,

which is closed by the diaphragm and borders the inferior aspects of the ribcage and to the bottom of the sternum.

In the thoracic cavity, we have the right lung and the left lung,

and between the lungs is the mediastinum, which we'll cover first.

the mediastinum is split up into compartments which are very important to know clinically

because different processes happen in each of the compartments and

so the differential diagnosis for things in each of the compartments is going to be different

there are a bunch of ways to split up the mediastinum

but the easiest and most logical way is to use the fibrous pericardium as your landmark.

So it's worth knowing a little bit about the pericardium.

So the pericardium is the sac that the heart sits in with the fibrous component being the outermost layer,

which you can actually see here on the CT.

It inserts into the diaphragm inferiorly here and up all the way the level of the roots of the great vessels.

Here is the fibrous pericardium on the sagittal images.

So everything superior to the pericardium and below the thoracic inlet is considered the superior mediastinum.

The superior mediastinum contains trachea, esophagus, and a bunch of vasculature that we'll talk about later.

The anterior mediastinum is anterior to the pericardium,

so this space right here.

In adult patients, it contains mostly fatty attenuation.

Notice the attenuation here is similar to the subcutaneous tissues.

But in younger patients, it can contain the thymus.

It can also contain lymph nodes and sometimes thyroid, which is up here if it extends inferiorly.

So that's why when you see an anterior mediastinal mass, the classic differential includes thymic lesions like thymoma,

thyroid lesions, and lymphoma, amongst other things like teratoma and other germ cell tumors.

The middle Posterior mediastinum is within the pericardium, mostly the heart and the vessels joining the heart,

including part of the ascending aorta and the pulmonary trunk, the SVC.

It also contains the tracheal bifurcation and some lymph nodes.

And lastly, the posterior mediastinum is posterior to the pericardium.

The posterior mediastinum of course contains the spine,

the paraspinal nerves, the vasculature back here, and the esophagus.

The differential for a posterior mediastinal mass is logical if you know the anatomy, with neurogenic tumors being the most common.

Let's look through this anatomy in a bit more detail starting with the middle mediastinum and the heart.

So this here is the right atrium which is where the major systemic veins drain,

namely the inferior vena cava or IVC which defines the right atrium.

This is coming from the lower body and the superior vena cava from above.

This here is the right atrial appendage

and you can see this structure here as well called the crista terminalis

which is a muscular ridge running from the superior vena cava down to the IVC it's a normal structure

and not a clot.

This is the right ventricle.

Notice that normally it is pretty thin -walled.

Not so important for this introductory talk, but important in general.

The right ventricle is defined by the moderator band,

which is this band coming from the interventricular septum here and extending towards the margin of the right ventricle,

also known as the septomarginal trabecula.

You may not see it very well on routine CT, and for now, don't worry about it too much.

100

The right ventricle pumps blood into the pulmonary artery.

101

So this is the pulmonary trunk and the right and left pulmonary arteries.

102

From here, blood goes into the lungs and then drains into the pulmonary veins.

103

these are pulmonary veins

104

that I'm pointing out the pulmonary veins drain into the left atrium

105

which sits posteriorly here this is the left atrial appendage

106

the left atrial appendage is a common location for blood clots to form

107

it's also a common area where you can see mixing artifact.

108

The left atrium is normally less than 4 centimeters or so in AP dimension.

109

Lastly, this is the left ventricle here.

110

Notice the relatively thick wall compared to the right ventricle.

111

You'll also notice the papillary muscles here.

112

The left ventricle pumps blood into the aorta.

113

So this is the aortic valve and the ascending aorta.

114

Okay, and that's a nice segue to move from the heart to the vascular anatomy.

115

So starting with the arteries, again, this is the aorta with the aortic valve,

116

ascending aorta, aortic arch, and descending aorta.

117

Important arterial branches to know include the coronary arteries.

118

So this is the left coronary artery here with the left anterior descending that extends down the intraventricular septum and the circumflex

119

as well as the right coronary artery which arises from the right coronary cusp

120

The three major branches of the aorta are first the brachiocephalic trunk

121

which splits into the right subclavian and the right common carotid artery that I'm following now.

122

the second major branch is the left common carotid artery and the third major branch is the left subclavian artery

123

other clinically important arteries to be aware of two arising from the subclavian vein are first the vertebral artery which I'm following now.

124

And second is the internal thoracic artery.

125

Here it is on the left, extending inferiorly along the anterior chest wall.

126

Lastly, the intercostal arteries are important to be aware of clinically clinically, they travel along the undersurface of the ribs.

127

Even if you don't see them that well, they're important to know clinically,

128

for example, if there is trauma and there's active extravasation or bleeding coming from this location, you know it's arising from an intercostal artery.

129

All right, moving along, we briefly talked about the pulmonary artery here, including the pulmonary trunk, right and left pulmonary arteries.

130

We'll cover the rest of the pulmonary artery branches all the

131

way to the segmental level in a future video on CT pulmonary angiogram.

132

Major veins to know include the left jugular vein,

133

which joins the left subclavian vein here to become the left brachiocephalic vein.

134

Similar on the right, the right subclavian vein and right jugular vein joined to make the right brachiocephalic vein.

135

The two brachiocephalic veins joined to become the superior vena cava.

136

which joins the right atrium.

137

The arch of the azagis here joins the superior vena cava, just above the level of the right main stem bronchus.

138

So this is the right main stem bronchus here.

139

Just above it is this arch of azagis joining into the superior vena cava.

140

The azygous itself comes from inferiorly here and extends up to the level of the arch.

141

And it runs along the right side of the aorta in the posterior mediastinum.

142

We mentioned the inferior vena cava that joins the red atrium inferiorly.

143

One other vein I didn't mention earlier is the largest cardiac vein, also known as the coronary vein here,

144

that runs along the posterior heart and drains into the right atrium as well.

145

Moving along to the airways,

146

this is the trachea that bifurcates into the right mainstem bronchus and the left mainstem bronchus.

147

The tracheal bifurcation is also known as the carina.

148

Notice that the right main stem bronchus here is a lot shorter than the left.

149

Also know that the right main stem bronchus usually has more of an inferior angulation to it compared to the left,

150

which is why foreign bodies and aspiration tend to go down the right side more than the left.

151

This here posteriorly is the esophagus,

152

extending all the way down to the level of the GE junction and stomach.

153

Before we go on to the lungs, one last important thing to touch on here are the lymph node stations,

154

and we'll cover the most clinically important ones.

155

So starting with the supraclavicular lymph nodes as well as the low cervical lymph nodes,

156

which are low in the neck.

157

The prevascular nodes, anterior to the great vessels here.

158

The aortopulmonary zone or AP window, which is just inferior to the aorta and above the pulmonary artery,

159

hence A for aorta, P for pulmonary artery window.

160

This space here.

161

We have paratracheal nodes which are surrounding the trachea, and that includes left paratracheal nodes.

162

You can see a normal appearing lymph node here on the left, for example, and right paratracheal nodes.

163

The dividing line between left paratracheal and right paratracheal is the left lateral border of the trachea.

164

So left paratracheal nodes are out here and right paratracheal nodes are anterior and to the right.

165

As we scroll down here past the carina, we have the subcarinal station.

166

This is a normal subcarinal lymph node.

167

And then more inferiorly and posteriorly we have paraesophageal nodes if they happen to be present.

168

We also have bilateral hyalur nodes adjacent to the mainstem bronchi.

169

And then we have interlobar, lobar, segmental, and subsegmental nodes as you go outwards.

170

But don't worry about those for now, just understand the naming convention in the mediastinal nodes for now.

171

Other important lymph nodes to be aware of in the chest include axillary nodes bilaterally,

172

internal thoracic nodes along the internal thoracic chain, and cardiophrenic nodes down here.

173

Okay so let's move on to the lungs themselves.

174

So we'll start with the right lung which is separated into three lobes by the fissures.

175

So here on the sagittal images you can see the oblique fissure here and

176

the horizontal fissure here which separates the lungs into the right upper lobe,

177

right middle lobe, and right lower lobe.

178

When I scroll through the axial images.

179

We are in the upper lobe here.

180

I can see the oblique fissure here.

181

And so all of this posterior to the oblique fissure, just like on the sagittal images you can see, are part of the lower lobe here.

182

As I scroll down, you'll start to see the horizontal fissure, which is this line here.

183

And so now we have the right upper lobe, this is above the horizontal fissure,

184

right middle lobe between the horizontal and oblique fissure down here, and this is all right lower lobe.

185

on the left we have only the oblique fissure separating the left upper lobe from the left lower lobe posteriorly

186

and inferiorly on the axials here again you can see the oblique fissure

187

this is all upper lobe and posteriorly

188

and inferiorly this is all lower lobe the inferior part of

189

the left upper lobe is called the lingula here near the heart.

190

Now if you're going into radiology, you'll probably need to know the segmental anatomy of the lungs as well.

191

So we'll cover that in detail in the CTPA video, but let's briefly go through it now.

192

If this is your first time hearing this stuff, don't worry if it's over your head.

193

You'll probably need to review this on your own and it just takes time and you'll get it eventually.

194

So the right lung is split into 10 segments and the left into eight.

195

On the right, starting with the upper lobe, the upper lobe is split into three.

196

So we have the apical segment and we're going to follow the bronchi to see where we're going.

197

So this is the apical segment here.

198

we have the anterior segment and we have the posterior segment.

199

In the right middle lobe, again following the bronchi to indicate where I'm going,

200

in the right middle lobe we have a medial segment and a lateral segment.

201

Notice that it splits into a medial and lateral bronchi here.

202

And the right lower lobe is split into five segments.

203

So this is right lower lobe here.

204

This posteriorly and superiorly is the superior segment of the right lower lobe, pretty high in the chest.

205

And then as I scroll down, it splits into four basal segments,

206

the anterior, the medial, the posterior,

207

and the lateral basal segments.

208

so again three in the right upper lobe apical anterior

209

and posterior two in the right middle lobe medial and lateral

210

and five in the right lower lobe superior

211

and then the four basal logically anterior medial posterior lateral the

212

left is split into eight segments with a few differences from the right

213

so the left upper lobe basically you're just combining the apical and posterior segments.

214

So you have the apico -posterior segment,

215

and then you also have an anterior segment.

216

So anterior is here, and apico -posterior is all of this.

217

The lingula, which is down here, is instead of medial and lateral, like the right middle lobe, split into the superior.

218

You'll see a bronchus coming off here.

219

So the superior and then inferior segments.

220

So we're at four so far.

221

And then the left lower lobe, again, has a superior segment up here.

222

And then we have basal segments and on the left we only have three instead of four.

223

The anterior and medial segments are combined and then we have our lateral and posterior basal segments.

224

So the major differences between the two lungs are that we have the apical posterior

225

combined in the left upper lobe and the anteromedial in the lower lobe, which gets rid of the two segments,

226

making it eight on the left and ten on the right.

227

The other difference is that the lingular are separated into superior

228

and inferior instead of the medial and lateral in the right middle lobe.

229

Again, if you're new to that and this terminology is new, that's likely way too much for now.

230

Don't worry.

231

It's not that important at this point, and we'll go through it again when we talk about pulmonary emboli.

232

Okay, so surrounding each of the lungs is a double layer of pleura.

233

You don't actually see them when you have normal pleura on CT, but the space between these layers is called the pleural space.

234

So you're going to be looking for things like pleural effusions that will fill that space dependently, and when it's filled with gas,

235

a pneumothorax, amongst other pathology.

236

All right, so that's the meat and potatoes of the anatomy that I wanted to cover.

237

A few other things to briefly mention.

238

We can see the lower neck here as well on CTs of the chest, including the thyroid gland.

239

Notice how bright it is.

240

we also have the entire chest wall which includes subcutaneous fat musculature and bones

241

starting with the bones we have our ribs starting from the first rib all the way down to the 12th rib

242

We have our spine posteriorly here.

243

We have our manubrium and sternum anteriorly here.

244

We have our bilateral clavicles.

245

The acromioclavicular joints up here can sometimes be seen.

246

This is the scapula back here.

247

And then we can often see part of the humerus.

248

On sagittal images, the spine and the sternum.

249

There are many muscles that you can see on CT of the chest that are beyond the scope of this talk,

250

including pectoralis major here and pectoralis minor,

251

bilaterally, rotator cuff muscles back here, paraspinal muscles.

252

We can also see quite a bit of the upper abdomen here,

253

and we covered the anatomy here in detail in our CT abdomen and pelvis talk.

254

Okay, so that's it for the anatomy let's move on to a brief approach.

255

So usually I start by looking at the scout image.

256

That's because the scout image often covers more anatomy than does the CT itself, looking for any incidental findings.

257

Then I start by looking at the soft tissue window.

258

First looking for any medical devices, things like pacemakers, lines, tubes.

259

Staying on soft tissue window, I then look at the chest wall, including all the way up to the lower neck,

260

which also includes the thyroid, looking for incidental thyroid nodules or thyroid masses.

261

As part of my scan of the chest wall on soft tissue windows.

262

I'll quickly look down the spinal canal for any incidental findings and then start looking at the thoracic cavity itself,

263

starting with the heart and mediastinum.

264

So generally when I'm looking at the heart itself,

265

I'm looking for specific chamber enlargement or other pathology like clot or tumor.

266

I'm looking in the pericardial space here, posterior to the fibrous pericardium for any evidence of pleural effusions,

267

pleural thickening, pleural calcification.

268

As I'm scrolling up here, I look for coronary calcifications.

269

On non -gated routine CTs, it's difficult to assess the coronary arteries much more than looking for calcifications most of the time.

270

So knowing the anatomy is important to pick up on what is coronary calcifications or stents.

271

I then look at the mediastinal vessels, so specifically looking at the aorta and pulmonary artery to start.

272

Starting with the pulmonary artery, I usually measure the pulmonary artery here in this axis.

273

The pulmonary trunk is considered enlarged if it's over three centimeters, which would also indicate pulmonary hypertension.

274

I also then follow the pulmonary arteries themselves when we give an IV contrast, even if it's a routine CT like this,

275

because we'll often pick up on incidental pulmonary emboli.

276

I also measure the diameter of the ascending aorta only if it looks big to me,

277

and your eyes will get used to what is too big, and if it's over 4 cm, that's considered aneurysmal for the ascending aorta.

278

I'm going to follow the aortic arch and down to the descending aorta, looking for any other aortic pathology,

279

as well as briefly following the major branches of the aorta.

280

I'm looking at the esophagus in the posterior mediastinum.

281

And as I'm looking at all these things,

282

I'm also looking for any obvious mediastinal masses in each of the compartments that we mentioned in the anatomy section.

283

I then look for lymph nodes.

284

I'm looking through all of the chains that we mentioned.

285

So starting with the lower neck bilaterally and looking closely for supraclavicular lymph nodes.

286

In the mediastinum, the prevascular chain,

287

AP window, paratracheal nodes, subcarinal nodes, paraesophageal nodes.

288

Looking for hylar nodes along the internal thoracic, bilaterally, cardiophanic.

289

Then on soft tissue window, I'm looking at the pleura for any pleural effusions dependently,

290

pleural thickening, calcification, masses.

291

And then switch to lung window to look for pneumothorax first.

292

In the setting of trauma, you're going to pick up little tiny pneumothoraces looking anteriorly and medial here. or posterior medial here.

293

This is also non -dependent for this part of the lung.

294

While I'm still on lung window, I'm looking at the airways.

295

And then I start to look at the lungs.

296

And so everyone has their own search pattern for how they look through the lungs.

297

I tend to start by doing a quick overview of both lungs to look for any obvious pathology.

298

I usually split it into halves on the axial cuts, so I'm looking right anterior first,

299

and then right posterior, and then the same on the left,

300

left anterior, and left posterior.

301

I then take my time and look at the lungs in more detail, looking for smaller lung nodules.

302

I tend to use the MIP images if they're available.

303

MIP images are maximum intensity projections with thicker slices.

304

So as you can see, the vessels look very elongated and linear.

305

that is contrary to what a lung nodule would look like

306

so for example there is a lung nodule it doesn't look linear like these vessels

307

so lung nodules will pop up as dots amongst all of these connecting linear structures that are the vessels

308

so when I'm looking at the MIPS depending on your plane I actually split the coronals into three

309

so I'm looking superiorly here first, from front to back, middle, and then inferiorly, scrolling relatively slowly.

310

Here's another nodule, for example.

311

And then do the same on the left.

312

If you happen to identify a nodule on the MIPS,

313

the next step is to then cross -correlate and find that same nodule on your normal axial cuts.

314

I then switch to bone window to look at the bones.

315

Looking at the ribs I generally split them into posterior

316

and anterior so I'm looking posteriorly on the right here and then anteriorly or anterior laterally here on the right.

317

Same thing on the left, repeat.

318

Looking at both clavicles here, the manubrium and sternum.

319

I tend to look at the axial images for the spine as well, and the scapulae, as well as the humeral heads here.

320

and then I do pull up the sagittal images as well to look at the spine.

321

sternum again.

322

Lastly on soft tissue window I'm looking at the upper abdomen

323

for incidental findings and we went through an approach on the abdomen

324

and pelvis talk but again looking at the liver or what I can see of it,

325

the gallbladder, pancreas, spleen, adrenals, and kidneys.

326

Remember lung cancers like to metastasize to the adrenals

327

so you're specifically looking for adrenal nodules when looking at cases of lung cancer.

328

I also follow the stomach to the duodenum or what I can

329

and have a look at the bowel as well as for any incidental lymph nodes in the upper abdomen.

330

But again watch the CT, abdomen, and pelvis talk, and this will take you a very short amount of time to look through.

331

All right, so that's the end of this video.

332

In the next video, we'll cover how to look at CT pulmonary angiogram with a more detailed look at segmental anatomy

333

and how to diagnose acute and chronic pulmonary emboli.

334

Thanks a lot.

335

Thank you.

ดาวน์โหลดแอป

ทุกอย่างที่ต้องใช้เพื่อพูดได้คล่อง

AI ให้คะแนนการออกเสียงให้คะแนนทุกประโยค

ฝึก IPAเชี่ยวชาญทุกเสียง

คำศัพท์สร้างคลังคำของคุณ

เกมคำศัพท์เล่นไปเรียนไป

สแกน QR

Download on theApp Store Get it onGoogle Play

FOR YOU

วิดีโอแนะนำ

91 ประโยค

คำศัพท์และข้อสังเกตด้านการพูดสำหรับบทเรียนนี้

บทเรียนฝึกพูดนี้ใช้วิดีโอ “Introduction to CT Chest - Anatomy and Approach” เป็นสื่อ คำที่ถูกพูดซ้ำบ่อยที่สุด: pulmonary, lobe, node, lung, posterior วิดีโอนี้มี 335 ประโยค และ 4343 คำ สำหรับฝึกพูดตาม ช่วงที่มีเสียงพูดยาว 36:53 ผู้พูดพูดด้วยความเร็วสม่ำเสมอ ประมาณ 118 คำต่อนาที เหมาะกับการฝึกพูดตาม มีเพียง 72% ของคำที่อยู่ใน 3,000 คำที่ใช้บ่อยที่สุดในภาษาอังกฤษ คำศัพท์จึงค่อนข้างยาก

คำศัพท์สำคัญในวิดีโอนี้

คำที่ควรเรียนรู้ 15 คำจากวิดีโอ พร้อมคำอ่านและความหมาย:

คำศัพท์	คำอ่าน	ความหมาย
artery คำนาม	/ˈɑɹ.təɹ.i/	เส้นเลือดแดง, หลอดเลือดแดง
lung คำนาม	/ˈlʌŋ/	ปอด
vein คำนาม	/veɪn/	หลอดเลือดดำ, เส้นเลือด
anatomy คำนาม	/əˈnætəmi/	กายวิภาคศาสตร์
scroll คำนาม	/skɹoʊl/	ม้วนกระดาษ
cavity คำนาม	/ˈkæv.ɪt.i/	ฟันผุ
vessel คำนาม	/ˈvɛsəl/	เรือ
tissue คำนาม	/ˈtɪʃ.(j)u/	ทิชชู่
abdomen คำนาม	/ˈæb.də.mən/	ท้อง
thyroid คำคุณศัพท์	/ˈθaɪ.ɹɔɪd/	ไทรอยด์
bone คำนาม	/boʊn/	กระดูก
muscle คำนาม	/ˈmʌs.əl/	กล้ามเนื้อ, กล้าม
trunk คำนาม	/tɹʌŋk/	ต้น, ลำ
arch คำนาม	/ɑɹt͡ʃ/	ช่องโค้ง
spine คำนาม	/spaɪn/	กระดูกสันหลัง

กริยาวลีที่คุณจะได้ยิน

คำศัพท์	ความหมาย
bring up คำกริยา	เลี้ยงดู, ฟูมฟัก
pick up คำกริยา	ยก, หยิบ

ประโยคที่ควรฝึกพูดซ้ำ

ประโยคสั้น ๆ ที่สมบูรณ์จากวิดีโอ ซึ่งนำไปใช้ในบทสนทนาประจำวันได้:

Alright, so let's get started.
You'll also notice the papillary muscles here.
You'll see a bronchus coming off here.
I'm looking at the esophagus in the posterior mediastinum.

ไวยากรณ์ในวิดีโอนี้

โครงสร้างที่ผู้พูดใช้บ่อยที่สุด พร้อมคำพูดจริงจากวิดีโอ:

โครงสร้าง	ในวิดีโอ
ประโยคเงื่อนไข if + อนุประโยค, will/would + กริยา — เงื่อนไขและผลลัพธ์	if you're on your phone you'll see · If we image then, it would be · if you're going into radiology, you'll probably
Passive voice be + กริยาช่อง 3 — เน้นสิ่งที่เกิดขึ้น ไม่ใช่ผู้กระทำ	is designed · was performed · was administered
Relative clauses who / which + อนุประโยค — ข้อมูลเพิ่มเติมเกี่ยวกับคนหรือสิ่งของ	ribs which are · compartments which are · thyroid, which is

การออกเสียงที่ควรระวัง

ผู้พูดใช้รูปย่อและรูปลดเสียง 71 ครั้ง เช่น I'm, we'll, you'll ให้พูดแบบสั้นตามที่ได้ยิน

เสียง “th”: thyroid /ˈθaɪ.ɹɔɪd/, pathology /pəˈθɒləd͡ʒi/, thin /ˈθɪn/, thick /θɪk/, thoracic /θəˈɹæsɪk/
เสียง “sh” และ “zh”: contrast /kənˈt(ʃ)ɹæst/, tissue /ˈtɪʃ.(j)u/, injection /ɪnˈd͡ʒɛk.ʃən/, differential [dɪfəˈɹənʃəɫ], fissure /ˈfɪʃ.ɚ/
คำยาว — ลงเสียงหนักให้ถูกพยางค์: anterior /ænˈtɪɹ.i.ɚ/, superior /sʊˈpɪɹ.i.ɚ/, anatomy /əˈnætəmi/, inferior /ɪnˈfɪɹ.i.ɚ/, horizontal /ˌhoɹəˈzɑn.təl/

เสียงที่คนไทยมักออกเสียงยาก:

เสียงท้ายคำ — ออกเสียงให้ครบ ไม่เปลี่ยนเป็นตัวสะกดแบบไทย: scroll /skɹoʊl/, lateral /ˈlætəɹəl/, vessel /ˈvɛsəl/, muscle /ˈmʌs.əl/, arch /ɑɹt͡ʃ/
/v/ — ไม่ใช่ /w/ ให้ฟันบนแตะริมฝีปากล่าง: vein /veɪn/, cavity /ˈkæv.ɪt.i/, vessel /ˈvɛsəl/, valve /ˈvælv/, interactive /ˌɪn.tɚˈæk.tɪv/
/z/ — เสียงก้อง ไม่ใช่ /s/: horizontal /ˌhoɹəˈzɑn.təl/, arise /əˈɹaɪz/, basal [ˈbeɪzəɫ]

วิธีฝึกกับวิดีโอนี้

ฟังวิดีโอให้จบหนึ่งรอบโดยยังไม่ต้องพูด แล้วจดคำที่ยังไม่รู้จัก
พูดตามทีละประโยคด้วยความเร็วปกติ ทำซ้ำแต่ละประโยคจนจังหวะของคุณตรงกับผู้พูด
อัดเสียงตัวเองแล้วเทียบกับต้นฉบับ โดยสังเกตคำอย่าง artery, lung, vein เป็นพิเศษ

เทคนิค Shadowing คืออะไร?

Shadowing เป็นเทคนิคการเรียนรู้ภาษาที่ได้รับการรับรองทางวิทยาศาสตร์ พัฒนาขึ้นสำหรับการฝึกนักแปลมืออาชีพ วิธีการนี้เรียบง่ายแต่ทรงพลัง: คุณฟังเสียงภาษาอังกฤษจากเจ้าของภาษาและพูดตามทันที — เหมือนเงาที่ตามผู้พูดด้วยช่วงเวลาห่าง 1-2 วินาที การวิจัยแสดงว่าเทคนิคนี้ปรับปรุงความแม่นยำในการออกเสียง ทำนองเสียง จังหวะ การเชื่อมเสียง การฟังเข้าใจ และความคล่องแคล่วในการพูดได้อย่างมีนัยสำคัญ

เทคนิค shadowing: อ่านคู่มือฉบับเต็มทีละขั้นตอน →

ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Introduction to CT Chest - Anatomy and Approach

เลือกโหมดฝึก

ดาวน์โหลดแอป

How To: Ultrasound for Pneumothorax Case Study Video

What are Capital Markets? | Intro to Capital Markets (Part 1)

Anatomy & Physiology: The Ultimate Beginner's Guide | Dr. Bee's Tutorials

Transient Thermal Analysis in ANSYS AIM

Other Corneal Disorders - CRASH! Medical Review Series

4 How to use PCR and qPCR

Scoliosis: How to medically classify scoliosis (the Lenke System for AIS)

Introduction to HPLC - Lecture 1: HPLC Basics

MIT Introduction to Deep Learning | 6.S191

Surgical Anatomy 2 (Spleen)

Respiratory System 5, Podcast on breathing

Abdominal Examination - OSCE Guide (Latest) | UKMLA | CPSA | PLAB 2