Shadowing Practice: SVINutes: Pulsatile Tinnitus - Learn English Speaking with Video
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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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Bu dersin kelimeleri ve konuşma notları
Bu videoda gölgeleme çalışması için 41 cümle ve 588 kelime var. Konuşma bölümü 4:51 sürüyor. Konuşmacı dakikada yaklaşık 121 kelimelik dengeli bir hızla konuşuyor; gölgeleme için rahat bir tempo. Kelimelerin yalnızca %57’i İngilizcede en sık kullanılan 3.000 kelime arasında, bu yüzden kelime dağarcığı zorlayıcı.
Bu videodaki önemli kelimeler
Videodan öğrenmeye değer 15 kelime, telaffuzu ve anlamıyla:
| Kelime | Telaffuz | Anlam |
|---|---|---|
| vascular sıfat | /ˈvæskjələ/ | vasküler |
| pulse isim | /pʌls/ | nabız |
| artery isim | /ˈɑɹ.təɹ.i/ | arter, atardamar |
| narrow sıfat | /ˈnæɹəʊ/ | dar |
| dual sıfat | /ˈdul/ | ikil, tesniye |
| reveal fiil | /ɹɪˈviːl/ | açığa vurmak |
| examination isim | /ɪɡˌzæm.ɪˈneɪ.ʃən/ | imtihan etmek, sınav yamak |
| diagnostic sıfat | /ˌdaɪ.əɡˈnɑ.stɪk/ | tanılayıcı, tanısal |
| cerebral sıfat | /səˈɹi.bɹəl/ | beyinsel |
| occur fiil | /əˈkɜː/ | olmak |
| remote sıfat | /ɹəˈməʊt̞/ | uzak, uzaktan kontrol |
| hence zarf | /ˈhɛns/ | itibaren |
| comprehensive sıfat | /ˌkɑm.pɹəˈhɛn.sɪv/ | şamil, kapsayici |
| indicate fiil | /ˈɪndɪˌkeɪt/ | belirtmek, göstermek |
| cure fiil | /kjɔː/ | tedavi etmek, iyileştirmek |
Dikkat edilecek telaffuzlar
- “th” sesleri: thorough /ˈθʌɹoʊ/, pathway /ˈpæθˌweɪ/, rhythmic /ˈɹɪð.mɪk/, thump /θʌmp/
- “sh” ve “zh” sesleri: vibration /vaɪˈbɹeɪʃən/, crucial /ˈkɹuː.ʃəl/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, tissue /ˈtɪʃ.(j)u/, evaluation /ɪˌvæljuˈeɪʃn̩/
- Uzun kelimeler — vurguyu doğru yere koyun: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, diagnostic /ˌdaɪ.əɡˈnɑ.stɪk/, comprehensive /ˌkɑm.pɹəˈhɛn.sɪv/, evaluation /ɪˌvæljuˈeɪʃn̩/, identification /aɪˌdɛn(t)ɪfɪˈkeɪʃn̩/
Bu videoyla nasıl çalışılır
- Videonun tamamını konuşmadan bir kez dinleyin ve bilmediğiniz kelimeleri not edin.
- Normal hızda cümle cümle tekrar edin; ritminiz konuşmacıyla aynı olana kadar her cümleyi yineleyin.
- Kendinizi kaydedin ve orijinaliyle karşılaştırın; vascular, pulse, artery gibi kelimelere özellikle dikkat edin.
Gölgeleme Tekniği Nedir?
Gölgeleme, başlangıçta profesyonel tercüman eğitimi için geliştirilen ve çok dilli Dr. Alexander Arguelles tarafından popüler hale getirilen, bilim destekli bir dil öğrenme tekniğidir. Yöntem basit ama güçlüdür: ana dili İngilizce olan bir sesi dinler ve hemen yüksek sesle tekrar edersiniz — konuşmacıyı 1-2 saniye gecikmeyle takip eden bir gölge gibi. Pasif dinleme veya dilbilgisi alıştırmalarının aksine, gölgeleme beyninizi ve ağız kaslarınızı gerçek konuşma kalıplarını eşzamanlı olarak işlemeye ve yeniden üretmeye zorlar. Araştırmalar, telaffuz doğruluğu, tonlama, ritim, bağlı konuşma, dinleme anlama ve konuşma akıcılığını önemli ölçüde geliştirdiğini göstermektedir — bu da onu IELTS Konuşma hazırlığı ve gerçek dünya İngilizce iletişimi için en etkili yöntemlerden biri yapar.