跟讀練習: Gynaecological Examination - 通過影片學習英語口語

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84 句

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The gynecological examination.

So continuing on our examination series, we're going to be taking a look at the gynae examination.

So when performing any examination on the patient, we always need to have a discussion prior, explain what we're going to be doing and obtain verbal consent.

We need to inform her that she will need to get undressed from the waist down, therefore we need to have an appropriate room where the patient will be able to get undressed in privacy

and we should provide the sheet so that she can cover herself.

We can ask her if she would like to empty her bladder

and also perform a pregnancy test before proceeding with the examination.

For this examination we will need to have a chaperone present with us.

Finally we need to ensure we have all our equipment prepared for the examination including a Cusco speculum,

lubricant gel, swabs used to assess for any infections and possibly a cervical smear brush.

Now we also need to prepare the couch.

This time we need to position the couch completely flat.

Then we need to make sure we wear disposable gloves as you can see here.

And then we would always start with the abdominal examination.

So here we will assess for tenderness, rebound guarding and any masses.

If you would like to see a detailed video on the abdominal examination, let me know in the comments.

Okay, so now we can start off the proper gynae examination.

So we start off by asking the patient to bend her legs and bring her heels to her buttocks, and allow her knees to fall to the sides.

This is called the modified litotomy position, and is preferred nowadays to placing the patient's legs in stirrups.

Now we can uncover the patient, and start off with inspection of the vulva.

So, here we are looking for any scars,

erythema, discoloration, masses, warts or ulcers and discharge or bleeding from the entroitis.

We can also part the labia a bit to improve our inspection.

At this point, we can also ask the patient to cough to assess for any prolapse.

Again, if you'd like to see a video from me about vaginal prolapse, leave a comment down below.

next up we've got the speculum examination

so first let's take a look at the instrument

so this is a cusco's speculum over here we have the blades the fixation screw and the handles

i like to hold the speculum as you can see here with my thumb

and index finger above the anterior blade

and my third finger below the posterior blade this gives me good stability

when handling the speculum and prevents the blades from opening before I want them to.

So next we'll look at how to insert the speculum, so of course on an actual patient we'll need to lubricate the blades of the speculum.

Then part the labia, insert the speculum on its side slowly with the blades closed

and then rotate the speculum with the handles positioned at the top.

I prefer this approach rather than having the handles facing downwards and having to fiddle with them close to the anus.

Once the speculum has been inserted all the way in, we start to open the blades under direct vision until the cervix has come into view.

Of course you must have some form of light available to see properly.

When we are happy, we can use a fixation screw to keep the speculum in place.

Once we have done this, we can inspect the cervix and the vaginal walls.

First of all, looking at the cervix, we want to identify any cervical ectropion,

any obvious masses any discharge or bleeding then we want to look at the vaginal walls

and inspect for any vaginal tears or lacerations

that is one advantage of using these transparent speculums as you

can still inspect all vaginal walls during the examination now here

i've also shown how to take a high vaginal swab

so essentially we are guiding the swab into the posterior fornix

which is location underneath the cervix and here we're taking a cervical smear

so here we are using a cervical broom the tip is inserted into the cervical loss

and is brushed in a circular motion over the cervix by

360 degrees for five turns some pressure should be applied to make sure

that the cells are sticking to your cervical broom for more

information on smears i have created a video all about this subject next we need to remove the speculum

so first we will retract the speculum slightly keeping the blades

open until we have passed the cervix then we can close the blades

and then we draw the speculum gently in the same position or rotate it again and withdraw it completely.

To perform the bimanual vaginal examination, we first lubricate two fingers.

Again, part the labia using our left hand and insert the fingers of our right hand gently into the vagina.

Now, our left hand will be placed on the abdomen so that we can bellow the structures between our two hands.

Starting off with the uterus, we want to assess the position, size and mobility of the uterus.

so back to some revision here so

when we talk about the position of the uterus we refer to version

and flexion of the uterus but what are these

so these refer to angles created by the curvature of the uterus

so the first is how the long axis of the uterus

is bent over the long axis of the vagina this refers

to version then we've got the angle created by the long axis of uterus, bent over the long axis of the cervix,

and this is referred to as flexion.

So keeping these two diagrams in mind, here we have got an antiverted uterus, with the uterus bent forwards over the vagina.

Then we have a retroverted uterus, with the uterus bent backwards over the vagina.

an anti -flexed uterus with the uterus bent forwards over the cervix

and a retroflexed uterus with the uterus bent backwards over the cervix.

So during a bimanual examination from these two images, you can appreciate how the cervix will be positioned in a different direction

and the uterus will be much harder to palpate when in a retroverted position.

now we also want to assess ferny masses

or cervical excitation cervical excitation refers to acute tenderness on palpation

of the cervix these patients might literally jump off the couch

so be careful when listing this sign some causes include pelvic inflammatory disease

or ectopic pregnancy we will then move over to the right at nexa again feeling ferny masses or adnexal tenderness,

a normal ovary will not be palpable in examination and will repeat the same on the left.

When talking about adnexal tenderness, this could be secondary to an ovarian cyst accident, such as ovarian cyst structure or ovarian torsion.

I hope you found this helpful.

If you haven't watched my previous video on the obstetric examination, you can have a look at it here.

Let me know what you think in the comments, like and subscribe.

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本課的詞彙與口語要點

這節口語課以影片“Gynaecological Examination”為素材。影片中反覆出現的詞有：uterus, examination, speculum, cervix, blade。這段影片共有 84 個句子、1203 個單詞可供跟讀。講話部分時長為 7:37。說話人語速自然，每分鐘約 158 個詞，接近日常對話。只有 74% 的單詞屬於英語最常用的 3,000 詞，詞彙難度較高。

影片中的重點詞彙

影片中 15 個值得學習的單詞，附發音和釋義：

單詞	發音	釋義
examination 名詞	/ɪɡˌzæm.ɪˈneɪ.ʃən/	檢查 /檢查
blade 名詞	/bleɪd/	刃, 刀身
bend 動詞	/bɛnd/	彎 /彎
refer 動詞	/ɹɪˈfɜː/	談到 /談到
insert 動詞	/ɪnˈsɝt/	插入, 插上
finger 名詞	/ˈfɪŋɡɚ/	手指, 指頭 /指頭
axis 名詞	/ˈæksɪs/	軸 /軸, 軸心 /軸心
vagina 名詞	/vəˈdʒaɪ.nə/	陰道 /陰道
couch 名詞	/ˈkaʊ̯t͡ʃ/	沙發 /沙發, 長沙發椅 /長沙發椅
inspect 動詞	/ɪnˈspɛkt/	調查 /調查, 檢查 /檢查
angle 名詞	/ˈæŋ.ɡəl/	角, 角度
pregnancy 名詞	/ˈpɹɛɡnənsi/	懷孕 /懷孕, 妊娠
brush 名詞	/bɹʌʃ/	刷子, 刷
inspection 名詞	/ɪnˈspɛkʃən/	檢查 /檢查
bleed 動詞	/ˈbliːd/	出血, 流血

影片中的語法

說話人最常用的結構，並附上影片中的原話：

結構	影片中的用法
被動語態 be + 過去分詞 — 強調發生了什麼，而不是誰做的	is called · has been inserted · is inserted
現在完成時 have/has + 過去分詞 — 過去發生但與現在仍有關聯的事	has been inserted · have done · i've also shown

需要注意的發音

說話人用了 10 次縮略和弱讀形式，例如 we're, we'll, we've。請按聽到的簡短形式來說。

“th” 音: underneath /ˌʌndɚˈniθ/, withdraw /wɪðˈdɹɔ/, thumb /ˈθʌm/, erythema /ˌɛɹɪˈθiːmə/
“sh” 和 “zh” 音: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, brush /bɹʌʃ/, inspection /ɪnˈspɛkʃən/, essentially /ɪˈsɛnʃəli/, sheet /ʃit/
長單詞——注意重音位置: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, essentially /ɪˈsɛnʃəli/, stability /stəˈbɪlɪti/, mobility /mə(ʊ)ˈbɪlɪti/, inflammatory /ɪnˈflæmət(ə)ɹi/

中文母語者容易讀錯的音：

/v/ — 不要讀成 /w/，上齒輕觸下唇: vagina /vəˈdʒaɪ.nə/, privacy /ˈpɹaɪ.və.si/, verbal /ˈvɜː.bəl/, revision /ɹəˈvɪʒ.ən/, glove /ɡlʌv/
詞尾子音 — 要讀清楚，後面不要加母音: blade /bleɪd/, bend /bɛnd/, assess /əˈsɛs/, insert /ɪnˈsɝt/, axis /ˈæksɪs/
/r/ 和 /l/ 的區別: circular /ˈsɜɹ.kjə.ləɹ/, inflammatory /ɪnˈflæmət(ə)ɹi/, lubricate /ˈluːbrɪkeɪt/, prolapse /ˈpɹoʊlæps/, laceration /læsəˈɹeɪʃən/

如何用這段影片練習

先完整聽一遍影片，不要開口，記下不認識的單詞。
先用 0.75 倍速逐句跟讀，熟練之後再回到正常速度。
錄下自己的聲音並與原聲對比，特別注意 examination, blade, bend 這類單詞。

什麼是跟讀法？

跟讀法 (Shadowing) 是一種有科學依據的語言學習技巧，最初開發用於專業口譯員的培訓，並由多語言者Alexander Arguelles博士普及。這個方法簡單而強大：您在聽英語母語原聲的同時立即大聲重複——就像是一個延遲1-2秒緊跟說話者的影子。與被動聽力或語法練習不同，跟讀法強迫您的大腦和口腔肌肉同時處理並模模擬實的講話模式。研究表明它能顯著提高發音準確性，語調，節奏，連讀，聽力理解和口語流利度——使其成為雅思口語備考和真實英語交流最有效的方法之一。

影子跟讀法: 閱讀完整分步指南 →

跟讀練習: Gynaecological Examination - 通過影片學習英語口語

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