跟讀練習: Retinal Artery Occlusion vs. Retinal Vein Occlusion - 通過影片學習英語口語

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Medical students hate this question, retinal artery occlusion versus retinal vein occlusion.

The reason that this is so difficult is that both of these processes will present with acute painless monocular vision loss.

And yes, we can kind of nitpick here and maybe say

that retinal vein occlusion tends to be a little bit more painful, or maybe there's some temporal sparing in retinal artery occlusion,

but the test writer knows this and they're not going to give you that.

So in your exam, the way that you're going to get this right is

if you can identify buzzwords and identify the picture when they show you the back of somebody's eye.

So the way that I think you can simplify this is let's break it down and get back to basics.

If you understand pathophysiology, this makes perfect sense.

One of these has artery in the name.

One of these has vein in the name.

Artery brings the blood to something and the vein takes it away.

So if we block the artery, blood cannot get to the retina.

If we block the vein, blood can't get out of the retina.

And if we keep it that stupid and that simple, this all makes perfect sense.

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.

A retinal vein occlusion, meaning that the blood cannot drain out of the eye, that's a drainage problem.

So, let's pause for a second, and I've got a really silly picture here at the bottom of the slide.

If blood can't get in, what physical findings would you expect to see?

And if blood can't get out, what physical findings would you expect to see so taking

that one step further in the artery occlusion

you see a pale fundus with a cherry red spot in the vein occlusion you see hemorrhage

and edema now this should make sense to you

when we look at hemorrhage and edema if blood is pooling into the eye

and can't get out through the retinal vein there will be hemorrhage and there will be edema specifically of the optic disc.

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.

If you can't get blood to part of the eye, it will appear pale.

And that should make sense to you.

Now, as far as the cherry red spot goes, here's what you want to look for.

You see the black arrow here pointing to the cherry red spot.

And something that is important to understand here is

that you see the reason that the cherry red spot is cherry red at the center,

but then pale around it is because the fovea will stay red.

And the reason that the fovea stays red is that it gets its blood supply from the posterior ciliary arteries.

It does not get its blood supply from the central retinal artery.

So basically anything that is supplied from the central retinal artery will become pale because it's ischemic,

but anything that is supplied from the posterior ciliary arteries will appear well perfused because we don't have the blockage there.

Again, in a retinal artery occlusion, the occlusion is in the retinal artery or the central retinal artery.

And this is why the fovea will be a nice dark red color, but the surrounding tissue will be pale.

Now, let's contrast that to what you see in a retinal vein occlusion.

So in a retinal vein occlusion, you're looking for optic disc edema, so the optic disc would swell, and retinal hemorrhage.

And you can see, I hope you can appreciate the very stark contrast between these two pictures.

One is showing you hemorrhage and some swelling.

The other shows you that cherry red spot with the pale fundus.

And again, if you think about this as artery occlusion equals supply problem, it's ischemic, and vein equals drainage problem,

it's buildup and swelling and hemorrhage, this really should make sense to you.

Now on your exam, they're going to show you one of these pictures, like 90 % of the time.

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.

So you really should commit this to memory.

But if you're looking at causes here,

the retinal artery occlusion typically is due to some type of thromboembolic event.

And the retinal vein occlusion is typically due to a compressive effect of nearby central retinal arteries having atherosclerosis.

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,

which prevents the retinal vein from draining properly, hence the hemorrhage, hence the edema.

But in the retinal artery occlusion, the problem is inherent to whatever thromboembolic event takes place that occludes the actual central retinal artery itself.

And that's really important to understand.

So, I've gone through this video, and so far I would say

that I've covered much of what you probably need to know for the purposes of your exam.

Again, you want to be able to identify these pictures and know that the buzzwords pale fundus, cherry red spot equals artery occlusion,

retinal hemorrhage, and optic discodema equals vein occlusion.

But if you need a way to memorize this and pair these together, I always think about artery is red and vein is blue.

That's just how it is in my head, probably from years of studying this way.

So the way that I memorize this is when I think about a pale fundus with a cherry red spot,

pale to me pales like a bucket.

So I think about a bucket or a pale filled with cherries.

And then I associate pale fundus, cherry red spot with red,

you know, everything else by process of elimination would be a retinal vein.

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.

That's a supply problem.

So, you're looking for ischemic symptoms.

If the vein is occluded, blood can't get out.

That's a drainage problem.

You're looking for hemorrhage and edema type symptoms.

If you can keep that straight, then when you look at these images,

you can kind of guess based on which blood vessel looks more engorged versus which one looks more like a cherry.

So there you go.

Good luck.

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本課的詞彙與口語要點

這節口語課以影片“Retinal Artery Occlusion vs. Retinal Vein Occlusion”為素材。影片中反覆出現的詞有：retinal, artery, occlusion, vein, blood。這段影片共有 77 個句子、1105 個單詞可供跟讀。講話部分時長為 6:33。說話人語速自然，每分鐘約 169 個詞，接近日常對話。只有 75% 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
artery 名詞	/ˈɑɹ.təɹ.i/	動脈 /動脈
vein 名詞	/veɪn/	靜脈 /靜脈
cherry 名詞	/ˈt͡ʃɛɹi/	櫻桃 /櫻桃
pale 形容詞	/peɪl/	蒼白 /蒼白, 白皙
optic 形容詞	/ˈɑp.tɪk/	視覺的 /視覺的
examination 名詞	/ɪɡˌzæm.ɪˈneɪ.ʃən/	檢查 /檢查
disk 名詞	/dɪsk/	圓盤 /圓盤
drainage 名詞	/ˈdɹeɪnəd͡ʒ/	排水
swell 動詞	/swɛl/	膨脹 /膨脹, 擴大 /擴大
contrast 名詞	/kənˈt(ʃ)ɹæst/	對比度
hence 副詞	/ˈhɛns/	從這裡 /從這裡, 從這兒 /從這兒
versus	/ˈvɝsəs/	對 /對
bucket 名詞	/ˈbʌkɪt/	水桶, 吊桶
symptom 名詞	/ˈsɪm(p)təm/	症狀 /症狀, 病徵 /病徵
associate 名詞	/əˈsoʊʃi.ət/	同行, 同事

影片中出現的短語動詞

單詞	釋義
go through 動詞	通過 /通過

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 let · is blocked · is supplied
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	I've gone · I've covered

需要注意的發音

說話人用了 20 次縮略和弱讀形式，例如 can't, you're, I've。請按聽到的簡短形式來說。

“sh” 和 “zh” 音: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, contrast /kənˈt(ʃ)ɹæst/, associate /əˈsoʊʃi.ət/, tissue /ˈtɪʃ.(j)u/, elimination /ɪlɪmɪˈneɪʃ(ə)n/
長單詞——注意重音位置: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, associate /əˈsoʊʃi.ət/, elimination /ɪlɪmɪˈneɪʃ(ə)n/, ciliary /ˈsɪl.iˌɛɹ.i/, posterior /poʊˈstɪɹ.i.ɚ/

中文母語者容易讀錯的音：

/v/ — 不要讀成 /w/，上齒輕觸下唇: vein /veɪn/, versus /ˈvɝsəs/, vessel /ˈvɛsəl/, fovea /ˈfəʊ.vi.ə/, compressive /kəmˈpɹɛsɪv/
詞尾子音 — 要讀清楚，後面不要加母音: optic /ˈɑp.tɪk/, disk /dɪsk/, drainage /ˈdɹeɪnəd͡ʒ/, contrast /kənˈt(ʃ)ɹæst/, hence /ˈhɛns/
/r/ 和 /l/ 的區別: temporal /ˈtɛm.pə.ɹəl/, retinal /ˈɹɛt.ən.əl/, ciliary /ˈsɪl.iˌɛɹ.i/, atherosclerosis /ˌæθɚoʊskləˈɹoʊsəs/, monocular /məˈnɑkjələɹ/

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 artery, vein, cherry 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: Retinal Artery Occlusion vs. Retinal Vein Occlusion - 通過影片學習英語口語

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