跟讀練習: ST Elevation and Depression on an EKG Rhythm Strip - 通過影片學習英語口語
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56 句
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In this video, we'll take a look at ST segment changes.
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How do we identify and measure ST elevation and depression?
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And what does it mean for our patient?
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The ST segment is the space between the QRS and the T wave.
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It should be resting comfortably on the baseline, but in some strips you may see it above or below the baseline.
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When you're checking location of the ST segment, sometimes it seems a little variable.
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But what we're basing this measurement on is where the J -point is.
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That's the junction between the QRS and the ST segment.
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It's where we stopped measuring the QRS complex.
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So start by identifying where the baseline is.
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Where does your PR segment rest?
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And where does your diastolic phase between the T -wave and the P -wave come to rest?
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That's your baseline.
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Now, is the J -point on, below, or above the baseline.
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The threshold for this is one millimeter or more elevated or depressed,
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so one small box above or below the baseline is considered significant and warrants noting on the interpretation.
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Take your calipers.
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Place one point on the baseline and one point on the J -point.
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You're measuring vertically for this, so take that measurement to a nice clear area where you can count the small boxes.
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Vertically, each box represents one millimeter, so count the boxes and note ST elevation or depression
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if you have at least one full small box or one millimeter of change from the baseline.
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For this strip we have elevation.
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The J point is three small boxes above the baseline.
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So it's a three millimeter ST elevation.
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For this strip we have depression.
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The J point is two small boxes below the baseline.
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So it's a two millimeter ST depression.
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A lot of elevation and depression is chronic, and is indicative of some level of ischemic damage.
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You can get a lot more specific with that
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if you do a 12 -lead and look at how the ST changes appear on a number of different leads,
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but on a 3 and 5 -lead monitor, we'll just say they indicate ischemia.
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There are a couple of findings that are a bit more concerning, though.
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If you see acute elevation, meaning it wasn't there before, and after the J -point you see a convex curve,
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meaning after the j -point the tracing goes back up before returning to the baseline.
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It ends up taking on a shape known commonly as a tombstone.
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When you see tombstones, think heart attack.
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The tombstone shape won't always show in every lead.
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Depending on where the infarct is, the tombstone will show itself in the associated leads, and others may show nothing.
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Here's an example of a 12 -lead EKG.
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If we were looking at lead 2, we would have seen a tombstone shape appear for our patient.
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But if we were looking at lead 1, it's only showing a minor depression.
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Some other leads, like 3 or AVF, are showing the tombstone, but the rest are showing depression or sometimes no change at all.
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This EKG may be indicative of an inferior wall MI,
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which can be figured out based on which leads are showing the elevation changes and which are not.
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That being Having said, we'll only be viewing leads 1, 2, 3, AVR, AVL, AVF and V1 on our 5 -lead setup.
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And primarily, we'll be looking at lead 2.
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So we can't see every infarct with a 5 -lead setup.
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But when you do see it, check your patient for symptoms and activate the emergency response.
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If the patient is showing symptoms, even if the 5 -lead isn't showing any elevation, activate the emergency response.
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The 12 -lead may reveal what we couldn't see with the 5.
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Another acute change you may see is when after the J -point, the ST segment curves down into a concave curve.
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It can be indicative of pericarditis.
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This ST change is usually widespread across many leads.
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Pericarditis is inflammation of the pericardial sac surrounding the heart.
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Symptoms include sharp chest pains, much like infarction.
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So again, if you see this ST change on your strip, check your patient for symptoms and activate the emergency response.
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本課的詞彙與口語要點
這節口語課以影片“ST Elevation and Depression on an EKG Rhythm Strip”為素材。 影片中反覆出現的詞有：lead, baseline, elevation, depression, tombstone。 這段影片共有 56 個句子、693 個單詞可供跟讀。 講話部分時長為 4:15。 說話人語速自然，每分鐘約 163 個詞，接近日常對話。 只有 77% 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 |
|---|---|---|
| baseline 名詞 | /ˈbeɪslaɪn/ | 基綫 /基線 |
| segment 名詞 | /ˈsɛɡmɛnt/ | 片斷 /片斷, 段 |
| symptom 名詞 | /ˈsɪm(p)təm/ | 症狀 /症狀, 病徵 /病徵 |
| curve 名詞 | /kɚv/ | 彎子 /彎子 |
| activate 動詞 | /ˈæktɪˌveɪt/ | 啟用 |
| measurement 名詞 | /ˈmɛʒ.ə.mənt/ | 尺寸 |
| acute 形容詞 | /əˈkjut/ | 激烈, 敏銳 /敏銳 |
| sharp 形容詞 | /ʃɑɹp/ | 銳利 /銳利, 尖銳 /尖銳 |
| reveal 動詞 | /ɹɪˈviːl/ | 透露, 顯示 /顯示 |
| associate 名詞 | /əˈsoʊʃi.ət/ | 同行, 同事 |
| commonly 副詞 | /ˈkɑmənli/ | 通常 |
| monitor 名詞 | /ˈmɑ.nɪ.tɚ/ | 顯示器 /顯示器 |
| indicate 動詞 | /ˈɪndɪˌkeɪt/ | 表明, 表示 |
| interpretation 名詞 | /ɪnˌtɜːpɹəˈteɪʃən/ | 翻譯 /翻譯 |
| chronic 形容詞 | /ˈkɹɑ.nɪk/ | 慢性 |
影片中出現的短語動詞
| 單詞 | 釋義 |
|---|---|
| end up 動詞 | 到達 |
| figure out 動詞 | 弄清楚 |
需要注意的發音
說話人用了 12 次縮略和弱讀形式，例如 we'll, you're, can't。請按聽到的簡短形式來說。
- “sh” 和 “zh” 音: elevation /ˌɛlɪˈveɪʃn̩/, measurement /ˈmɛʒ.ə.mənt/, sharp /ʃɑɹp/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/
- 長單詞——注意重音位置: indicative /ɪnˈdɪk.ə.tɪv/, primarily /ˈpɹaɪ.mə.ɹə.li/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/, inferior /ɪnˈfɪɹ.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: elevation /ˌɛlɪˈveɪʃn̩/, curve /kɚv/, activate /ˈæktɪˌveɪt/, indicative /ɪnˈdɪk.ə.tɪv/, reveal /ɹɪˈviːl/
- 詞尾子音 — 要讀清楚，後面不要加母音: segment /ˈsɛɡmɛnt/, strip /ˈstɹɪp/, curve /kɚv/, activate /ˈæktɪˌveɪt/, indicative /ɪnˈdɪk.ə.tɪv/
- /r/ 和 /l/ 的區別: primarily /ˈpɹaɪ.mə.ɹə.li/, reveal /ɹɪˈviːl/, variable [ˈvæɹ.i.ə.bl̩], threshold /ˈθɹɛʃ(h)oʊld/
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 baseline, segment, symptom 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。