跟读练习: ST Elevation and Depression on an EKG Rhythm Strip - 通过视频学习英语口语
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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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本课的词汇与口语要点
这节口语课以视频“ST Elevation and Depression on an EKG Rhythm Strip”为素材。 视频中反复出现的词有：lead, baseline, elevation, depression, tombstone。 这段视频共有 56 个句子、693 个单词可供跟读。 讲话部分时长为 4:15。 说话人语速自然，每分钟约 163 个词，接近日常对话。 只有 77% 的单词属于英语最常用的 3,000 词，词汇难度较高。
视频中的重点词汇
视频中 15 个值得学习的单词，附发音和释义：
| 单词 | 发音 | 释义 |
|---|---|---|
| baseline 名词 | /ˈbeɪslaɪn/ | 基綫 /基线 |
| segment 名词 | /ˈsɛɡmɛnt/ | 片斷 /片断, 段 |
| symptom 名词 | /ˈsɪm(p)təm/ | 症狀 /症状, 病徵 /病征 |
| curve 名词 | /kɚv/ | 彎子 /弯子 |
| activate 动词 | /ˈæktɪˌveɪt/ | 激活 |
| measurement 名词 | /ˈmɛʒ.ə.mənt/ | 尺寸 |
| acute 形容词 | /əˈkjut/ | 激烈, 敏銳 /敏锐 |
| sharp 形容词 | /ʃɑɹp/ | 銳利 /锐利, 尖銳 /尖锐 |
| reveal 动词 | /ɹɪˈviːl/ | 透露, 顯示 /显示 |
| associate 名词 | /əˈsoʊʃi.ət/ | 同行, 同事 |
| commonly 副词 | /ˈkɑmənli/ | 通常 |
| monitor 名词 | /ˈmɑ.nɪ.tɚ/ | 顯示器 /显示器 |
| indicate 动词 | /ˈɪndɪˌkeɪt/ | 表明, 表示 |
| interpretation 名词 | /ɪnˌtɜːpɹəˈteɪʃən/ | 翻譯 /翻译 |
| chronic 形容词 | /ˈkɹɑ.nɪk/ | 慢性 |
视频中出现的短语动词
| 单词 | 释义 |
|---|---|
| end up 动词 | 到达 |
| figure out 动词 | 弄清楚 |
需要注意的发音
说话人用了 12 次缩略和弱读形式，例如 we'll, you're, can't。请按听到的简短形式来说。
- “sh” 和 “zh” 音: elevation /ˌɛlɪˈveɪʃn̩/, measurement /ˈmɛʒ.ə.mənt/, sharp /ʃɑɹp/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/
- 长单词——注意重音位置: indicative /ɪnˈdɪk.ə.tɪv/, primarily /ˈpɹaɪ.mə.ɹə.li/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/, inferior /ɪnˈfɪɹ.i.ɚ/
中文母语者容易读错的音：
- /v/ — 不要读成 /w/，上齿轻触下唇: elevation /ˌɛlɪˈveɪʃn̩/, curve /kɚv/, activate /ˈæktɪˌveɪt/, indicative /ɪnˈdɪk.ə.tɪv/, reveal /ɹɪˈviːl/
- 词尾辅音 — 要读清楚，后面不要加元音: segment /ˈsɛɡmɛnt/, strip /ˈstɹɪp/, curve /kɚv/, activate /ˈæktɪˌveɪt/, indicative /ɪnˈdɪk.ə.tɪv/
- /r/ 和 /l/ 的区别: primarily /ˈpɹaɪ.mə.ɹə.li/, reveal /ɹɪˈviːl/, variable [ˈvæɹ.i.ə.bl̩], threshold /ˈθɹɛʃ(h)oʊld/
如何用这段视频练习
- 先完整听一遍视频，不要开口，记下不认识的单词。
- 先用 0.75 倍速逐句跟读，熟练之后再回到正常速度。
- 录下自己的声音并与原声对比，特别注意 baseline, segment, symptom 这类单词。
什么是跟读法？
跟读法 (Shadowing) 是一种有科学依据的语言学习技巧，最初开发用于专业口译员的培训，并由多语言者Alexander Arguelles博士普及。这个方法简单而强大：您在听英语母语原声的同时立即大声重复——就像是一个延迟1-2秒紧跟说话者的影子。与被动听力或语法练习不同，跟读法强迫您的大脑和口腔肌肉同时处理并模仿真实的讲话模式。研究表明它能显着提高发音准确性，语调，节奏，连读，听力理解和口语流利度——使其成为雅思口语备考和真实英语交流最有效的方法之一。