常常有病人問醫生：「哪種枕頭最適合我？」事實上，沒有一個答案適用於所有的人。沒有一種枕頭適用於所有的人。下面我們就談談不同類型的枕頭以及各自的優缺點，然後再與你的私人保健醫生討論決定最適合於你的一個或一系列的枕頭。
警告：請在有WIFI的場所觀看視頻，土豪請隨意。
The main benefit of a pillow really is for comfort and support. You want to support the neck, support the spine, but also feel well rested when you wake up so it has to be comfortable.
枕頭最大的好處實際上是舒適和支撐。你希望支撐頸部，支撐脊柱，同時當你醒來時會感覺休息得很好，所以枕頭必須很舒適。
For optimum support, it is best to select a pillow that is designed to keep the spine in neutral alignment – that is in a neutral position, a straight line basically.
在支撐作用這一選項上，最好選一個根據脊柱正常生理曲度設計的枕頭，因為那是自然的位置，基本上是連續的線。
Any cervical pillow that’s too high will cause a malalignment of the cervical spine and can cause pain upon waking in the morning or even throughout the night because this strain and this pain can wake you up from your sleep. The same thing goes for any pillow that is too flat or too low in which the neck will bend the other direction towards the pillow and lead to malalignment.
頸椎枕如果太高，就會引起頸椎排列不齊，這樣早晨醒來時就會引起疼痛，甚至一晚上都在痛，因為這種張力和疼痛會使你從睡夢中醒來。同樣如果枕頭太平、太低，頸椎就會彎向另一方向，朝向枕頭，導致排列不齊。
The pillow has to feel comfortable, you have to feel well rested, and it has to be adjustable – meaning it has to conform to various sleep positions. Most people don’t stay in one position all night long and, therefore, if you change positions the pillow has to accommodate those changes – it has to move with you.
枕頭必須讓人感覺舒適，睡醒後你應該感覺到休息得很好。而且枕頭需要調整，也就是說應該符合不同的睡眠體位。很少有人一晚上睡覺都採用一種姿勢，因此，當您改變體位時，枕頭需要與這種變化相適應，它必須與你一起移動。
There are several additional types of pillows that can be used, for example a knee pillow. A knee pillow simply refers to a regular pillow that’s placed under knees if you are a back-lier and a back-sleeper and the knee flexion will actually cause a flattening out of the lumbar spine – the lower back.
另外還可以使用一些其它類型的枕頭。例如膝枕。膝枕是指放在膝關節後面的普通的枕頭。如果仰天躺或仰天睡，膝關節屈曲可以使腰椎曲度變平。
Body pillows can also be used. Now, a body pillow can be an elongated pillow that’s used to cradle the upper body and knees and the knees can be draped over the pillow. This can also help keep the spine in a neutral position.
身體枕也可使用。現在，身體枕可以是狹長的，可用於支撐上身和膝關節，膝關節跨過枕頭。這也可以使脊柱保持自然的位置。
There’s also contoured neck pillows; these are also called cervical pillows or orthopedic pillows. This is a pillow that has a deeper depression in the center than the edges, which allows for more of a natural contour of the cervical spine. This is not the end-all-be-all of pillows.
還有一種波浪型的頸部枕，被稱為頸椎枕或骨科枕。這種枕頭中間比邊緣低，更符合頸椎自然輪廓。這並不是終極完美的枕頭。
Some people swear by them and others really can’t stand them, so it just depends if it works for you. It may be something you want to try first before investing into a pillow like this because oftentimes they can be expensive.
有些人信賴它們，而另一些人不能忍受它們，因此這取決於它們對你是否適用。當你想要購買這種枕頭前，最好先試用一下，因為通常這種枕頭比較昂貴。
Travel pillows can also be useful. A travel pillow is simply a 「U」 shaped pillow that can be used when you are in the upright or seated position, whether it be in a car or an airplane. What it does is it allows you – not necessarily to sleep better – but to rest and to stay in that seated position for an extended period of time, but take some of the stress off the neck in traveling.
旅行枕有時也很有用。旅行枕呈「U」形，無論你是坐車或乘飛機，當你處於直立或坐位時可以使用。它的作用並不是讓你睡得更香，而是讓你在漫長的旅途中，坐在座位上減少頸部的緊張，使你可以休息得更好。
There’s also other pillows such as lumbar support pillows or low back pillows, which are also intended to be used when you are in the seated position. These pillows are placed behind the back over the lumbar spine – the lower spine – in order to help encourage the normal lordotic curve of the lumbar spine and provide support.
另外還有些枕頭比如腰部支撐枕，即腰墊，也適用於你坐著的體位。這類枕頭放於背後腰段脊柱上，目的是保持正常腰椎前凸的曲線並提供支撐作用。
Lastly, a donut pillow can be appropriate for people who suffer from a specific condition, such as coccydynia - which is pain of the tailbone, pain of the coccyx. Sitting on a donut pillow simply takes pressure off of that area of the spine.
最近，一種圓環枕適用於一些特殊病情的人，比如尾骨痛，就是尾巴骨部位的疼痛，坐在圓環枕上，可以去除脊柱的這個區域的壓力。
Proper pillow selection is more of an art than a science – it’s a process of trial and error. So, you may try something and it may work or it may not, but the point is that not one pillow will work for all people. Try different things. See what works. If it feels right, it’s probably right for you.
選擇合適的枕頭與其說是科學，不如說是門藝術。它是種嘗試與失敗的過程。因此，你可多試試，它是否對你有效。要知道沒有一種枕頭適用於所有的人。試試不同的，看看是否合適，如果感覺好，那可能對你是合適的。
（胡佰文 譯）
A3型題 以下提供若干個案例，每個案例下設若干道考題。請根據答案所提供的信息，在每一道考題下面的A、B、C、D、E五個備選答案中選擇一個最佳答案。
1~4題共用題幹 男性，27歲，3天前搬重物後感腰痛，伴右下肢放射痛，咳嗽、噴嚏時症狀加重，不能下床活動，以前無類似發作史。查體：腰椎生理弧度消失，活動明顯受限，直腿抬高僅達40度，加強試驗陽性，右足外側外踝部皮膚感覺過敏，右跟腱反射減弱，X線平片除腰椎生理弧度消失外，未見其他異常，尿常規正常
1.醫師在分析病情時下列哪一項是錯誤的
A.腰5神經根受壓常表現有伸踇肌力減弱
B.腰5 / 骶1椎間盤突出通常是骶1神經根受壓
C.腰5 / 骶l椎間盤突出，感覺異常區在外踝部和足外側
D.踝反射異常表示腰5神經根受壓
E.脛前肌肌力減弱常見於腰34椎間盤突出
2.其診斷首先考慮為
A.急性腰扭傷
B.急性腰椎小關節功能紊亂
C.腰椎弓根峽部骨折
D.腰4 / 5椎間盤突出
E.腰5 / 骶l椎間盤突出
3.下列措施中哪一項不適宜採用
A.手術治療，椎板開窗減壓、髓核摘除
B.臥硬板床休息及藥物治療
C.骨盆牽引及理療
D.封閉治療(硬膜外注射類固醇藥物)
E.硬膜外麻醉下推拿
4.經過一階段治療，症狀緩解後，首選的康復預防措施為
A.增加營養，增強抵抗力
B.禁止彎腰活動
C.減輕體重
D.腰背肌肉力量鍛鍊
E.下肢肌力鍛鍊
5~7題共用題幹 男性，60歲，搬運工人，因間歇性跛行1年，加重1個月來就診，無菸酒嗜好，亦無外傷史。
5.首先考慮的診斷為
A.先天性心臟畸形，伴右向左分流
B.動脈閉塞性脈管炎
C.腰臀部軟組織勞損
D.腰椎管狹窄症
E.腰椎間盤突出症
6.體格檢查最可能發現的是
A.直腿抬高試驗陽性
B.足背動脈搏動明顯減弱
C.口唇發紺
D.腰臀部明顯壓痛點
E.腰腿部無明顯陽性體徵
7.最適合的輔助檢查是
A.腰椎正側位X線片
B.肌電圖
C.腰椎CT
D.MRI
E.腰椎X線平片
8~10題共用題幹 男孩，12歲，左大腿下端持續劇痛伴高熱3天，寒戰，頭痛，食慾差。查體:體溫39度，左大腿下端稍腫，局部皮溫高，深壓痛，右膝活動時疼痛加重。化驗檢查:白細胞1.8*10 9/L，中性粒細胞75%
8.對確診最有價值的輔助檢查是
A.局部分層穿刺
B.結核菌素試驗
C.X線片檢查
D.膝關節穿刺
E.肌肉活檢
9.若本患者確診為急性骨髓炎，在細菌培養及藥物敏感試驗得出報告以前，下列最佳的抗生素應用方案是
A.廣譜抗生素
B.一種針對陽性球菌，另一種為廣譜抗生素
C.一種針對陰性桿菌，另一種為廣譜抗生素
D.窄譜針對陽性球菌有效的抗生素
E.針對陰性桿菌的抗生素
10.患者病情好轉後，抗生素停止使用的指徵是
A.白細胞正常後2~3周
B.血沉正常後2~3周
C.傷口癒合後2~3周
D.血紅蛋白恢復正常後2~3周
E.體溫恢復正常後2~3周