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apart study guide > Aeromedical Factors > Flashcards

Aeromedical Factors Flashcards

1
Q

When and what should you inform a flight surgeon?

A

Aircrew members will immediately inform their flight surgeon or APA (aeromedical physician assistant) when they have participated in activities or received treatment for which flying restrictions may be appropriate.

This includes exposure to any exogenous factors listed in this regulation (AR 40-8) as well as any treatment or procedure performed by a non-flight surgeon or APA.

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2
Q

What treatments or procedures performed by a non-flight surgeon or APA need to be reported to them?

A

1) Any medical or dental procedure requiring use of medication after the treatment.
2) Any medical or dental procedure requiring use of any type of anesthesia or sedation.
3) Treatment by mental health professionals, including but not limited to psychological, social, psychiatric, alcohol, or substance abuse counseling.
4) Any chiropractic or osteopathic manipulative treatment.
5) Any treatment given by a homeopath, naturopath, herbalist, or practitioner of other types of alternative medicine.
6) Any emergency room or urgent care visits.

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3
Q

What are the regulations on medication use?

A

Use of all medications will be with the knowledge of flight surgeon or APA. Self-medication is permitted only in accordance with the OTC medication APL.

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4
Q

What does AR 40-8 says about use of dietary supplements, herbal and dietary aids, and performance enhancers?

A

All supplements, herbal and dietary aids and preparations, and performance enhancers are prohibited unless cleared by the flight surgeon or APA in consultation with applicable APLs.

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5
Q

What activity requires 6 hours of restriction?

A

Centrifuge runs, with no residual effects.

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6
Q

Which activities require 12 hours of restriction?

A

ASIA

Anesthesia - local
Simulator sickness - 12 hours after full recovery
Immunizations - if no adverse reactions
Alcohol - and no residual effects

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7
Q

Which activities require 24 hours of restriction?

A

PHDS

Plasma donation
Hypobaric chamber runs above 25,000’
Decompression experience if cabin altitude will exceed 10,000’
Scuba Diving/Hyperbaric Chambers

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8
Q

What activity requires 48 hours of restriction?

A

Anesthesia - general, spinal, epidural.

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9
Q

What activity requires 72 hours of restriction?

A

Blood donation greater than 200cc.
Cannot be regular blood donors. (More than 2 times per year).

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10
Q

What does AR 40-8 say about restriction due to CS/Tear Gas?

A

No residual effects and local effects have resolved.

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11
Q

If you experience decompression sickness what are the restrictions?

A

You cannot fly until cleared by a flight surgeon.

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12
Q

What does AR 40-8 say about tobacco?

A

It degrades physical performance including vision. Aircrews are discouraged from use of tobacco.

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13
Q

What does AR 40-8 say about strenuous physical activity?

A

They may adversely affect the ability of aircrew members to perform their respective flight tasks safely.

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14
Q

What does AR 40-8 say about vision?

A

If a crewmember requires corrective lenses for 20/20 vision, they are restricted unless they are wearing contact lenses or glasses that correct to 20/20.

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15
Q

What is Hypoxia?

A

A lack of oxygen in the body.

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16
Q

What are the 4 types of hypoxia?

A

1) Hypoxic
2) Hypemic
3) Stagnant
4) Histotoxic

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17
Q

What is hypoxic hypoxia?

A

Not enough oxygen in the air (altitude).

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18
Q

What is hypemic hypoxia? What can it be caused by?

A

A reduction in the oxygen carrying capacity of the blood. There is less hemoglobin to combine with oxygen.

Can be caused by carbon monoxide, anemia, blood loss.

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19
Q

What is stagnant hypoxia? What can it be caused by?

A

Lack of circulation of oxygen through the body.

Caused by heart failure, arterial spasm, high Gs.

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20
Q

What is histotoxic hypoxia? What can it be caused by?

A

Interference with the use of oxygen by the body tissues.

Caused by alcohol, narcotics, certain poisons.

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21
Q

What are the stages of hypoxic hypoxia and what altitude and oxygen saturation is associated with each stage?

A

ICDC

Indifferent (0-10k)(90-98% O2 saturation) - Decrease in night vision at 4,000’.

Compensatory (10k-15k)(80-89% O2 saturation) - The body starts to compensate for the effects of oxygen deficiency (increase in respiration, heart rate, etc). Symptoms include: drowsiness, poor judgement, impaired coordination, and impaired efficiency.

Disturbance (15k-20k)(70-79% O2 saturation) - The body can no longer compensate for the O2 deficiency. Symptoms include: fatigue, sleepiness, dizziness, headache, breathlessness, euphoria, loss of senses, slow mental process, change in personality, or cyanosis (blue skin).

Critical (20k-25k)(60-69% O2 saturation) - Within 3-5 minutes judgement and coordination deteriorate. Symptoms include: mental confusion, dizziness, incapacitation, unconsciousness, and death.

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22
Q

How can we prevent hypoxia?

A

1) Limit time at altitude
2) Use supplemental oxygen
3) Pressurize the cabin

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23
Q

How can we treat hypoxia?

A

1) Give 100% oxygen
2) Descend below 10,000’

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24
Q

What is the definition of stress?

A

The nonspecific response of the body to any demand placed upon it.

25
Q

What is a stressor?

A

Any event which requires you to adjust or adapt in some way.

26
Q

What are the types of stressors?

A

PEP-C

Psychosocial - life events, work, illness, family issues
Environmental - altitude, speed, temp, cockpit design, etc
Physiological - self-imposed stressors (DEATH)
Cognitive - our perception of the problem

27
Q

What are the physiological (self-imposed) stressors?

A

Drugs
Exhaustion - lack of rest or physical condition
Alcohol - 1 ounce of pure alcohol = 2000’ PA
Tobacco - adds 5,000’ to physiological altitude, and decreases night vision by up to 20%
Hypoglycemia and poor nutrition

28
Q

What are the body’s responses to stress?

A

PEB-C

Physical - heart rate, blood pressure, breathing
Emotional - anxiety, irritability, depression
Behavioral - work performance, conflict, violence, suicide
Cognitive - concentration, judgement, attention, impaired memory

29
Q

What are some ways to manage stress?

A

CAV-L

Change your thinking (positive self-talk)
Avoid stressors
Venting stress (talk, physical exercise)
Learn to relax (deep breathing, meditation, hobbies)

30
Q

What is the definition of fatigue?

A

State of feeling tired, weary, or sleepy that results from prolonged mental or physical work, extended periods of anxiety, exposure to harsh environments, or loss of sleep.

31
Q

What are the different types of fatigue?

A

1) Acute
2) Chronic
3) Motivational Exhaustion/Burnout

32
Q

What is acute fatigue?

A

Type of fatigue that occurs between 2-3 regular sleep periods. It is treated with normal sleep. You can recover with 1 regular sleep cycle.
Symptoms: inattention, errors, and irritability.

33
Q

What is chronic fatigue?

A

Inadequate recovery from successive periods of acute fatigue. It may take several days to several weeks to recover.
Symptoms: insomnia, depressed mood, irritability, weight loss, poor judgement, loss of appetite, slow reaction time, and poor motivation.

34
Q

What is motivational exhaustion/burnout?

A

In this type of fatigue the body ceases to function occupationally and socially. Recovery can take months.

35
Q

What is middle ear discomfort caused by?

A

During descent, the pressure of external air is greater than the pressure in the middle ear and the eardrum is forced inward.

36
Q

What conditions make middle ear discomfort worse?

A

More susceptible with a cold or sore throat, sinusitis, etc., and descending altitude. It is more evident during rapid descents at low altitudes.

37
Q

How can middle ear discomfort be prevented?

A

1) Don’t fly with a cold, sore throat, sinusitis, etc.
2) Descend at a slow/normal rate.
3) Clear your sinuses early and often by swallowing, yawning, and tensing muscles in the throat.

38
Q

What is the treatment for middle ear discomfort?

A

1) Stop the descent and perform the Valsalva maneuver. Never do the valsalva during ascent.
2) If it’s not cleared, climb to an altitude until cleared, reduce the rate of descent and equalize the ears and sinuses frequently during ascent.
3) Contact a flight surgeon if the problem persists.

39
Q

What spatial disorientation (SD)?

A

A pilot’s erroneous perception of position, attitude, or motion in relation to the gravitational vertical or the Earth’s surface.

40
Q

What are the countermeasures and mitigation techniques for SD?

A
  • Understand risk factors and plan for preconditions before flight.
  • Employ good crew coordination
  • Assess mission environment
  • Don’t attempt visual flight below WX mins or areas of deteriorating weather
  • Maintain instrument proficiency and initiate prompt IIMC procedures if needed
  • Trust your instruments
    If SD is suspected or recognized, reference instruments with a good cross check and attempt to ignore conflicting sensory inputs
    Announce SD and transfer controls
41
Q

What are the types of SD?

A

Type 1: Uncrecognized
Type 2: Recognized
Type 3: Incapacitating

42
Q

Describe Type 1 SD?

A

(Most dangerous) - Aviator does not perceive any indication of spatial disorientation. He does not think anything is wrong - and may fail to correct the disorientation resulting in a fatal aircraft mishap.

43
Q

Describe Type 2 SD

A

The pilot perceives a problem (resulting from SD). The pilot may fail to recognize it as SD.

44
Q

Describe Type 3 SD

A

The pilot experiences such an overwhelming sensation of movement that he cannot orient himself by using visual cues or the aircraft instruments. Not fatal if co-pilot can gain control of the aircraft.

45
Q

What are the 3 systems that affect equilibrium maintenance and SD?

A

1) Visual - Most important, 80% of our orientation.
2) Vestibular - Inner ear organs (semicircular and otolith).
3) Somatosensory - Sensors in the joints, muscles, etc.

46
Q

The inner ear contains the vestibular system which contains the motion and gravity detecting sense organs. Each vestibular contains two distinct structures, what are they?

A

1) Semicircular canals
2) Otolith organs

47
Q

What do the semi-circular canals provide and how do they provide it?

A

Sense changes in angular acceleration (pitch, roll, or yaw attitude).
There is “endolymph” fluid in the canals that moves on the three planes stimulating hairs through the cupula which then is transmitted to the brain.

48
Q

What do the otolith organs provide and how do they provide it?

A

Provides gravity and linear acceleration/deceleration sensory indications. Provides it through sensory hairs that bend from movement of the otolithic membrane when under gravitational forces/accel/decel forces.

49
Q

What are the types of Vestibular Illusions and what causes each type?

A

1) Somatogryal Illusions (semicircular canals) are caused by a misperception of direction or magnitude of rotation.
2) Somatogravic Illusions (otolith organs) are caused by changes in linear acceleration/deceleration and gravity.
3) Oculoargravic Illusions - visually analogous to somatogravic illusions and occur under similar conditions.

50
Q

What are the Somatogyral Illusions?

A

1) Leans (most common)
2) Graveyard Spin (usually fixed-wing)
3) Coriolis Illusion (most dangerous)
4) Post-Roll (Gillingham Illusion)

51
Q

Describe the Leans

A

Pilot fails to perceive angular motion - rolling in and out of banking maneuvers may cause a false perception of attitude and the pilot will “lean” his body until the false sensation leaves.

52
Q

Describe the Graveyard Spin

A

The pilot enters a spin, recovers from the spin, but feels as though he is spinning in the other direction, and reenters the initial spin direction again.

53
Q

Describe the Coriolis Illusion

A

Prolonged turn is initiated and pilot makes a head motion in a different geometrical plane, can result in a head-over-heels tumbling sensation. If the controls are not quickly taken by the co-pilot, the aircraft may never recover.

54
Q

Describe the Post-Roll (Gillingham) Illusion

A

Can manifest after a roll maneuver. Pilot may initiate a roll rate into a coordinated turn, complete the maneuver, but then incorrectly provide control input to add additional bank in the same direction with the misperception of a decrease in bank.

55
Q

What are the Somatogravic Illusions?

A

1) G-Excess Illusion
2) Elevator Illusion

56
Q

Describe the G-Excess Illusion

A

Occurs in a sustained (>1) G environment with a head movement in a steep turn. If a pilot turns his/her head up to the inside of a steep turn at high G, it may be interpreted as an underbank and the pilot may overbank the aircraft with an inadvertent descent.

57
Q

Describe the Elevator Illusion

A

A type of G-excess illusion whereby a false sense of pitch may be experienced with significant upward or downward acceleration. A sudden increase in vertical G-force drives the eyeballs downward. May be perceived as nose high and dive the aircraft.

58
Q

Describe the Oculoargravic Illusion

A

Visually analogous to the somatogravic illusions and occur under similar conditions. It is due to the visual misperception of a fixed object (such as, the instrument panel) moving up or down due to acceleration or deceleration.

59
Q

Describe Alternobaric Vertigo (pressure vertigo)

A

This is not actually an illusion. Changes in atmospheric pressure can sometimes lead to vestibular dysfunction. May arise due to changes in altitude, a middle ear equilibration maneuver (Valsalva or Tyonbee), or pressure differences between the two ears. Usually only lasts 10 seconds or less.

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