HPL – Basics of aviation physiology and health maintenance – EASA: 040 02 00 00

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HPL – Basics of aviation physiology and health maintenance

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040 02 01 00 Basics of flight physiology

040 02 01 01 – The atmosphere

(1) The volume percentage of the gasses in the ambient air remain constant at all altitudes which conventional aircraft operate

040 02 01 02 – Respiratory and circulatory system.

(1) List the main components of the respiratory system and their function.

Pharynx – larynx – Trachea – 2 Bronchi to 2 lung Alveoli  
  • Pharynx
    Cavity behind mouth and nose
  • Larynx
    Respiratory tract containing the vocal chords
  • Trachea
    Wind pipe
  • Bronchi
    Tubes that diverge from the trachea – one to each lung.
  • Alveoli
    Air sacks of the lungs which do the gas transfer

(2) Identify the different volumes of air in the lungs and state the normal respiratory rate.

12 breaths per minute (Padpilot) 18 (CATS) 12-20 (Oxford) 12-16 (BristolGS)
  • Total lung capacity
    6L
  • Residual
    1.4L
  • Tidal
    0.5L – each normal breath.
  • Functional residual
    2.5 – 3L This is the expiratory reserve volume plus residual
  • Inspiratory reserve volume
    3L
  • Expiratory reserve volume
    1.5L

(3) Explain the role of carbon dioxide in the control and regulation of respiration.

CO2 levels in the blood change more rapidly than oxygen levels so CO2  is used to regulate oxygen levels and therefore respiration rate.

(4) Describe the basic processes of external respiration and internal respiration.

External – The process of taking oxygen from the air, diffusing it into the blood stream and expelling unwanted gasses. Internal – The exchange of oxygen and carbon dioxide across the membrane of each cell, CO2 subsequently sent back to the lungs.

(5) List the factors that determine pulse rate. (8)

Exercise, emotions, age, decreases with age then increases toward old age, body temperature increase, blood pressure increase, pain and digestion.

(6) Name the major components of the circulatory system and describe their function. (3)

Heart (pumps blood around the body), arteries (carry oxygenated blood to organs and tissues), veins (carry de-oxygenated blood back)

(7) State the values for a normal pulse rate and the average cardiac output of an adult at rest. (3)

70bpm, cardiac output = heart rate × stroke volume (about 75ml = 0.075) Litres per minute. 5.2 L/minute.

(8) Define ‘systolic’ and ‘diastolic’ blood pressure.

Systolic is the pressure when the heart contracts (120mmHg -ish). Diastolic is when the heart is relaxed (80mmHg -ish).

(9) State the values for a normal blood pressure range

120/80.

(10) List the main constituents of blood and describe their functions.

Red blood cells carry oxygen, white blood cells fight infection and plasma is the transporting fluid and (CO2 nutrients and hormones). Platelets clot blood.

(11) Stress the function of haemoglobin in the circulatory system.

Haemoglobin greatly increases the oxygen carrying capabilities of red blood cells. Oxygen sticks to it.

(12) Define ‘anaemia’ and state its common causes.

Lack of red blood cells or haemoglobin – can be caused by blood loss, iron deficiency, peptic ulcers and pregnancy. Also sickle-cell anaemia, common in Afro-Caribbeans

(13) Indicate the effect of increasing altitude on haemoglobin oxygen saturation.

The internet says this, The amount of haemoglobin in blood increases at high altitude. This is one of the best-known features of acclimatisation (acclimation) to high altitude. Increasing the amount of haemoglobin in the blood increases the amount of oxygen that can be carried. However, there is a downside: when there is too much haemoglobin, blood becomes sticky and viscous and it is harder for the heart to pump the blood around the body. https://www.altitude.org/high-altitude 

Hypertension and hypotension

(14) Define ‘hypertension’ and ‘hypotension’.

Abnormally high (>140/90 CAA) and low blood pressure.

(15) List the effects that high (2) and low blood pressure (4) will have on some normal functions of the human body.

High – Thickening and reduced strength of the heart muscle and thickening and narrowing of the blood vessels. Low – dizziness, shortness of breath, fainting and coma

(16) Hyper and hypo tension can disqualify a pilot form gaining a medical certificate.

(17) List the factors which can lead to hypertension for an individual.

Age, hereditary factors, obesity, booze, smoking, stress, oral contraceptive, salt and lack of exercise and certain medical conditions

(18) State the corrective actions that may be taken to reduce high blood pressure..

Drugs and addressing the causes.

(19) Hypertension is the major factor of strokes in the general population.

Coronary artery disease

(20) Differentiate between ‘angina’ and ‘heart attack’..

Angina is chest pain normally during exercise caused by progressive narrowing of the arteries and veins. A heart attack is the complete blocking of the coronary artery

(21) Explain the major risk factors for coronary disease. (5)

Hypertension, high cholesterol, obesity, smoking and lack of exercise.

(22) State the role physical exercise plays in reducing the chances of developing coronary disease. (5)

Strengthens the heart muscle, improves circulation, increases red blood cells, improves blood flow and reduces blood pressure

Hypoxia

(23) Define the two major forms of hypoxia (hypoxic and anaemic), and the common causes of both.

Hypoxic – low oxygen saturation levels – reduced atmospheric pressure, also infections, airway blockage and drug overdose. Anaemic hypoxia is a reduced ability of the blood to carry oxygen, CO poisoning, low haemoglobin. Also trauma, blood donation and disorders.

(24) State the symptoms of hypoxia. (12)

  • T
    Tingling in hands and feet
  • C
    Cyanosis – blue discolouration
  • I
    Increased breathing rate.
  • H
    Headache, nausea, light headedness, sissiness, sweating.
  • I
    Irritability or euphoria
  • I
    Impaired vision
  • I
    Impaired judgement.
  • I
    Impaired motor skills
  • M
    Memory loss,
  • D
    Difficulty concentrating

(25) State that healthy people are able to compensate for altitudes up to approximately -

 10 000–12 000 ft.

(26) Name the three physiological thresholds and allocate the corresponding altitudes for each of them:

  • R
    Reaction threshold (7,000 ft)
  • D
    Disturbance threshold (10-12,000 ft)
  • C
    Critical threshold (22,000 ft)

(27) State the altitude at which short-term memory begins to be affected by hypoxia.

12 000ft but may begin at 8,000 ft or 5000ft (PadPilot)

(28) Define the terms:

  • ‘Time of useful consciousness’ (TUC)
    This is the time available for the development of hypoxia and the pilot to do something about it.
  • ‘Effective performance time’ (EPT).
    Effective Performance Time is always within and shorter than TUC. Its quantification, however, is not possible since it will depend upon the individual, the task in hand, physiological and mental stress, altitude and the circumstances involved. PadPilot says these two are the same…

Note: some texts state these are the same thing.

(29) State that TUC varies among individuals, but the approximate values for a person seated (at rest) are:

  • 20,000 ft
    30 mins
  • 30,000 ft
    1-2 mins
  • 35,000 ft
    30-90 seconds
  • 40,000 ft
    15-20 seconds

(30) The severity of hypoxia depends on:

  • R
    Rapidness of onset
  • S
    Severity of the hypoxic conditions
  • P
    Level of physical activity or workload
  • H
    Individual healh
  • W
    Weight
  • H
    Individual healh
  • T
    Temperature
  • B
    Booze
  • I
    Illness

(31) State the equivalent altitudes when breathing ambient air and 100 % oxygen at mean sea level (MSL) and at approximately 10 000, 30 000 and 40 000 ft. ????????

  • MSL
    103 mmHg
  • 10,000 ft
    55mmHg (limit for gaseous exchange)
  • 30,000 ft
    100% oxygen to remain at 103mmHg
  • ”100%

Hyperventilation

(32) Describe the roll of carbon dioxide in hyperventilationLack of CO2 in the blood caused by excess exhaust increasing the blood’s alkalinity

(33) Define the term ‘hyperventilation’.

The state of breathing faster than is necessary for the body’s current demand for oxygen.

(34) List the factors that cause hyperventilation:

  • V
    Voluntary over treating
  • S
    Strokes and brain injury
  • S
    Stress and anxiety

(35) State that hyperventilation may be caused by psychological or physiological reasons.

(36) List the signs and symptoms of hyperventilation.

  • R
    Raping breathing rate
  • F
    Feeling light headed and dizzy
  • T
    Tingling
  • H
    Hot or cold flushes
  • H
    Headache
  • I
    Impaired performance

(37) List the measures which may be taken to counteract hyperventilation:

  • B
    Breath slowly,
  • C
    Close one opening of the nose,
  • S
    Speak loudly,
  • P
    Place a paper bag over nose and mouth.

Decompression sickness

(38) State the normal range of cabin pressure altitude in pressurised commercial air transport aircraft and describe its protective function for aircrew and passengers.

6,000 to 8,000 ft. Maintaining a survivable atmosphere.

(39) List the vital actions the crew has to perform when cabin pressurisation is lost and state that decompression sickness symptoms can occur up to 24 hours later.

  • O
    Oxygen masks on
  • E
    Emergency descent
  • L
    Land ASAP
  • N
    No further flight for 24 hours.

(40) Identify the causes of decompression sickness in flight operation.

Nitrogen is absorbed into tissues and blood plasma, reduced pressure causes it to come out of solution forming bubbles, they get larger forming embolisms and get trapped at pinch points – elbows and knees thus blocking the passage of blood.

(41) State how decompression sickness can be prevented.

Stay below 14,000 ft cabin altitude.

(42) List the symptoms of decompression sickness (bends, creeps, chokes, staggers).

  • B
    Bends, embolisms in the joints cause arthritis type pain.
  • C
    Creeps, embolisms in the capillaries causes a feeling of insects under the skin.
  • C
    Chokes, a large embolism in the lungs, chest pain the cough, signs of hypoxia. Embolism can make its way into the heart and this can be curtains….
  • S
    Staggers, Disturbances in walking caused by embolisms in the capillaries of the brain.

(43) Indicate how decompression sickness may be treated..

Increase ambient pressure in all cases.

(44) Define the hazards of diving and flying, and give the recommendations associated with these activities.

  • N
    Diving causes more Nitrogen to be dissolved
  • N
    No flying within 12 hours of shallow diving with compressed air.
  • N
    No flying within 24 hours if diving >30 ft using compressed air.

Acceleration

(45) Define ‘linear acceleration’ and ‘angular acceleration’.

  • Linear acceleration
    Gx – The rate of change of velocity without change in direction.
  • Angular acceleration
    Gz – The rate of change in angular velocity, usually measured in degrees or radians.

(46) Describe the effects of z-acceleration on the circulation and blood volume distribution..

Z or angular acceleration, pitch up, reduces blood circulation to the head.

(47) List factors that determine the effects of acceleration on the human body.

magnitude, duration and speed of onset

(48) List the effects of positive acceleration with respect to type, sequence and corresponding G-load:

  • H
    Heaviness
  • S
    Skin pulled down.
  • L
    Loss of vision
  • F
    Fatigue and drowsiness
  • B
    Breathing difficulty
  • A
    All vision lost.
  • L
    Loss of consciousness.

Carbon monoxide

(49) State how carbon monoxide is produced.

Incomplete combustion of fuel

(50)  State how the presence of carbon monoxide in the blood affects the distribution of oxygen.

It binds t readily to red blood cells preventing oxygen from being absorbed

(51) List the signs and symptoms of carbon-monoxide poisoning.

  • H
    Headache
  • D
    Dizziness.
  • F
    Loss of vision
  • F
    Flu-like symptoms
  • N
    Nausia
  • A
    Abdominal pain.
  • S
    Sore throat, dry cough.

(52) Explain immediate countermeasures on suspicion of carbon-monoxide poisoning and how poisoning can be treated later on the ground.

  • C
    Close hot air vents
  • T
    Turn off cabin heating
  • O
    Open windows.

040 02 01 03 – High altitude environment.

(1) State how an increase in altitude may change the proportion of ozone in the atmosphere and that aircraft can be equipped with special ozone removers.

Radiation

(2) State the sources of radiation at high altitude.

Galactic (from outside the solar system) and Cosmic (low energy from the sun) radiation.

(3) List the effects of excessive exposure to radiation.

Damage DNA, central nervous system and cause cancer

Humidity

(4) List the factors that affect the relative humidity of both the atmosphere and cabin air.

Warm air can hold more water, at high altitudes there is therefore less moisture in the cabin and the atmosphere.

(5) List the effects of low humidity on human body

Spurious thirst, dry eyes, dry skin, dry mucus membranes – Drink water use eye drops and aqueous cream,

040 02 02 00 – People and the environment: the sensory system

040 02 02 01 – The different senses.

(1) List the different senses. (9)

Sight, hearing, taste, smell, touch, accelerations, temperature, body position, pain.

040 02 02 02 – The Central, peripheral and autonomic nervous system.

(1) Define the term ‘sensory threshold’.

Above which a neurone can transmit

(2) Define the term ‘sensitivity’, especially in the context of vision.’.

The eye will detect light reflection and transmit to the brain

(3) Give examples of sensory adaptation..

Wearing a watch.

(4) Define the term ‘habituation’ and state its implication for flight safety..

Lasts longer than adaptation, it’s not dependant on short term physiological changes, you may not then notice then stimulus.

040 02 02 03 – Vision.

Functional anatomy

(1) Name the most important parts of the eye and the pathway to the visual cortex. (8)

Cornea > lens > retina (rods and cones inside) > optic nerve > visual cortex in the back of the brain

(2) State the basic functions of the parts of the eye.

The cornea and lens focus light onto the retina. Lens fine tunes focus. Rods/cones detect black and white and colour. The iris controls amount of night.

(3) Define ‘accommodation’.

is the contraction and relaxation of the ciliary muscle which changes the shape and focal length

(4) Distinguish between the functions of the rod and cone cells.

rods black & white, cones colours

(5) Describe the distribution of rod and cone cells in the retina and explain their relevance to vision.

Cones are central, rods are peripheral

The fovea (fovea centralis) and peripheral vision

(6) Explain the terms and explain their function in the process of vision:

  • ‘visual acuity’,
    Small details – highest in the fovea
  • ‘visual field’,
    The entire area you can see at any one time
  • ‘central vision’,
    Provided by the fovea, primarily cones, peripheral vision at the edges of the visual field
  • ‘peripheral vision’,
    Image falls further away from the fovea
  • ‘‘the fovea’,
    Central region of the retina, densely packed with cones.

(7) List the factors that may degrade visual acuity and the importance of ‘lookout’.

Smoking, hypoxia, age, cataracts,damage to the retina. Lookout relies the motion-detection capability of the peripheral vision

(8) State the limitations of night vision and the different scanning techniques at both night and day.

At night – rods take over – so look off centre.

(9) State the time necessary for the eye to adapt both to dark and bright light.

10 seconds

(10) State the effect of hypoxia, smoking and altitude in excess of 5 000 ft on night vision.

Reduces night vision

(11) Explain the nature of colour blindness.

Inability to detect, or distinguish between some colours.

Binocular and monocular vision

(12) Distinguish between monocular and binocular vision.

Monocular – one eyed vision lacking stereoscopic cues, near field depth perception, non-stereoscopic cues give far-field depth perception. Stereoscopic vision achieved by a slight difference in perspective.

(13) Explain the basis of depth perception and its relevance to flight performance.

Obtained from stereoscopic and other cues: colour, contrast, relative size and motion.

(14) List the possible monocular cues for depth perception.

Colour, contrast, relative size and motion.

(15) State that for high-energy blue light and UV rays, sunglasses can prevent damage to the retina.

Defective vision

(16) Explain long-sightedness, short-sightedness and astigmatism:

  • L
    Long – Hyperopia – inability to focus on near objects – convex corrective lens to point focus forward on to the retina
  • S
    Short – myopia – inability to focus on far objects – convex corrective lens to bring the lens’ point of focus onto the the retina
  • A
    Astigmatism – imperfections in the curvature of the cornea or the lens, causes variations in power between areas  

(17) List the causes of and the precautions that may be taken to reduce the probability of vision loss due to:

  • Presbyopia
    Age-related long sightedness due to reduction of elasticity of the lens
  • Cataracts
    Clouding of the lens
  • Glaucoma
    High internal eye pressure leading to irreversible damage to the retina

(18) List the types of sunglasses that could cause perceptional problems in flight.

Photo-chromatic don’t adapt quick enough. Polarised can result is reduction of visibility on windscreen or computer screens

(19) List the measures that may be taken to protect oneself from flash blindness.

Lightening – turn up cockpit lighting.

(20) State the possible problems associated with contact lenses.

Damage to the cornea because of slightly hypoxic conditions

(21) State the current rules/regulations governing the wearing of corrective spectacles and contact lenses when operating as a pilot.

Spectacles must correct to no worse than 6/9 in one eye and 6/6 in both. Carry a spare.

(22) Explain the significance of the ‘blind spot’ on the retina in detecting other traffic in flight – OBVS We have two eyes for that !!!

040 02 02 04 – Hearing

Descriptive and functional anatomy

(1) State the basic parts and functions of the outer, the middle and the inner ear.

  • Outer
    Channels sound to the eardrum
  • Middle
    Transmits vibrations of the eardrum to the fluid in the inner ear
  • Inner
    Cochlea translates fluid to auditory signals and the balance organ (vestibular system) detects linear and angular accelerations.

(2) Differentiate between the functions of the vestibular apparatus (accelerations) and the cochlea (sounds) in the inner ear.

Hearing loss

(3) Define the main causes of the following hearing defects/loss:

  • Conductive deafness
    Problems of the middle ear that prevents sound waves reaching inner ear. Damage, wax, glue ear (Otitis media).
  • Noise induced hearing loss
    Prolonged exposure to >90 db
  • Presbycusis
    Age

(4) Summarise the effects of environmental noise on hearing.

  • Loud noises
    Jet engines, cars etc.

(5) State the decibel level of received noise that will cause NIHL.

90 db

(6) Identify the potential occupational risks that may cause hearing loss. Exposure to loud noise NIHL.

(7) List the main sources of hearing loss in the flying environment. Jets, propellors.

(8) List the precautions that may be taken to reduce the probability of onset of hearing loss. Ear defenders….OBVS!

040 02 02 05 – Equilibriam

Functional anatomy

(1) List the main elements of the vestibular apparatus:

  • 3 semi-circular canals
    to detect angular accretions
  • Utricle
    To detects linear, horizontal accelerations
  • Saccule
    To detect linear and vertical acceleration(gravity)

(2) State the functions of the vestibular apparatus on the ground and in flight.

As above

(3) Distinguish between the component parts of the vestibular apparatus in the detection of linear and angular acceleration as well as on gravity.

As above

(4) Explain how the semicircular canals are stimulated.

They contain fluid which moves when subjected to angular accelerations. Hairs in the canal are bent by the fluid that generated electrical signals.

Motion sickness

(5) Describe air sickness and its accompanying symptoms.

Motion sickness caused by flight. Disagreement between signals given by the vestibular systems and accelerations and orientation detected by the eyes. Symptoms are dizziness.

(6) List the causes of air sickness.

Motion sickness caused by flight. Disagreement between signals given by the vestibular systems and accelerations and orientation detected by the eyes

(7) *Blank*

(8) Describe the necessary actions to be taken to counteract the symptoms of air sickness.

Restore straight and level and unaccelerated flight and look steadily at the visual horizon.

040 02 02 06 – Integrations of sensory inputs

(1) State the interaction between vision, equilibrium, proprioception and hearing to obtain spatial orientation in flight.

(2) Define the term ‘illusion’.

A false or misinterpreted perception of a sensory experience

(3) Give examples of visual illusions based on;

  • shape constancy,
    The brain- tries – to interpret ambiguous information as a consistent 3D shape. A face looks different from different angles but the brains sees it as one face.
  • size constancy,
    The brain make sometimes false assumptions about the size of objects. We believe a large flat expanse has no slope
  • aerial perspective,
    Up-sloping runway makes you think you are high
  • atmospheric perspective,
    False depth perception from haze
  • the absence of focal or ambient cues,
    High height perception due to featureless terrain
  • autokinesis,
    A static light will appear to move if stared at for long enough.
  • vectional false horizons,
    A sloping cloud making you think you are level when you are not.
  • field myopia,
    Nothing to focus on so difficult to spot distant aircraft
  • surface planes.
    Sloping cloud tops

(4) Relate these illusions to problems that may be experienced in flight and identify the danger attached to them.

(5) List approach and landing illusions for slope of the runway, black-hole approach,

Runway surrounded by dark terrain induces low approach
and terrain around runway
Rising valley floors prevent a view of the horizon
, and state the danger involved with recommendations to avoid or counteract the problems with high or low approach or flare at the wrong time.
Illusions are very real and pilots need to use instrumentation.

(6) State the problems associated with flickering lights (strobe lights, anti-collision lights, propellers and rotors under certain light conditions, etc.).

Can induce dizziness and vertigo

(7) the Leans

False sensation of increasing or decreasing bank angle or attitude
, Coriolis
False sense of tumbling usually while moving head in IMC
) and linear accelerations (somatogravic
False sense of pitching up when accelerating or pitching down the decelerating
,G-effect
Positive G = down. Illusion of being the right way up when inverted.

(8) Relate the above-mentioned vestibular illusions to problems encountered in flight and state the dangers involved.

  • Angular accelerations
    The leans – Gentle or unintentional control inputs when in IMC
  • Angular accelerations
    Coriolis – Turning in IMC
  • Linear accelerations
    Somatogravic – pitching up and down
  • Linear accelerations
    G-effect – misleading seat-of-the-pants – danger in IMC

(9) State that the ‘seat-of-the-pants’ sense is completely unreliable when visual contact with the ground is lost or when flying in instrument meteorological conditions (IMC) or with a poor visual horizon.

(10) Differentiate between vertigo, Coriolis effect, and spatial disorientation.

Vertigo, generalised dizziness. Coriolis, misperception of dynamic aircraft movement, Spatial disorientation, persistent misperception of attitude and orientation.

(11) List the measures to prevent or overcome spatial disorientation.

Establish visual clues, rely on instruments, return to VMC

040 02 03 00 Health and hygiene

040 02 03 01 – Blank

040 02 03 02 – Body rhythm and sleep

(1) Name some internal body rhythms and their relevance to sleep. Explain that the most important of which is body temperature.

  • Body temperature
    Reduced during sleep
  • Arterial blood pressure
    Reduced during sleep
  • Peak respiration flow
    Reduced during sleep
  • Kidney function
    ?
  • Hormone secretion
    ?
  • Blood cell numbers
    ?
  • Enzyme activity
    ?
  • Blood gas levels
    ?

(2) Explain the term ‘circadian rhythm’.

It prepares the body for rest or action.

(3) State the approximate duration of a ‘free-running’ rhythm.

25 hours

(4) Explain the significance of the ‘internal clock’ in regulating the normal circadian rhythm.

Brought into line by daylight cues

(5) State the effect of the circadian rhythm of body temperature on an individual’s performance standard and on an individual’s sleep patterns.

Lowest body temperature is in the early hours of the morning and is the window of circadian low. At these times performance is degraded.

(6) List and describe the stages of a sleep cycle.

  • 1
    Drowsiness
  • 2
    Light sleep with short periods of fast EEG waves
  • 3
    Deeper sleep
  • 4
    Sleep, deep or low wave sleep, body rhythm changes. Difficulty in being aroused from
  • 5
    REM associated with dreaming

(7) Differentiate between rapid eye movement (REM) and non-REM sleep.

REM sleep is deeper

(8) Explain the function of sleep and describe the effects of insufficient sleep on performance.

Sleep recharges the brain, cements memories, cleans the brain of plaques. Sleep deficit can build up degrading mental and physical performance, slowing reaction times and increases risk of accidents

(9) Explain the simple calculations for the sleep/wake credit/debit situation.

+ 2 for each sleep hour up to 8. -1 for every awake hour.

(10) Explain how sleep debit can become cumulative.

(11) State the time formula for the adjustment of body rhythms to the new local time scale after crossing time zones.

90 minutes per day

(12) State the problems caused by circadian disrhythmia (jet lag) with regard to an individual’s performance and sleep.

Trying to work during circadian low and sleep during the high.

(13) Differentiate between the effects of westbound and eastbound travel.

Eastbound is much worse.

(14) Explain the interactive effects of circadian rhythm and vigilance on a pilot’s performance during flight as the duty day elapses.

Working outside of the circadian rhythm is not just about getting enough sleep. The body will work against someone trying to do this. Pilot’s crossing timezone are subjected to being outside.

(15) Describe the main effects of lack of sleep on an individual’s performance.

Degrades physical and mental performance, concentration, reaction times and therefore increases the chance of accidents.

(16) List the possible strategies to cope with jet lag.

Avoid sleep during the new zone’s day. Expose yourself to sunlight in the morning. Avoid mental stimulation before bed. Avoid booze.

040 02 03 03 – Problem areas for pilots

Common minor ailments

(1) State the role of the Eustachian tube in equalising pressure between the middle ear and the environment.

Normally closed but opens at each swallow to equalise pressure in the middle ear to equalise with the atmosphere

(02) State  that  the  in-flight  environment  may  increase  the severity of symptoms which may be minor while on the ground.

(03) List  the  negative  effects  of  suffering  from  colds  or  flu on   flight   operations   especially   with   regard   to   the middle ear, the sinuses, and the teeth.

  • Middle ear
    Otic barotrauma is caused by a pressure difference. Tissues around the nasal end of the Eustachian tube can swell. Resulting in vertigo and pain, especially in fast descents.
  • Sinuses
    Blocked sinuses can cause pressure build up in the sinus passages.   
  • Teeth
    Posible pain from sinusitis   *check* 

(04) State when a pilot should seek medical advice from an aeromedical  examiner   (AME)  or  aeromedical  centre (AeMC).

  • H
    Admitted to a hospital or clinic
  • O
    Operation or invasive procedure
  • M
    Medication

(05) Describe the measures to prevent or clear problems due to pressure changes during flight.

Close month, pinch nose and blow, it increases pressure in the pharynx and can force a way though to the middle ear 

Entrapped gases and barotrauma

(06) Define ‘barotrauma’.

An injury cause by pressure.

(07) Differentiate  between  otic,  sinus,  gastrointestinal  and aerodontalgia  (of  the  teeth)  barotraumas  and  explain avoidance strategies.

  • Otic
    A blocked Eustachian tube causing pain and possible rupture of the eardrum. Valsalva manoeuvre can relive light blockage.
  • Sinus
    Can be blocked by mucus and infection, sudden intense pain in the forehead or between the eyes (sinuses). Not avoidable and the only remedy is not to fly or remain at altitude and descent gently as sinuses are effected by ascent and descent. Avoid gaseous foods.
  • Gastrointestinal
    Trapped gas in the stomach and intestine can cause abdominal pain. A damn good guff can alleviate this.
  • Aerodontalgia
    Cause by trapped gas in teeth cavities under a filling or a cavity caused by a dental abscess. Prevention probably the same as for sinus related barotrauma

(08) Explain why the effects of otic barotrauma can be worse in the descent

The Eustachian tube acts like a flap and tends to close with increasing atmospheric pressure.

Gastrointestinal upsets

(09) State the effects of gastrointestinal upsets that may occur during flight.

Severe pressure pain, guffing, cramps, burping.

(10) List the precautions that should be observed to reduce the occurrence of gastrointestinal upsets.

  • W
    Drink bottled water from sealed bottles
  • Teeth
    Clean teeth using bottled water[/Expand]
  • WWash hands
  • Avoid
    Ice-creams, salads and buffets
  • Wash
    Fruit and veg with bottled water.
  • Eat
    Fresh hot food not reheated, avoid shellfish
  • Boil
    Water

    • (11) Indicate the major sources of gastrointestinal upsets.

    High pressure differential.

    As above

    Obesity

    (12) Define obesity

    Fat bastard. Excessive stores of fat.

    (13) State the following harmful effects obesity can cause:

    • P
      Possibility of developing coronary problems; 
    • I
      Increased chances of  developing diabetes;  
    • R
      Reduced ability to withstand G-forces;
    • D
      Development  of  problems  with  the  joints  of  the limbs;
    • G
      General circulatory problems;  
    • R
      Reduced    ability    to    cope    with    hypoxia    or decompression sickness;
    • P
      Sleep apnoea. 

    (14) Describe  the  problems  associated  with  Type  2  (mostly adult) diabetes:

    —      risk factors;

    Age, skin colour, hereditary, blood pressure, weight.

    —     I

    insulin resistance;

    —     Complications

    (vascular,   neurological)  and the disqualification of licence;

    —      pilots  are  not  protected  from  Type  2  diabetes more than other people.

    (15) Describe  the  typical  back  problems  (unspecific  back pain, that  pilots  have.) slipped disc

    A curved spine resulting in asymmetric loads causing a cartilage disc to pop out.

    Explain  also  the ways of preventing and treating these problems:

    • G
      Good sitting posture;  
    • L
      Lumbar support; 
    • P
      Good physical condition;
    • E
      In-flight exercise, if possible;
    • P
      Physiotherapy.

     

    Food hygiene
    (16) Stress  the  importance  of  and  methods  to  be  adopted by aircrew, especially when travelling abroad, to avoid contaminated food and liquids.

    (17) List the major contaminating sources in foodstuffs.

    The major sources of food contamination are from unhygienic food preparation and poor storage methods, undercooked or rancid meats, unwashed salads (or washed in contaminated water), unpeeled fruit and vegetables, seafood and locally made ice cream and mayonnaise.

     

    (18) State the major constituents of a healthy diet.

    Water and a balance of protein, carbohydrates, fats, minerals and vitamins.

    (19) State the measure to avoid hypoglycaemia (glucose deficiency).

    Eat meals at regular times.

    (20) State the importance of adequate hydration.

    All major body processes depend on adequate hydration. Healthy cell function, free flowing circulation and oxygenation of the corneas.

     

     

    Tropical climates
    (21) List the problems associated with operating in tropical climates.

    • C
      Cover skin at dawn and dusk to avoid insects;  
    • P
      Poor water quality; 
    • I
      Insect Bourne disease;
    • P
      Parasitic worms;
    • R
      Rabies.
    • S
      STDs.

    (22) State  the  possible  causes/sources  of  incapacitation  in tropical countries with reference to:

    —      standards of hygiene;

    May be lower

    —      quality of water supply;

    Cholera(bacteria from shit – diarrhoea, vomiting, dehydration 50-60% fatal with not treatment) Hepatitis(Inflammation of the liver from a virus, malaise, fever. A – Usually recoverable. B/C teated with anti-viral drugs. No dodgy shagging or dodgy blood transfusions. Typhoid Fever (Bateria from shit, rising fever, sweating, gastro-enteritis, diarrhoea, abdominal pain, red spots on the chest. Oral rehydration and antibiotics.

    —      Insectborne diseases;

    Malaria – flu, high fever. Yellow fever (Virus, fever, Nausia, pain, internal bleeding, liver damage. Vaccination.

    —    parasitic worms;

    Contaminated food or water. Abdominal pain, Nausia, weight loss, chronic fatigue. Anti-parasitic drugs.

    —    rabies or other diseases that may be spread through contact with animals;

    Rabies, attacks the brain, untreated is always fatal. Malaise, fever, headaches, violent mood swings and pathological fear of water. Wash wound and use iodine antiseptic. Injections needed within 10 days or you’re knackered.

    —      sexually transmitted diseases.

    Grotty shagging.

    (23) State the precautions to be taken to reduce the risks of developing problems in tropical areas.

    • V
      Vaccines up to date;  
    • PH
      Rigerous personal hygeine; 
    • M
      Follow instructions on anti material drugs rigorously;
    • D
      Dress to cover up from insects;
    • F
      Food and water from reliable sources.
    • B
      Sealed bottled water only.

    Infectious diseases

    (24) State the major infectious diseases that may severely incapacitate or kill individuals.

    Malaria, yellow fever, TB, polio, rabies.

    (25) State the precautions that must be taken to ensure that disease-carrying insects are not transported between areas.

    Spraying the cabin.

    040 02 03 04 Intoxication

     

    Tobacco

    (01) State the harmful effects of tobacco on:

    —      the respiratory system;

    Lung cancer

    —      the cardiovascular system;

    Reduced performance.

    —      the ability to resist hypoxia;

    Occurs at a lower altitude 

    —      the ability to withstand G-forces;

    Lower resistance.

    —      night vision.

    Degraded.

     

    Caffeine

    (02) Indicate the level of caffeine dosage at which performance is degraded.

    >300 mg. Brewed coffee 80-130 mg. Black Tea 30-70 mg

    (03) Besides coffee, indicate other beverages containing caffeine.

    Tea, chocolate, energy drinks.

     

    Alcohol

    (04) State the maximum acceptable limit of alcohol for flight crew according to the applicable regulations.

    EASA 20 mg per 100 ml (0.02%)

    (05) State the effects of alcohol consumption on:

    —      the ability to reason;

    Reduced

    —      inhibitions and self-control;

    Reduced

    —      vision;

    Degraded

    —      the sense of balance and sensory illusions;

    Degraded

    —      sleep patterns;

    Disrupted

    —      hypoxia.

    Increased risk

    (06) State the effects alcohol may have if consumed together with other drugs.

    Degraded

    (07) List the signs and symptoms of alcoholism.

    Gulping, needing to feel good, drinking before and for longer than others, guilt, anger when questioned, secrecy, drinking alone, hiding consumption levels, binge and compulsive drinking, the shakes.

     

    (08) List the factors that may be associated with the development of alcoholism.

    Prolonged use and abuse

    (09) Define the ‘unit’ of alcohol and state the approximate elimination rate from the blood.

    10 ml of pure alcohol. Eliminated at about 1 unit per hour (15 mg/100 ml per hour)

    (10) State the maximum daily and weekly intake of units of alcohol which may be consumed without causing damage to the organs and systems of the human body.

    3-4 per day (men). 2-2(women)

     

    (11) Discuss the actions that might be taken if a crew member is suspected of being an alcoholic.

    Approach directly but expect denial.

     

    Prescription   and   non-prescription   drugs   and   self- medication

    (12)State the dangers associated with the use of non- prescription drugs.

    Effect may be greater in slightly hypoxic conditions

    (13) State the side effects of common non-prescription drugs used to treat colds, flu, hay fever and other allergies, especially medicines containing antihistamine preparations.

    Drowsiness, alertness etc.

    (14) Interpret the rules relevant to using (prescription or non-prescription) drugs that the pilot has not used before.

    Consult AME or do not take.

    (15) Interpret  the  general  rule  that  ‘if  a  pilot  is  so  unwell that  they  require  any  medication,  then  they  should consider themselves unfit to fly’.

     

    Toxic materials

    (16) List  those  materials  present  in  an  aircraft  which  may, when uncontained, cause severe health problems.

    • H
      Hydraulic oil – caustic, irritation to the skin. Wash off.
    • F
      Fuels – Toxic additives, phosphates and lead. Can cause drowsiness and carcinogenic elements
    • A
      Anti-icing fluid – Contains ethylene glycol, can damage heart and central nervous system and kidney.
    • F
      Fire extinguishers contain Halon 1211 or BCF, not particularly toxic but can cause suffocation without breathing aids.
    • B
      Batteries contain concentrated hydrochloric acid, which is corrosive and damaging to skin. Wash it off straight away.
    • E
      Exhaust gases = CO
    • S
      Solvents and de-greasers contain toluene and other toxic things.
    • C
      Composite material can contain kevlar, boron and fibreglass. Asbestos type effects.

    (17) List those aircraft-component parts which if burnt may give off toxic fumes.

    • C
      Cabin plastics when burnt – cyanide, fluorine, phosgene. Highly toxic.
    • E
      Electrical insulation. Toxic when burnt.

    (18) Describe a fume event and the possible incapacitating effects on those exposed to it.

    Because of the a/c systems, fumes can spread, toxic fumes can degrade performance leading to incapacitation.

     

    040 02 03 05 – Incapacitation in flight

    (01) State  that  incapacitation  is  most  dangerous  when  its onset is insidious.

    (02) List the major causes of in-flight incapacitation.

    • 1
      Gastroenteritis
    • 2
      Low blood sugar
    • 3
      Standing up too quickly !!!
    • 4
      Sudden shock leading to hyperventilation

    (03) State  the  importance  of  crew  to  be  able  to  recognise and  promptly  react  upon  incapacitation  of  other  crew members, should it occur in flight.

     

    (04) Explain methods and procedures to cope with incapacitation in flight.

    Don oxygen masks, select 100% oxygen, emergency descent, depressurise when able and ventilate. Land ASAP