1. What does the US Army Aeromedical Activity (AAMA) do?<br />Review and recommends disposition of flying duty medical examinations and medical waivers for continued flying duty. <br />What are Flight Surgeons (FS) considered to be?<br />Physicians are considered to be rated crewmembers, NOT rated aviators.<br />Flight Surgeons, Aeromedical PA’s and Nurse Practitioners are responsible for what?<br />Clinical and preventive medicine, unit readiness, staff function, clinical support<br />Aeromedical psychologists are responsible for what?<br />Clinical consultations and support to flight surgeons, consultatnt to commanders, education and training.<br />What is the primary goal of Aviation Medicine Program?<br />Preventative medicine services<br />There are two broad categories of the Flying Duty Medical Examination (FDME).<br />What are they?<br />A. Initial FDME – (class 1-4) accession purposes. Good for 18 months<br />B. Comprehensive FDME (class 2-4) – every 5 years < 50 years old then annually. Good <br /> for 12 months expiring on the last day of the soldiers birth month<br />What is the requirement for a flight student’s status to change from class 1 to 2 of FDHS? <br />The physical must be completed by the last day of the birth month after the soldier completes flight school. However, the soldier may take the examination within a three-month period preceding the end of the birth month. <br />Ex. Q: If your B-day is Jan 20th, what month/date can you begin to take the exam?<br />A: November 1st.<br />What form is the Medical Recommendation for flying duty?<br />DA Form 4186 or “UPSLIP”<br />-An official document used to notify the aviation commander of the initial recommendation for certification of medical fitness for all classes of military and civilian aviation personnel. <br />Who is the final approval authority for the form in question #6?<br />Unit Commander - may agree or disagree. -Remember “UNIT” Co.<br />What is a temporary disqualification and what is it likely to result in?<br />Imposed by the FS/APA for a temporary aero medical disqualifying condition, that are minor, self-limited and likely to result in re-qualification within 365 days.<br />What are the temporary restrictions due to exogenous factors?<br />Medications, Anesthesia, Dietary supplements, alcohol (12 hrs), immunization, tear gas exposure, blood or plasma donations, altitude chamber, diving, tobacco smoking, strenuous sporting activities, simulator sickness (12 hrs), centriguge runs (6 hrs)<br />What is a “medication” under class 1 IAW AR40-8 that may be used without a waiver?<br />Protein supplements, antacids, artificial tears, aspirin/acetophetomine, cough syrup, decongestant, pepto bismal, multiple vitamins, nasal sprays, Metamucil, throat losenges<br />How many classes are under Herbals and Dietary Supplements?<br />3 --- Class 1, Class 2, and Class 3<br />Which class of Herbal Supplements may be used without approval of a FS/APA?<br />CLASS 1 -- most water soluble <br />Which class may be used only with prior approval of the FS/APA?<br />CLASS 2<br />What is an essential component of the Army Aviation Medicine Program?<br />Occupational Medicine -- do not confuse this for the PRIMARY purpose of the Army Aviation Medicine Program (which is Preventative medicine services)<br />What are the three types of hazards?<br />Physical, Chemical, Biological<br />What is exposure? <br />The actual contact of the harmful substance with the biological organism<br />What is the exposure of an agent over a short period of time that can cause adverse health changes?<br />Acute Exposure<br />Route of Entry Principle: What are the 3 principle ways a toxin can enter the body?<br />1. Inhalation 2. Absorption 3. Ingestion<br />What are the physiological principles related to toxins?<br />Metabolism slows with age, amount of body fat, genetics<br />What are the environmental principals related to toxins?<br />Atmospheric pressure, temperature, humidity<br />What is a product of incomplete combustion?<br />Carbon Monoxide <br />You’re using JP8, what is toxic about it?<br />Carbon monoxide<br />What are the three protective measures needed to prevent or reduce toxic substance exposure?<br />1. Individual 2. Cockpit 3. General<br />What are the four safety features provided by an aircraft? <br />1. Structural shell - prevent intrusion of structure in the occupiable living space<br />2. Landing gear and crashworthy seats<br />3. Personnel restraint system<br />4. Post-crash factors - crashworthy fuel systems, self sealing fuel cells, break free self <br /> sealing fuel lines, and fire extinguishing systems<br />Which one of the safety features are essential for survival? <br /> (Structural Shell) PROVIDED AN OCCUPIABLE LIVING SPACE<br />What is an example of a safety feature of the aircraft?<br /> BREAK RESISTANT FUEL LINES (Post-crash factors) <br />What are the ONLY 3 types of material that ARE allowed for underwear?<br />COTTON, WOOL, NOMEX = flame resistant<br />Can the three types of underwear material be combined?<br />YES<br />What MAY be used in the rinse cycle to remove body oils? <br />FABRIC SOFTENERS<br />What setting can you IRON the NOMEX flight suit and at what temperature?<br />PERMANENT PRESS SETTING @ MEDIUM TEMPERATURE <br />What temps can you wash flight suits and NOMEX?<br />Flight suits < 180 NOMEX < 120 degrees <br />What can you NOT wear on your flight suit?<br />Metal Badges<br />Define acceleration <br />The rate of change of velocity with respect to time.<br />What are the factors that determine the effects of acceleration on the human body?<br /> (BIRDI)<br />Body Area and site – Greater area = lesser effects<br /> Intensity – increases effect<br />Rate of onset – increases effect<br />Duration -- increases effect<br />Impact direction – increases effect<br />Define Inertia<br />The resistance to a change in the state of rest or motion.<br />What are low magnitude accelerations?<br />G’s that range from 1 to 10 G’s and last for several seconds<br />What are the factors that reduce the overall efficiency of the body, especially the circulatory system, to withstand G’s called?<br />Decremental factors<br />What are the factors that enhance the ability of the body to withstand G-forces called?<br />Incremental factors<br />Name a criteria that occupant survivability is contingent upon during an accident?<br />Occupiable living space: Two objects cannot occupy the same space<br />What are aircraft design features that enhance crash survivability?<br /> (CREEP)<br />Container, Restraint System, Encironment, Energy Absorption, Post Crash Factors<br />__________ is the mechanical radiant energy that is transmitted by __________ pressure waves.<br />Sound, longitudinal<br />Noise is a ________ that is ______, ___________, or ___________.<br />Sound, loud, unpleasant, unwanted<br />4 NOISE effects are:<br />1. Annoyance 2. Fatigue 3. Speech Interference 4. Hearing loss<br />True or False? Noise has measurable characteristics.<br />TRUE <br />What are the three measurable characteristics of NOISE? <br />F.I.D Frequency Intensity Duration<br />What is Sensorineural hearing loss?<br />The cochlea is damaged (permanent hearing loss)<br />What are the three types of stressors?<br />Psychosocial stressors, Cognitive Stressors, Physiological stressors<br />In Army aircraft, the overall noise levels are generally equal to or exceed what?<br />100 dB<br />What is Amplitude? <br />The maximum displacement of an object from its position at rest<br />What are the three components of VIBRATION?<br />F.A.D<br />Frequency<br />Amplitude<br />Duration<br />What are the short-term effects that vibration can cause?<br /> FCMDR- (flight commander)<br />Fatigue <br />Circulatory effects<br />Motion sickness <br />Disorientation <br />Respiratory effects <br />What are some long term effects of vibration?<br />Raynauds disease, Bachache/back pain, Kidney/lung damage<br />What are the physical divisions of the atmosphere? <br />Troposphere - Extends to an Alt. Of 30,000 ft. at the poles and 60,000 ft. at the equator<br />Tropopause – boundary between troposphere and stratosphere<br />Stratosphere – tropopause to about 50 miles upward. Constant -55 degree C temp<br />Ionosphere – end of stratosphere upward to 600 miles<br />Exo sphere – end of ionosphere to about 1200 miles (true space)<br />What are the three physiological zones of the atmosphere and at what altitudes?<br />1. Efficient Zone: Sea level to 10,000 ft.<br />2. Deficient Zone: 10,000ft. To 50,000 ft.<br />3. Space Equivalent Zone: Above 50,000 ft. <br />Which physiological zone is lethal to humans?<br />Space equivalent zone<br />What is the standard sea level atmospheric pressure?<br />760mm/Hg (reduces by half at 18,000 ft)<br />What are the substances that make up the mixture of air?<br />Nitrogen – 78%, Oxygen – 21%, Other – 1%<br />What are the functions of the circulatory system?<br />Transport O2 and nutrients to cells<br />Transport metabolic wastes to organ removal sites<br />Assists in temperature regulation<br />What are the components and functions of blood?<br />Plasma – transports CO2 in blood, White Blood Cells – fights infection<br />Platelets – aid in blood coagulation, <br />Red blood Cells (RBCs or erythrocytes) – transports nearly 98.5% of all O2 in blood <br />What are the functions of respiration?<br />Provide O2 to cells, Remove carbon dioxide from cells<br />Assist in maintaining body temperature, Assist in maintaining body acid-base balance<br />What are the two phases of external respiration? <br />Active - inhalation<br />Passive - exhalation <br />What are the four types of hypoxia?<br />1. Hypemic – caused by anemia and blood loss<br />2. Stagnant - varicose veins, pooling of blood<br />3. Histotoxic – interference with use of O2 by tissues usually due to poisons<br />4. Hypoxic - insufficient O2, partial pressure (most likely to be encountered at altitude)<br />What are the four stages of hypoxia? <br />(like ACDC)<br />1. Indifferent 2. Compensatory 3. Disturbance4. Critical<br />Which of the four stages of hypoxia is the most dangerous and kills the most soldiers?<br /> Indifferent <br />What is the only significant effect of mild hypoxia at the indifferent stage?<br />Night vision deteriorates at about 4,000ft. <br />______________ is an ______________ and ________ of respiration leading to abnormal loss of _______ from the blood.<br />Hyperventilation, excessive rate, depth, CO2<br />What is the difference between signs and symptoms?<br />Symptoms are observable by the individual and signs are observed by the crew members<br />Distinguish the difference between hyperventilation and hypoxia.<br />A. Above 10,000 ft. is _______________.<br />B. Below 10,000 ft. is _______________.<br />A. Hypoxia B. Hyperventilation<br />Your co-pilot has pain in one tooth, what is it and what do you do? <br />Barodontalgia (trapped gas disorders of the teeth). Land and seek dental care.<br />What occurs as pressure decreases and gases dissolved in the body fluids are released as bubbles? <br />Evolved Gas Disbars (decompression sickness)<br />What are the primary symptoms Skin Manifestations where N2 bubbles are trapped under the skin?<br /> <br />Paresthesia which is a tingling and itching, reddish discoloration (occurs to the skin)<br />What are the components of the human eye and their functions?<br />1. Cornea - protective tissue located over front of eye<br />2. Iris - regulates the amount of light entering the eye by adjusting pupil<br />3. Pupil - Center of iris, allows light to enter eye<br />4. Retina - contains the rod and cone cells - permit us to see<br />What are the four common visual deficiencies?<br />1. Astigmatism, 2. Myopia, 3. Hyperopia, 4. Presbyopia<br />Which one of the four common visual deficiencies occurs with natural aging process?<br />Presbyopia<br />What occurs when the natural aging process causes the lens to harden and lose its elasticity?<br />Presbyopia<br />What are the four terms associated with spatial disorientation?<br />1. Vertigo<br />2. Sensory illusion<br />3. Spatial disorientation<br />4. Orientation or equilibrium<br />What are the different Monocular Cues?<br />1. Geometric Perspectives<br />(LAV) – Linear Perspective, Apparent foreshortening, vertical position<br />2. Retinal Image Size<br />(KITO) – Known size, Increasing/Decreasing size, Terrestrial assoc, Overlapping<br />3. Arial Perspective<br />4. Motion Parralax<br />The sensory inputs that provide orientation and equilibrium are the ___________,<br />______________, and ________________.<br />Visual, vestibular and proprioceptive systems <br />What is the most important bodily sense of orientation?<br />Vision<br />Role of visual cues: Orientation by vision requires what 3 things:<br />R.I.P.<br />Recognition<br />Identification<br />Perception<br />What are the different visual illusions?<br />False Horizon<br />Fascination/Fixation<br />Flicker Vertigo<br />Confusion with Ground Lights -- Gives the aviator a false horizon thus descending<br />Relative Motion<br />Altered Planes of Reference – wrong reference point<br />Structural Illusions<br />Height/Depth Perception <br />Crater Illusion<br />Size-Distance <br />Autokinesis – when a static light appears to move after staring at it for several seconds<br />Reversible Perspective – at night an aircraft may appear moving away instead of approach<br />What visual confusion occurs when an aviator mistakes ground lights for stars?<br />Confusion with ground lights<br />What illusion promotes the aviator to place aircraft in an unusual attitude? <br />confusion with ground lights<br />What three major reasons make the function of the vestibular system extremely important?<br />VOR (v for vestibular)<br />1. Visual tracking<br />2. Orientation in the absence of vision <br />3. Reflex information<br />What are components of the vestibular system? <br />Semicircular canals<br />Otolith organs <br />What are the three types of Vestibular illusions?<br />The leans -- turning in wrong direction without knowing it<br />Graveyard Spiral – difficulty maintain straight flight after continuous curve<br />Coriolis illusion – rapid movement while feeling weightless<br />What is the most dangerous vestibular illusion?<br />Coriolis illusion<br />What proprioceptive mechanism is unreliable in the absence of vision while in flight?<br />Seat of the pants flying<br />What type of spatial disorientation is the most dangerous and why?<br />Type 1 (unrecognized) is the MOST DANGEROUS because the pilot doesn’t perceive any indications of spatial disorientation. <br />What are the 3 dynamics of spatial disorientation?<br />1. Visual dominance<br />2. Vestibular suppression<br />3. Vestibular opportunism<br />How do you prevent spatial disorientation? <br />Learn instruments <br />What is the definition of sleep inertia.<br />Sleep inertia is the short term grogginess experienced right after awakening. <br />What are the factors that influence your sleep cycle.<br />(METAL)<br />Medication<br />Environment<br />Timing of sleep<br />Age<br />Level of fatigue<br />What is the best fatigue countermeasure.<br />Strategic Napping<br />What are the countermeasures for shift lag <br />Reduce mental demands on night flights<br />Minimize administrative duties after the shift<br />Implement shorter continous periods at the controls<br />Maximize every sleep opportunity<br />Determine if circadian readjustment is neccessary<br />Ensure the crew double checks everything.<br />