HPL

01 Aviation Industry

02 Nervous System

03 Atmosphere and Respiration

05/16 Cardiovascular System

06 Eye and Vision

07 The Ear, hearing and balance

16 Hazards of Aviation

17 Personal Health and Hygiene

08 Higher Functions and Sleep

13 Human Overload and Underload

10 Info Processing, Memory and Learning

08/09 Perception and Perceptual Errors

12 Personalities and Attitude

14 Cockpit Management and Automation

FLIRJ

Swiss Cheese (Error Chain)

Main causes of Pilot Accidents

LOOPINGPING - LPNPN:

Lack of directional control

Poor Judgement

Not maintaining the correct airspeed

Poor pre-flight planning

Not maintaining ground clearance

CFIT - controlled flight into Terrain is the most common within this area - GPWS (Ground Proximity Warning System) was designed in the 1980s = the largest reduction in accidents

TEM

Threat - LEO

Error - PAC

UAC - AGI

SKA - Pilot competency defined by ICAO

CAA Pilot LAWS

PNS Peripheral nervous system

Consist of sensory (5 senses) and motor neurones (quick reflexes)

ANS Autonomic Nervous System (Vegetative or Autonomous NS)

Controls all our involuntarily actions i.e breathing, temp control, digestion, heart rate, sweating, gastrointestinal movements, internal organs basically….

ANS is a neuro-hormonal control system , highly self regulating and is constantly trying to control our internal environment (Homeostasis)

Temp 37C, ph 7.35, blood sugar

Somatic NS

responsible for body movement, sensing external stimuli, etc..

CNS (Central Nervous System)

Homeostasis

the tendency of the internal environment of a body to remain constant in spite of varying external conditions (situations or stimuli)

Temp 37C, ph 7.35, 0.1% blood sugar, CO2 level, etc...

Combined gas law

PV/T = k

Boyles law P is inversely proportional to Volume

```
 P ~ 1/V   (at constant temp)
```

Boyles law can be accounted to these illnesses in aviation:

Barotrauma

Aerodontalgia

Charles Law - Volume it proportional to Temperature

V ~ T

Gay Lussac Law Pressure and Temperature are proportional

P ~ T

Dalton’s Law (aka The law of partial pressures).

each gas has it’s own pressure (partial pressure)

the total pressure is the sum of all the individual partial pressures

```
 PTotal = PA + PB + PC
```

Hypoxia

Henry’s Law

the amount of gas dissolved into a liquid (i.e blood stream) is proportional to its partial pressure

Decompression sickness

Atmosphere

Composition

Lung partial pressure

Lungs have constant partial pressure 47mmHG due to water vapour

O2 proportion falls from 21% to 13.7% (to accommodate CO2 and water vapour)

55mmG (12,000ft)

Min partial press fo O2 saturation

02 requirements with altitude

< 10,000 Nothing

<33,700 O2 and Air mix

              Increasing O2 with altitude
              Keeps body at SL

*<=40,000 100% O2 required

              Keep body at 10,000ft

40, 000 GREATER THAN!!!!!

100% O2 under pressure
Keep body at 10,000ft

Cabin pressure/altitude are between 6-8000ft

Anatomy of Breathing System

Barorecpetors (Carotid Artery)

Internal Respiration

Metabolism

External Respirations

16-20 breaths

Lung Volumes

click to edit

tidal volume 500ml

Average volume of air inhaled and exhaled in one normal breathe i.e. 500ml in , 500 out

Inspiratory reserve volume 3100ml

the additional volume of air that we can forcibly inhale after inhaling normally i.e. our tidal volume

Expiratory reserve volume 1200ml

the additional volume of air that we can now forcibly exhale after exhaling our normal tidal volume

Residual volume 1200ml-1400ml

the amount of air remaining in your lunges after exhaling your expiratory reserve volume

Illnesses

Hypoxia

Hypoxic Hypoxia

ICDC / RDC

Anaemic Hypoxia

Stagnant Hypoxia

Histotoxic hypoxia

Hyperventilation

TUC

DCS

Treatment

100% O2
go to MSA

Treatment

Regulation of breathing rate….breath slower. Talk to them, distract them.
Breathe into a paper bag - increases the amount of CO2 that they are breathing in

Treatment - Pure O2 and land as soon as possible

Systemic - heart to body
Pulmonary - heart to lung

Veins, Arteries and capillaries

Blood composition

Made in bone marrow

Plasma:

Salty yellow/transparent fluid.

Helps transports Carbonic acid.

Helps regulate the acidity of the blood

Red cells:

Contains haemoglobin and thus carries the O2

White blood cells:

immune system fights off any infections/bacteria

Platelets

Helps with clotting/coagulation

Heart & Circulation

Average rate = 72 bpm
Stroke Vol = 70ml
Controlled by CNS

Controlled by ANS:

measuring the amount of glucose and CO2 and adrenalin

Exercise can increase pulse rate in short term but reduce over time
Temp, food, stress can all affect the pulse rate

Cardiac output = Heart Rate x Stroke Volume
= 5-5.5 litres

Illnesses

Coronary Heart Disease

Angina

Heart Attack

Anaemias -lack of iron

Illness

CO Poisioning

Treatment

100% O2
Turn off the cabin heat
Open any windows/vents if possible
Land ASAP

Smoking

Smoking affects

hypoxia severity and our night vision
decompression sickness
coronary heart disease - makes use more prone to heart attacks
greater chance of CO poisioning
reduces G force tolerance
can cause emphysema - damage or enlarge the alveoli making it difficult to breathe

Blood Pressure

a measure of the force of the blood on the walls of the arteries

Depends on:

heart rate

elasticity of the arterial walls

peripheral resistance (causes by clogging of arteries etc..)

viscosity of the blood

Systolic BP = the force of the blood flowing through the arteries when the heart (left ventricle) contracts

Average healthy adult BP should be 120mmHg

if we increase the peripheral resistance increases the systolic BP

Diastolic BP = …as the heart relaxes

Average healthy adult BP should be 80mmHG

Illness

Hypertension - high BP i.e. 140/90

Hypotension - if lower than 90/60

BARORECEPTORS (Pressoreceptors)

Sensors that measure BP
located in the carotid sinus upstream of the of the brain (gets to baroreceptors before the brain)
If we are hypertensive, the baroreceptors will make the heart rate reduce, the arteries relax and reduce the stroke volume
If we are hypotensive then the opposite applies

Blood donation

Increase risk of hypoxia

hypotensions

24 Hrs before back on duty

Before giving blood what are the precautions?

Seek advice from AME (Aeromedical Expert)

Drink plenty of fluids

Lie down for 15 to 20 minutes

Smoking affects

hypoxia severity and our night vision

decompression sickness

coronary heart disease - makes use more prone to heart attacks

greater chance of CO poisioning

reduces G force tolerance

can cause emphysema - damage or enlarge the alveoli making it difficult to breathe

Visual Acuity

Measure of central vision

At 5 degrees from the fovea, visual acuity falls by half
By 25degrees form the fovea visual acuity drops to 1/10th (20/200 or 6/60)

Depends on

Smoking
Age
Hypoxia
Fatigue
Alcohol
Certain medications
Contrast in colours

Visual field = central vision + peripheral vision

Each can see left to right 120degrees meaning 60degree over lap in the central area - known as binocular
Each eye can also see 150degrees up and down (75 up and 75 down)

Depth Perception

Far away = pale, small, high contrast,

Motion - closer = faster

Overlapping (Obscuration)

Problems

Empty Field Myopia

Blind Spot

Parallax Error (monocular viz)

Myopia

Hypermetropia

Presbyopia

Astigmatism

Cataracts

Glaucoma

Colour Vision

common in men 7% of men suffer, only 0.1% of women

Flash Blindness

Correcting Glasses

Contacts

Sunglasses

Audible range and measurement

Adult human has range 20-20,000Hz (20khz)
The most sensitive range is 750-4000Hz

Conditions

Noise Induced Hearing Loss (NIHL)

Conductive Hearing Loss

Presbycusis

Tinnitus

The vestibular system (balance) - inner ear

3 Semi circular canals - yaw, pitch, roll and sensing angular acceleration

3 Semi circular canals - yaw, pitch, roll and sensing angular acceleration

The otolith - linear acceleration

vestibular nerve to the CEREBELLUM

Vestibular illusions

Somatogravic illusion (AccelDecel = Pitch up/down
Somotogyral illusion aka The Leans(Angular 3 semi circular canals)

Graveyard Spin

The Coriolis Illusion

Coriolis Illusion = When we stimulate 2 or more of our semi circular canals
Symptoms = dizziness, nausea, vomiting
Recommendation to reduce = Avoid sudden head movements

Spatial disorientation

* Changing from VMC to IMC
* Aerobatics

About 80% of accidents caused by spatial disorientation are fatal

Vertigo

The sensation of tumbling, rotating, turning or being dizzy

Causes:

an infection …possibly in the eusation tube
a contradictory sensory information
alcohol
Through Coriolis you can cause the sensation of vertigo, minimise head movements, monitor the instruments or look at the horizon

Hypoxia

Hypoxic hypoxia - low saturation levels of O2 in blood

Histotoxic Hypoxia - poisoning of the red blood cells

Anaemic Hypoxia - insufficent haemoglobin in the red blood cells

Stagnant Hypoxia - low blood flow

G-Tolerance

Gz rhymes with head

Hydrostatic variation (blood pressure)

BP lowest in the head - as gravity can help push it down

BP highest in the feet

+ve G

Blood pooling into the Feet
Tunnelling
Grey out
G-Loc (G induced loss of consciousness) Black out

-ve G

Red Out

Carbon Monoxide (CO) Poisoning

NO CYANOSIS

BODY REMOVES CO AT A RATE OF 0.5% EVERY 4 HOURS

Barotrauma

Valsalva manoeuvre

Aerodontalgia

Otic barotuama

Worse on Descent

Gastrointestinal Barotrauma

Paranasal Sinus Barotrauma

Ascent and Descent

Cabin relative humidity = 4%

Incapacitation

Gastro-enteritis is the MOST COMMON cause of incapacitation

Drink bottled water

Clean teeth with bottled water

Wash hands often

Avoid ice in drinks and ice-cream

Avoid salads unless you know its washed in treated water

Thoroughly wash fruit with bottled water

Avoid shellfish

Hypoxia most dangerous …it’s insidious

Ozone

Destroys lung tissue

Dry/stinging eyes
Tightness in chest
Dry throat
Tiredness
Nausea
Painful breathing

Symptoms from: 1.0/2.0 parts per million

Records kept from 49,000ft

Radiation (Cosmic/Galactic)

Least protection = poles

Increases with altitude

Steady and reasonably predictable

SI unit for radiation is SIEVERT
Older unit was Rontgen Equivalent Man (REM)

Motion Sickness

Nausea caused by a mismatch between movements the brain detects visually and movements the brain detects through inputs from the vestibular system and the proprioreceptors/mechanoreceptors.

Back Pain

BACK ACHE: The most common form of back pain is BACK ACHE. Felt initially in the lumbago i.e. lower back especially when sat for long periods

SLIPPED DISC: Slipped disc is misalignment of a disc in the spine and the pain comes from the nerve being touched

SCIATICA: Irritation or compression of the sciatic nerve.

The pain/numbness can go from leg all the away up to neck

WHIPLASH: Neck injury caused by a sudden impact

FROZEN SHOULDER: Inflammation in the shoulder joint stops movement

ANKYLOSING SPONDYLITIS: Pain or stiffness where the spine meets the pelvis

Alcohol

1 unit = 15mg
Burn off 1 unit per hour
EASA limit = 20mg

Recommended

Men: 5units daily, 21 units per

Women: 3 units daily,14 units per week

EU Ops regulations when comes to flying:

The max amount allowed 20mg per 100ml of blood (0.2 promile)

Need to wait 8hrs from last drink to next duty

Alcoholism

Caffeine

200-300ml daily

Psychiatric Illnesses

Schizophrenia, by-polar, etc….will result in not getting your medical

Tropical Diseases

BMI

Weight
'-------------------
Height SQRD

Under 18.5 = Underweight
18.5 - 25 = Normal
26 - 30 = Overweight (25 male / 24 female)
31 - 35 = Obese (over 30 male / 29 female )
35 and over = morbidly obese

Obesity = +20% body fat

Excercise

3 times a week
20mins
Double HR

Minerals that the body needs

Iron - for blood , haemoglobin, bone marrow
Phosphorous - helps body with many functions, such as filtering waste and repairing tissue and cells.
Calcium - bones

Drugs

Recreational drugs should not be used
Alcohol when taken simultaneously with drugs will intensify the effects of the drugs
If you deem yourself unwell enough to need to take over the counter medication you should register yourself unfit to fly
Side effects of some drugs
Anti-histamine - used for allergies
- ```
can cause drowsiness
```
Aspirin
- ```
gastric bleeding
```
Imodium - diarrhoea
- ```
blurred vision
```
Barbiturates (Sedatives, sleeping pills)
- ```
Shouldn’t be used
```

Amphetamines - stimulants, diet pills

Can cause recklessness or over confidence

Antibiotics
- ```
Dont fly if on them
```

Local and general anaesthetics

Local A, you need to wait 12hrs before flying

General A, you need to wait 48hrs(2 days )

Nutrition

Best diet we want high carbs and high fibre and low fat

Carbs: Pasta, rice, cereals, potatoes

Don’t miss breakfast

If we don’t eat enough we can become hypoglycaemic

Symptoms of hypoglycaemia - when blood sugar levels drop below 50mg per 100ml of blood

Sleep

Circadian Rhythms

Free running - last 25hrs

(No Zeitgebers)

Endogenous - lasts 24hrs

Zeitgebers - external factors that control our endogenous rhythm

Meal times
Alarms,
Work schedules
Traffic outside

Body Temp

Easiest to sleep when lowest

Circadian LOW: 2-5am

our body tmp at lowest, we find it best to sleep, easiest to sleep BUT our performance is the worst

Sleep credits and sleep debits

1:2 (Gain) 2:1(Debt) 1:1 (Burn)

1hr sleep = e gain 2 sleep credits

16 = max amount of sleep credits you can gain (2 * recommended 8hrs!!)

Lose 1 sleep credit per hour when awake

If in Sleep Debit

1 sleep debit you need to sleep for 2hrs

Performance Degrades

Lethargic
Fatigue
Irritable
Mood swings
Concentration level reduces
More error prone

EEG (Brain activity)

Electroencephalogram

There are 5 stages as we sleep:

Feel drowsy - transition stage between being awake and falling asleep

Light sleep - EEG would be fast high freq. brain waves

50% of our sleep is spent in stage 2

Deeper Sleep (aka SLOW WAVE, ORTHODOX Sleep)

DEEPER SLEEP (aka SLOW WAVE, ORTHODOX Sleep)

we are in our most relaxed, muscles completely relaxed, slower pulse, drop in BP, rhythmic breathing

REM sleep (aka paradoxical sleep): in this stage we dream. Their eyes are moving behind their eyelids.

EEG for REM sleep is the same as EEG for person when they are awake

Paralysis can occur

This is where you have dreams and nightmares

Orthodox & Paradoxical Sleep

We need both types

Rebound Effect

Brains ability to determine how much orthodox and paradoxical sleep we need

Orthosdox/Slow Wave

Paradoxical/REM

Mind repair - organise and refresh the brain i.e. important for memories

Body repair/Cell restoration

Sleep Cycle

We are constantly going in and out of the different sleep cycles

Start awake to first rem cycle

1.5hr/90min = average sleep cycle aka how long before the first stage of REM (~10min)

Start awake > stages 1 to 4 > 4 to 1 > REM
As we go through our 8hrs of sleep the duration of REM increases
An average night can be between 4-5 cycles of REM

Naps and Microsleeps

Microsleep

fraction of a second - 2-3seconds
Your body forces it upon you, dangerous as you don’t always know it happens
Microsleep are NOT restorative

10min = min time for a nap to be restorative

20min+ = recovery time for a nap

To not still be suffering from performance loss, you need to wait 20min

Responses and reactions very slow 5min after waking up from a nap

Jet lag / Circadian Dysrhythmia / Trans-meridian Desynchronisation

WEST IS BEST

Jet lag and recovery is SUBJECTIVE

Handling Jet lag

<24hr
Stay on your own home circadian rhythm

*>24hr
Adjust to the new local time zone

*=24hr
Nap when first arrive then plan your long sleep, 8hr, to wake up just before your next duty time

Sleep Hygiene

Remove blue light - screens
Don’t eat close to bed time….as BP , temp, heart rate increases
- ```
Should be 2hrs before
```
Don’t drink alcohol as it affects your REM
No mental stress or physical exertion

Any relaxation - Good
Hot milky drinks - Good

Sleep Disorders

Narcolepsy

Sleep Apnea (secs - minutes)

Blocked airway

Falling asleep without warning

Sleep walking (Somnambulism) /Sleep talking (Somniloquism)

More common in children than adults

Insomnia - 2 types

Situational Insomnia

Caused by the situation that you are in i.e. jet lag, noise, temp, stress, etc

Short term

Clinical Insomnia

On going long term stress

Sunrise/Sunset - Most important

Fatigue

Fatigue = too much mental or physical exertion
Fatigue is always BAD!!!!! Especially for performance
Fatigue is cumulative

Short term fatigue - Acute Fatigue

Chronic fatigue - long term fatigue

Causes:

Ongoing stress
Ongoing Work pressures
Ongoing Personal problems

Affects:

Can see long term psychological and physiological issues
Might start gastrointestinal problems
Coronary problems

Cure:
Declare yourself unfit to fly

Causes:

Lack of sleep
Exercise
Jet lag
Being overexcited

Affects:

Concentration is reduced
More Error prone
Communication is degraded
Fixation/tunnelling of attention
Reversion to old habits

Cure:

Sleep

Avoiding and managing fatigue

no caffeine, alcohol before bed
relaxation techniques

Stress = The none specific action or response, whether it be physical or psychological, to the demands placed on a body
Stress is an every day part of life
STRESS IS NOT ALWAYS A BAD THING
Stress can help us learn to manage or cope with a task so when we encounter that task again we can handle it better
Stress is cumulative
Stress is subjective

ACUTE STRESS

The on the spot type of stress
Caused by a situation or demand at that time
Our bodies very quickly mobilise any resources needed to cope with that situation

CHRONIC STRESS

Long term exposure to stress can damage the body

Effects

Stomach ulcers
Gastrointestinal problems
Coronary disorders
Headaches
Change behaviours
Increase risk of diabetes
Change to reproductive
Insomnia

Cognition (brain activity)

Poor concentration

Increased errors

* Fixation/Tunnelling of attention

Reversion to old habits

* Situational awareness degrades (Situational Awareness = being aware of everything internal and external to you, these should match)

* Confirmation bias - where we ignore every piece of information telling us our idea/perception is wrong

Behaviour (the way we act)

Aggressive or withdrawn

Change in appetite

Drinking more alcohol, smoking more, drugs , etc

Personality (what makes us who we are)

Depressed

Tearful

Diabetes

Type 1 (aka Juvenile diabetes)

Type 2

ommonly found in young children or since birth
Deficiency in insulin or the pancreas isn’t producing insulin
Insulin pen to inject insulin must be done daily to help regulate the blood sugar levels

More commonly discovered later in life with adults related to poor diet, obesity
With diet with too much sugar we may not be producing enough insulin to break it down
Eat better and exercise can be a treatment

Can have a class 1 with type 2 diabetes, type 1 is more difficult

Symptoms

Thirst
Urine and breath can smell sweet
Fatigue
Lethargy
Frequently have skin, gum and bladder infections
Irritability
Gout

Long term effects on the body

hypertension
neuropathy - numbness
blurred vision
Can lead to complete kidney failure
Diabetic coma
Hypoglycemia - too little blood sugar

Exam - The ideal environmental temperature for a human clothed is 19-20°C

Categories of Stress

Physiological aka Environmental Stress

Too Cold: Normal body temp 36-37C

If we drop below 35C we get hypothermia

If we drop below 32C

We stop shivering, loss consciousness and die

Shaking/shivering - using up O2 and energy
Pale

Cyanosis

Can lead to frostbite on extremities due to lack of O2

Breathing rate increases
Can find it difficult to speak, words blurred
Apathy (aka content)

Too hot: Heat Exhaustion > Heat Stroke

HEAT EXHAUSTION

We sweat when we get too hot, sweat salts, water, electrolytes can cause us to get dehydrated, then diarrhoea which can mean losing more water. Headache, dizzy, muscle cramps

HEAT STROKE (about 43C) the brain swells

IF not treated loss consciousness and can lead to death

Noise and vibrations:

1-4Hz (up to4 i.e. 3.99)

Vibrations can interfere with breathing
Visual acuity reduced

4-10Hz

Chest and abdominal pain

8-12Hz

Back ache

10-20Hz

Headache
Pain in the eye
Pain in throat, speech difficulties

Humidity

40-60% RH is ideal for humans

In flight it’s 5-15%
Dry skin, nose, mouth, throat, etc…
Recommended to keep hydrated

EXAM: Take 2 weeks to acclimatise to a warmer and more humid climate - the body adapts

Internal Stress

Illness
Fatigue
Hunger
Thirst
Pain

Mental Stress aka Cognitive aka Psychological stress

Definition = When the perceived demand of a task is greater than our perceived ability to cope with the task

Effects

We tend to rush things i.e. not good if on the flight deck

Non-organisational Stress aka non-professional aka domestic

* EXAM: Death of a spouse (is the #1 cause of domestic stress)

Relationships
Financial worries
Death of a family member

Imaginary aka Anxiety aka Apprehension

Fears
Phobias
Don’t feel you have control of anything

Organisational aka professional aka occupational

Work - LACK OF INSUFFICIENT HANDS ON FLYING (Top for Exam), rosters, scheduling, workload, performance, fuel policies, turn arounds

Stressors - Cause the response or arousal or the activation of the body

Acute Stress - Arousal

Sympathetic NS

Increases arousal

Causes the activation or response in the body to cope with a stressor. It does this by:

Increase heart rate, respiration rate, BP, secretion of Adrenalin, inhibits flow of saliva

Parasympathetic NS

Decrease arousal , brings it back to normal i.e. does the opposite

EXAM Having repeated exposure to these MODERATE levels of environmental and physiological stresses can cause the body to adapt….

Acute Stress - General Adaption Syndrome aka GAS (linked to fight or flight)

3 STAGES

ALARM (REACTION) stage:

Can affect our mental/cognitive abilities - we tend to just concentrate on the problem, memories come to us quickly to help us solve the problem. Decision making is increased

RESISTANCE stage:

Parasympathetic NS starts to recover the body from it’s initial reaction. It will also try repair any damage that has been done.

If we are still continuing to fight the stressor, more glucose can now be put into the blood stream , fats can be burned into sugars giving us more energy.

Cortisone (hormone) can be secreted into the blood stream - Cortisone acts as a pain killer and helps us go through the pain barrier i.e. if we are tired when running

EXHAUSTION stage:

Any muscles or organs used in stages 1 and 2 go into the exhaustion stage - used all our energy, glucose supplies, etc.

The chemical reactions from previous stages if haven’t been removed can cause damage i.e. lactic acid

Effects:

Hypertension
Heart disease
Indigestion or digestive problems
Ulcers (stomach)
Death - if in the stage for too long

3 REACTIONS
(linked to stage 2)

PSYCHOLOGICAL REACTION: The brain is registering the fact that there is a threat or a danger

PSYCHOSOMATIC REACTION: The brain is triggering the release of hormones and other chemicals into the blood

SOMATIC REACTION: The body is now reacting to the chemicals that are now in the blood

Sympathetic NS kicks in - increase in BP, HR, breathing rate, etc…- more blood sugars into the blood stream, might sweat a bit more, digestion and bladder function are slowed down

Inverted U Hypothesis

SUB-OPTIMAL ZONE

Too little anxiety/arousal (underload) and too much anxiety/arousal (overload), will cause performance to be poorer.

Optimum Arousal (stress can have benefits):

Break Point

Performance degraded
More errors
Inability to handle simple tasks
Mental breakdown

Overload vs Underload

Coping with Stress (DCS) - short term

DIRECT ACTION COPING

We are removing the stressor completely or altering it so it becomes less demanding

IE. leave the job or stress

COGNITIVE COPING

We are trying to rationalise the situation or emotionally detach ourselves from the situation

i.e. self pep-talk before an exam or interview

SYMPTOM /SYSTEM DIRECTED COPING

We remove the symptoms but not the stressor

i.e. instead of removing what is making us stressed we turn to alcohol or drug

Stress Management (Long term)

Health and fitness programs

Endorphins help us cognitively

Counselling/Talk things through- can be a non - professional

Can help with cognitive coping and direct action coping

Relaxation Techniques