1. ALTITUDE PHYSIOLOGY
WE ARE ADAPTED FOR LIFE AT SEA LEVEL AND LOW ALTITUDES 10,000 FEE AND BELOW.
AS WE ASCEND INTO THE ATMOSPHERE THERE ARE LARGE AND SUDDEN PRESSURE CHANGES WHICH HAS AN ADVERSE AFFECT ON ARE BODIES.
DEATH WILL RESULTS IF WE ARE NOT PROFIDED WITH A ENVORMENT SIMILAR TO THE GROUND LEVEL ATMOSPHERE
FOR THESE RESONS IT’S ESSENTIAL THAT WE UNDERSTAND BASIC ATMOSPHERIC PHSIOLOGY AND THE LAWS THAT GOVERNS THE WORLD WE LIVE

2. TERMINAL LEARNING OBJECTIVE
Action: Manage the physiological effects of altitude
Condition: While performing as an aircrew member
Standard: IAW AR 95-1, AR 40-8, FM , Fundamentals of Aerospace Medicine

3. ELO #1
ACTION: Identify the physiological zones and the physical divisions of the atmosphere.
CONDITION: Given a list.
STANDARD: IAW FM

4. Physical Divisions of the Atmosphere
1200 miles
EXOSPHERE
600 miles
IONOSPHERE
50 miles
STRATOSPHERE
Tropopause
ATMOSPHERE GASEOUS ENVELOPE SURROUNDING THE EARTH, WHICH INCLUDES A VAST MIXTURE OF GASES, TRACE QUANTITIES OF LIQUIDS AND SOLIDS AND ADDITION PRTECTS US FROM ULTRVIOLET RADIATION
ATMOSPHERE STARTS AT THE EARH SURFACE AND EXTENTS TO 1,200 MILES
AIRCRAFTS FLYS IN THE FIRST TWO LAYERS THE TROPOSHERE AND THE STRATOSHERE
TROPOSPHERE CONTAINS WATER VAPOR WEATHER TUBULANCE AND THE JET STREAM EXTENDS FROM 30,000 AT THE POLES AND TO 60,000 FEET AT THE EQUATOR
STRATOSPHERE EXTENDS UPWARD TO 50 MILES VOID OF WATER VAPOR AND TUBULANCETEMP RANGES FROM -49 TO -112 DEGRES
THE OUTER LAYER IS CALLED THE IONOSPHERE AND EXOSPHERE
IONOSPHERE EXTENDS FROM 50 MILES TO 600 MILES THIS LAYER ACT AS REFLECTOR FOR ELETROMAGNETIC ENERGY WAVES
EXOSPHERE EXTENDS FROM 600 MILES TO 1,200 MILES AND GRADUALL BECOMES THE VACUUM OF SPACE
THE OUTER EDGE OF EACH LAYER IS CALLED THE PAUSE
THE TROPOPAUSE VARIES IN THICHNESS FROM A FEW FEET TO SEVERAL THOUSAND FEET IT INCREASES IN HIGHT AS IT LEAVES THE POLES AND APPROACHES THE EQUATOR
TROPOSPHERE
Sea level to flight level depending on temperature, latitude and season.
MOUNT EVEREST ,028 FEET

5. Physiological Zones of the Atmosphere
SPACE EQUIVALENT ZONE: 50,000 feet and above
63,000 ft
50,000
DEFICIENT ZONE: 10,000 to 50,000 feet
18,000 ft
10,000
1. EFFICIENT ZONE SEA LEVEL TO FEET THIS IS THE ZONE THE HUMAN BODY IS ADAPTED TO LIFE ABOVE THIS ZONE REQUIRES CONSIDERABLE ACCLIMATIZATION
2. DEFICENT ZONE EXTENDS FROM 10,000 TO 50,000 FEET. BECAUSE OF REDUCED ATMOSPHERIC PRESSURE INADEQUATE OXGEN IS AVAILABLE. GAS EXPANDION DOUBLES AT 18,000 FEET AND OTHER EVOLVED GAS DISORDERS CAN OCCUR DECOMPRESSION SICKNESS (WHICH WE WILL TALK ABOUT LATER)
3. SPACE EQUIVALENT ZONE EXTENDS ABOVE 50,000 FEET. WE NEED PROTECTION IN A SEALED CABIN OR A FULL PRESSURE SUIT, THIS IS EXTREMELY HAZARDOUS TO THE HUMAN BODY 63,000 FEET ARMSTRONG LINE
EFFICIENT ZONE: Sea level to 10,000 feet

6. Composition of the Air 78 % Nitrogen (N2) 21 % Oxygen (O2) 1 % Other
1. NITROGEN MOST PLENTIFUL GAS IN THE ATMOSPHERE
BUILING BLOCKS OF LIVE, BUT NOT USED BY THE HUMAN BODY BUT IT SATURATES THE BODY TISSUES AND CELLS WHICH MAY CAUSE EVOLED GAS DISORDERS AT HIGH ALTITUDES.
2. OXYEN SECOND MOST PENTIFUL GAS THE HUMAN BODY OXGEN IS NECESSARY FOR METABOLISM
3. OTHER GASES 1% .03% OF THOSE GASES CONTAIN CO2 THIS GAS IS ESSENTAIL IN CONTROLLING RESPIRATION. AND INERT GASES SUCH AS NEON AND HELIUM

7. Questions ???

8. ELO #1 Check On Learning Atmosphere
Physiological Zones of the Atmosphere
Composition of the air

9. ELO #2 ACTION: Select the correct barometric pressure at sea level.
CONDITION: Given a list.
STANDARD: IAW FM

10. Sea Level Pressure lbs Scale Barometer / Altimeter 14.7 PSI 760 mm HgOR
in. Hg
ATMOSPHERIC (BAROMETRIC) PRESSURE THE MEASUREMENT OF PRESSURE EXERTED ON THE EARTH SURFACE FROM GASES AND WATER IN THE ATMOSPHERE
THE WEIGHT OF THE ATMOSPHERE CAN BE MEASURED IN
POUNDS PER SQUARE INCH (PSI)
INCHES OF MERCURY (in Hg)
MILLI METER OF MERCURY (mm Hg)
SEA LEVEL STANDARD PRESSURE IS 760 mm Hg AT 18,000 FEET IT REDUCED TO 380 OR 1/2
29.92 in Hg (WHERE HAVE YOU SEEN THIS MEASUREMENT)
ANSER ALTIMETER
lbs
Scale
Barometer / Altimeter

11. PERCENT COMPOSITION OF THE ATMOSPHERE REMAINS
CONSTANT
BUT PRESSURE
DECREASES
WITH ALTITUDE
AS WE GO UP IN ALITIUDE THE % OF NITROGEN AND OXGEN REMANS THE SAME AS ON THE EARTH SURFACE ,BUT THE PRESSURE OR PARTIAL PRESSURE DECRECREASE CAUSING THE OXGEN MOLECULES TO SPREAD OUT SO THERE ARE FEWER OXGEN MOLECULES TO BREATH

12. SIGNIFICANT PRESSURE ALTITUDES
FEET mm/HG ATMOSPHERES
18, /2
34, /4
48, /8
63, /16

13. Partial Pressure (Dalton’s Law) 21% O2 78% N2 760 mm Hg 1% Other
760 mm Hg
THIS IS PRETTY MUCH A PICHURE OF WHAT WE HAVE BEEN TALKING ABOUT

14. (Dalton’s Law)
The pressure exerted by a mixture of gases is equal to the sum of the partial pressures of each gas in the mixture.
IN OTHER WORDS IF THE AS AMBIENT ALTITUDE INCREASESE THE PARTIAL PRESSURE OF OXGEN DECREASES BUT THE % OF STAY THE SAME
PARTIAL PRESSURE OF OXGEN AT SEA LEVEL IS 21 mm Hg
PARTIAL PRESSURE OF OXGEN AT 18,000 FEET IS 360 mm Hg
½ EARH ATMOPHERE
Pt = P P Pn

15. (Oxygen) P1=F1 X P. 160mm=21% X 760mm. Pt = P1 + P2 + ...+ Pn
THIS IS A FORMLA YOU CAN DO IN YOU SPARE TIME IT’S ALSO IN FM
160mm IS THE PRESSURE INSIDE THE LUNGS
Pt = P P Pn

16. (Oxygen)
63,000 ft
P1=F1 X P.
10mm=21% X 47mm.
Pt = P P Pn

17. Questions!!

18. Check on Learning #2 Atmospherics (barometric) pressure
Dalton’s Law of partial pressure

19. ELO #3
ACTION: Identify the components of the circulatory system that transport oxygen throughout the human body.
CONDITION: Given a list.
STANDARD: IAW FM

20. CIRCULATION
DIAGRAM OF THE HEART LUNGS AND THE CIRCULATORY SYSTEM

21. FUNCTIONS OF THE CIRCULATORY SYSTEM
Oxygen and nutrient (fuel) transport to the cells.
Transport of metabolic waste products to organ removal sites.
Assists in temperature regulation.
WE NEED OXGEN TO MAINTAIN LIFE, RESPIRATION IS HOW WE RECEIVE IT
RESPIRATION IS THE PHYSICAL AND CHEMICAL PROCESS USED BY ORGANISM TO SUPPLY CELLS WITH O2 AND TO RMOVE WASTE SUCH AS C02

22. Components of the Circulatory System
AIR IS TAKEN IN THOUGH THE NOSE OR MOUTH TRAVELS THROUGH THE TRACHEA OR WIND PIPE. IT THEN BRACHES OFF INTO THE LEFT AND RIGHT BRONCHI, THEN INTO THE LUNGS WERE THE BRONCHI FUTHER BRANCHES OF TO SMALLER BRONCHIOLES. THEY CONTINUE UNTILL THEY REACH THE ALVEOLI THIS IS WHERE THE OXGEN AND CARBON DIOXIDE EXCHANGE OCCURS IN THE RESPITORY SYSTEM
OXGEN AND CO2 MOVES BETWEEN AIR AND BLOOD BY SIMPLE DIFFUSION HIGH PRESSURE MOVES TO LOW PRESSURE.
WHEN THE BLOOD COME BACK TO THE LUNGS THE PARTIAL PRESSURE IS LOWER THAN THE INCOMING OXGEN PRESSURE CAUSING THE OXGEN TO FORCE THE CO2 MOLECULES OUT OF THE BLOOD INTO THE ALVEOLI REPLACING IT WITH THE OXGEN MOLECULES.
WHEN WE BREATH OUT OR EXHALE WE ARE GETTING RID OF THE CO2. THE OXGENATED BLOOD IS THEN PUMP BY THE HEART TO ALL THE TISSUE IN THE BODY BY THE BLOOD VESSELS.

23. Blood transport of O2 and CO2
Plasma
CO2
CO2 O2
CO2 O2
COMPONENTS OF THE BLOOD
10 PINTS OF BLOOD
THE HEART PUMPS 5 PINTS A MIN
5% OF TOTAL BODY WIEGHT
55% OF THE BLOOD CONTAINS PLASMA, IT 90% WATER 10% SOLUTES
RED BLOOD CELLS IS THE TRANSPORTATION OF 02 AND C02
THE HEMOGLOBIN IN THE RBC ARE RESPONSIBLE FOR THIS ACTIVITY 4 OXGEN TO 1 HEMOGLOBIN MOLECULES
WHITE BLOOD CELLS FIGHT FOREIGH ORANISMS
PLATELETS FORMED IN THE BONE MARROW ARE ESSENTIAL FOR BLOOD CLOTTING
hemoglobin
molecule
O2 molecule
Red Blood Cell

24. QUESTIONS?

25. Check on Learning #3 Functions of the circulatory systems
Components of the circulatory systems

26. ELO #4 ACTION: Select the functions and types of respiration.
CONDITION: Given a list.
STANDARDS: IAW FM

27. FUNCTIONS OF THE RESPIRATORY SYSTEM
Intake of Oxygen [O2]
Removal of Carbon Dioxide [CO2]
Maintenance of body heat balance
Maintenance of body acid base balance [pH]

28. Phases of Respiration Active Phase INHALATION Passive Phase EXHALATION
Breathing in
Breathing out
Active Phase INHALATION
Passive Phase EXHALATION 20

29. QUESTIONS

30. COMPONENTS OF THE RESPIRATORY SYSTEM
Nasal/Oral pharynx
Trachea
Bronchiole
Bronchi
Alveolar
Ducts
Alveoli

31. Law of Gaseous Diffusion
Gas molecules of higher pressure move in the direction of gas molecules of a lower pressure
PO2 = 100mmHg PO2 = 40mmHg
PO2 = 74mmHg PO2 = 66mmHg 24

32. Hemoglobin Saturation 75% Hemoglobin Saturation 98%
Blood Gas Exchange
Venous Capillary
Hemoglobin Saturation 75%
PCO2 = 46 mm
PO2 = 40 mm
Tissue
Alveoli
CO2
CO2
PO2 = 100 mm
PO2 = mm O2
PCO2 = 46 mm
PCO2 = 40 mm O2 O2 O2
PCO2 = 40 mm
PO2 = 100 mm
Arterial Capillary
Hemoglobin Saturation 98% 25

33. Oxygen transport in the blood:
dependent on the partial pressure of oxygen.
pO2

34. Correction of Altitude, Alveolar O2, Hb saturation -------- ambient air --------
ALTITUDE BAROMETRIC ALVEOLAR HEMOGLOBIN
(FEET) PRESSURE OXYGEN SATURATION
(mmHg) ( PAO2) % (Hb)
Sea level
10,
20,
30,
40,
50,

35. Correction of Altitude, Alveolar O2, Hb saturation -------- 100% Oxygen --------
ALTITUDE BAROMETRIC ALVEOLAR HEMOGLOBIN
(FEET) PRESSURE OXYGEN SATURATION
(mmHg) ( PAO2) % (Hb)
Sea level
10,
20,
30,
40,
50,

36. Questions!!

37. Check on learning #4 Functions of the respiratory systems
Phases of the
respiratory systems

38. 10 Minutes
Take a break!

39. ELO #5 ACTION: Match the type of hypoxia with their respective causes.
CONDITION: Given a list of hypoxia types and a list of hypoxia causes.
STANDARDS: IAW FM

40. Hypoxia State of oxygen [O2] deficiency in the blood cells and tissues
sufficient to cause
impairment of function.

41. Types of Hypoxia
Hypemic
Stagnant
Histotoxic
Hypoxic

42. Inability of the blood to accept oxygen in
Hypemic Hypoxia
Inability of the blood to accept oxygen in
adequate amounts + + + + + + + + + + + + + + +

43. Stagnant Hypoxia Reduced blood flow Adequate oxygen Blood moving
slowly
Red blood cells
not replenishing
tissue needs
fast enough

44. Histotoxic Hypoxia Inability of the cell to accept or use oxygen
Adequate
oxygen
Red blood cells
retain oxygen
Poisoned tissue

45. Hypoxic Hypoxia Reduced pO2 in the lungs (high altitude) Red
blood cells
Body tissue

46. QUESTIONS ?

47. Hypoxia Symptoms what you feel (subjective)
Air hunger
Apprehension
Fatigue
Nausea
Headache
Dizziness
Denial
Hot & Cold Flashes
Euphoria
Belligerence
Blurred Vision
Numbness
Tingling

48. Hypoxia Signs what we see in you (objective)
Hyperventilation
Cyanosis
Mental confusion
Poor Judgment
Lack of muscle coordination

49. Stages of Hypoxia Indifferent Stage Compensatory Stage
Disturbance Stage
Critical Stage

50. Indifferent Stage Altitudes:
Air: ,000 feet
100% O2: , ,000 feet
Symptoms: decrease in night 4000 feet
acuity
color perception

51. Compensatory Stage Altitudes: Air: 10,000 - 15,000 feet
100% O2: 39, ,000 feet
Symptoms: impaired efficiency, drowsiness, poor judgment and decreased coordination

52. Failure to recognize your result in an aircraft mishap.
CAUTION!!!!
Failure to recognize your
signs and symptoms may
result in an aircraft mishap.

53. Disturbance Stage
Altitudes Air: 15, ,000 FEET % O2: 42, ,800 FEET

54. Disturbance Stage symptoms
Mental
Memory
Judgment
Reliability
Understanding

55. Disturbance Stage symptoms
Personality
Happy Drunk versus the
Mean Drunk

56. Disturbance Stage symptoms
Performance
Coordination
Flight Control
Speech
Handwriting

57. Disturbance Stage symptoms
Sensory
Vision
Touch & pain
Hearing

58. CAUTION!!!! FAILURE TO RECOGNIZE THESE SIGNS AND SYMPTOMS MAY RESULT IN A AIRCRAFT MISHAP.

59. Disturbance Stage
Signs
Hyperventilation
Cyanosis

60. Critical Stage
Altitudes Air: 20,000 feet and above 100% O2: 44,800 feet and above
Signs: loss of consciousness, convulsions and death

61. 65% WARNING! When hemoglobin saturation falls below
serious cellular dysfunction occurs;
and if prolonged, can cause death
65%
WARNING!

62. Factors modifying hypoxia symptoms
Pressure altitude
Rate of ascent
Time at altitude
Temperature
Physical activity
Individual factors
Physical fitness
Self-imposed stresses

63. DEATH Drugs Exhaustion Alcohol Tobacco Hypoglycemia
keep self imposed stresses out of the aircraft

64. Expected Performance Times
FL 430 & above seconds
FL seconds
FL seconds
FL minutes
FL / minutes
FL minutes
FL minutes
FL minutes

65. RD Rapid Decompression
Expected performance time for a crew member flying in a pressurized cabin is reduced approximately one-half following loss of pressurization such as in a: RD
Rapid Decompression

66. Hypoxia
Prevention
Limit time at altitude
100% O2

67. Hypoxia
Treatment
100% O2
Descend to a safe altitude

68. Questions ????

69. Check on Learning #5 Hypoxia types/stages Causes of hypoxia
Signs/Symptoms
Treatment of hypoxia

70. ELO #6 ACTION: Select the symptoms of hyperventilation.
CONDITION: Given a list.
STANDARD: IAW FM and Fundamentals of Aerospace Medicine.

71. Hyperventilation (definition)
An excessive rate and depth of respiration leading to the abnormal loss of CO2 from the blood.

72. Hyperventilation (causes)
Emotional
(fear, anxiety, apprehension)
Pressure breathing
Hypoxia

73. Hyperventilation Symptoms
tingling sensations
muscle spasms
hot and cold sensations
visual impairment
dizziness
unconsciousness

74. Hyperventilation reason for symptoms:
loss of carbon dioxide [CO2]
shift in pH balance

75. Hyperventilation significance
incapacitation of an otherwise outstanding, healthy air crewmember
confusion with hypoxia

76. (distinguishing factors)
Hyperventilation
(distinguishing factors)
above 10,000 feet
possible hypoxia
below 10,000 feet probably hyperventilation

77. Hyperventilation (corrective actions)
Don’t Panic
Control your breathing
Check your oxygen equipment - it may be hypoxia

78. Questions!!!!

79. Check on Learning #6 Hyperventilation Causes of hyperventilation
Treatment of hyperventilation

80. Let’s take
10 minutes
a break

81. ELO #7
ACTION: Select the causes and treatment of an ear, sinus and tooth trapped gas dysbarism.
CONDITION: Given a list.
STANDARD: IAW FM

82. Dysbarism
Syndrome resulting from the effects, excluding hypoxia, of a pressure differential between the ambient barometric pressure and the pressure of gases within the body.

83. Boyle’s Law
The volume of a gas is inversely proportional to its pressure; temperature remaining constant.

84. Gas Expansion
43,000
9.5X
6.0X
4.0X
34,000
5.0X
2.5X
3.0X
25,000
1.8X
18,000
2.0X
DRY GAS EXPANSION
WET GAS EXPANSION

85. Gas Expansion (prevention of gas pain)
Watch your diet, don’t eat too fast
Avoid soda and large amounts of water just prior to going to altitude
Don’t chew gum during ascent
Keep regular bowel habits; eat your fiber 77

86. Anatomy of the Ear Eustachian tube Cochlea Semicircular canal
Auditory nerve
Ear drum
Middle ear
External ear
Eustachian tube
Opening to throat 78

87. Pressure Effect Clear Ear Block Middle Ear Cavity Tympanic Membrane
Atmospheric
Pressure
Clear
External Ear
Eustachian Tube
Middle Ear Cavity
Tympanic
Membrane
Atmospheric
Pressure
Ear Block
External Ear
Eustachian Tube
Blocked / Infected

88. The Sinuses
Frontal
Ethmoid
Maxillary
Sphenoid

89. Treatment of an Sinus/Ear Block
Stop the descent of the aircraft and attempt to clear by valsalva.
If unable to clear, climb back to altitude until clear by pressure or valsalva.
Descend slowly and clear ear frequently during descent.

90. Barodontalgia Tooth pain due to: Gum abscess: dull pain on ascent
Inflamed pulp: sharp pain on ascent
Inflamed maxillary sinus: pain primarily on descent 86

91. TREATMENT of Barodontaliga
Descend aircraft/chamber to sea level.
Seek dental help

92. Questions
Questions

93. Check on Learning #7 Trapped gas dysbarism Treatment of ear and sinus
dysbarisms
Treatment of tooth pain

94. ELO #8
ACTION: Identify the types and treatments of evolved gas dysbarsims, which occurs with altitude.
CONDITIONS: Given a list.
STANDARD: IAW FM and Fundamentals of Aerospace Medicine

95. Decompression Sickness (evolved gas dysbarism) Results due to the reduction in atmospheric pressure. As pressure decreases, gases dissolved in body fluids are released as bubbles.

96. Henry’s Law
The amount of gas dissolved in solution is directly proportional to the pressure of the gas over the solution.

97. must be sought immediately.
WARNING
Evolved gas disorders are considered serious and medical treatment and advice
must be sought immediately.

98. Evolved Gas Disorders The Bends Paresthesia The Chokes
Central Nervous System-CNS

99. Evolved Gas Disorders The Bends
N2 bubbles become trapped in the joints. Onset is mild, but eventually painful!

100. Evolved Gas Disorders Paresthesia
N2 bubbles form along nerve tracts. Tingling and itchy sensation and possibly a mottled red rash.

101. Evolved Gas Disorders The Chokes
N2 bubbles block smaller pulmonary vessels. Burning sensation in sternum. Uncontrollable desire to cough. Sense of suffocation ensues.

102. Evolved Gas Disorders CNS
N2 bubbles affect spinal cord. Visual disturbances, paralysis, one sided tingling.

103. Evolved gas factors Rate of ascent Exercise Altitude
Body fat content
Age
Exercise
Duration of exposure
Repeated exposure

104. Decompression Sickness prevention
Denitrogenation
Denitrogenation
Maintain cabin pressurization

105. Decompression Sickness treatment
Descend
100% Oxygen
Land at nearest location where qualified medical assistance is available.
Compression greater than 1 atmosphere (absolute).

106. 24 Hour restriction between diving and flying!!!!!
Scuba Divers Beware!
24 Hour restriction
between diving and flying!!!!!

107. QUESTIONS 95

108. Check on Learning #8 Evolved gas dysbarism Four types of DCS Treatment95

109. CONCLUSION