ALTITUDE PHYSIOLOGY

PRESENTED BY Dick Williams

REFERENCES
FM 1-301
Introduction

Atmosphere Composition
Circulation System
Respiratory System
Hypoxia
Hyperventilation
Dysbarism
Conclusion
Atmosphere Composition
Definition: a mixture of gases that surround the
earth from it’s surface to approximately 1,200 miles
above the surface.

Composition: a mixture of water vapor and gases.

Layers of the atmosphere: Troposphere,

Tropopause, Stratosphere, Ionosphere, Exosphere.
Description of Atmospheric Layers
Troposphere:
 closest to the earth’s surface
extends to an altitude of approx. 30,000 ft. @ poles and
60,000 ft @ the equator.
standard temp. lapse rate is about 2 degrees for each
1,000 foot increase in altitude (sea level = 15 degrees
and standard pressure of 29.92)
Tropopause:
constant temp.
varies in width
gradually increases in alt from the polar region to the
equator.
Description of Layers cont.
Stratosphere
extends upward of the tropopause to 50 miles
above the surface
constant temp. 55 degrees Celsius
absence of water vapor and turbulence

Ionosphere
extends from surface to approx. 600 miles above
the surface
protects from ultraviolet rays

Exosphere
extends from the ionosphere to about 1,200 miles
above the surface
this outer fringe becomes a vacuum of space
Quick notes about the layers of the
atmosphere
The layers of the atmosphere vary in
temperature and pressure.
Humans can not adapt to these changes
independent of life support systems.
These layers are then divided further into
three other categories referred to as the
Physiological Zones” of the atmosphere, which
are based on their resultant effect on the
human body.
Physiological Zones
 Efficient Zone
 Deficient Zone
 Space Equivalent Zone
Efficient Zone
 Extends from sea level to 10,000 feet (troposphere)
 humans are physiologically adapted to this zone
 also where Army aviators conduct the majority of their
operations
 changes in pressure in this zone can cause sinus
and/or middle ear discomfort
 oxygen levels are sufficient for healthy person w/o the
aid of protective equipment
Deficient Zone
 Extends from 10,000 ft to 50,000 ft
 the barometric pressure drops so significantly that
noticeable physiological problems will occur in this
range unless supplemental oxygen is used
 this is the region where hypoxia and trapped gas
expansion will occur
 Dalton’s Law
Space Equivalent Zone (Lethal Zone)
 Extends upward from 50,000 ft.
 it is the lethal zone because without supplemental
oxygen death would occur rapidly
 due to the reduction of atmospheric pressure the
boiling point of bodily fluids is 98.6 °
 basically your blood boils and you and die.
Dalton’s Law of Partial Pressures
Definition: the pressure exerted by a mixture of nonreacting
gas is equal to the sum of the partial pressures of the
separate components. Each gaseous mixture is independent
of other gases in the mixture.
Formula: Pt= P1 +P2….Pn
% of atmospheric concentration total atmospheric pressure of
the individual gas x @ a given altitude
100
= Partial pressure of the individual gases
Dalton’s Law (cont.)
Significance
 The percentages of oxygen and nitrogen in air remain
constant however their partial pressure will decrease in
direct proportion to the total atmospheric pressure.
(basically there is less oxygen available at higher
altitudes)

 the total atmospheric pressure exerted on the body

decreases with altitude
Dalton’s Law (cont)
 the total atmospheric pressure exerted on the body
decreases with altitude

 the loss of available oxygen may not be obvious at low

altitudes but the effects are present.
 The loss of oxygen can degrade night vision acuity

at altitudes as low as 4,000 ft.

 Hypoxia
 Circulatory System
The circulatory system consists of all structures that
transport blood throughout the body. It regulates the
equilibrium of fluids in the body. It also regulates
body chemical balance, body heat exchange, body
excretion and provides cell nutrition and oxygen.
Components of the Circulatory System
Arteries are vessels that move blood from the heart to
the body tissue

Veins are vessels that return blood to the heart

Capillaries connect arteries and veins and contact most

of the tissues of the body transferring Oxygen and
Carbon dioxide, nutrients and waste products
between the cells and blood.
Components and functions of Blood
Red Blood Cells- transport 100% of all oxygen in
humans. If this saturation is not maintained than than
folks will begin to suffer from lack of oxygen.
Hemoglobin is the iron-containing compound in
every red blood cell responsible for the oxygen
uptake of the cells
produced in bone marrow
production of red blood cells is affected by

environment
Components and functions of Blood (cont.)
White Blood Cells- their main function is to fight infection
and inflammation within the body.
 have no hemoglobin

 widely distributed in the body and move between

body cells and blood

 their small size allows them to pass through

capillaries
Components and functions of Blood (cont.)
Platelets- small irregular shaped bodies that aid in
coagulating the blood and maintaining the circulatory sys.
Produced in bone marrow

Plasma - it’s most important function is to transport

carbon dioxide in the blood
55% of whole blood
the fluid part of the blood composed of water protein, and
salts
yellowish in color
Respiration
Definition: the process by which living organisms exchange
gases with the environment. There are two processes by
which this occurs. They are external and internal
respiration.
Functions:
 oxygen intake

 carbon dioxide removal

 body heat balance

 body chemical balance

Functions of the Respiratory System
Oxygen intake- oxygen enters the system through the
respiratory system and is transported by the circulatory
system.
 all body cells require oxygen to metabolize food

Carbon Dioxide Removal- carbon dioxide is a by-

product of the metabolic process.
 it is dissolved in the plasma

 transported from the tissues to the lungs for release

Functions of the Respiratory System

Body heat balance- since we’re warm blooded

critters we have to maintain our body temperature
at or around 98.6 degrees.
 perspiration and evaporation aid in this process

 warm air that is released into the environment via

the lungs also aids in this process

 basically, the respiratory system warms or cools air

before it enters our system

Functions of the Respiratory System
Body chemical balance- a delicate balance exists between
the amounts of oxygen and carbon dioxide in the body.
 The uptake of O2 and CO2 takes place through super

complicated chemical changes.

 As these chemical pathways are disrupted the chemical

balance of the body changes

 the equilibrium that the human body is maintained in is

a very narrow band

 if there is too much CO2 present in the system the pH

level will increase making blood acidic

Functions of the Respiratory System
Body chemical balance (cont.)
 the brain will perceive this imbalance

 chemical receptors then respond by triggering the

respiratory system to help return the levels to

normal limits
Processes of respiration
External respiration- in this process the lungs are
ventilated during inhalation and exhalation and gases
are transferred through the lungs to the bloodstream.
 active phase- inhalation

 passive phase- exhalation

Internal respiration- gases are transported to and from

the body tissues by the blood and chemical changes
take place within the tissue cells to metabolize oxygen.
Pieces & Parts of the Respiratory System
Oral -nasal passage- includes the nasal cavities and mouth
 ciliated hair cells work as filters in the nasal cavities

 air entering through the nasal cavity is filtered better

than air entering through the mouth

Pharynx - connects the back of throat to the nasal and oral
cavities.
 primarily humidifies and warms the air entering the
respiratory system
Trachea- windpipe
Pieces & Parts of the Respiratory System
Alveoli- tiny cells located in the lung tissue. they are
surrounded by a network of capillaries that join veins and
arteries. This is where the actual gaseous exchange
occurs between CO2 and O2.
 movement of CO2 and O2 occurs as a result of pressure

differentials
 movement is based on the law of gaseous diffusion

which states that gas always moves from an area of

high pressure to an area of lower pressure .
 O2 saturation takes place because of as the blood
traverses the capillary networks of alveoli the oxygen is
going from high pressure to low pressure.
Pieces & Parts of the Respiratory System
Alveoli-
 the amount of O2 and CO2 transferred from across

the alveolar-capillary membrane into the blood

depends primarily on alveolar pressure in relation
to venous pressure of oxygen
 this is important because of the pressure

differential which causes the O2 saturation on the

blood.
 decrease in saturation may lead to hypoxia
Hypoxia
Definition: a condition resulting from inefficient amounts of
oxygen in the body.

Major classifications of hypoxia:

 Hypoxic hypoxia

 Hypemic hypoxia

 Stagnant hypoxia

 Histotoxic hypoxia
Hypoxia
Hypoxic Hypoxia - insufficient oxygen in the air.
 associated with high altitudes

Hypemic Hypoxia- a.k.a. anemic hypoxia.

 caused by a reduction in the oxygen carrying

capacity of the blood

 blood loss or anemia

 carbon monoxide, nitrites, and sulfa drugs can

also cause this type of hypoxia

Hypoxia
Stagnant Hypoxia- oxygen carrying capacity is adequate but
the circulation is bad.
 heart conditions

 arterial spasm

 occlusion of blood vessel

 venous pooling that occurs during positive-G maneuvers

Hystotoxic Hypoxia- interference with the use of O 2 by body

tissues
 use of alcohol, narcotics, poisons interfere with the cell’s

ability to use an adequate supply of oxygen

Hypoxia - Signs and symptoms
Symptoms
 air hunger
 apprehension or anxiety
 fatigue
 nausea
 headaches
 dizziness
 euphoria
 belligerence
 blurred vision
 tunnel vision
 numbness
 tingling
 denial
Hypoxia - Signs and symptoms
Signs
 hyperventilation

 cyanosis

 mental confusion

 poor judgment

 muscle coordination

 seizure
Stages of Hypoxia
Indifferent stage - same as the efficient zone.
 sea level to 10,000 ft

 decrease in night vision at 4,ooo ft

 hemoglobin is saturated

Compensatory stage- the circulatory and respiratory

systems are working to compensate for the reduction in
available oxygen
 10,000 ft - 15,000 ft.

 @ 12,000 ft the effects on the nervous system become

apparent
 increase in blood pressure, respiration and cardiac

output
Stages of Hypoxia
Compensatory stage cont.-
 after 10-15 minutes impaired efficiency is obvious

 crew members may become drowsy

 coordination begins to slip

 errors in judgment

 hemoglobin saturation is 80-90%

Disturbance stage- physiological responses can no longer

compensate for the oxygen deficiency.
 hemoglobin saturation is between 70 and 80%

 Senses- peripheral and central vision are impaired and

visual acuity is diminished. touch and pain is reduced.

hearing is one of the last senses to go
Stages of Hypoxia
Disturbance stage cont.-
 Mental processes- intellectual impairment is an early

sign; thinking is slow and calculations are unreliable.

 Personality traits- release of basic personality traits

similar to being drunk ( euphoria, aggressiveness,

overconfidence, and depression).
 Psychomotor function- muscular coordination is

decreased, stammering and writing illegibly are also

typical of this stage of Hypoxia
 Cyanosis- the skin turns a bluish color because O2

molecules fail to attach themselves to hemoglobin

Stages of Hypoxia
Critical stage- within 3-5 minutes judgment, and
coordination deteriorate. Subsequently mental confusion,
dizziness and unconsciousness occur.
 20,000 ft and above

 hemoglobin saturation is less than 70%

 convulsions, and death are possible

Prevention and Treatment of Hypoxia
Prevention
 Limited time at altitude

 use of supplemental oxygen

 use of pressurized cabins

 physical fitness

Treatment
 100% oxygen

 descend to a safe altitude

Hyperventilation
Definition: an excessive rate and depth of respiration
leading to abnormal loss of CO2 from the blood.
Causes:
 emotions, such as, fear, apprehension, and

excitement
 pressure breathing

 hypoxia

Symptoms:
 Tingling sensations

 muscle spasms (only symptom different from

hypoxia)
 hot cold sensations

 visual impairment
Hyperventilation
Symptoms:
 Tingling sensations
 muscle spasms (only symptom different from
hypoxia)
 hot cold sensations
 visual impairment
 dizziness
 unconsciousness

Why these symptoms?

 stores of O2 are depleted

 blood is diffusing so rapidly that the alveoli can not

keep up and the body chemical balance is thrown out

of calibration
Additional quick notes about
Hyperventilation
 it can incapacitate a perfectly healthy crewmember
 can be confused with hypoxia
 to prevent it from occurring try not to panic and
control the rate and depth of respiration
 to correct it descend below 20,00 feet and
administer 100% oxygen if available
 if you’re above 10,000 feet assume it is hypoxia
Dysbarism
Definition: syndrome resulting from the effects ,
excluding hypoxia, of a pressure differential between
absent barometric pressure and the pressure of
gases in the body.
Types:
 trapped

 evolved
Trapped gas dysbarism
During ascent the free gas normally present in body
cavities expands. if the escape of that gas is impeded
than the pressure will build up and eventually cause
pain in the abdomen, ears, sinuses, and teeth.
 Boyle’s Law - the volume of gases is inversely
proportionate to the pressure exerted upon it.
 Dry gas conditions- under conditions of constant
temperature and increased altitude the volume of gas
expands as the pressure decreases.
 Wet gas conditions- gases within the body are
saturated with water vapor. Under constant temperature
and barometric pressure the volume of wet gas is
greater than the volume of the dry gas
Trapped gas dysbarism
Gastrointestinal tract
 the stomach and intestine contain gas which expand

during ascent causing gas pains

 to prevent it, avoid bubbly beverages prior to flight,

maintain a good diet, don’t chew gum during ascent

 to treat it in flight let that gas blow on out, or

descend to a lower altitude if pain persists and

mission permits
Trapped gas dysbarism
Ear blocks
 air trapped in the middle ear.(Eustachian tube)

 to treat it in flight stop the descent and attempt a

valsalva, if ascending try to do so at a slower rate.

Sinus blocks
 avoid flying with a cold or congestion

 try to slow descent and valsalva

 attempt to equalize the ears / sinus frequently

Trapped gas dysbarism
Barodontalgia- trapped gas disorder of the teeth.
 change in barometric pressure can cause a

toothache
 avoid flying following dental restoration when in

need of restoration
 occurs between 5,000 and 15,000 ft

 descent almost always relieves the pain

Evolved Gas Dysbarism
(decompression sickness)

Evolved gas disorders occur in flight as a direct result

of the reduction in atmospheric pressure.

 Henry’s law- the amount of gas dissolved in a

solution is directly proportional to the pressure
of the gas over the solution (soda pop bottle)
 Evolved Gas Dysbarism
(decompression sickness)
When barometric pressure decreases the partial
pressures of atmospheric gases also decrease
proportionately leaving the tissue temporarily
saturated as the body responds to the saturation
by trying to transport the excess gases to the
lungs however it is inefficient and causes the
evolved gas disorders.
Four types of evolved gas disorders
 Bends
 Paresthesia
 Chokes
 CNS disorder
Quick notes about evolved gas disorders
 Rate of ascent, altitude, body fat, exercise, duration
and repeated exposure are factors that increase the
risk of having an evolved gas disorder
 pressurized cabins and denitrogenation are
recommended for prevention
 if it occurs, get the individual to ground level
immediately, give him 100% O2 seek medical
attention and compression therapy
Conclusion
Atmosphere Composition( layers, altitudes, and zones)
Circulation (pieces, parts, and operation)
Respiratory ( pieces, parts, functions)
Hypoxia (types, symptoms, prevention, treatment)
Hyperventilation (description, symptoms, treatment)
Dysbarism (trapped and evolved, prevention, treatment)
Questions?