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Archive / FAA Pilot’s Handbook of Aeronautical Knowledge / Pilot’s Handbook: Chapter 17 — Aeromedical Factors

Chapter 17, Part 2

Aeromedical Factors — Part 2

FAA-H-8083-25C (2023)

Figure 17-4. Human sensation of angular acceleration.

No turning

No sensation.

Start of turn

Sensation of turning

as moving fluid deflects

hairs.

Constant rate turn

No sensation after fluid

accelerates to same

speed as tube wall.

Turn stopped

Sensation of turning in

opposite direction as moving

fluid deflects hairs in opposite

direction.

Endolymph

Cupola

Tube

Figure 17-5. Graveyard spiral.

Graveyard spin

Graveyard spiral

Vestibular Illusions

The Leans

A condition called the leans, is the most common illusion

during flight and is caused by a sudden return to level flight

following a gradual and prolonged turn that went unnoticed by

the pilot. The reason a pilot can be unaware of such a gradual

turn is that human exposure to a rotational acceleration of 2

degrees per second or lower is below the detection threshold

of the semicircular canals. [Figure 17-4] Leveling the wings

after such a turn may cause an illusion that the aircraft is

banking in the opposite direction. In response to such an

illusion, a pilot may lean in the direction of the original turn

in a corrective attempt to regain the perception of a correct

vertical posture.

Coriolis Illusion

The “coriolis illusion” occurs when a pilot has been in a turn

long enough for the fluid in the ear canal to move at the same

speed as the canal. A movement of the head in a different

plane, such as looking at something in a different part of the

flight deck, may set the fluid moving, creating the illusion

of turning or accelerating on an entirely different axis. This

action causes the pilot to think the aircraft is performing a

maneuver it is not. The disoriented pilot may maneuver the

aircraft into a dangerous attitude in an attempt to correct the

aircraft’s perceived attitude.

For this reason, it is important that pilots develop an

instrument cross-check or scan that involves minimal head

movement. Take care when retrieving charts and other objects

in the flight deck—if something is dropped, retrieve it with

minimal head movement and be alert for the coriolis illusion.

Graveyard Spiral

As in other illusions, a pilot in a prolonged coordinated,

constant-rate turn may experience the illusion of not

turning. During the recovery to level flight, the pilot will

then experience the sensation of turning in the opposite

direction causing the disoriented pilot to return the aircraft

to its original turn. Because an aircraft tends to lose altitude

in turns unless the pilot compensates for the loss in lift,

the pilot may notice a loss of altitude. The absence of any

sensation of turning creates the illusion of being in a level

descent. The pilot may pull back on the controls in an attempt

to climb or stop the descent. This action tightens the spiral

and increases the loss of altitude; this illusion is referred to

as a “graveyard spiral.” [Figure 17-5] This may lead to a

loss of aircraft control.

Somatogravic Illusion

A rapid acceleration, such as experienced during takeoff,

stimulates the otolith organs in the same way as tilting the

head backwards. This action may create what is known as

the “somatogravic illusion” of being in a nose-up attitude,

especially in conditions with poor visual references. The

disoriented pilot may push the aircraft into a nose-low or

dive attitude. A rapid deceleration by quick reduction of the

throttle(s) can have the opposite effect, with the disoriented

pilot pulling the aircraft into a nose-up or stall attitude.

Figure 17-6. Sensations from centrifugal force.

Skid, slip, and uncoordinated turns feel similar.

Pilots feel they are being forced sideways in their seat.

Level Coordinated turn Pull out

Level skid Forward slip Uncoordinated turn

Inversion Illusion

An abrupt change from climb to straight-and-level flight can

stimulate the otolith organs enough to create the illusion of

tumbling backwards, known as “inversion illusion.” The

disoriented pilot may push the aircraft abruptly into a nose-

low attitude, which may intensify this illusion.

Elevator Illusion

An abrupt upward vertical acceleration, as can occur in an

updraft, can stimulate the otolith organs to create the illusion

of being in a climb. This is known as “elevator illusion.”

The disoriented pilot may push the aircraft into a nose-low

attitude. An abrupt downward vertical acceleration, usually

in a downdraft, has the opposite effect with the disoriented

pilot pulling the aircraft into a nose-up attitude.

Visual Illusions

Visual illusions are especially hazardous because pilots rely

on their eyes for correct information. Two illusions that lead

to spatial disorientation, false horizon and autokinesis, affect

the visual system only.

False Horizon

A sloping cloud formation, an obscured horizon, an aurora

borealis, a dark scene spread with ground lights and stars,

and certain geometric patterns of ground lights can provide

inaccurate visual information, or “false horizon,” when

attempting to align the aircraft with the actual horizon.

The disoriented pilots as a result may place the aircraft in a

dangerous attitude.

Autokinesis

When flying in the dark, a stationary light may appear to

move if it is stared at for a prolonged period of time. As

a result, a pilot may attempt to align the aircraft with the

perceived moving light potentially causing him/her to lose

control of the aircraft. This illusion is known as “autokinesis.”

Postural Considerations

The postural system sends signals from the skin, joints, and

muscles to the brain that are interpreted in relation to the

Earth’s gravitational pull. These signals determine posture.

Inputs from each movement update the body’s position to

the brain on a constant basis. “Seat of the pants” flying is

largely dependent upon these signals. Used in conjunction

with visual and vestibular clues, these sensations can be

fairly reliable. However, because of the forces acting upon

the body in certain flight situations, many false sensations

can occur due to acceleration forces overpowering gravity.

[Figure 17-6] These situations include uncoordinated turns,

climbing turns, and turbulence.

Demonstration of Spatial Disorientation

There are a number of controlled aircraft maneuvers a pilot

can perform to experiment with spatial disorientation. While

each maneuver normally creates a specific illusion, any false

sensation is an effective demonstration of disorientation.

Thus, even if there is no sensation during any of these

maneuvers, the absence of sensation is still an effective

demonstration because it illustrates the inability to detect

bank or roll.

aircraft to approximately 45° bank attitude while maintaining

heading and pitch attitude. This creates the illusion of a strong

sense of rotation in the opposite direction. After this illusion

is noted, the pilot should open his or her eyes and observe

that the aircraft is in a banked attitude.

Diving or Rolling Beyond the Vertical Plane

This maneuver may produce extreme disorientation. While

in straight-and-level flight, the pilot should sit normally,

either with eyes closed or gaze lowered to the floor. The

instructor pilot starts a positive, coordinated roll toward a

30° or 40° angle of bank. As this is in progress, the pilot

tilts his or her head forward, looks to the right or left, then

immediately returns his or her head to an upright position.

The instructor pilot should time the maneuver so the roll is

stopped as the pilot returns his or her head upright. An intense

disorientation is usually produced by this maneuver, and the

pilot experiences the sensation of falling downward into the

direction of the roll.

In the descriptions of these maneuvers, the instructor pilot is

doing the flying, but having the pilot do the flying can also

be a very effective demonstration. The pilot should close his

or her eyes and tilt the head to one side. The instructor pilot

tells the pilot what control inputs to perform. The pilot then

attempts to establish the correct attitude or control input with

eyes closed and head tilted. While it is clear the pilot has no

idea of the actual attitude, he or she will react to what the

senses are saying. After a short time, the pilot will become

disoriented and the instructor pilot will tell the pilot to look

up and recover. This exercise allows the pilot to experience

the disorientation while flying the aircraft.

Coping with Spatial Disorientation

To prevent illusions and their potentially disastrous

consequences, pilots can:

1. Understand the causes of these illusions and remain

constantly alert for them. Take the opportunity to

experience spatial disorientation illusions in a device,

such as a Barany chair, a Vertigon, or a Virtual Reality

Spatial Disorientation Demonstrator.

2. Always obtain and understand preflight weather

briefings.

3. Before flying in marginal visibility (less than 3 miles)

or where a visible horizon is not evident, such as flight

over open water during the night, obtain training and

maintain proficiency in aircraft control by reference

to instruments.

4. Do not fly into adverse weather conditions or into

dusk or darkness unless proficient in the use of flight

instruments. If intending to fly at night, maintain

There are several objectives in demonstrating these various

maneuvers.

1. They teach pilots to understand the susceptibility of

the human system to spatial disorientation.

2. They demonstrate that judgments of aircraft attitude

based on bodily sensations are frequently false.

3. They help decrease the occurrence and degree

of disorientation through a better understanding

of the relationship between aircraft motion, head

movements, and resulting disorientation.

4. They help instill a greater confidence in relying on

flight instruments for assessing true aircraft attitude.

A pilot should not attempt any of these maneuvers at

low altitudes or in the absence of an instructor pilot or an

appropriate safety pilot.

Climbing While Accelerating

With the pilot’s eyes closed, the instructor pilot maintains

approach airspeed in a straight-and-level attitude for several

seconds, then accelerates while maintaining straight-and-

level attitude. The usual illusion during this maneuver,

without visual references, is that the aircraft is climbing.

Climbing While Turning

With the pilot’s eyes still closed and the aircraft in a straight-

and-level attitude, the instructor pilot now executes, with a

relatively slow entry, a well coordinated turn of about 1.5

positive G (approximately 50° bank) for 90°. While in the

turn, without outside visual references and under the effect of

the slight positive G, the usual illusion produced is that of a

climb. Upon sensing the climb, the pilot should immediately

open the eyes to see that a slowly established, coordinated

turn produces the same sensation as a climb.

Diving While Turning

Repeating the previous procedure, but with the pilot’s

eyes should be kept closed until recovery from the turn is

approximately one-half completed, can create the illusion of

diving while turning.

Tilting to Right or Left

While in a straight-and-level attitude, with the pilot’s eyes

closed, the instructor pilot executes a moderate or slight skid

to the left with wings level. This creates the illusion of the

body being tilted to the right.

Reversal of Motion

This illusion can be demonstrated in any of the three planes

of motion. While straight and level, with the pilot’s eyes

closed, the instructor pilot smoothly and positively rolls the

night-flight currency and proficiency. Include cross-

country and local operations at various airfields.

5. Ensure that when outside visual references are used,

they are reliable, fixed points on the Earth’s surface.

6. Avoid sudden head movement, particularly during

takeoffs, turns, and approaches to landing.

7. Be physically tuned for flight into reduced visibility.

Ensure proper rest, adequate diet, and, if flying at

night, allow for night adaptation. Remember that

illness, medication, alcohol, fatigue, sleep loss, and

mild hypoxia are likely to increase susceptibility to

spatial disorientation.

8. Most importantly, become proficient in the use of

flight instruments and rely upon them. Trust the

instruments and disregard your sensory perceptions.

The sensations that lead to illusions during instrument

flight conditions are normal perceptions experienced by

pilots. These undesirable sensations cannot be completely

prevented, but through training and awareness, pilots can

ignore or suppress them by developing absolute reliance

on the flight instruments. As pilots gain proficiency in

instrument flying, they become less susceptible to these

illusions and their effects.

Optical Illusions

Of the senses, vision is the most important for safe flight.

However, various terrain features and atmospheric conditions

can create optical illusions. These illusions are primarily

associated with landing. Since pilots must transition from

reliance on instruments to visual cues outside the flight

deck for landing at the end of an instrument approach, it

is imperative that they be aware of the potential problems

associated with these illusions and take appropriate corrective

action. The major illusions leading to landing errors are

described below.

Runway Width Illusion

A narrower-than-usual runway can create an illusion that the

aircraft is at a higher altitude than it actually is, especially

when runway length-to-width relationships are comparable.

[Figure 17-7] The pilot who does not recognize this illusion

will fly a lower approach, with the risk of striking objects

along the approach path or landing short. A wider-than-

usual runway can have the opposite effect with the risk of

the pilot leveling out the aircraft high and landing hard or

overshooting the runway.

Runway and Terrain Slopes Illusion

An upsloping runway, upsloping terrain, or both can create an

illusion that the aircraft is at a higher altitude than it actually

is. [Figure 17-7] The pilot who does not recognize this

illusion will fly a lower approach. Downsloping runways and

downsloping approach terrain can have the opposite effect.

Featureless Terrain Illusion

An absence of surrounding ground features, as in an

overwater approach over darkened areas or terrain made

featureless by snow, can create an illusion that the aircraft is

at a higher altitude than it actually is. This illusion, sometimes

referred to as the “black hole approach,” causes pilots to fly

a lower approach than is desired.

Water Refraction

Rain on the windscreen can create an illusion of being at a

higher altitude due to the horizon appearing lower than it is.

This can result in the pilot flying a lower approach.

Haze

Atmospheric haze can create an illusion of being at a greater

distance and height from the runway. As a result, the pilot

has a tendency to be low on the approach. Conversely,

extremely clear air (clear bright conditions of a high attitude

airport) can give the pilot the illusion of being closer than

he or she actually is, resulting in a high approach that may

result in an overshoot or go around. The diffusion of light

due to water particles on the windshield can adversely affect

depth perception. The lights and terrain features normally

used to gauge height during landing become less effective

for the pilot.

Fog

Flying into fog can create an illusion of pitching up. Pilots

who do not recognize this illusion often steepen the approach

abruptly.

Ground Lighting Illusions

Lights along a straight path, such as a road or lights on moving

trains, can be mistaken for runway and approach lights. Bright

runway and approach lighting systems, especially where

few lights illuminate the surrounding terrain, may create the

illusion of less distance to the runway. The pilot who does

not recognize this illusion will often fly a higher approach.

How To Prevent Landing Errors Due to Optical

Illusions

To prevent these illusions and their potentially hazardous

consequences, pilots can:

1. Anticipate the possibility of visual illusions during

approaches to unfamiliar airports, particularly at night

or in adverse weather conditions. Consult airport

Figure 17-7. Runway illusions.

25

Normal Approach

25 Normal Approach

2525

25

Normal Approach

25

Normal Approach

Downsloping runway Upsloping runway

Upsloping runway Downsloping runway

Wider runway Narrower runway

Wider runwayNarrower runway

Normal approach Approach due to illusion

Runway width illusion

• A narrower-than-usual runway can

create an illusion that the aircraft

is higher than it actually is, leading

to a lower approach.

• A wider-than-usual runway can

create an illusion that the aircraft is

lower than it actually is, leading to

a higher approach.

Runway slope illusion

• A downsloping runway can create

the illusion that the aircraft is lower

than it actually is, leading to a

higher approach.

• An upsloping runway can create

the illusion that the aircraft is higher

than it actually is, leading to a lower

approach.

diagrams and the Chart Supplement U.S. (formerly

Airport/Facility Directory) for information on runway

slope, terrain, and lighting.

2. Make frequent reference to the altimeter, especially

during all approaches, day and night.

3. If possible, conduct an aerial visual inspection of

unfamiliar airports before landing.

4. Use Visual Approach Slope Indicator (VASI) or

Precision Approach Path Indicator (PAPI) systems

for a visual reference, or an electronic glideslope,

whenever they are available.

5. Utilize the visual descent point (VDP) found on many

nonprecision instrument approach procedure charts.

6. Recognize that the chances of being involved in an

approach accident increase when an emergency or

other activity distracts from usual procedures.

7. Maintain optimum proficiency in landing procedures.

In addition to the sensory illusions due to misleading inputs to

the vestibular system, a pilot may also encounter various visual

illusions during flight. Illusions rank among the most common

factors cited as contributing to fatal aviation accidents.

Sloping cloud formations, an obscured horizon, a dark scene

spread with ground lights and stars, and certain geometric

patterns of ground light can create illusions of not being

aligned correctly with the actual horizon. Various surface

features and atmospheric conditions encountered in landing

can create illusions of being on the wrong approach path.

Landing errors due to these illusions can be prevented by

anticipating them during approaches, inspecting unfamiliar

airports before landing, using electronic glideslope or VASI

systems when available, and maintaining proficiency in

landing procedures.

Motion Sickness

Motion sickness, or airsickness, is caused by the brain

receiving conflicting messages about the state of the body. A

pilot may experience motion sickness during initial flights, but

it generally goes away within the first few lessons. Anxiety

and stress, which may be experienced at the beginning of

flight training, can contribute to motion sickness. Symptoms

of motion sickness include general discomfort, nausea,

dizziness, paleness, sweating, and vomiting.

It is important to remember that experiencing airsickness is

no reflection on one’s ability as a pilot. If prone to motion

sickness, let the flight instructor know, there are techniques

that can be used to overcome this problem. For example,

avoid lessons in turbulent conditions until becoming more

comfortable in the aircraft or start with shorter flights and

graduate to longer instruction periods. If symptoms of motion

sickness are experienced during a lesson, opening fresh air

vents, focusing on objects outside the airplane, and avoiding

unnecessary head movements may help alleviate some of the

discomfort. Although medications like Dramamine can prevent

airsickness in passengers, they are not recommended while

flying since they can cause drowsiness and other problems.

Carbon Monoxide (CO) Poisoning

CO is a colorless and odorless gas produced by all internal

combustion engines. Attaching itself to the hemoglobin in

the blood about 200 times more easily than oxygen, CO

prevents the hemoglobin from carrying oxygen to the cells,

resulting in hypemic hypoxia. The body requires up to 48

hours to dispose of CO. If severe enough, the CO poisoning

can result in death. Aircraft heater vents and defrost vents

may provide CO a passageway into the cabin, particularly if

the engine exhaust system has a leak or is damaged. If a strong

odor of exhaust gases is detected, assume that CO is present.

However, CO may be present in dangerous amounts even

if no exhaust odor is detected. Disposable, inexpensive CO

detectors are widely available. In the presence of CO, these

detectors change color to alert the pilot of the presence of CO.

Some effects of CO poisoning are headache, blurred vision,

dizziness, drowsiness, and/or loss of muscle power. Any time

a pilot smells exhaust odor, or any time these symptoms are

experienced, immediate corrective action should be taken

including turning off the heater, opening fresh air vents and

windows, and using supplemental oxygen, if available.

Tobacco smoke also causes CO poisoning. Smoking at

sea level can raise the CO concentration in the blood and

result in physiological effects similar to flying at 8,000 feet.

Besides hypoxia, tobacco causes diseases and physiological

debilitation that can be medically disqualifying for pilots.

Stress

Stress is the body’s response to physical and psychological

demands placed upon it. The body’s reaction to stress includes

releasing chemical hormones (such as adrenaline) into the

blood and increasing metabolism to provide more energy

to the muscles. Blood sugar, heart rate, respiration, blood

pressure, and perspiration all increase. The term “stressor”

is used to describe an element that causes an individual to

experience stress. Examples of stressors include physical

stress (noise or vibration), physiological stress (fatigue), and

psychological stress (difficult work or personal situations).

Stress falls into two broad categories: acute (short term) and

chronic (long term). Acute stress involves an immediate

threat that is perceived as danger. This is the type of stress that

triggers a “fight or flight” response in an individual, whether

the threat is real or imagined. Normally, a healthy person can

cope with acute stress and prevent stress overload. However,

ongoing acute stress can develop into chronic stress.

Chronic stress can be defined as a level of stress that presents

an intolerable burden, exceeds the ability of an individual

to cope, and causes individual performance to fall sharply.

Unrelenting psychological pressures, such as loneliness,

financial worries, and relationship or work problems can

produce a cumulative level of stress that exceeds a person’s

ability to cope with the situation. When stress reaches these

levels, performance falls off rapidly. Pilots experiencing

this level of stress are not safe and should not exercise their

airman privileges. Pilots who suspect they are suffering from

chronic stress should consult a physician.

Original source PDFPublished from pages 7–12 of the recorded source chapter.
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