Aeromedical Orientation Practice Exam

During ascent or descent, the middle ear must be able to equalize with the outside air pressure through the Eustachian tube. If the tube doesn’t open adequately, a pressure difference builds across the tympanic membrane, leading to ear pain, muffled hearing, and sometimes vertigo as the inner ear is affected by the rapid pressure change. Prevention focuses on keeping the Eustachian tube working and using pressure-equalization techniques: swallow, yawn, or chew gum to encourage opening, and perform a gentle Valsalva maneuver (pinch the nose and softly blow with the mouth closed) to equalize air pressure. If congestion or a cold is present, treat it or delay flying if possible to improve tube function; avoid flying with significant nasal obstruction or active infection. If you can’t equalize or the pain persists, pause descent and attempt to equalize, or seek medical advice. Other signs like nosebleeds, nasal discharge, coughing, sore throat, or facial numbness are not typical indicators of middle ear barotrauma during flight.