68W ALC PHASE 3 QUESTIONS & ANSWERS
What is Threat Stress? - Answer -Anything that stimulates the sympathetic nervous
system (fight-or-flight).
Examples of threat stress? - Answer -Bullets flying, written test, practical test,
intimidating instructor.
The nervous system is divided into two main structural divisions: - Answer -The Central
Nervous System (CNS) and the Peripheral Nervous System (PNS)
Central Nervous System (CNS) - Answer -Controls the brain and spinal cord.
The Peripheral is divided into two sub-systems: - Answer -The Somatic Nervous
System and the Autonomic Nervous System.
The Somatic Nervous System - Answer -Controls sensory nerves and the efferent,
motor nerves (intentional movement and sensation).
The Autonomic Nervous System - Answer -Controls automatic (involuntary) body
functions (unconscious body functions).
1. The physiological effects seen from threat stress are under the influence of the
Autonomic Nervous System, which is a sub-system of the Peripheral Nervous System.
2. The Autonomic Nervous System is further broken down into two sub-systems:
a. Sympathetic Nervous System (Fight-or-Fight)
b. Parasympathetic Nervous System ("Feed and Breed")
Two sub-systems of the Autonomic Nervous System? - Answer -1. Sympathetic
Nervous System (Fight-or-Flight)
2. Parasympathetic Nervous System ("Feed and Breed")
Sympathetic Nervous System (Fight-or-Flight) - Answer -This system is mediated by
catecholamine's including epinephrine (adrenalin), norepinephrine and dopamine.
Effects of Sympathetic Nervous System (Fight or flight) - Answer -1. Pupil dilation.
Enables better light gathering for better vision, but causes loss of depth perception and
loss of peripheral vision. This may cause problems for 68Ws with Intravenous
catheterization and surgical cricothyroidotomy.
,2. Tremors. This may make handling of tools and performance of procedures such as
intravenous catheterization, surgical cricothyroidotomy and writing more difficult.
3. Tachycardia. May cause more oxygen consumption.
4. Vasoconstriction. May result in decreased large muscle endurance due to decreased
oxygen supply.
5. Bronchodilation. May result in enhanced respiration.
6. Blood shunting from the fore-brain (the human, thinking part of our brain) to the
midbrain (the basic, mammal, animal-instinct part of our brain). Result in decreased
cognitive (thinking) ability.
7. Enhanced neural stimulation of large muscle groups. Resulting in more strength.
Effects of Parasympathetic Nervous System ("Feed and Breed") include: - Answer -1.
Asserts an opposite effect to the SNS (Sympathetic Nervous System).
2. Mediated by acetylcholine, mainly in the 10th Cranial Nerve (Vagus Nerve).
3. Stimulates digestion, slowing of the heart rate and reproductive functions.
4. Since pulse increases as SNS stimulation increases, pulse can be used as an
approximate indicator of stimulation.
What does not correlate with SNS (Sympathetic Nervous System) stimulation? -
Answer -Tachycardia due to medications, illness, or exercise.
Physiological changes: fear and performance are based on levels of physiological
stimulation during battle, which are categorized within five conditions: - Answer -1.
Condition White
2. Condition Yellow
3. Condition Red
4. Condition Black
5. Condition Gray
Describe Condition White? - Answer -The individuals baseline vital signs are at normal
range with no elevated stimulation.
1. Normal pulse, respiratory rate, fine motor skills intact, cognition normal.
2. Example is a deployed Soldier in his billet or recreation area.
Describe Condition Yellow? - Answer -Limited stimulation.
,1. Pulse rate approximately 80-115.
2. Heightened awareness, normal respiratory rate, blood pressure elevated, tremors.
3. Fine motor skills deteriorate at 115 BPM.
4. Example: Soldier locking and loading as he rolls out of the wire.
Describe Condition Red? - Answer -Condition Red is significant stimulation.
1. Pulse rate approximately 115-145.
2. Complex motor skills, cognition, and visual reaction time at peak.
3. Example: Soldier in a firefight, especially at initial ambush/IED.
**Ideal Training Zone**
Describe Condition black? - Answer -Maximum stimulation.
1. Pulse rate above 145-175.
2. Cognition decreases.
3. Loss of depth perception, peripheral vision and near vision.
4. Auditory exclusion (decreased hearing).
Describe Condition Gray? - Answer -A special level within Condition Black.
1. Simple motor functions can still be performed by very well trained operators.
2. Example: NASCAR drivers often perform for hours at a pulse of 170 and can still
perform their "mission," but that only includes simple turns, pedal controls and shifting.
3. Another Example: The Special Forces Soldier who can clear a building in Condition
Gray with relatively simple movements of walking, kicking doors, and firing weapons.
**Muscle Memory**
Describe is Failure Mode? - Answer -1. Pulse above 175.
2. Irrational fight or fly.
3. Submissive behavior.
, 4. Loss of bowel or bladder control.
5. Gross motor skills at highest level.
The impact of these conditions (White, Yellow, Red, Black, Gray) can vary significantly
depending upon what? - Answer -Physical fitness
What are three types of Threat Stress Management? - Answer -1. Stress Inoculation
2. Training Variables
3. Breathing Control
Threat Stress Management - Stress Inoculation - Answer -The process of building a
person's resistance to the effects of threat stress. It is similar to inoculating a person to
a disease and building resistance to it.
Stress inoculation occurs best with realistic training during which condition? - Answer -
Condition Red. This requires instructors to be able to recognize the condition of the
trainee and add or subtract stress to keep them in Condition Red.
Threat Stress Management - Training Variables - Answer -a. Environment (classroom
vs. outdoors)
b. Uniform (ACU vs. ACU with body armor, helmet and weapon)
c. Distractors (noise, smoke, odors)
d. Task complexity (simple, isolated task vs. task embedded in a tactical scenario)
e. Stressors from the instructor: 1) Intimidation (yelling, berating, cursing, glaring,
disruption). 2) Scrutinization (questioning, close observation, second guessing).
Threat Stress Management - Breathing Control - Answer -a. Controlled breathing
stimulates the Parasympathetic Nervous System (PNS) to counteract the sympathetic
stimulation (effects of adrenalin).
b. One effective method is a slow, deep inhalation lasting 4 seconds, holding it for 4
seconds, and a slow, full exhalation lasting 4 seconds.
What is TCCC? - Answer -Tactical Combat Casualty Care
TCCC Goals - Answer -a. Complete the mission
b. Prevent additional causalities (i.e. fire superiority)
What is Threat Stress? - Answer -Anything that stimulates the sympathetic nervous
system (fight-or-flight).
Examples of threat stress? - Answer -Bullets flying, written test, practical test,
intimidating instructor.
The nervous system is divided into two main structural divisions: - Answer -The Central
Nervous System (CNS) and the Peripheral Nervous System (PNS)
Central Nervous System (CNS) - Answer -Controls the brain and spinal cord.
The Peripheral is divided into two sub-systems: - Answer -The Somatic Nervous
System and the Autonomic Nervous System.
The Somatic Nervous System - Answer -Controls sensory nerves and the efferent,
motor nerves (intentional movement and sensation).
The Autonomic Nervous System - Answer -Controls automatic (involuntary) body
functions (unconscious body functions).
1. The physiological effects seen from threat stress are under the influence of the
Autonomic Nervous System, which is a sub-system of the Peripheral Nervous System.
2. The Autonomic Nervous System is further broken down into two sub-systems:
a. Sympathetic Nervous System (Fight-or-Fight)
b. Parasympathetic Nervous System ("Feed and Breed")
Two sub-systems of the Autonomic Nervous System? - Answer -1. Sympathetic
Nervous System (Fight-or-Flight)
2. Parasympathetic Nervous System ("Feed and Breed")
Sympathetic Nervous System (Fight-or-Flight) - Answer -This system is mediated by
catecholamine's including epinephrine (adrenalin), norepinephrine and dopamine.
Effects of Sympathetic Nervous System (Fight or flight) - Answer -1. Pupil dilation.
Enables better light gathering for better vision, but causes loss of depth perception and
loss of peripheral vision. This may cause problems for 68Ws with Intravenous
catheterization and surgical cricothyroidotomy.
,2. Tremors. This may make handling of tools and performance of procedures such as
intravenous catheterization, surgical cricothyroidotomy and writing more difficult.
3. Tachycardia. May cause more oxygen consumption.
4. Vasoconstriction. May result in decreased large muscle endurance due to decreased
oxygen supply.
5. Bronchodilation. May result in enhanced respiration.
6. Blood shunting from the fore-brain (the human, thinking part of our brain) to the
midbrain (the basic, mammal, animal-instinct part of our brain). Result in decreased
cognitive (thinking) ability.
7. Enhanced neural stimulation of large muscle groups. Resulting in more strength.
Effects of Parasympathetic Nervous System ("Feed and Breed") include: - Answer -1.
Asserts an opposite effect to the SNS (Sympathetic Nervous System).
2. Mediated by acetylcholine, mainly in the 10th Cranial Nerve (Vagus Nerve).
3. Stimulates digestion, slowing of the heart rate and reproductive functions.
4. Since pulse increases as SNS stimulation increases, pulse can be used as an
approximate indicator of stimulation.
What does not correlate with SNS (Sympathetic Nervous System) stimulation? -
Answer -Tachycardia due to medications, illness, or exercise.
Physiological changes: fear and performance are based on levels of physiological
stimulation during battle, which are categorized within five conditions: - Answer -1.
Condition White
2. Condition Yellow
3. Condition Red
4. Condition Black
5. Condition Gray
Describe Condition White? - Answer -The individuals baseline vital signs are at normal
range with no elevated stimulation.
1. Normal pulse, respiratory rate, fine motor skills intact, cognition normal.
2. Example is a deployed Soldier in his billet or recreation area.
Describe Condition Yellow? - Answer -Limited stimulation.
,1. Pulse rate approximately 80-115.
2. Heightened awareness, normal respiratory rate, blood pressure elevated, tremors.
3. Fine motor skills deteriorate at 115 BPM.
4. Example: Soldier locking and loading as he rolls out of the wire.
Describe Condition Red? - Answer -Condition Red is significant stimulation.
1. Pulse rate approximately 115-145.
2. Complex motor skills, cognition, and visual reaction time at peak.
3. Example: Soldier in a firefight, especially at initial ambush/IED.
**Ideal Training Zone**
Describe Condition black? - Answer -Maximum stimulation.
1. Pulse rate above 145-175.
2. Cognition decreases.
3. Loss of depth perception, peripheral vision and near vision.
4. Auditory exclusion (decreased hearing).
Describe Condition Gray? - Answer -A special level within Condition Black.
1. Simple motor functions can still be performed by very well trained operators.
2. Example: NASCAR drivers often perform for hours at a pulse of 170 and can still
perform their "mission," but that only includes simple turns, pedal controls and shifting.
3. Another Example: The Special Forces Soldier who can clear a building in Condition
Gray with relatively simple movements of walking, kicking doors, and firing weapons.
**Muscle Memory**
Describe is Failure Mode? - Answer -1. Pulse above 175.
2. Irrational fight or fly.
3. Submissive behavior.
, 4. Loss of bowel or bladder control.
5. Gross motor skills at highest level.
The impact of these conditions (White, Yellow, Red, Black, Gray) can vary significantly
depending upon what? - Answer -Physical fitness
What are three types of Threat Stress Management? - Answer -1. Stress Inoculation
2. Training Variables
3. Breathing Control
Threat Stress Management - Stress Inoculation - Answer -The process of building a
person's resistance to the effects of threat stress. It is similar to inoculating a person to
a disease and building resistance to it.
Stress inoculation occurs best with realistic training during which condition? - Answer -
Condition Red. This requires instructors to be able to recognize the condition of the
trainee and add or subtract stress to keep them in Condition Red.
Threat Stress Management - Training Variables - Answer -a. Environment (classroom
vs. outdoors)
b. Uniform (ACU vs. ACU with body armor, helmet and weapon)
c. Distractors (noise, smoke, odors)
d. Task complexity (simple, isolated task vs. task embedded in a tactical scenario)
e. Stressors from the instructor: 1) Intimidation (yelling, berating, cursing, glaring,
disruption). 2) Scrutinization (questioning, close observation, second guessing).
Threat Stress Management - Breathing Control - Answer -a. Controlled breathing
stimulates the Parasympathetic Nervous System (PNS) to counteract the sympathetic
stimulation (effects of adrenalin).
b. One effective method is a slow, deep inhalation lasting 4 seconds, holding it for 4
seconds, and a slow, full exhalation lasting 4 seconds.
What is TCCC? - Answer -Tactical Combat Casualty Care
TCCC Goals - Answer -a. Complete the mission
b. Prevent additional causalities (i.e. fire superiority)
