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20-September-2008 10:08:30 - Fatigue medical Exhausted redirects here. For the alternative rock song, see Exhausted song. Exhaustion redirects here. For other uses, see Exhaust disambiguation. Lethargy redirects here. For the death metal band, see Lethargy band. Symptom/Sign: Fatigue Classifications and external resources ICD-10 R53. ICD-9 780.7 DiseasesDB 30079 MedlinePlus 003088 MeSH D005221 Fatigue also called exhaustion, lethargy, languidness, languor, lassitude, and listlessness is a weariness caused by exertion. It can describe a range of afflictions, varying from a general state of lethargy to a specific work-induced burning sensation within one's muscles. It can be both physical and mental. Physical fatigue is the inability to continue functioning at the level of one's normal abilities.123 It is ubiquitous in everyday life, but usually becomes particularly noticeable during heavy exercise. Mental fatigue, on the other hand, rather manifests in somnolence. Contents 1 Types 1.1 Physical fatigue 1.2 Mental fatigue 2 Causes 2.1 Diseases and Conditions 2.2 Medications 3 Fatigue in aviation 3.1 Fatigue in Military Flight Operations 4 See also 5 References 6 External links Types Physical fatigue Main article: Muscle weakness Physical fatigue or muscle weakness or lack of strength is a direct term for the inability to exert force with one's muscles to the degree that would be expected given the individual's general physical fitness. A test of strength is often used during a diagnosis of a muscular disorder before the etiology can be identified. Such etiology depends on the type of muscle weakness, which can be true or perceived as well as central or peripheral. True weakness is substantial, while perceived rather is a sensation of having to put more effort to do the same task. On the other hand, central muscle weakness is an overall exhaustion of the whole body, while peripheral weakness is an exhaustion of individual muscles. Mental fatigue See also: Somnolence In addition to physical, fatigue also includes mental fatigue, not necessarily including any muscle fatigue. Such a mental fatigue, in turn, can manifest itself both as somnolence decreased wakefulness or just as a general decrease of attention, not necessarily including sleepiness. In any case, this can be dangerous when performing tasks that require constant concentration, such as driving a vehicle. For instance, a person who is sufficiently somnolent may experience microsleeps. However, objective cognitive testing should be done to differentiate the neurocognitive deficits of brain disease from those attributable to tiredness. Causes Fatigue is typically the result of working, mental stress, over stimulation and under stimulation, jet lag or active recreation, depression, and also boredom, disease and lack of sleep. It may also have chemical causes, such as poisoning or mineral or vitamin deficiencies. Massive blood loss, resulting in anemia, frequently results in fatigue. The sense of fatigue is believed to originate in the reticular activating system of the lower brain. Musculoskeletal structures may have co-evolved with appropriate brain structures so that the complete unit functions together in a constructive and adaptive fashion.4 The entire systems of muscles, joints, and proprioceptive and kinesthetic functions plus parts of the brain evolve and function together in a unitary way.5 Diseases and Conditions Temporary fatigue is likely to be a minor illness like the common cold. Chronic fatigue, on the other hand, meaning of six months or more duration, is a symptom of a large number of different diseases or conditions. Autoimmune diseases Anemia Anorexia Nervosa Anxiety or Panic Disorder Arthritis Cancer Celiac Disease Chemical dependency Chronic fatigue syndrome CFS Clinical depression Da Costa's syndrome Diabetes Endometriosis Female androgen insufficiency syndrome Fibromyalgia Heart disease Hemochromatosis Hypothyroidism Infectious diseases Lead poisoning Leukemia or Lymphoma Lyme disease Muscular Dystrophy Parkinson's disease Post-Concussion Syndrome Pregnancy Sinusitis Sleep deprivation or sleep disorders Spondyloarthropathy Superior canal dehiscence syndrome Wilson's disease Certain medications, e.g. lithium salts, ciprofloxacin Medications Beta blocker medication causes fatigue, especially after exertion, inducing exercise intolerance.6 Many cancer treatments cause fatigue, particularly chemotherapy and radiotherapy Fatigue in aviation In 1999, the National Aeronautics and Space Administration, NASA, testified before the U.S. House of Representatives that pilot fatigue impacts aviation safety with unknown magnitude. The report cited evidence of fatigue issues in areas including aviation operations, laboratory studies, high-fidelity simulations, and surveys. The report indicates that studies consistently show that fatigue is an on-going problem in aviation safety.7 A November 2007 report by the National Transportation Safety Board indicates that air crew fatigue is a much larger, and more widespread, problem than previously reported.8 The report indicates that since 1993 there have been 10 major airline crashes caused by aircrew fatigue, resulting in 260 fatalities. Additionally, a voluntary anonymous reporting system known as ASAP, Aviation Safety Action Program,9 reveals widespread concern among aviation professionals about the safety implications of fatigue. The NTSB published that FAA's response to fatigue is unacceptable and listed the issue among its Most Wanted safety issues.10 Fatigue in Military Flight Operations In the late 1990s the US Air Force began testing and developing the Fatigue Avoidance Scheduling Tool FAST, to address the problem of aircrew fatigue in aircrew flight scheduling.11 According to the Air Force Research Lab, Human Effectiveness Directorate, FAST is a fatigue forecasting system developed by NTI and SAIC under a small business innovative research SBIR grant from the US Air Force. Fatigue predictions are derived from the Sleep, Activity, Fatigue, and Task Effectiveness SAFTEtm model invented by Dr. Steven Hursh, currently the President of the Institutes for Behavior Resources and Adjunct Professor of Behavioral Biology, Johns Hopkins University School of Medicine. The SAFTEtm model has received a broad scientific review and the DoD considers it a complete, accurate, and operationally practical model to aid operator scheduling.12 After several years of attempting to integrate proactive fatigue risk mitigation into Air Force scheduling, the FAST model fell into mainly a mishap analysis role. Since its 2003 release, FAST was primarily used by the Air Force to investigate fatigue factors in aircraft mishaps, after the fact.13 Following an aircraft mishap, Air Force crash investigators would consult fatigue and human performance experts at the Air Force Research Laboratory's Fatigue Countermeasures Branch at Brooks City-Base in San Antonio, TX. The scientists at the Lab would run the FAST model to determine the possible impact, if any, of aircrew fatigue on the mishap. The tool required expert level knowledge of the data input methods and was ideally suited for analyzing historical flying schedules, but did not achieve widespread use in prevention or future scheduling except in B-2 bomber operations. In early 2007, the 201 Airlift Squadron of the District of Columbia Air National Guard, successfully integrated FAST into its daily scheduling operations. This integration required the full-time attention of two pilot schedulers, but yielded valuable risk mitigation data that could be used by planners and leaders to predict and adjust critical times of fatigue in the flight schedule. In August 2007, the Air National Guard Aviation Safety Division funded a project to improve the User Interface of FAST, permitting daily use by pilot schedulers and integration with automated flight scheduling software.14 See also Combat stress reaction Battle fatigue Malaise Asthenia Paresis Debility Muscle fatigue Eye circles References ^ Gandevia SC 1992. Some central and peripheral factors affecting human motoneuronal output in neuromuscular fatigue. Sports medicine Auckland, N.Z. 13 2: 93-8. PMID 1561512. ^ Hagberg M 1981. Muscular endurance and surface electromyogram in isometric and dynamic exercise. Journal of applied physiology: respiratory, environmental and exercise physiology 51 1: 1-7. PMID 7263402. ^ Hawley JA, Reilly T 1997. Fatigue revisited. Journal of sports sciences 15 3: 245-6. PMID 9232549. ^ Edelman, Gerald Maurice 1989. The remembered present: a biological theory of consciousness. New York: Basic Books. ISBN 0-465-06910-X. ^ Kelso, J. A. Scott 1995. Dynamic patterns: the self-organization of brain and behavior. Cambridge, Mass: MIT Press. ISBN 0-262-61131-7. ^ Fatigue caused by medications. ^ NASA report to Congress on fatigue, http://comair-5191.com/NASA%20Statement%20on%20Pilot%20Fatigue.pdf ^ USA Today coverage of NTSB report, http://www.usatoday.com/news/washington/2007-04-10-fatigue-air-safety_N.htm ^ FAA's ASAP Program, http://www.faa.gov/safety/programs_initiatives/aircraft_aviation/asap/ ^ NTSB Most Wanted List, fatigue, http://www.ntsb.gov/Recs/mostwanted/aviation_reduce_acc_inc_humanfatig.htm ^ Air Force Research Lab summary of project, http://www.dtic.mil/dticasd/ddsm/srch/ddsm0219.html ^ DoD's SAFTE Model, Hursch, et al, http://www.nps.navy.mil/orfacpag/resumePages/projects/Fatigue/HurshSAFTEFAST.pdf ^ DoD's SAFTE Model as investigation tool, Hursch, et al, http://www.nps.navy.mil/orfacpag/resumePages/projects/Fatigue/HurshSAFTEFAST.pdf ^ ANG Aviation Safety Division's Fatigue Project, Fly Awake, http://www.FlyAwake.org External links Fatigue -- Information for Patients, U.S. National Cancer Institute v d e Symptoms and signs: general R50-R69, 780-789 Fever Hyperpyrexia - Fever of unknown origin Pain Headache - Chronic pain Malaise/Fatigue Asthenia - Debility Fainting/syncope Vasovagal syncope - Carotid sinus syncope - Heat syncope Ingestion food and fluid intake Anorexia, Polydipsia, Polyphagia - Cachexia - Xerostomia Anorexia/Weight loss Hemodynamic Shock: Cardiogenic - Hypovolemic - Distributive Septic, Neurogenic Edema: Peripheral edema - Anasarca Hyperaemia: Functional - Reactive Lymphadenopathy Underdevelopment Delayed milestone - Failure to thrive - Short stature Idiopathic Other Seizure Febrile seizure Hyperhidrosis Sleep hyperhidrosis Clubbing - Tenderness v d e Common cold Viruses Rhinovirus - Coronavirus - Human parainfluenza viruses - Human respiratory syncytial virus - Adenovirus - Enterovirus - Metapneumovirus Symptoms Pharyngitis - Rhinorrhea - Nasal congestion - Sneezing - Cough - Muscle aches - Fatigue - Malaise - Headache - Weakness - Loss of appetite Complications Acute bronchitis - Bronchiolitis - Croup - Pneumonia - Sinusitis - Otitis media - Strep throat Antiviral drugs Pleconaril experimental Retrieved from http://en..org/wiki/Fatigue_medical Categories: Exercise physiology | Symptoms Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Català Deutsch Español Français עברית Nederlands 日本語 Português Shqip Suomi ไทย ייִדיש Svenska This page was last modified on 18 August 2008, at 10:19
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