Body Temperature

Dr. Shafali Singh

Learning Objectives
List the mechanisms by which heat is
produced in and lost from the body.
Comment on the differences in temperature
in the hypothalamus, rectum, oral cavity,
and skin.
List the temperature-regulating mechanisms,
and describe the way in which they are
integrated under hypothalamic control to
maintain normal body temperature.
Applied

Humans maintain a normal body

temperature at a set point of 37 C
(98.6 F)
Core Temperature: The temperature of the deep
tissues of the bodythe core of the bodyremains
very constant, within 1F (0.6C)
Range from less than 97F (36C) to over 99.5F
(37.5C).
The average normal core temperature is generally
considered to be between 98.0 and 98.6F when
measured orally and about 1F higher when
measured rectally
Skin temperature: in contrast to the core
temperature, rises and falls with the temperature of
the surroundings.

Body Temperature Is Controlled by Balancing

Heat Production Against Heat Loss

When the rate of heat production in

the body is greater than the rate at
which heat is being lost, heat builds
up in the body and the body
temperature rises.
Conversely, when heat loss is
greater, both body heat and body
temperature decrease.

Heat Production

Heat Production
(1) basal rate of metabolism of all the cells of the body;
extra rate of metabolism
2) caused by muscle activity
3)caused by the effect of thyroxine
(and, to a less extent, growth hormone and
testosterone) on the cells;
4) caused by the effect of epinephrine, nor-epinephrine,
and sympathetic stimulation on the cells;
5) caused by increased chemical activity in the cells
themselves
(6) extra metabolism needed for digestion, absorption,
and storage of food( thermogenic effect of food)

 Thyroid Hormones- are thermogenic:

Their actions on target tissues result
in heat production.
Major actions of thyroid hormone are
stimulation of Na+-K+ ATPase,
increased O2 consumption, increased
metabolic rate, and increased heat
production.

Heat Loss
Heat is transferred from the deeper organs( liver,
brain, and heart, and in the skeletal muscles
during exercise and tissues) to the skin, where it
is lost to the air and other surroundings.
Therefore, the rate at which heat is lost is
determined almost entirely by two factors:
(1) how rapidly heat can be conducted from
where it is pro-duced in the body core to the skin
and
(2) how rapidly heat can then be transferred
from the skin to the surroundings.

Heat Loss
Body heat is lost by:
Radiation and conduction -70 %
Vaporization of sweat- 27 %
Respiration- 2 %
Urination and defecation -1 %

Q. When an individual is naked in

a room in which the air
temperature is 21C and the
humidity 80%,the greatest amount
of heat is lost bya) Elevated metabolism
b) Respiration
c) Urination
d) Vaporization
e) Radiation and conduction

Effect of high and low atmospheric

temperatures of several hours
duration on the internal body core
temperature

Regulation of Body
TemperatureRole of the
Hypothalamus

The temperature of the body is

regulated almost entirely by nervous
feedback mechanisms, and almost
all these operate through
temperature-regulating centers
located in the hypothalamus

Role of the Anterior Hypothalamic-Preoptic Area in Thermostatic

Detection of Temperature

Anterior hypothalamic-preoptic area has been found

to contain large numbers of heat-sensitive neurons as
well as about one third as many cold-sensitive neuron
The heat-sensitive neurons increase their firing rate
2- to 10-fold in response to a 10C increase in body
temperature.
This results in profuse sweating (skin blood vessels
over the entire body become greatly dilated).
sweat glands are innervated by cholinergic nerve fibers (fibers that
secrete acetylcholine but that run in the sympathetic nerves along with
the adrenergic fibers)

Posterior Hypothalamus Integrates the Central

and Peripheral Temperature Sensory Signals
The posterior hypothalamus integrate body temperature
information from sensory receptors (primarily cold receptors)
in the skin, deep tissues, spinal cord, extrahypothalamic
portions of the brain, and the hypothalamus itself( anterior
hypothalamic-preoptic area ).
Each of these five inputs contributes about 20% of the
information that is integrated.
There are threshold core temperatures for each of the main
temperature-regulating responses and when the threshold is
reached the response begins. The threshold is 37 C for
sweating and vasodilation, 36.8 C for vasoconstriction, 36
C for nonshivering thermogenesis, and 35.5 C for shivering.

 The reflex responses activated by

cold are controlled from the posterior
hypothalamus. Posterior
hypothalamic stimulation causes
shivering
Those activated by warmth are
controlled primarily from the anterior
hypothalamus .Stimulation of the
anterior hypothalamus causes
cutaneous vasodilation and sweating

 If core temperature is below the setpoint temperature,then heatgenerating and heat-retaining

mechanisms are activated.
If core temperature is above the setpoint temperature,then heatdissipating mechanisms are
activated

Temperature-Regulating
Mechanisms
Mechanisms activated by
cold
Shivering
Hunger
Increased voluntary activity
Increased secretion of
norepinephrine and
epinephrine
Decreased heat loss
Cutaneous vasoconstriction
Curling up
Horripilation

Mechanisms activated by
heat
Increased heat loss
Cutaneous vasodilation
Sweating
Increased respiration
Decreased heat production
(shivering and chemical
thermogenesis, are
strongly inhibited.)
Anorexia
Apathy and inertia, fanning

Q.If core body temperature rises above

normal, which of the following would occur to
cool the body?
(1)dilation of vessels in the skin, (2) increased
radiation and conduction of heat to the
environ-ment, (3) increased metabolic rate,
(4) evaporation of perspiration,(5)
increased secretion of thyroid hormones.
()(a) 3, 4, and 5 (b) 1, 2, and 4 (c) 1, 2, and 5
()(d) 1, 2, 3, 4 and 5 (e) 1, 2, 4, and 5

Concept of a Set-Point
for Temperature Control
There is a critical body core
temperature of about 37.1C (98.8F)
This crucial temperature level is called
the set-point of the temperature
control mechanism.
That is, all the temperature control
mechanisms continually attempt to
bring the body temperature back to
this set-point level.

Feedback Gain for Body

Temperature Control
Feedback gain is a measure of the
effectiveness of a control system.
The feed-back gain of the temperature
control system is equal to the ratio of the
change in environmental temperature to the
change in body core temperature minus 1.0 .
Experiments have shown that the body
temperature of humans changes about 1C
for each 25 to 30C change in
environmental temperature

Abnormalities of Body
Temperature Regulation

Fever
Means a body temperature above the
usual range of normal
Caused by abnormalities in the brain
itself or by toxic substances that
affect the temperature-regulating
centers

Pathophysiology of fever

Endogenous pyrogens
,IL-1

Resetting the Hypothalamic

Temperature-Regulating Center in
Febrile Diseases

When the set-point of the

hypothalamic temperature-regulating
center becomes higher than normal,
all the mechanisms for raising the
body temperature are brought into
play, including
Heat conservation and increased
heat production

Effects of changing the set-point of the hypothalamic

temperature
controller.

Fever, within limits, is beneficial because it:

-inhibits the growth of many micro-organisms.

-increases formation of neutrophils in bone marrow
-increases antibody production, thus increasing
immunity.
-Helpful in, anthrax, pneumococcal pneumonia,
leprosy, and various fungal, rickettsial, and viral
diseases.
-slows growth of some tumors.

Very high temperatures are harmful:

-Temperature above 41 0C for prolonged periods

leads to some permanent brain damage.
-Temperature above 43 0C, death results.

Treatment
The commonest antipyretic is
aspirin(acetyl-salicylic acid).
It inhibits the enzyme cyclooxygenase,
thereby inhibiting prostaglandin secretion.
It acts directly on hypothalamus.

Heat exhaustion
Occur as a consequence of the body's
responses to elevated environmental
temperature.
Normally, the response to increased
temperature includes vasodilation and
sweating in order to dissipate heat.
However, if the sweating is excessive, it
can result in decreased ECF volume,
decreased blood volume, decreased
arterial pressure, and fainting.

Heatstroke
When the body temperature rises beyond a
critical temperature, into the range of 105 to
108F, the person is likely to develop
heatstroke.
Body temperature increases to the point of
tissue damage.
Is characterized by high core temperature and
the development of serious neurological
disturbances with a loss of consciousness and,
frequently, convulsions.

 Heat stroke occurs in two forms, classical and exertional.

In the classical form, the primary factor is environmental heat stress
that overwhelms an impaired thermoregulatory system, and most
patients have preexisting chronic disease.
In exertional heatstroke, the primary factor is high metabolic heat
production. Patients with exertional heatstroke tend to be younger
and more physically fit (typically, soldiers and athletes) than patients
with the classical form. Rhabdomyolysis, hepatic and renal injury,
and disturbances of blood clotting are frequent accompaniments of
exertional heatstroke.
The traditional diagnostic criteria of heatstrokecoma, hot dry skin,
and rectal temperature above 41.3C (106F)are characteristic of the
classical form; however, patients with exertional heatstroke may
have somewhat lower rectal temperatures and often sweat profusely

malignant hyperthermia
Various mutations of the gene coding
for the ryanodine receptor , lead to
excess Ca2+ release during muscle
contraction triggered by stress.
This in turn leads to contractures of
the muscles, increased muscle
metabolism, and a great increase in
heat production in muscle.

Periodic fevers also occur in humans

with mutations in the gene
for pyrin, a protein found in
neutrophils;
for mevalonate kinase, an enzyme
involved in
cholesterol synthesis;
for the type 1 TNF receptor, which is
involved in inflammatory responses

Acclimatization to Heat.
Soldiers on duty in the tropics and miners.
A person exposed to heat for several hours each day
while performing a reasonably heavy workload will
develop increased tolerance to hot and humid
conditions in 1 to 3 weeks.
approximately twofold increase in the maximum rate
of sweating, an increase in plasma volume, and
diminished loss of salt in the sweat and urine to
almost none
the last two effects result from increased secretion
of aldosterone by the adrenal glands.

Hypothermia
It is a lowering of core body
temperature to 35C(95F) or below.
Causes of hypothermia include an
overwhelming cold stress(immersion
in icy water), metabolic diseases
(hypoglycemia, adrenal in-sufficiency,
or hypothyroidism), drugs (alcohol,
antidepressants, sedatives, or
tranquilizers), burns, and malnutrition.

Hypothermia
Hypothermia is characterized by :
sensation of cold, shivering,
confusion, vasoconstriction, muscle
rigidity, bradycardia, acidosis,
hypoventilation, hypotension, loss of
spontaneous movement, coma, and
death (usually caused by cardiac
arrhythmias).
The elderly are at greater risk

Exposure of the Body to

Extreme Cold
Unless treated immediately, a person exposed to ice
water for 20 to 30 minutes ordinarily dies because
of heart standstill or heart fibrillation.
There is loss of Temperature Regulation at Low
Temperatures. below about 85F
the reason for this diminished temperature regulation
is that the rate of chemical heat production in each
cell is depressed.
Also, sleepiness develops (later followed by coma),
which depresses the activity of the central nervous
system heat control mechanisms and prevents
shivering

Frostbite.
When the body is exposed to extremely low
temperatures, surface areas can freeze; the freezing
is called frostbite.
This occurs especially in the lobes of the ears and in
the digits of the hands and feet.
If the freeze has been sufficient to cause extensive
formation of ice crystals in the cells, permanent
damage usually results, such as permanent
circulatory impairment as well as local tissue
damage.
Often gangrene follows thawing, and the frostbitten
areas must be removed surgically.

Artificial Hypothermia.
Induced by administering a strong sedative to depress the
reactivity of the hypothalamic temperature controller and then
cooling the person with ice or cooling blankets until the
temperature falls.
The temperature can then be maintained below 90F for
several days to a week or more by continual sprinkling of cool
water or alcohol on the body.
Such artificial cooling has been used during heart surgery so
that the heart can be stopped artificially for many minutes at
a time.
Cooling to this extent does not cause tissue damage, but it
does slow the heart and greatly depresses cell metabolism, so
that the bodys cells can survive 30 minutes to more than 1
hour without blood flow during the surgical procedure..

Q. immediately following the break of

fever(while the core temp is falling):
a. The set point gradually return to normal
b. There will be sweating and peripheral
vasodilatation
c. There will be shivering and peripheral
vasoconstriction
d. The person will feel subjectively cold

Q. Heat stroke is charateristically

associated with
a.
b.
c.
d.
e.

Profuse sweating
Elevated basal metabolic rate
Hot dry skin
a and b only are correct
b and c only are correct

The hypothalamic set-point temperature normally

averages about 98.6F. Which of the following
factors can alter the set-point level for core
temperature control?
Skin temperature Pyrogens Antipyretics Thyroxin
A) No
Yes
Yes
No
B) No
Yes
Yes
Yes
C) Yes
Yes
Yes
Yes
D) Yes
No
No
Yes
E) Yes
Yes
Yes
No

Most of the heat loss from an

unclothed person at room
temperature occurs by which of the
following mechanisms?
A) Conduction to air
B) Conduction to objects
C) Convection
D) Evaporation
E) Radiation

Which of the following mechanisms

causes heat loss from a normal
person when the environmental
temperature is 106F and the
relative humidity is less than 10%?
A) Conduction
B) Convection
C) Evaporation
D) Radiation

A scuba diver explores an underwater lava flow where

the water temperature is 102F. Which of the following
profiles best describes the mechanisms of heat loss
that are effective in this man?
Evaporation
Radiation
Convection
Conduction
A) No
No
No
Yes
B) No
No
No
No
C) Yes
Yes
No
Yes
D) No
Yes
No
Yes
E) Yes
Yes
Yes
Yes

A 54-year-old man is admitted to the emergency

department after being found lying in his yard near a
running lawnmower on a hot summer day. His body
temperature is 106F, blood pressure is normal, and
heart rate is 160 beats/min. Which of the following
sets
of changes is most likely to be present in this man?
Sweating
Hyperventilation
Vasodilation of
skin
A) No
No
No
B) No
Yes
Yes
C) Yes
No
Yes
D) Yes
Yes
No
E) Yes
Yes
Yes

THANK YOU