SUBJECT: PHYSIOLOGY
TOPIC: THERMOREGULATION
LECTURER: DR. MENDOZA
DATE: MARCH 2011
Thermoregulation
Overview
First we will discuss variations of normal temperature
We will talk about the balance of heat among human
beings, the physiological factors that can affect the
production of heat as well as the physical factors that
affect the exchange of heat between the body and the
environment.
Also, we will discuss the integration of the various
responses of the human body in so far as the handling
of heat as well as cold is concern.
And of course, we will talk about fever and other
disorders of the regulation of temperature.
Lecture Proper
We all know that physical and chemical reactions are
dependent on temperature. With this, physiological
reactions are actually sensitive to changes. And of
course, we want all these reactions to be relatively high
in terms of rate. And we want these reactions to be
optimal. So that means we really need to regulate
temperature and if we do not there are certain
consequences to it. If it is very cold, even the heart can
be affected and the heart can undergo fibrillation. If it is
very hot and we cannot control this, we can develop
brain lesions. Of course we all know that the nerves are
affected by heat and denaturation of proteins can occur
in extreme settings. So the normal range of body
temperature is 36-38°C (37°C or 98.6°F).
Temperature Physiological response
27-29°C Cardiac fibrillation
30-34°C Impairment of
temperature regulation
34-36°C Mild hypothermia
36-38° Normal
38-40°C Fever or exercise
40-44°C Heat stroke, brain lesion
PHYSIOLOGY:THERMOREGULATION
Normal Variations of Human Body Temperature
The body tries to maintain the normal temperature but
nevertheless there are still variations in the normal
body temperature. When we talk about temperatures,
there are certain temperatures that we can actually
obtain. There is what is known as the core body
temperature (temperature within the body especially
your internal organs such as the liver, heart) and skin
temperature.
It is really the core temperature that is as much as
possible maintained at a constant level where as the
skin temperature can be varied depending upon the
temperature of the environment.
Core body temperature: homeothermic body
temperature
Core Temperatures:
a. Core temperature differences : 0.2 C -
1.2 C; brain exhibits radial temp.
gradient of > 1 C from center to cortex.
b. Rectal temperature - highest
temperature
c. sublingual (0ral) temperature - most
preferred clinically, 0.2 C - 0.5 C lower
than rectal; affected by inspired air
and by food and drink
d. esophageal temperature - (above
cardia) - used in sports medicine, with
thermosensors; shorter delay than
rectal to measure body-temp.
e. axillary temperature - can represent
core temperature but a delay of 30
minutes for equilibration to measure
accurately; readings affected by
vasoconstriction especially when fever
is building up, in a low ambient
temperature
Skin temperature: poikilothermic shell
Skin Temperature
a. Skin temperature- represents shell
temperature
b. mean skin temperature - from
measurements of forehead, chest,
abdomen, upper arm, forearm, back of
hand, thigh, calf, and dorsum of foot;
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 in calculating mean, mean is Degree of alertness
calculated in accordance with body-
surface area they represent. The When you are alert, your temperature is relatively
mean skin temperature measured in higher.
this way for a nude person in a
comfortable ambient temperature is 33 Menstrual cycle
- 34 C.

But there are variations even in the core body

temperature. And there are several factors that can
affect this. One is time of day. Second is among females,
it is where they are in terms of their menstrual cycle
that can affect the temperature. Another is physical
activity. Fourth is the age of the subject because usually
infants as well as the elderly have very poor control of
temperature. For instance, one way in which we can
dissipate heat is by sweating. However, infants cannot
sweat. So obviously infants are like other organisms
Then among females, the rhythm method is actually a
whose temperature are actually dependent upon the
form of contraceptives or birth control. What is done
external temperature. Then among the elderly, there
here is that the female actually measures her body
temperature sensors are already deranged and at the
temperature. When ovulation is about to happen, body
same time, their metabolic rate is very low therefore
temperature actually increases. When this happen is it
their ability to produce heat is not that good anymore.
safe or not? NOT. Traditionally, it has been thought that
Secondly, in terms of heat production, one of the ways
the reason of this increase in temperature is the surge
in which heat can be produced within the body is by
in progesterone. (new researche: undetermined cause)
muscular contraction. We know that the muscle mass of
the elderly is significantly reduced. So age can actually
affect the core temperature.
Exercise
Factors that affect the core body temperature: With exercise, we produce more heat. As a result, you
get to see an increase in core body temperature as
 Time of day reflected by the temperature taken from the rectum.
 Menstrual cycle As you can see, in work, there is an increase in the core
 Physical activity body temperature but there is a drop in the skin
 Age of the subject temperature. This is because in exercise, there is an
 Degree of alertness increase in sweating. Sweat evaporates which displace

Periodic Fluctuations of Core Temperature

Diurnal Rhythm

The core temperature can fluctuated depending on

the time of day. Normally, the lowest temperature is
at 3:00-6:00 am and the highest temperature is at
3:00-6:00 pm.

So, this is known as the diurnal rhythm as far as the

core body temperature is concerned. It is not really
related to the night-day cycle but in the 24-hour
cycle and some believe that this is synchronized with
the heat. This is why the skin temperature is much
the earth’s rotation along its axis and this occurs in the
lower.
absence of signals such as light stimulus. It is dependent
By the way there are several ways in which we can
upon the sleep-wake pattern. So if you are moving to
measure the body temperature. You can use oral
another time zone, we neec 1-2 weeks in order for the
thermometer. Nowadays, there is what we call the
temperature rhythm to adjust to the normal living automatic thermometer that uses the heat generated
patterns set by the new time zone. by ear. This is correlated with the oral temperature. We

PHYSIOLOGY:THERMOREGULATION Page 2
can also take the core body temperature through the
rectum. Among the two, the more reliable but not
practical is the rectal temperature because it is not
affected by the environment or the air.
Why does the body maintain its core temperature
constant at 37°  0.6°C?
This is because a lot of chemical and physical factors are
depedent upon the body temperature. Also,
physiological functions are sensitive to temparature
fluctuations. And we want as much as possible for these
reactions to be optimal.
The rate of enzymatic reaction increases with an
increase in body temperature. primarily because of this
increase in energy of substrates otherwise known as the
Brownian motion. But beyond a certain temperature,
you can actually damage, especially proteins
(denaturation). So as much as possible we want all
reactions to operate at an optimal range.
How is it that the body maintains a constant
temperature?
There are several factors that come into play to regulate
the core body temperature.
Physical factors and physiological factors
For us to have a constant temperature there must be
heat balance
Heat loss = heat gain
Heat production Heat loss
PHYSIOLOGIOCAL PHYSICAL
Metabolism Heat transfer at the skin’s
surface
Muscle contraction
Physiologic Factors Affecting Heat Production
1) Basal metabolic rate of all cells (biological
and chemical processes of the cells utilized
energy and the by product of this is heat)
PHYSIOLOGY:THERMOREGULATION
2) Increased metabolic rate due to muscle
activity (voluntary as well as involuntary). When
muscles are at work (contraction), the consume
much energy (ATP) which produces heat.
Exercise can also increase metabolic rate 100x
to 1000x compared to the basal metabolic rate.
3) Sympathetic Nervous Excitation which leads
to release of (i) Norephinephrine and
Epinephrine (produced by adrenal medulla; can
actually induce glycogenolysis which in turn
produces heat) and (ii) increased Metabolism of
brown adipose tissue (brown fat—in neck,
scapular, nape area)
Brown fat metabolism induce heat production
through the stimulation of the sympathetic
nervous system which induces the release of
free fatty acids which undergoes β-oxidation.
In infants, heat production rate can increase by
100% with chemical thermogenesis while in
adults the increase is only 10-15%.
**infant cannot shiver so they generate heat
through brown fat metabolism.
4) hermogenic effects of hormones : (i)
glucagon (induces glycogenolysis); basal and
long-term effects of (ii) thyroxine (affect
metabolism by increasing transcription,
translation protein synthesis  enzymatic
activity  fuel utilization  heat production); (iii)
progesterone (menstrual cycle); (iv) growth
hormone; (v) catecholamines.
A.5) Temperature-dependent increase in cell
metabolism; Brownian motion and temperature
effects on enzyme kinetics.
As you increase the temperature in tissues,
the metabolic rate of tissue itself increases. This
produces more heat. An increase in temperature
in tissues of about 10°C will double the
metabolic rate of that tissue.
6) the metabolism of food that we take in
produces heat. This is known as the specific
dynamic action of food intake. It is the obligatory
energy expenditure that occurs in assimilation
into the body.
For instance, when protein is ingested, we
increase the metabolic rate by 30 kcal,
carbohydrates by 6 kcal, and fats by 4 kcal. So
oxidation of food itself will bring about an increase in
heat production.
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Physical Factors Affecting Heat Exchange with
the Environment
Formula: Htot = Hc + Hr + He + Hs
Legend:
Htot = rate of metabolic heat production
Hc = rate of conductive and convective heat exchange*
Hr = rate of radiative heat exchange*
He = rate of evaporative heat exchange*
Hs = rate of storage of heat in the body*
When heat produced is already in excess you need to
have a mechanism by which you are able to lose the
heat. These are the factors in which the body can
dissipate heat towards the environment:
1. conduction to objects (3% of heat loss) –
whenever you are in direct contact with an
object which has a lower temperature than
your skin, then there is actually heat transfer
(conduction).
If the temperature of the object is higher than
the skin temperature then the opposite can
occur.
2. air currents - heat dissipation by convection
3. evaporation (accounts for 22% of heat loss)
4. radiation (60% emmission of infrared)
Every object emmits infrared radiation. So if the
environment is lower than the human
temperature then the body is able to radiate
this infrared electromagnetic waves.
5. conduction to air or fluid (15%)
if air or water surrounding the body has lower
temperature then the body, then you lose heat
by direct conduction.
As far as air is concern, when you lose heat, the
air around you increases in temperature. When
there is equal temperature between the body
and the environment, then there is no more
heat exchange.
With air, when it is heated up, air rises so it is
replaced by cooler air. With this, heat exchange
can continue.
Another way to displace heat in the air is
through air currents. So when there is wind the
that displaces the air surrounding your body
PHYSIOLOGY:THERMOREGULATION
which is a little bit higher because of the heat
exchange that occurs. This is the reason why
when you are in a cold temperature and there is
wind you feel colder still. That is because the air
that surrounds you that is heated up by your
body is replaced by new air.
Effects of clothing on External Heat Flow
Conduction and convection can be affected by
insulation (clothes that you wear).
***the percentages presented above occurs in a person
without clothing (KINKY!!!)***
the human body has its own insulation in the form of fat
content. That is the reason why females are more
resistant to changes in temperature (females have a
higher fat content than males).
Thermal resistance or insulation - Trapped air
spaces in the weaved material decreases
conduction, evaporation, and convective heat
transfer.
Half the heat from skin to clothing is radiated. This
is further radiated from clothing to air.
Specialized clothing can prevent radiative heat
loss,such as insulating the inner lining with gold.
Body temperature during exercise
During exercise, the body produce more heat. As a
result you need more heat dissipation. Evaporation
accounts for heat dissipation during exercise. However,
evaporation is not dependent on temperature gradient.
It depends upon the water content of air. If humidity is
very high, then significant less evaporation will occur
because water content of air is high already. If humidity
is very low then evaporation can occur efficiently.
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Therefore heat disspation is much greater. (During
exercise, do not wipe of the sweat, let it evaporate for
this will cause a greater amount of heat exchange).
Countercurrent principle and thermal conductance
Going to the extremeties you have your warm arterial
blood.
Going away from the extremeties you have your cold
arterial blood.
So there is actually an exchange because usually, your
arteries and veins run parallel with each other so there
can be a counter exchange (heat transfer).
Arterial blood is warm because it came you’re your core
organs especially your the heart.
responds to changes in temperature. And then you
should have an afferent pathway which is projected
towards your central integrator in the brain. From the
central integrator, you should have an efferent pathway
that goes towards your target organs (muscles, blood
vessels and sweat glands) which help in the control of
heat exchange.
A lot of patients are subjected to surgery, in surgery,
they are subjected to anesthesia. Anesthesized patients
have a special need as far as thermal regulation is
concerned so they have to be watched because if their
normal thermoregulatory apparatus is dysfunctional,
they can go into a lot of trouble. They can develop a
malignant hypothermia in reaction to anesthetic.

Temperature Receptor Reaction

Freezing cold Cold Pain withdrawal reflex
nociceptor before cold block ensues
15-38°C Cold Thermoregulatory reflex
receptor
30-43°C Warm
receptor
45-49°C Cold Paradoxical cold
Body size receptor sensation
Increased metabolic rate per unit mass therefore Heat
produces more heat receptor
Among infants the surface area: volume ratio is greater Burning hot Heat Pain withdrawal reflex
as compared to adults. Therefore there is a tendency nociceptor
for infants to lose more heat as compared to adults.
Unfortunately, infants do not have a lot of the
mechanisms that are available for adults to produce Afferent fibers
heat. That is the reason why when you look into the
Cold afferents: Type Aδ and Type C
nursery, infants are placed under a lamp to keep them
heated up. Warm afferents: Type C
This relationship is called the Law of metabolic Number of receptors
reduction. Cold receptor > warm receptor
Age matters when it comes to controlling the core body In most areas of the skin such as the lips, the
temperature. infants have a hard time controlling there fingers etc.
core body temperature because they do not have
mechanisms of heat production same with the adults. These receptors are stimulated dependent upon the
Their only consolation is that they do have a significant temperature
amount of brown fat so they can induce naturing heat Aside form the skin thermoreceptors, you also have
generation. Infants have higher metabolic rate. receptors in the central nervous system (in the
Whereas in elderly, they have a lower metabolic rate hypothalamus). When you apply an electrical impulse
compared to normal adult. (heat) in the hypothalamus you can activate these warm
sensitive neurons which are found in the anterior
The greater metabolic rate among infants is really to hypothalamus and preoptic area. This will result in the
match the greater loss of heat as a result of the freater activation of the heat loss center. This will then activate
surface area:volume body ratio. mechanisms in the periphery that will result in the loss
of heat such as increase blood flow in skin, activate
sweat gland. Lesions at the hypothalamus and the
In terms of the integration of all of these, in matching
preoptic area will result to hyperthermia.
heat production and heat loss, there has to be a system
to keep this in balance. There are several components On the other hand, when the hypothalamus is sent cold
to this system. One of which is that it has to have a stimulus, then there are also cold sensitive neurons
thermoreceptor (both in the skin and in the brain) that (cooling center) found in the anterior hypothalamus and

PHYSIOLOGY:THERMOREGULATION Page 5
preoptoc area which in turns activates the posterior areas Warming of these Local Cooling of
hypothalamus (heat conservation center), inducing heat structures these structures
conservation in the body (shivering, muscle contraction, Lower Enhanced heat loss
vasoconstrictionless blood flow to skin less loss of Brainstem
heat). thermo- (lesser degree
sensitive compared to
structures hypothalamic
Hypothalamic area Effects of Effects of (midbrain, sensitivity)
Local Local medulla
Warming Cooling oblongata)
these nuclei these nuclei
Anterior Local warming Local cooling Spinal cord Local warming Local
Hypothalamus and thermosensitiv Activate heat loss cooling activates
activates of this region
e structures mechanisms such as shivering
Pre-optic Area of thermo- activates cold- (a) panting in dogs thermogenesis
Hypothalamus(gene regulatory sensitive (extremely and other
rally contain cold- cooling neurons thermosensitiv animals .
and warm-sensitive mechanisms . which in turn e) (b) vasodilation
neurons – respond to (c ) inhibition of
may activate
local cooling and What do you call thermogenesis
neurons in the
local warming this center ? posterior
respectively).
hypothalamus
Majority are warm-
sensitive. Two Lateral
thermoregulatory hypothalamus
fcns:
(dashed lines)
1. Central
thermostat- Effects of
hypothalamic Lesion ?
thermostatic
detector ,

2. cooling center
Posterior Localized Localized
Hypothalamus warming has no cooling has no
(generally contain clearcut effect. clearcut
neurons which effect.
respond to signals However,
from distant or cooling
peripheral
anterior
thermosensors, and
hypothalamic
are not responsive to
neurons-
local changes in
preoptic area
temperature ).
Majority respond to can activate
cold signals from the this region –to
periphery. Two induce heat
thermoregulatory production
fcns: and heat
conservation
1. Integrates mechanism.
peripheral and
central temperature Lesion
effects ?
2. Heat production
and conservation
center)

There are other thermo-sensitive structures in the

brainstem and spinal cord, which also mediate
thermoregulatory reflexes.

Other CNS Effects of Local Effects of

PHYSIOLOGY:THERMOREGULATION Page 6
 They act on the Organum
vasculosum of the lamina
terminalis (OVLT). These
structure has fenestrated
capillaries. These OVLT serves
as a chemoreceptors for
cytokines and thereby activate
the preoptic area of the
hypothalamus. This in turn will
induce the production of
prostaglandin E (PGE2) which
will in turn act with the cells in
the hypothalamus thereby
resetting the set point of
temperature regulation. This
will be set in a higher level.
This will activate the posterior
hypothalamus as a result the
body will produce more heat
 shivering, increase in
metabolic rate and promote
the concentration of heat by
vasoconstriction  FEVER. In
infants, this will activate the
sympathetic nervous system which will metabolize brown fats
which will induce heat production.
As much as 30% of cardiac output can go to the skin in an
effort to dissipate heat.
Why do we develop fever during infection? At a higher
temperature, the phagocytes act to combat the infection.
temperature,  blood flow, phagocytosis (due to
metabolism), lymphocyte proliferation. In viral infection,
fever can stimulate the production of interferon which can
limit viral damage.

Heat stoke – condition wherein you can induce brain damage

as a result of very high body temperature (41°C) for a long
period of time. This can cause nerve degeneration, protein
denaturation, cerebral edema, disorientation, delirium,
convulsion.
Heat stroke above 43°C can lead to death.
Antipyretics
Example: aspirin (NSAID), paracetamol
alteration of behavior:
These act on cyclooxygenase pathway which is the one
when hot, there is a tendency for the person to go to an responsible for the production of PGE2.
airconditioned room.
Its basic mechanism is to prevent prostaglandin production to
prevent resetting the temperature regulation at the
Dysfunction of temperature control hypothalamus.

One of the most common changes as far as the body
temperature is concern is FEVER. Fever is the shifting of set
point for body temperature which results from increased
heat production by shivering and increased vasoconstriction.
During the recovery from fever, there is an increase in sweat
secretion, vasodilation  reduction in body temperature.
Posterior hypothalamus (cooling center) is activated as fever
develops.
===========END OF TRANSCRIPTION===========
it’s the time of year again when all we can think about are the
trips that we’re going to go this summer, the warm waters
where we’re going to be dipped in, and people who we
missed this past school year. But there are still a few more
blows of evaluations on our way! So let’s give our best to
these last set of exams so we can enjoy our summers to the
fullest!!!

Fever can be caused by several things. When we are dealing Good luck batch 2014  we started this year together, we are
with bacterial infection, this triggers the release of cytokines going to end this TOGETHER!!!!
(IL-1, IL-6 ). In malignancies, you can develop fever without
infection, this is due to the production of cytokines through
the TNFa (tumor necrosis factor).
Sometimes, the IL-1 cannot penetrate the blood brain barrier.
How can these cytokines induce fever?
PHYSIOLOGY:THERMOREGULATION Page 7
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