Vital Signs: Body Temperature

Video 4.1: Introduction to Thermoregulation

-

metabolic rate: measure of all of the chemical reactions going on in the

body at a given time
o certain organs have continuous rate of metabolism that contributes
significantly to establishing our resting metabolic rate --e.g., the heart,
brain, liver, kidneys
o

body core the internal region of body where we normally maintain a

fairly constant temperature

heat is released with an increase in metabolic rate because cells are

not 100% efficient increased metabolism, as occurs during exercise,
creates more heat

core body temperature

normal range: 35.8C-38.2C

normal core temperatures vary between individuals and

throughout the day
lowest during

important to maintain a normal temperature for optimal enzyme

activity-

body shell

more temperature fluctuation occurs in the body shell

based on atmospheric temperature and bodys metabolic
rate

blood mechanism of heat transfer in body

highest during-

picks up heat in body core > carries heat to less

metabolically active parts of body

types of heat transfer:

o conduction heat transfer between 2 objects in direct content
o

radiation transfer of heat in the form of infrared waves

convection heat loss that occurs because a warm fluid (which could
be air or liquid) rises away from the body surface and is replaced by a
cooler fluid
body heat will transfer to the cold fluid, which will then rise away
from the body surface and be replaced by cooler fluid
the cooler fluid will warm (due to heat transfer from the body)
and then it will rise away from the body surface
the greater the temperature gradient between the body and the
cool fluid that replaces the warm fluid, the greater will be the
heat loss

evaporation
heat is required to vaporize water (called the heat of
vaporization)
it is not sweating per se that makes us feel cooler it is
the evaporation of sweat that cools us
when sweat evaporates, it is body heat that vaporizes the
water in sweat

wind chill

heat index

heat loss from the body can be sensible or insensible:

o

sensible heat loss-

example: sweating

insensible heat loss-

example: evaporation that occurs as air moves past the airway

surfaces during inhalation

Video 4.2: Maintaining Body Temperature

Reflex arc:
-

all reflex arcs begin with a sensory receptor the temperature sensors of
the body are called thermoreceptors

o
-

sensitive to hot and cold

peripheral thermoreceptors provide the information which helps
us cope with environmental temperature changes

body has high water content which creates thermal inertia

peripheral thermoreceptors make the brain aware of changes in
environmental temperature so that adjustments can be made to
maintain core temperature

central thermoreceptors

neurons carry the sensory input to the hypothalamus, which is the control
center for body temperature regulation
o

peripheral thermoreceptors

temperature control center is located in the preoptic nucleus of the

hypothalamus

motor effects allow us to maintain our temperature

o

temperature homeostasis state of dynamic equilibrium in which we

maintain our body core temperature within the normal range (35.8C38.2C)

decreased body temperature when body temperature falls below the

hypothalamic set point it causes:

vasoconstriction of subcutaneous blood vessels

shivering the slight shaking or shuddering that we call shivering is

due to rapid involuntary muscle contractions
remember: about 60% of the energy stored in the
molecular bonds of fuel molecules is released as heat
thus, as skeletal muscles generate ATP to fuel shivering,
they also generate a lot of heat

hormonal secretion
in prolonged cold, hormones can stimulate metabolism &
help to maintain a normal body temperature

increased body temperature body/blood is warmer than the

hypothalamic set point

vasodilation of subcutaneous blood vessels

increases heat loss via radiation (and possibly convection)

sweating

negative feedback is built into the temperature regulating system

Video 4.3: Hypothermia & Hyperthermia

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hypothermia condition in which the body core temperature falls below the
normal range
o

normal physiological mechanisms to warm body (constriction of

subcutaneous blood vessels, shivering) are not enough to raise body
temperature back to the normal range

manifestations decreased heart rate

decreased respiration rate
decreased blood pressure
brain functions will also begin to fail if the hypothermia become
severe enough and/or prolonged

interventions-

hyperthermia:
o

varies in severity

heat exhaustion

blood cannot circulate effectively due to blood volume

loss from excessive sweating

conflicting signals

can occur after prolonged exercise in heat

manifestations

interventions:

heat stroke condition is more severe than heat exhaustion

positive feedback cycle created that generates heat loss

mechanisms that worsen the condition

manifestations:
o hot, dry skin
o

Video 4.4: Fever

organs shut down (i.e., organ failure)

predisposing factors can put some people at higher risk:

o older adults
o

young children and neonates

people with cardiovascular disease-

pregnant women-

people who have impaired fluid regulation

capability (as in chronic kidney failure)-

interventions:

Fever:
o

pyrogens molecules released by the cells of the immune system that

have the ability to raise the hypothalamic set point
released by cells of the immune system (mainly) and can
circulate in the blood
when they arrive in the brain, they affect hypothalamic function
when hypothalamus set point is increased, the higher body
temperature of a fever is interpreted by the hypothalamus as
normal

may feel cool despite high temperature

a fever breaks when the pyrogens are removed from body and
hypothalamus returns to normal set point

fever is not always a bad thing

Video 4.5: Assessing Body Temperature Demo

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Types of thermometerso

oral

place probe of thermometer in sublingual pocket

temporal

close to sublingual artery a deep artery, which gives a

more accurate measure of core body temperature

run probe over patients forehead assesses temperature in

temporal artery, which also carries blood a short distance from
the core and gives a relatively accurate measure of core
temperature

tympanic

placed in external auditory canal against tympanic membrane

(or ear drum)
close to hypothalamus --thus, gives a fairly accurate
measure of core temperature

axillary

rectal

measured in axilla (or armpit)

it is difficult to get an accurate reading at this site, for
various reasons

sensor probe is placed in rectum

requires practice and training for accurate readings

important to take a temperature when patient is healthy then, are able to

compare future readings to this baseline temperature