98.6 is equivalent to 100.4 is equivalent to 104 is equivalent to
37 C38 C40C
What temp is someone febrile?
100.4 F
How is body temp controlled?
Balancing heat production against heat loss
Extra rate of metabolism is caused by?
-Muscle activity-Thyroxine-Epinephrine, norepinephrine-Increase chemical activity of cells-Metabolism
Which tissues work together to act as a heat insulator?
-Subcutaneous tissues-Skin
In cold temps, there is a
low rate of skin flow
What are the 4 types of heat loss?
-Radiation-Conduction-Convection-Evaporation
What is conduction?
Transfer of heat thru physical contact, kinetics
Convection
Removal of heat from body by air current
Radiation
Loss of heat in form of infrared heat rays, naked person will lose 60% of total heat by radiation
Is rate of heat loss to water greater or lesser than the rate of heat loss to air?
Greater
Evaporation
Loss of heat when H2O evaporates from body surface
2 types of sweat glands
apocrine: Androgenseccrine: Somatic Nervous System
If temp of surroundings is greater than skin temp, body gains heat by
RadiationConduction
What is the only way of heat loss if temp of surrounding is greater than skin temp?
Evaporation
Which 3 organs systems are responsible for heat loss?
-Skin-Cardiovascular-Respiratory
What do heat sensitive cells do?
-Induce sweating-Vasodilation-Decrease heat production (inhibit shivering)
What do cold sensitive cells do?
-Piloerection-Vasoconstriction-Increase in heat production (Shivering, thyroxine)
Predisposing factors of hyperthermia
-Age of pt-Type 1 DM-Diuretics-Beta blockers:vasodilation-Psychotropics-Level of acclimation-Length + intensity of exposure-Env. factors: humidity + wind
heatstroke
Critical organ damageMortalityBody temp > 105F
How to treat heat cramps?
-Cooling measures-Fluid-Electrolytes
signs of heat exhaustion
-Nausea-Vomiting-Lightheadedness-Minimal altered mental status
Signs of heatstroke
-Confused-Agitated-Tachycardia-Tachypnea-Decrease in BP
Exertional vs Classic Heatstroke
Exertional: younger, fit pt, not dehydrated, has elevated body temp (organs) Classic: Exposed to sig. temps over hours/days, sweat a lot and very dehydrated
Treatment of heatstrokes
-ABC's-Prevent shivering-NPO-Fluid bolus-IV-Anticipate seizures: treat w/ Diazepam-High mortality
Hypothermia
Core temp. less than 95F
Heat generated by cell metabolism through which 2 organs?
Heart + Liver
MILD Hypothermia symptoms
-Tachypnea-Tachycardia-Hyperventilation-Impaired judgement -Ataxia: poor muscle control-Dysarthria: slurred speech-Increased urination (cold diuresis)
Why does cold diuresis occur?
-Way to preserve heat-
MODERATE hypothermia
-Bradycardia-Decreased cardiac output-Hypoventilation-A-Fib-Junctional Bradycardia + other arrythmia-Decreased renal blood flow -Paradoxical undressing-CNS depression, hyporeflexia-muscles less responsive to stimuli
SEVERE hypothermia
-Pulmonary edema-Oliguria- low urine output-Areflexia- muscles don't respond to stimuli-Coma-Hypotension-Bradycardia-Asystole-V dysrhythmia
Hypothermia management
-Warm blankets-Radiant heat-Warm bath-Warm trunk 1st + minimize use of peripheral muscles
Which tests to run w/ Hypothermia?
-Electrolytes-Hematocrit-Coag studies-ABGs (Arterial Blood Gas) EKG
Treatment of Hypothermia Induced Dysrhythmia
-A-fib + flutter resolve w/ rewarming, try this before med -Management of V-fib + Asystole is difficult, have to warm pt to core temp 1st
A hypothermic heart is
-Very sensitive to movement, rough handling could lead to dysrhythmia
Metabolic rate
Energy spent per unit of time
Factors that influence metabolic rate
-Exercise-Food intake-Shivering-Anxiety
Factors that influence BMR
-Food intake-Thyroid hormone-Activity level-Age
Basal metabolic rate (BMR)
Minimal rate of energy spent by endothermic animals at rest
Glycogenesis
glucose to glycogen
Glycogenolysis
breakdown of glycogen to glucose
Gluconeogenesis
production of glucose in the liver using fats and proteins
protein syntheis
creation of proteins by cells that uses DNA, RNA
protein degradation
the splitting of proteins by hydrolysis of the peptide bonds, with the formation of smaller polypeptides.
fat synthesis
Creation of fatty acids from acetyl CoA thru fatty acid synthesis
fat breakdown
fatty acids broken down to metabolites, generates Acetyl CoA
Pancreas produces
2 antagonistic hormones to control blood sugar:-Insulin -Glucagon
How does insulin play a role in blood sugar?
-Beta cells produce insulin which:-Facilitate glucose entry into cells -Stimulates Glycogenesis-Inhibits Glycogenolysis-Inhibit Gluconeogenesis
How does insulin play a role in fat?
-Increase transport to adipose tissue-Promote protein synthesis-Inhibit protein degradation
Insulin play a role on protein
-Promote uptake of amino acids-Promote protein synthesis-Inhibit protein degradation
glucagon comes from
alpha cells of pancreas
What does glucagon do?
Raises blood glucose levels by making liver metabolize glycogen into glucose
What do epinephrine, cortisol + growth hormone do?
Increase glucose + fatty acids
WHat does cortisol do?
Increase blood amino acids + decrease muscle protein
What does growth hormone do?
decrease blood amino acids + increase muscle protein
Calorie
the energy needed to raise the temperature of 1 gram of water through 1 °C
What are the final products of carbohydrate digestion?
-Glucose--> most-Fructose-Galactose
By what process does the liver store glucose as glycogen?
Glycogenesis
Which organs does Epinephrine work on?
Liver + Skeletal muscle
Where does Glycogenolysis take place?
Liver + Skeletal muscle
What stimulates Gluconeogenesis?
Serum glucagon levels
How are fats in diet absorbed into intestinal lymph by?
Chylomicrons
How are chylomicrons removed from blood in adipose tissue + liver?
Lipoprotein lipase
What can thyroid hormone do in fat metabolism?
Cause rapid mobilization of fat
What does growth hormone do?
-Increase synthesis of cellular protein-Decrease glucose release + use fatty acid for energy
What do Glucocorticoids do?
-Decrease proteins in tissue
What does testosterone do?
-Increase protein in tissue
BMI <18 is 18-24 is25-29 is30-39 is>39 is
-Underweight-Healthy/optimal-Overweight-Obese-Extremely obese
If skin temp is > temp. of surroundings, heat is lost via
radiation, conduction + convection
If temp of surroundings is > skin temp., body can only lose heat via
Evaporation