New Human Physiology Ch 21-Thermo-regulation,Temperature and Radiation

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7/23/2019 New Human Physiology Ch 21-Thermo-regulation,Temperature and Radiation http://slidepdf.com/reader/full/new-human-physiology-ch-21-thermo-regulationtemperature-and-radiation 1/20 N e w H u m an P h y s i o l o gy | P a u l e v - Z u b i e t a 2 n d E d i t i o n C h a p t e r 2 1 : T h e r m o - R e g u l a t i o n , T e m p e r a t u r e a n d R a d i a t i o n  HOME P RE FA CE TABLE OF CONTENTS SYMBOLS SECTION INFO CONTRIBUTORS LINKS CONTACT US  ghlights tudy_Objectives rinciples efinitions ssentials athophysiology quations elf-Assessment nswers urther Reading Chapter 21  This Chapter is written following discussions with my colleague, Leif Vanggaard, MD, Arctic Institute, Copenhagen.  S t u d y O b j e c t i v e s  To define  body core and body shell, heat balance, heat exchange (conduction, conversion, evaporation and radiation), hyperthermia, hypothermia, mean body temperature, heat capacity, and thermal steady state.  To describe  fever (pyrogens), benignant and malignant hyperthermia, heat exhaustion, heat syncope, heat stroke, sun stroke, and hypothermia.  To describe  radiation sickness.  To calculate one thermal variable, when relevant variables are given.  To explain  the concepts heat exchange, thermogenesis by food and shivering, the human temperature control system and its function at different environmental temperatures.  To us e the above concepts in problem solving and case histories.  P r i n c i p l e s  Newton’s law of cooling : The dry heat loss is proportional to the temperature difference between the human body (shell) and the surroundings.  The total energy of a system is conserved in an interaction, not the kinetic energy or the  mass (Einstein). If the mass changes during an interaction, there is a resultant change in kinetic energy, so that the total energy remains constant. – Heat energy is proportional to molecular movement rates – “heat energy equals movement.”   Stefan-Boltzmanns rule: The higher the temperature of an object, the more it radiates. The energy radiated from an object is proportional to the fourth power of its Kelvin temperature. – The energy radiating from an object and received by the human body is proportional to the temperature difference between the object and the skin (see Eq. 21-4  ) . T hi s is be c au s e hu ma n lif e im pl ie s relatively small temperature gradients.  D e f i n i t i o n s  Body core consists of the thermoregulated deeper parts of the body and the proximal extremity portions of warm-blooded animals including man.  Body shell  refers to those outer parts of the body (skin and subcutaneous tissue) that change temperature at cold exposure.  Conductance changes of the shell are used as a measure of skin bloodflow.

Transcript of New Human Physiology Ch 21-Thermo-regulation,Temperature and Radiation

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N e w H u m a n P h y s i o l o g y | P a u l e v - Z u b i e t a 2 n d E d i t i o n

C h a p t e r 2 1 : T h e r m o - R e g u l a t i o n , T e m p e r a t u r e a n d R a d i a t i o n

HO ME P RE FA CE T AB LE O F CO NT ENT S S YMB OL S S ECT IO N I NF O CO NT RI BUT ORS L INK S CO NT ACT US

ghlights

tudy_Objectives

r i n ci p l es

efinitions

ssentials

athophysiology

quations

elf-Assessment

nswers

urther Reading

C h a p t e r

2 1

T h i s C h a p te r i s w ri t te n fo l l o w i n g d i s c u s s i o n s w i th my c o l l e a g u e , L e i f V a n g g a a rd , MD , A rc ti c In s ti tu te ,

C o p e n h a g e n .

S t u d y O b j e c t i v e s

T o define b o d y c o re a n d b o d y s h e l l , h e a t b a l a n c e , h e a t e x c h a n g e (c o n d u c ti o n , c o n v e rs i o n ,

e v a p o ra ti o n a n d ra d i a ti o n ), h y p e rth e rmi a , h y p o th e rmi a , me a n b o d y te mp e ra tu re , h e a t c a p a c i ty ,

a n d th e rma l s te a d y s ta te .

T o d e s c ri b e fe v e r (p y ro g e n s ), b e n i g n a n t a n d ma l i g n a n t h y p e rth e rmi a , h e a t e x h a u s ti o n , h e a t

s y n c o p e , h e a t s tro k e , s u n s tro k e , a n d h y p o th e rmi a .

T o d e s c ri b e ra d i a ti o n s i c k n e s s .

T o c a l c u l a t e o n e th e rma l v a ri a b l e , w h e n re l e v a n t v a ri a b l e s a re g i v e n .

T o explain th e c o n c e p ts h e a t e x c h a n g e , th e rmo g e n e s i s b y fo o d a n d s h i v e ri n g , th e h u ma n

te mp e ra tu re c o n tro l s y s t e m a n d i ts fu nc ti o n a t d if fe re n t e n v i ro n me n ta l te mp e ra tu re s .

T o us e th e a b o v e c o n c e p ts i n p ro b l e m s o l v i n g a n d c a s e h i s to ri e s .

P r i n c i p l e s

N e w t o n ’ s l a w o f c o o l i n g : T h e d ry h e a t l o s s i s p ro p o rt i o n a l t o t h e t e mp e ra t u re d i f f e re n c e

b e t w e e n t h e h u ma n b o d y (s h e l l ) a n d t h e s u rro u n d i n g s .

T h e t o t a l e n e r g y o f a s y s t e m i s c o n s e rv e d i n a n i n t e ra c t i o n , n o t t h e k i n e t i c e n e rg y o r t h e m a s s

(E i n s t e i n ). I f t h e ma s s c h a n g e s d u ri n g a n i n t e ra c t i o n , t h e re i s a re s u l t a n t c h a n g e i n k i n e t i c e n e rg y ,

s o t h a t t h e t o t a l e n e rg y re ma i n s c o n s t a n t . – H e a t e n e rg y i s p ro p o rt i o n a l t o mo l e c u l a r mo v e me n t

ra t e s – “h e a t e n e rg y e q u a l s mo v e me n t . ”

S t e f a n - B o l t z m a n n s r u l e: T h e h i g h e r t h e t e mp e ra t u re o f a n o b j e c t , t h e mo re i t ra d i a t e s . T h e

e n e rg y ra d i a t e d f ro m a n o b j e c t i s p ro p o rt i o n a l t o t h e f o u rt h p o w e r o f i t s K e l v i n t e mp e ra t u re . – T h e

e n e rg y ra d i a t i n g f ro m a n o b j e c t a n d re c e i v e d b y t h e h u ma n b o d y i s p ro p o rt i o n a l t o t h e t e mp e ra t u re

d i f f e re n c e b e t w e e n t h e o b j e c t a n d t h e s k i n (s e e E q . 2 1 -4 ) . T hi s is be c au s e hu ma n lif e im pl ie s

re l a t i v e l y s ma l l t e mp e ra t u re g ra d i e n t s .

D e f i n i t i o n s

B o d y c o re c o n s i s ts o f th e th e rmo re g u l a te d d e e p e r p a rts o f th e b o d y a n d th e p ro x i ma l e x tre mi ty

p o rt i o n s o f w a rm-b l o o d e d a n i ma l s i n c l u d i n g ma n .

B o d y s h e l l re fe rs to th o s e o u te r p a rts o f th e b o d y (s k i n a n d s u b c u ta n e o u s t i s s u e ) th a t c h a n g e

te mp e ra tu re a t c o l d e x p o s u re .

C o n d u c t a n c e c h a n g e s o f th e s h e l l a re u s e d a s a me a s u re o f s k i n b l o o d fl o w .

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C o n d u c t i v e h e a t l o s s d e s c ri b e s a d i re c t tra n s fe r o f h e a t e n e rg y b y c o n ta c t b e tw e e n tw o b o d i e s

o f d i f fe re n t te mp e ra tu re (e g , s k i n a n d o b j e c ts ).

C o n v e c ti v e h e a t l o s s i s d e fi n e d a s th e h e a t l o s s b y c o n ta c t b e tw e e n th e s u rfa c e (s k i n ) a n d a

mo v i n g me d i u m (a i r o r w a te r).

E v a p o ra ti v e h e a t l o s s i s d e fi n e d a s th e h e a t l o s s b y e v a p o ra ti o n fro m th e b o d y s u rfa c e o r

l u n g s .

F e v e r o c c u r s w h e n t h e c o re t e mp e ra t u re o f t h e b o d y i s ra i s e d a b o v e n o rma l s te a d y s ta te l e v e l s .

T h e b o d y re a c ts a s i f i t i s to o c o l d . F e v e r i mp l i e s a d i s o rd e r re s u l t i n g i n s h i v e ri n g c o mb i n e d w i th

v a s o c o n s tr i c t i o n , h e a d a c h e , d e d o l a ti o n , a n d g e n e ra l d i s c o mfo rt (e g , ma l a ri a ).

H e a t f l o w i s d e fi n e d a s e n e rg y e x c h a n g e d d u e to a te mp e ra tu re d i ffe re n c e . H e a t f l o w i s

tra n s mi tte d a l o n g a te mp e ra tu re g ra d i e n t.

H e a t c a p a c i ty i s th e a mo u n t o f h e a t re q u i re d to p ro d u c e a te mp e ra tu re i n c re a s e fo r a g i v e n

a mo u n t o f s u b s ta n c e .

H e a t e n e rg y b a l a n c e i n a re s ti n g p e rs o n i s a c o n d i t i o n , w h e re th e h e a t p ro d u c ti o n i s e q u a l to th e

h e a t l o s s . T h u s th e b o d y te mp e ra tu re i s c o n s ta n t a n d th e h e a t s to ra g e i s z e ro ( t h e rma l s t e a d y

s t a t e). U s u a l l y , th e re i s n o i n te rn a l h e a t e n e rg y f l u x b e tw e e n b o d y c o re a n d s h e l l .

H y p e rth e rmi a i s a n i n c re a s e i n c o re te mp e ra tu re a b o v e n o rma l .

H y p o t h e r m i a re fe rs to a c l i n i c a l c o n d i t i o n w i th a l o w e re d c o re te mp e ra tu re (b e l o w 3 5 oC) .

M e a n b o d y t e m p e r a t u re i s d e fi n e d a c c o rd i n g to E q . 2 1 -1 (s e e e n d o f C h a p te r).

N o n - s h i v e r in g t h e r m o g e n e s is i s a r i s e i n me ta b o l i s m, w h i c h i s n o t re l a te d to mu s c u l a r a c ti v i ty

( s h i v e r i ng o r e x e r c i s e ) .

I n s e n s i b l e p e rs p i ra ti o n ( l e a k a g e o f th e s k i n ) i s th e s ma l l c u ta n e o u s e v a p o ra ti o n l o s s , w h i c h i s

u n re l a te d to s w e a t g l a n d fu n c ti o n .

I n s u l a t i o n r e f e r s t o r e s i s t a nc e t o h e a t t r a n s f e r .

R a d i a ti v e h e a t l o s s i s a tra n s fe r o f h e a t e n e rg y b e tw e e n 2 s e p a ra te o b j e c ts a t d i f fe re n t

te mp e ra tu re . H e a t e n e rg y i s tra n s fe rre d v i a e l e c tro ma g n e ti c w a v e s (p h o to n s ). T h i s h e a t tra n s fe r

d o e s n o t re q u i re a me d i u m, a n d th e te mp e ra tu re o f a n y i n te rv e n i n g me d i u m i s i mma te ri a l .

S h e l l te mp e ra tu re i s th e te mp e ra tu re o f th e o u te r p a rts o f th e b o d y (me a s u re d o n th e s k i n

s u rfa c e ) a n d re l a te d to c o l d e n v i ro n me n ts .

S h i v e ri n g i s a re f l e x my o g e n i c re s p o n s e to c o l d w i th a s y n c h ro n o u s o r b a l a n c e d mu s c l e

c o n tra c ti o n s p e rfo rmi n g n o e x te rn a l w o rk .

S p e c i fi c h e a t c a p a c i ty i s th e re l a ti o n s h i p b e tw e e n h e a t e n e rg y e x c h a n g e d p e r w e i g h t u n i t o f a

s u b s ta n c e a n d th e c o rre s p o n d i n g te mp e ra tu re c h a n g e . T h e s p e c i f i c h e a t c a p a c i t y of w a t e r i s 4 .1 8

a n d o f th e h u ma n b o d y (b l o o d a n d t i s s u e s ) 3 .4 9 k J k g-1 o C -1 , re s p e c ti v e l y . T h e s p e c i f i c h e a t

c a p a c i ty o f a tmo s p h e ri c a i r i s 1 .3 k J (m 3) -1 o C -1 .

T e m p e r a t u r e i s th e me a s u re me n t o f h e a t e n e rg y c o n te n t.

E s s e n t i a l s

T h i s p a ra g ra p h d e a l s w i th

1. T h e t e m p e r a t u r e s o f t h e b o d y , 2 . B o d y re s p o n s e s to c o l d , 3 . B o d y re s p o n s e s to h e a t , 4.

E m o t i o n a l s w e a t i n g , 5 . Me ta b o l i c R a te a n d e n v i ro n me n ta l te mp e ra tu re, 6 . T e m p e r a t u re c o n t r o l ,

7. T h e h u m a n t h e r m o - c o n t r o l s y s t e m, a n d 8 . T h e r m o r e g u l at o r y e f f e c t o r s.

1 . T h e t e m p e r a t u r e s o f t h e b o d y

T h e h u ma n b o d y c o n s i s ts o f a p e ri p h e ra l s h e l l a n d a c e n tra l c o re ( F i g . 2 1 - 1) . T h e h e a t c o n t e n t ( H or

enthalpy ) o f th e h u ma n b o d y i s re f l e c te d b y i ts te mp e ra tu re . B y d e fi n i t i o n a th e rmo me te r o n l y

me a s u re s th e te mp e ra tu re o f th e th e rmo me te r, s o i ts l o c a ti o n i s e s s e n ti a l . T h e me a n c o re

te mp e ra tu re i s 3 7 oC i n h e a l th y a d u l ts a t re s t, b u t s ma l l c h i l d re n h a v e l a rg e r d i u rn a l v a ri a t i o n s .

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T he s k i n i s th e ma i n h e a t e x c h a n g e r o f th e b o d y . T h e s k i n te mp e ra tu re is d e te rmi n e d b y th e c o re

te mp e ra tu re a n d b y th e e n v i ro n me n t (te mp e ra tu re , h u mi d i ty , a i r v e l o c i ty ). T h u s th e s h e l l te mp e ra tu re

i s g o v e rn e d b y th e n e e d s o f th e b o d y to e x c h a n g e h e a t e n e rg y .

F i g . 2 1 - 1 : H e a t tra n s fe rs , b o d y c o re s a n d s h e l l s te mp e ra tu re s o f a n a k e d p e rs o n s ta n d i n g i n

c o l d a n d w a rm a i r, re s p e c ti v e l y .

T h e s h e l l t e mp e ra t u re i s me a s u re d o n th e s k i n s u r f a c e a n d a t th e h a n d s a n d f e e t to a p p ro a c h th e

ro o m te mp e ra tu re o f 1 9 o C i n a p e rs o n s ta n d i n g in a c o l d ro o m fo r h o u rs (F i g . 2 1 -1 , l e ft). T h e s h e l l

te mp e ra tu re i s s e v e ra l d e g re e s l o w e r th a n th e te mp e ra tu re i n th e c e n tra l c o re . T h e l i mb s h a v e b o th a

l o n g i tu d i n a l a n d a ra d i a l te mp e ra tu re g ra d i e n t. T h e s h e l l te mp e ra tu re a n d th e s i z e o f th e s h e l l v a ryw i th th e e n v i ro n me n ta l te mp e ra tu re a n d th e te rma l s ta te o f th e p e rs o n . A n a k e d p e rs o n , s ta n d i n g o n a

c o l d f l o o r i n 1 9 oC a i r h a s a s ma l l c o re a n d a th i c k s h e l l c o mp a re d to th e s a me p e rs o n i n a w a rm

e n v i ro n me n t (F i g . 2 1 -1 ). T h e s h e l l te mp e ra tu re o f th e s k i n a n d d i s ta l e x tre mi t i e s i s d i f f i c u l t to

e v a l u a te . T h e b e s t e s ti ma te i s me a s u re me n t o f th e i n fra re d h e a t ra d i a ti o n f l u x w i th a ra d i o me te r.

T h e c o re t e mp e ra t u re i s th e ra th e r c o n s ta n t te mp e ra tu re i n th e d e e p e r p a rt s o f t h e b o d y and in the

p ro x i ma l e x tre mi ty p o rt i o n s (s e e th e re d s t i p p l e d l i n e s o f F i g . 2 1 -1 ). H o w e v e r, th e c o re te mp e ra tu re

ma y v a ry s e v e ra l C e n ti g ra d e s b e tw e e n d i ffe re n t re g i o n s d e p e n d i n g o n th e c e l l u l a r a c ti v i ty . T h e b ra i n

h a s a ra d i a l te mp e ra tu re g ra d i e n t b e tw e e n i ts d e e p a n d s u p e rf i c i a l p a rts . In a s e n s e , th e te mp e ra tu re

o f th e mi x e d v e n o u s b l o o d re p re s e n ts a n e s s e n ti a l c o re te mp e ra tu re .

T h e re c t a l t e mp e ra t u re

A hi gh c or e te mp er at ur e is f ou nd t o be c on s t an t in t he r ec t um ab ou t 10 - 15 c m fr om th e an us . Wh en

me a s u ri n g th e re c t a l t e mp e ra t u re a s ta n d a rd d e p th o f 5 -1 0 c m i s u s e d c l i n i c a l l y . T h e v e n o u s p l e x u s

a ro u n d th e re c tu m c o mmu n i c a te w i th th e c u ta n e o u s b l o o d i n th e a n a l re g i o n . T h e re c ta l te mp e ra tu re

fa l l s w h e n th e fe e t a re c o l d , b e c a u s e c o l d b l o o d p a s s e s th e re c tu m i n th e v e i n s fro m th e l e g s fo r th e

s a me re a s o n . T h e re c ta l te mp e ra tu re r i s e s d u ri n g h e a v y w o rk i n v o l v i n g th e l e g s .

P a re n ts s h o u l d b e a d v i s e d to me a s u re th e re c ta l te mp e ra tu re i n d i s e a s e s u s p e c t c h i l d re n . T h e re c ta l

te mp e ra tu re i s a re l i a b l e e s ti ma te o f th e c o re te mp e ra tu re i n re s ti n g p e rs o n s .

S u b l i n g u a l (o ra l ) o r a x i l l a ry te mp e ra tu re s a re u n re l i a b l e me a s u re s o f th e c o re te mp e ra tu re - o fte n

mo re th a n h a l f a d e g re e l o w e r th a n th e re c ta l te mp e ra tu re .

T h e c ra n i a l t e mp e ra t u re (t y mp a n i c a n d n a s a l )

T h e ma i n c o n tro l o f te mp e ra tu re i s p e rfo rme d b y th e a n te ri o r h y p o th a l a mu s , w h i c h h a s a h i g h

b l o o d fl o w . Wi th i n th e c ra n i u m th e h y p o th a l a mu s l i e s o v e r th e C i rc l e o f Wi l l i s , w h i c h s u p p l i e s i t w i th

b l o o d , a n d c l o s e to th e c a v e rn o u s s i n u s w h i c h d ra i n s i t . H y p o th a l a mu s e l i c i ts h e a t l o s s re s p o n s e s

w h e n s t i mu l a te d b y h e a t. T h e ty mp a n i c me mb ra n e a n d a re a s i n th e n a s a l c a v i ty (th e a n te ri o r

e th mo i d a l re g i o n , p a rt o f th e s p h e n o i d s i n u s ) a re s u p p l i e d w i th b l o o d fro m th e i n te rn a l c a ro ti d a rte ry

ju s t lik e th e hy po th al am us . T he s e c ra n i a l l o c a ti o n s th e n s e rv e a s a s u b s ti tu te fo r th e me a s u re me n t o f

th e i n a c c e s s i b l e h y p o th a l a mi c te mp e ra tu re .

In ta k e o f 2 5 0 g o f i c e re l e a s e s a n a b ru p t fa l l i n th e n a s a l te mp e ra tu re i n a w a rm p e rs o n , w h e re a s th e

c h a n g e i n re c ta l te mp e ra tu re i s s ma l l e r a n d d e l a y e d (F i g . 2 1 -2 ). T h e c ra n i a l c o re te mp e ra tu re i s mo re

d y n a mi c th a n th e re c ta l .

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F i g . 2 1 - 2: I n ta k e o f i c e re d u c e s th e te mp e ra tu re i n a w a rm p e rs o n re s ti n g a t 4 5o C.

In s p o rts a n d i n s u rg i c a l h y p o th e rmi a d y n a mi c me a s u re me n ts o f c o re te mp e ra tu re a re e s s e n ti a l . T h e

c ra n i a l te mp e ra tu re i s o fte n p re fe rre d . D u ri n g fo rc e fu l mo v e me n ts th e th e rmi s to r ma y b e d i s p l a c e d . In

s u c h s i tu a ti o n s a n o e s o p h a g e a l l o c a ti o n i s a p p l i e d a t h e a rt l e v e l . T h i s i s a n a p p ro x i ma ti v e me a s u re o f

th e te mp e ra tu re o f th e mi x e d v e n o u s b l o o d o f th e r i g h t h e a rt l o c a te d c l o s e to th e th e rmi s to r.

T h e me a n b o d y t e mp e ra t u re i s d e fi n e d a c c o rd i n g to E q . 2 1 -1. T h e s to ra g e o f h e a t e n e rg y i n th e b o d y

c a n b e c a l c u l a te d a c c o rd i n g to i ts h e a t c a p a c i ty (3 .4 9 k J * k g -1 *o C -1 ), th e b o d y w e i g h t (k g ) a n d th e

c h a n g e i n me a n b o d y te mp e ra tu re i n th e p e ri o d ( E q . 2 1 -2) .

Ac c or di ng t o th e fi r s t la w of th er mo dy na mi c s , t he s to r ag e of he at en er gy eq ua ls th e me t ab ol ic en er gy

c h a n g e mi n u s th e h e a t l o s s ( E q . 2 1 -3). Q u a n ti f i c a ti o n o f th e rmo d y n a mi c s i n h u ma n s i s p o s s i b l e u s i n g

e q u a ti o n s 2 1 -1 to 2 1 -7 ( l a te r i n th i s c h a p te r).

T h e b o d y i s i n h e a t e n e rg y b a l a n c e , w h e n th e s to ra g e i s z e ro . H o w e v e r, th e c o re te mp e ra tu re ma y

c h a n g e w i th i n te rn a l f l u x e s o f h e a t e n e rg y b e tw e e n c o re a n d s h e l l w i th o u t s to ra g e o r l o s s o f h e a t

e n e rg y a t a c o n s ta n t a c ti v i ty .

V e n o u s b l o o d d ra i n i n g a c ti v e mu s c l e s a n d th e l i v e r i s l i k e l y to b e w a rme r th a n p u l mo n a ry v e n o u s

b l o o d , s i n c e th i s h a s u n d e rg o n e e v a p o ra ti v e c o o l i n g i n th e a l v e o l i . A p a ti e n t w i th h i g h fe v e r c a n b e i n

t h e rma l s t e a d y s t a t e , w i th a h i g h c o n s ta n t h e a t p ro d u c ti o n , i f b o th c o re - a n d s h e l l -te mp e ra tu re s a re

c o n s ta n t, a n d n o i n te rn a l e n e rg y f l u x o c c u rs .

Wa rm-b l o o d e d a n i ma l s , h o me o t h e rms s u c h a s h u ma n s , c a n c h a n g e th e i r me ta b o l i s m i n o rd e r to k e e p

th e i r h e a t p ro d u c ti o n e q u a l to th e h e a t l o s s . S u c h a n i ma l s h a v e a t e mp e ra t u re c o n t ro l s y s t e m an d

th e re b y ma i n ta i n a ra t h e r c o n s t a n t c o re t e mp e ra t u re. Wa rm-b l o o d e d a n i ma l s l i v e w i th th e a d v a n ta g e

o f a n u n c h a n g e d c e l l a c ti v i ty a n d te mp e ra tu re i n th e ir c o re . H o w e v e r, th e h u ma n c o re te mp e ra tu re

fa l l s d u ri n g th e o e s tro g e n p h a s e o f th e me n s tru a l c y c l e a n d d u ri n g s l e e p (c i rc a d i a n rh y th m). T h e

l o w e s t te mp e ra tu re i s b e tw e e n 1 8 a t n i g h t a n d 6 o ’ c l o c k i n th e mo rn i n g ( F i g . 2 1 - 3). T h e te mp e ra tu re

c y c l e i s p a rt o f th e c i rc a d i a n p e ri o d i c i ty . O u r b i o l o g i c a l c l o c k s e e ms to b e s y n c h ro n i s e d w i th th e

ro ta ti o n o f th e g l o b e . A l s o me a l s , l i g h t a n d te mp e ra tu re p l a y s a ro l e .

O v u l a ti o n re l e a s e s a s h a rp r i s e i n mo rn i n g te mp e ra tu re . P ro g e s te ro n e e ffe c ts s e e m to e x p l a i n th e

h i g h e r te mp e ra tu re i n th e l a s t p h a s e o f th e me n s tru a l c y c l e (F i g . 2 1 -3 ).

F i g . 2 1 - 3 : V a ri a ti o n s o f th e c o re te mp e ra tu re d u ri n g 2 4 h o u r (a b o v e ), a n d v a ri a ti o n s re l a te d to

p h a s e s o f t h e m e n s t r u a l c y cl e ( b e l o w ) .

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Cold-blooded animals ( po ik ilo th er ms ) l i v e w i th a b e h a v i o u ra l te mp e ra tu re rh y th m, b u t h a v e n o

a u to n o mi c te mp e ra tu re c o n tro l . T h e c o re - a n d s h e l l -te mp e ra tu re s v a ry w i th th e e n v i ro n me n t a n d th e

c e l l u l a r a c ti v i ty . R e p ti l e s , p re ma tu re a n d l o w w e i g h t-p re ma tu re n e w b o rn b a b i e s a re c o l d -b l o o d e d .

T h e s e b a b i e s h a v e n o th e rmo re g u l a ti o n (s e e l a te r). H o w e v e r, th e i r c a p a c i ty fo r h e a t p ro d u c ti o n i s 5 -

1 0 t i me s a s g re a t p e r u n i t w e i g h t a s th a t o f a d u l ts .

H u ma n s h a v e a w a rm-b l o o d e d (h o me o th e rmi c ) c o r e and a c o l d -b l o o d e d (p o i k i l o th e rmi c ) s h e l l in a cold

e n v i ro n me n t.

P e rs o n s e x p o s e d to g e n e ra l a n a e s th e s i a , a l c o h o l , a n d c e rta i n d ru g s l o s e th e a u to n o mi c

th e rmo re g u l a ti o n . C o l d -b l o o d e d a n i ma l s mu s t l i v e w i th v a ry i n g c o re a n d s h e l l te mp e ra tu re , w h e re b y

th e ra te o f th e i r c e l l u l a r a c ti v i t i e s v a ri e s w i th th e s u rro u n d i n g te mp e ra tu re ( F i g . 2 1 - 4) .

F i g . 2 1 - 4: T h e b o d y c o r e t e m p e r at u r e a n d t h e e n v i r o n m e n t a l b o d y t e m p e r a t u r e f o r a w a r m -

b l o o d e d a n i m a l ( c a t ) a n d a c o l d - b l o o d e d a n i m a l ( l i z a r d ) .

a ) C o n v e c t i o n. T h e c o n v e c ti v e h e a t l o s s i s c a l c u l a te d b y E q . 2 1 -7. A h e a l th y p e rs o n i n s p o rts

c l o th e s e x p e ri e n c e s th e rma l c o mfo rt a t th re e t i me s th e re s ti n g me ta b o l i c ra te (3 ME T ), w h e n th e

s u rro u n d i n g te mp e ra tu re i s 2 0 o C , th e h u mi d i ty i s 5 0 % a n d th e w i n d v e l o c i ty i s 0 .5 m*s -1 .

D i v i n g (w a te r h a s a h i g h th e rma l c o n d u c ti v i ty ) i l l u s tra te s th e i mp o rta n c e o f c o n d u c ti o n a n d c o n v e c ti o n

i n h e a t e n e rg y tra n s fe r.

T h e d ry d i v i n g s u i t e x c l u d e s w a te r fro m c o n ta c t w i th th e s k i n a n d tra p s l o w -c o n d u c ta n c e a i r i ni n s u l a ti n g c l o th i n g w o rn i n s i d e th e w a te r t i g h t s e a l i n g .

T h e w e t s u i t tra p s w a te r n e x t to th e s k i n b u t p re v e n ts i ts c i rc u l a ti o n . T h e w a te r i s w a rme d th ro u g h

c o n ta c t w i th th e s k i n , a n d th e h i g h i n s u l a ti o n o f th e fo a m ru b b e r w e t d i v i n g s u i t, w i th i ts ma n y p o c k e ts

o f tra p p e d a i r, mi n i mi s e s th e ra te o f h e a t e n e rg y l o s s to th e s u rro u n d i n g w a te r. A i r i s a p o o r h e a t

c o n d u c to r a n d th u s a g o o d i n s u l a to r. D u ri n g d e e p d i v i n g h i g h p re s s u re s c o mp re s s th e s e a i r p o c k e ts

a n d th u s re d u c e th e i n s u l a ti o n p ro p e rt i e s o f w e t d i v i n g s u i ts .

b ) R a d i a t io n d e s c ri b e s a tra n s fe r o f e n e rg y b e tw e e n o b j e c ts i n th e fo rm o f e l e c tro ma g n e ti c w a v e s

(p h o to n s ). T h i s i n c l u d e s u l tra v i o l e t a n d v i s i b l e (s u n l i g h t) ra d i a ti o n fro m th e o u ts i d e a n d fro m th e

b o d y i n fra re d o r w a rm h e a t ra d i a ti o n .

R a d i a t i v e h e a t t ra n s f e r c a n b e c a l c u l a te d fo r a n a k e d p e rs o n a c c o rd i n g to E q . 2 1 -4.

Wh e n th e s k i n te mp e ra tu re (T s k i n ) i s l e s s th a n th e te mp e ra tu re o f th e s u rro u n d i n g o b j e c ts , h e a t i s

g a i n e d b y r a d i a tio n .

At wi nt er ti me , he at c an be lo s t th r ou gh a wi nd ow gl as s by r ad ia t io n fr om th e bo dy t o th e c ol d

e n v i ro n me n t i rre s p e c ti v e o f th e ro o m te mp e ra tu re . T h i s i s b e c a u s e th e s k i n te mp e ra tu re i s h i g h e r

th a n th e o u ts i d e te mp e ra tu re .

c ) C o n d u c t i o n. S i tt i n g o n a c o l d s to n e i s a ty p i c a l e x a mp l e o f c o n d u c ti o n l o s s , j u s t a s s ta n d i n g o n a

c o l d f l o o r ( F i g . 2 1 - 1). – C o n d u c ti o n h e a t c a n a l s o b e g a i n e d , a l th o u g h i t i s re a l l y p o s s i b l e to w a l k o n

g l o w i n g c o a l s w i th s p e e d a n d a th i c k e p i d e rma l h o rn l a y e r.

d ) E v a p o ra t i v e h e a t l o s s - s e e s w e a t s e c re ti o n b e l o w .

2 . B o d y -re s p o n s e s to c o l d

C u t a n e o u s v a s o c o n s t r i c t i o n l o w e rs s k i n te mp e ra tu re , a n d th e re b y re d u c e s th e c o n d u c t i v e - c o n v e c t i v e

h e a t l o s s th a t i s d e te rmi n e d b y th e te mp e ra tu re g ra d i e n t fro m th e s k i n s u rfa c e to th e e n v i ro n me n t.

C u ta n e o u s v a s o c o n s tr i c t i o n d i re c ts th e p e ri p h e ra l v e n o u s b l o o d b a c k to th e b o d y c o re th ro u g h th e

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d e e p v e i n s a n d th e c o mmi ta n t v e i n s . T h e s e v e i n s a re l o c a te d a ro u n d th e a rte ri e s w i th w a rm b l o o d , s o

th a t th e v e n o u s b l o o d re c e i v e s p a rt o f th e h e a t e n e rg y fro m th e a rte ri a l b l o o d - s o -c a l l e d c o u n t e r

c u rre n t h e a t e x c h a n g e ( F i g . 2 1 - 5). T h e v a s o c o n s tr i c t i o n i s s o e ffe c ti v e , th a t th e b l o o d fl o w th ro u g h

th e a rte ri o -v e n o u s a n a s to mo s e s i n th e f i n g e rs a n d to e s c a n fa l l to b e l o w o n e p e rc e n t o f th e f l o w a t

n o rma l te mp e ra tu re . T h e c o o l i n g o f th e s h e l l i s i mme d i a te , a n d th e s i z e o f th e s h e l l i n c re a s e s ( F i g .

2 1 - 1). O b v i o u s l y , th e s h e l l i s l a rg e fo r a n a k e d p e rs o n i n c o l d a i r. T h e re s i s ta n c e v e s s e l s o f th e

h a n d s ma y o p e n p e ri o d i c a l l y to n o u ri s h th e t i s s u e s , b u t th e h i g h v i s c o s i ty o f th e c o l d b l o o d c a n

e n d a n g e r th e t i s s u e n u tr i t i o n a n d re s u l t i n tre n c h fo o t.

T h e a rt e ri o -v e n o u s s h u n t s o f th e h a n d s a n d fe e t a re c l o s e d , s o th e b l o o d fl o w to th e l i mb s i s a

n u tr i t i v e mi n i mum.

T h e d e e p a rte ri e s a n d v e i n s o f th e l i mb s l i e i n p a ra l l e l , s o th e a rte ri a l b l o o d fl o w l o s e s h e a t to th e

i n c o mi n g v e n o u s b l o o d p a rt i a l l y s u rro u n d i n g th e a rte ri e s (F i g . 2 1 -5 ). T h i s i s a ty p i c a l c o u n t e r - c u r r e n t

h e a t e x c h a n g e. In a c o l d e n v i ro n me n t, w h e re v a s o c o n s tr i c t i o n a n d h e a t e x c h a n g e p ro d u c e s c o l d

e x tre mi t i e s , th e to ta l i n s u l a ti o n i s i n c re a s e d a t th e e x p e n s e o f re d u c e d n e u ro mu s c u l a r e ff i c i e n c y .

F i g . 2 1 - 5: C o u n t e r - c u rr e n t e x c h a n g e i n a h u m a n a r m c o n s e r vi n g h e a t e n e r g y i n a c o l d c l i m a t e

( l e f t ) . S u p e rf i c i a l v e n o u s c o o l i n g r i b s e l i m i n a t e h e a t e n e r g y i n a w a r m c l i m a t e ( r i g h t ) .

In a w a rm c l i ma t e th e h i g h b l o o d fl o w o f th e e x tre mi t i e s e n s u re s a n o p ti ma l te mp e ra tu re o f th e d e e p e r

s tru c tu re s (e g , th e n e u ro mu s c u l a r s y s te m). T h e te mp e ra tu re o f th e a rte ri a l b l o o d i s ma i n ta i n e d (F i g .

2 1 -5 , r i g h t) a n d th e a rte ri o -v e n o u s a n a s to mo s e s a re w i d e o p e n c o n v e y i n g w a rm b l o o d to th e

s u p e rf i c i a l v e i n s . T h e s u p e rf i c i a l v e i n s a l s o a c t a s c o o l i n g r i b s a n d tra n s fe r l a rg e a mo u n ts o f h e a t to

th e s k i n s u rfa c e , w h e re i t i s e l i mi n a te d fro m th e b o d y b y c o n v e c ti o n , c o n d u c ti o n a n d e v a p o ra ti o n

(F i g . 2 1 -5 , r i g h t).

S h i v e ri n g i s a re f l e x my o g e n i c re s p o n s e to c o l d w i th a s y n c h r o n o u s o r b a l a n c e d mu s c l e c o n tra c ti o n s

e l i c i te d fro m th e h y p o th a l a mu s v i a c u ta n e o u s re c e p to rs . T h e a c ti v i ty i n a g o n i s t a n d a n ta g o n i s t

mu s c l e s b a l a n c e , s o th e re i s n o e x te rn a l w o rk . Wi th o u t o u ts i d e w o rk , a l l e n e rg y i s l i b e ra te d a s

me ta b o l i c h e a t e n e rg y . H e a t p ro d u c ti o n i s a l s o i n c re a s e d b y th y ro i d g l a n d a c ti v i ty a n d b y re l e a s e o f

c a te c h o l a mi n e s fro m th e a d re n a l me d u l l a .

E x t e rn a l w o rk , s u c h a s ru n n i n g , i s h e l p fu l i n ma i n ta i n i n g b o d y te mp e ra tu re w h e n fe e l i n g c o l d . C o l d

i n c re a s e s th e mo ti v a ti o n fo r w a r m - u p e x e r c i s e s a n d i l l u s tra te s th e v o l u n ta ry , c o rt i c a l ( fe e d fo rw a rd

i n fl u e n c e ) o n te mp e ra tu re h o me o s ta s i s . T h e c o re te mp e ra tu re i n c re a s e s p ro p o rt i o n a l l y to th e w o rk

i n te n s i ty d u ri n g p ro l o n g e d s te a d y s ta te w o rk (F i g . 2 1 -6 ). T h e me a n s k i n te mp e ra tu re fa l l s w i th

i n c re a s i n g w o rk i n te n s i ty a t 2 0 oC , b e c a u s e th e s w e a t e v a p o ra ti o n c o o l s th e s k i n .

F i g . 2 1 - 6: Mu s c u l a r a n d o e s o p h a g e a l te mp e ra tu re d u ri n g s te a d y s ta te e x e rc i s e . T h e l e v e l s o f

e x e rc i s e r a n g e f r o m z e r o t o 1 0 0 % o f t h e m a x i m u m o x y g e n u p t a k e .

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T h e te mp e ra tu re i n th e a c ti v e mu s c l e s d e te rmi n e s th e l e v e l o f th e re c ta l te mp e ra tu re . F o l l o w i n g

ma ra th o n re c ta l te mp e ra tu re s o f mo re th a n 4 1 o C h a v e b e e n me a s u re d a n d h e a t s tro k e s h a v e

o c c u rre d . A ma ra th o n i s e v e n mo re d i ff i c u l t to a c c o mp l i s h i n w a rm, h u mi d e n v i ro n me n ts a n d s tro n g

s u n m a y c a u s e s u n s t r o k e ( s e e l a t e r ) .

P e o p l e ma y a d a p t to p ro l o n g e d e x p o s u re to c o l d b y i n c re a s i n g th e i r b a s a l me ta b o l i c ra te u p to 5 0 %

h i g h e r th a n n o rma l . T h i s me t a b o l ic a d a p t a t i o n i s fo u n d i n In u i ts (E s k i mo s ) a n d o th e r p e o p l e

c o n ti n u o u s l y s u b j e c t to c o l d .

T h e e n v i ro n me n ta l te mp e ra tu re , w h e re w e ma i n ta i n o u r a u to n o mi c te mp e ra tu re c o n tro l , i s i n th e ra n g e

o f z e ro to 4 5o

C . B e l o w a n d a b o v e th i s ra n g e w e a d a p t to th e e n v i ro n me n t b y b e h a v i o u r (a d d i n g o r

re mo v i n g c l o th i n g , w a rm o r c o l d b a th , s u n o r s h a d o w ). A c o re te mp e ra tu re a b o v e 4 4 o C s ta rts p ro te i n

denaturation in al l cel ls and is incompatible with l i fe. Below 32 o C h u ma n s l o s e c o n s c i o u s n e s s a n d

b e l o w 2 8o C th e fre q u e n c y o f ma l i g n a n t c a rd i a c a rrh y th mi a ’ s i s i n c re a s i n g , e n d i n g w i th v e n tr i c u l a r

f i b ri l l a t i o n a n d d e a th a t a c o re te mp e ra tu re b e l o w 2 3 oC (F i g . 2 1 -7 ).

F i g . 2 1 - 7: E n v i ro n me n ta l te mp e ra tu re v a ri a ti o n s a n d te mp e ra tu re c o n tro l . L a c k o f v i ta l s i g n s i n

t h e c l i n i c ( r e s p i r at i o n , h e a r t r a t e , E E G ) m u s t n o t b e t a k e n a s d e a t h . T r e a t m e n t m u s t b e

i n s t i t u t e d u n t i l d e a t h s i g n s a r e d e v e l o p e d .

3 . B o d y -re s p o n s e s to h e a t

S w e a t s e c re ti o n . T h re e mi l l i o n s w e a t g l a n d s p ro d u c e s w e a t a t a ra te o f u p to 2 l i tre s pe r ho ur or

mo re d u ri n g e x e rc i s e i n e x tre me w a rm c o n d i t i o n s . I f n o t c o mp e n s a te d b y d ri n k i n g , s u c h h i g h s w e a t

ra te s l e a d to c i rc u l a to ry fa i l u re a n d s h o c k . S w e a t re s e mb l e s a d i l u te u l tra f i l tra te o f p l a s ma . H e a l th y

h u ma n s c a n n o t ma i n ta i n th e i r b o d y te mp e ra tu re , i f th e e n v i ro n me n ta l a i r re a c h e s b o d y te mp e ra tu re

a n d th e a i r i s s a tu ra te d w i th w a te r v a p o u r. P ri ma ry s w e a t i s s e c re te d a s a n i s o s mo ti c f l u i d i n to th e

s w e a t d u c t, a n d s u b s e q u e n t N a C l re a b s o rp ti o n re s u l ts i n th e f i n a l h y p o -o s mo ti c s w e a t. T h e rma l

s w e a t i n g i s a b o l i s h e d b y a tro p i n e , p ro v i n g th a t th e p o s tg a n g l i o n i c f i b re s a re c h o l i n e rg i c . C h o l i n e rg i c

d ru g s p ro v o k e s w e a ti n g j u s t a s a d re n e rg i c a g o n i s ts d o . E v a p o ra t i o n o f w a te r o n th e b o d y s u rfa c e

e l i mi n a te s 2 4 2 8 -2 4 3 6 J g-1 a t me a n s h e l l te mp e ra tu re s o f 3 0 -3 2o C . E v a p o ra ti o n o f a l a rg e v o l u me o f

s w e a t p e r t i me u n i t (V°s w e a t ) i mp l i e s a s u b s ta n ti a l l o s s o f h e a t a c c o rd i n g to E q . 2 1 -5 .

N o rma l l y , th e s k i n te mp e ra tu re fa l l s w i th i n c re a s i n g w o rk i n te n s i ty , b e c a u s e th e s w e a t e v a p o ra ti o n

c o o l s th e s k i n ( F i g . 2 1 - 6). D a n g e r o c c u rs w h e n th e a v e ra g e s k i n te mp e ra tu re a n d th e b o d y c o re

te mp e ra tu re c o n v e rg e to w a rd s th e s a me v a l u e .

C o n d e n s a t i o n o f w a te r o n th e s k i n g a i n s h e a t e n e rg y , w h i c h i s s to re d i n th e b o d y . T h i s i s w h a t

h a p p e n s i n a S a u n a .

V a s o d i l a t a t i o n o f s k i n v e s s e l s i n w a rm e n v i ro n me n ts re s u l ts i n i n c re a s e d c a rd i a c o u tp u t. T h e a rt e ri o -

v e n o u s a n a s t o mo s e s i n th e h a n d s a n d fe e t a re o p e n , a n d th e b l o o d fl o w c a n r i s e u p to a t l e a s t 1 0

fo l d s . T h e s h e l l i s mi n i ma l , w h e n a n a k e d p e rs o n i s i n w a rm a i r ( F i g . 2 1 - 1, r i g h t). T h e s k i n b l o o d f lo w ,

ma i n l y i n th e e x tre mi t i e s , d e te rmi n e s th e a mo u n t o f h e a t e n e rg y , w h i c h i s c a rr i e d fro m th e b o d y c o re

to b e l o s t o n th e s u rfa c e . T h e h e a t e n e rg y i s tra n s p o rte d fro m th e l a rg e b o d y c o re to th e s k i n b y

c o n v e c t i o n i n t h e b l o o d . A s u b s ta n ti a l p a rt o f th e h e a t e n e rg y i s l o s t th ro u g h th e s u p e rf i c i a l v e i n s o f

th e e x tre mi t i e s a c ti n g a s c o o l i n g r i b s ( F i g . 2 1 - 5). T h e b l o o d o f th e s u p e rf i c i a l v e i n s i s th u s

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a rte ri a l i z e d , w h e n th e p e rs o n i s w a rm.

A p i e c e o f s te a k h a s th e s a me c o mp o s i t i o n a s h u ma n s k i n b u t o f c o u rs e n o b l o o d f l o w a n d n o s w e a t

e v a p o ra ti o n . T h u s th e s te a k w i l l b e c o o k e d a t a n a i r te mp e ra tu re th a t h u ma n s c a n s u rv i v e . A p e rs o n

c a n s ta y i n a ro o m w i th d ry a i r a t 1 2 8o C fo r u p to 1 0 mi n d u ri n g w h i c h t i me th e s te a k i s p a rt i a l l y

c o o k e d .

4 . E m o t i o n a l s w e a t i n g

T h i s i s a pa r ad ox ic al r es po ns e i n c o n tra s t to th e t h e rma l s w e a t i n g o f th e r mo re g u l a ti on . E mo ti o n al

s t r e s s e l ic i t s v a s o c o n s t r i c t i o n i n th e h a n d s a n d fe e t c o mb i n e d w i th pr of us e s we at s ec r et io n o n th e

p a l ma r a n d p l a n ta r s k i n s u rfa c e s .

5 . Me ta b o l i c R a te a n d e n v i ro n me n ta l te mp e ra tu re

T h e to ta l h e a t l o s s c o n s i s ts o f th e e v a p o ra ti v e h e a t l o s s a n d th e d ry h e a t l o s s ( i e , th e s u m o f

c o n v e c ti v e , c o n d u c ti v e a n d ra d i a ti v e l o s s ). N e w t o n ’ s l a w o f c o o l i n g s ta te s th a t th e d ry h e a t l o s s i s

p ro p o rt i o n a l to th e te mp e ra tu re d i ffe re n c e b e tw e e n th e h u ma n b o d y (s h e l l ) a n d th e s u rro u n d i n g s .

L e t u s l o o k a t a h e a l th y , l i g h tl y d re s s e d s i t t i n g p e rs o n i n th e rma l b a l a n c e . H i s h e a t l o s s i s p l o tte d a s

th e o rd i n a te a n d th e e n v i ro n me n ta l te mp e ra tu re a s th e a b s c i s s a ( F i g . 2 1 - 8). T h e tw o ty p e s o f h e a t

l o s s a re a d d e d i n o rd e r to p ro v i d e th e to ta l h e a t e n e rg y l o s s . A t a ro o m te mp e ra tu re o f 3 7 o C th e re i s

a d ry h e a t l o s s o f z e ro , a n d b e l o w th e re i s a n i n c re a s i n g d ry h e a t l o s s . A b o v e 3 7 oC th e h e a t l o s s

tu rn s i n to h e a t i n p u t. O b v i o u s l y , th e d ry h e a t l o s s a l s o d e p e n d s u p o n c o n d u c ti o n a n d c o n v e c ti o n o f

h e a t i n s i d e th e b o d y b y c o n ta c t a n d b y th e p e rfu s i o n . A t e x tre me l y l o w e n v i ro n me n ta l te mp e ra tu re th e

d ry h e a t l o s s b e c o me s l a rg e r th a n th e me ta b o l i c h e a t l i b e ra ti o n a n d th e b o d y i s c o o l e d d o w n .

T h e p e rs o n i s i n t h e rma l s t e a d y s t a t e , a n d th e me ta b o l i c ra te i s a l mo s t c o n s ta n t i n th e t h e rmo n e u t ra l

z o n e b e tw e e n 2 0 a n d 3 0o C (F i g . 2 1 -8 ). T h e l a w o f me t a b o l i c re d u c t i o n re fl e c ts th e te n d e n c y fo r h e a t

p ro d u c ti o n to ma tc h th e ra te o f h e a t l o s s . T h e th e rmo n e u tra l z o n e , w h e re mi n i ma l c o mp e n s a to ry

a c ti v i ty i s re q u i re d , i s s e p a ra te d i n th e l o w e r v a s o m o t o r a n d th e u p p e r s u d o mo t o r c o n t ro l z o n e .

In th e l o w e r, c o mfo rta b l e z o n e (2 0 -2 6 o C ) th e t o t a l h e a t d i s s i p a t i on is maintained equal to the

me ta b o l i c ra te b y c u ta n e o u s , v a s o mo to r a l te ra ti o n s . T h e s ma l l e v a p o ra ti o n l o s s i s te rme d l e a k a g e o f

t h e s k i n o r i n s e n s i b l e p e rs p i ra t i o n, w h i c h i s u n re l a te d to s w e a t g l a n d fu n c ti o n a n d ra th e r c o n s ta n t a t

th e b a s a l me ta b o l i c ra te .

F i g . 2 1 - 8 : Me ta b o l i c ra te a n d e n v i ro n me n ta l te mp e ra tu re i n a fa s ti n g d re s s e d h u ma n a t re s t.

T h e w e t a n d t h e d r y h e a t l o s s , a s w e l l a s t h e m e t a b o l i c h e a t a n d t h e b a s a l m e t a b o l i c r a t e

( BM R ) i s me a s u re d i n Wa tts .

In th e u p p e r s u d o mo t o r z o n e a b o v e 2 6o C e n v i ro n me n ta l te mp e ra tu re , th e b l o o d fl o w th ro u g h th e s k i n

ri s e s , a s d o e s s w e a t s e c re ti o n a n d e v a p o ra ti o n . A t 3 7 o C th e r i s e i n e n e rg y l o s s o c c u rs v i a

e v a p o ra ti o n (F i g . 2 1 -8 ).

Wh e n th e e n v i ro n me n ta l te mp e ra tu re fa l l s th e me ta b o l i c ra te i n c re a s e s - f i rs t b y i n c re a s i n g mu s c l e

to n e a n d th e n b y s h i v e ri n g . T h e c h e mi c a l or me t a b o l i c t e mp e ra t u re c o n t ro l i s i n th e e n v i ro n me n ta l

re g i o n fro m 2 0 o C a n d b e l o w (F i g . 2 1 -8 ), w h e re s h i v e ri n g , d e c re a s e d b l o o d fl o w th ro u g h s k i n a n d n o n -

my o g e n i c h e a t p ro d u c ti o n ta k e p l a c e . H e re , me ta b o l i s m c o n tro l s th e c o re te mp e ra tu re b y i n c re a s i n g

me ta b o l i c ra te w i th fa l l i n g te mp e ra tu re i n th e e n v i ro n me n t. A b o v e 2 0 o C , th e ph y s ic al te mp er at ur e

c o n t r o l ta k e s o v e r, a s a n a u to n o mi c c a p a c i ty fo r a l te ra ti o n s i n h e a t l o s s . In th i s th e rmo n e u tra l z o n e

th e b o d y te mp e ra tu re i s k e p t c o n s ta n t a l mo s t w i th o u t e i th e r h e a t-p ro d u c i n g me c h a n i s ms o r s w e a t

s e c r e t i o n . - T h e t h e rma l c o mf o rt fo r l i g h t c l o th e d , s e a te d p e rs o n s i s a b o u t a n a i r te mp e ra tu re o f

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26 oC w h e n th e h u mi d i ty i s 5 0 %, 3 0 o C fo r n u d e p e rs o n s , a n d a b o u t 3 6 oC s i tt i n g i n w a te r to th e n e c k .

In th e me t a b o l i c z o n e , th e to ta l h e a t l o s s r i s e s w i th fa l l i n g e n v i ro n me n ta l te mp e ra tu re , b u t b e l o w 5 oC

i n th e e n v i ro n me n t, th e d ry h e a t l o s s e x c e e d s th e me ta b o l i c ra te , a n d th e b o d y i s c o o l e d d o w n ( F i g .

2 1 - 8). T h i s i s th e z o n e o f h y p o t h e rmi a , w h e re c o l d d e a th i s i n e v i ta b l e w i th o u t tre a tme n t.

T h e z o n e o f h y p e rt h e rmi a b e g i n s a t a n e n v i ro n me n ta l te mp e ra tu re o f 3 7 oC , w h e re h u ma n s s o o n

re a c h th e ma x i ma l c a p a c i ty fo r e v a p o ra ti o n a n d th e re i s a n u n b a l a n c e d h e a t i n f l u x to th e b o d y e n d i n g

in h e a t d e a t h .

T h e me ta b o l i s m v a ri e s w i th th e s h e l l a n d th e c o re te mp e ra tu re . T h e s e re l a ti o n s w e re e l u c i d a te d b y

s e ri e s o f s i mi l a r e x p e ri me n ts . A p e rs o n w a s p l a c e d i n s t i rre d w a te r to th e n e c k , w h e re th e w a te r

te mp e ra tu re th u s d e fi n e d th e me a n s h e l l te mp e ra tu re . B y p re -tre a tme n t i n o th e r b a th s a n a rra y o f

c o re -a n d s h e l l - te mp e ra tu re c o mb i n a ti o n s w e re o b ta i n e d a n d me a s u re d s i mu l ta n e o u s l y w i th th e

me ta b o l i c ra te ( me t a b o l ic h e a t l i b e ra t i o n). T h e c o re te mp e ra tu re w a s re d u c e d b y i n ta k e o f u p to 2 l o f

c ru s h e d i c e i n w a te r.

At a s he ll te mp er at ur e of 20 oC , i n ta k e o f i c e w a te r re d u c e s th e c o re te mp e ra tu re b e l o w 3 7 .1 oC

(h e re c a l l e d th e s e t p o i n t) a n d th e me ta b o l i c ra te i n c re a s e s b y s h i v e ri n g (F i g . 2 1 -9 ) w i th fa l l i n g c o re

te mp e ra tu re .

F i g . 2 1 - 9: T h e m e t a b o l i c r a t e a s a f u n c t i o n o f t h e c o r e a n d t h e s h e l l t e m p e r a t u r e.

Wa rme r s k i n ma k e s th e s e t p o i n t fa l l a n d th e r i s e i n me ta b o l i c ra te p e r o C (o f c o re te mp e ra tu re fa l l ) i s

l e s s s te e p . C o re te mp era tu re s a b o v e 3 7 .1 oC a l l h a v e a l o w me ta b o l i c ra te , re g a rd l e s s o f th e s h e l l

v a l u e s . A t a s h e l l te mp e ra tu re o f 3 0 oC th e s e t p o i n t d e c re a s e s fro m 3 7 .1 to 3 6 .7 oC . T h e

h y p o th a l a mu s fu n c ti o n s a s a t h e rmo s t a t u s i n g th e re s t o f th e b o d y to s ta b i l i s e i ts o w n te mp e ra tu re .

Wi th r i s i n g c o re te mp e ra tu re th e me ta b o l i c ra te i s ma i n ta i n e d l o w a n d th e b o d y tr i e s to c o o l d o w n .

Wh e n th e b o d y c o re te mp e ra tu re fa l l s b e l o w s e t p o i n t, th e me ta b o l i c ra te i n c re a s e s b y s h i v e ri n g a n d

th e h e a t e n e rg y s to ra g e a s w e l l. T h e c u ta n e o u s c o l d re c e p to rs a r e ma x i ma l ly a c ti v e a t 2 0 oC a n d

th e y a re s i l e n t a b o v e 3 3 oC - th e y c a n o n l y tr i g g e r s h i v e ri n g , w h e n th e c o re te mp e ra tu re i s b e l o w s e t

p o i n t. S h i v e ri n g c e a s e s i mme d i a te l y , w h e n w e ta k e a w a rm s h o w e r a n d th e s k i n i s w a rme d . T h e

h y p o th a l a mi c , p re o p ti c h e a t re c e p to rs i n h i b i t s h i v e ri n g , a n d s h i v e ri n g i s to ta l l y b l o c k e d a b o v e th e s e t

point.

An ot he r s er ie s of ex pe r im en ts we r e di r ec te d to wa r ds he at lo s s . T he he at lo s s fr om ev ap or at ed s we at

w a s re c o rd e d d u ri n g e x e rc i s e a t d i f fe re n t s h e l l te mp e ra tu re s .

F i g . 2 1 - 1 0: E v a p o r a t i ve h e a t l o s s a s a f u n c t i o n o f t h e c o r e a n d t h e m e a n s k i n t e m p e r a t u r e

d u r i n g d i f f e r e n t i n t e n s i t i e s o f e x e rc i s e .

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C o l d s t i mu l a te s c u ta n e o u s c o l d re c e p to rs w i th c o n n e c ti o n s to th e h y p o th a l a mu s ( F i g . 2 1 -1 2 ) .

At me an s k in te mp er at ur es of 33 - 39 oC , w h e re th e c u ta n e o u s c o l d re c e p to rs a re s i l e n t, th e p e rs o n i s

u n a b l e to s w e a t b e fo re th e c o re te mp e ra tu re i s a b o v e 3 6 .9 oC (th e s e t p o i n t o f F i g . 2 1 -1 0 ). B e lo w th e

s e t p o i n t, th e e v a p o ra ti o n i s l o w (p e rs p i ra ti o i n s e n s i b i l i s ). Wi th i n c re a s i n g mu s c l e a c ti v i ty a n d c o re

te mp e ra tu re th e e v a p o ra ti v e h e a t l o s s ma y r i s e to w a rd s 2 0 k J e a c h mi n .

Me a n s k i n te mp e ra tu re s b e l o w 3 3 oC re d u c e th e e v a p o ra ti v e h e a t l o s s . T h e r i s i n g h y p o th a l a mi c

te mp e ra tu re re l e a s e s th e s w e a t s e c re ti o n , b u t th e l o c a l s e c re ti o n i s i n h i b i te d b y th e c u ta n e o u s c o l d

r e c e p t o r s .

H e a t h a s a d i re c t e ffe c t o n p re o p ti c h e a t re c e p to rs i n th e h y p o th a l a mu s . A t i n c re a s e d c o re

te mp e ra tu re , th e p re o p ti c h e a t re c e p to rs to ta l l y b l o c k s h i v e ri n g , a l th o u g h th e h y p o th a l a mi c c e n tre

a l s o re c e i v e s s h i v e ri n g s i g n a l s fro m c u ta n e o u s c o l d re c e p to rs i n c o l d s u rro u n d i n g s w i th me a n s k i n

te mp e ra tu re s b e l o w 3 3 oC . T h e fa l l i n g me a n s k i n te mp e ra tu re c a n a l s o a c t d i re c tl y to l o w e r c u ta n e o u s

b l o o d fl o w a n d s w e a t s e c re ti o n .

6 . T e mp e ra tu re c o n tro l

H u ma n s h a v e a ra th e r c o n s t a n t c o re t e mp e ra t u re a l th o u g h th e me ta b o l i s m a n d e n v i ro n me n ta l

te mp e ra tu re ma y v a ry c o n s i d e ra b l y . T h i s i mp l i e s th a t c o n t ro l i s e x e rte d .

F i g . 2 1 - 1 1: T h e r m o r e g u l a t i o n b y d y n a m i c g a i n a n d s e t p o i n t s y s t e m s .

In fo rma ti o n a b o u t th e e n v i ro n me n ta l te mp e ra tu re i s p ro v i d e d b y p e ri p h e ra l t h e rmo -s e n s o rs , w h i c h a re

l o c a te d i n th e s k i n , a b d o mi n a l o rg a n s , a n d mu s c l e s . In te rn a l o r b l o o d te mp e ra tu re i s mo n i to re d b y

c e n t r a l t h e r m o - s e n s o r s i n th e p re o p ti c h y p o th a l a mu s a n d th e me d u l l a .

A r is e in h y p o t h a l a mi c t e mp e ra t u re c a u s e s v a s o d i l a ta ti o n i n th e s k i n a n d re d u c e s mu s c u l a r to n e . T h e

p e rs o n l o o s e s mo ti v a ti o n fo r p h y s i c a l a c ti v i ty a n d re d u c e s c l o th i n g . T h e n th e rma l s w e a t i s o b s e rv e d ,

a n d a fte r s o me t i me , re d u c e d a c ti v i ty o f th e a d re n a l c o rte x a n d o f th e th y ro i d g l a n d i s a l s o o b s e rv e d .

A f a l l i n h y p o t h a l a mi c t e mp e ra t u re b y c o o l i n g o f th e s h e l l a n d c o re re l e a s e s c u ta n e o u s

v a s o c o n s tr i c t i o n to g e th e r w i th i n c re a s e d mu s c u l a r to n e a n d s h i v e ri n g . T h e re i s a s y mp a th e ti c

a c ti v a ti o n w i th s e c re ti o n o f c a te c h o l a mi n e s , o x i d a ti o n o f fa tty a c i d s a n d g l u c o s e , a n d i n c re a s e d

s e c re ti o n o f th e th y ro i d a n d a d re n a l g l a n d . T h e mu s c l e to n e i s i n c re a s e d , a n d s h i v e ri n g i s tr i g g e re d

re fl e x l y a s a s y n c h ro n o u s mu s c l e c o n tra c ti o n s w i th o u t e x te rn a l w o rk (mo v e me n ts ), s o a l l th e

me ta b o l i c e n e rg y i s re l e a s e d a s h e a t. T h e c a p a c i ty fo r mu s c u l a r th e rmo g e n e s i s b y s h i v e ri n g i s h i g h .

U p to f i v e fo l d s b a s a l me ta b o l i c ra te i s o b s e rv e d , w h i c h c o rre s p o n d s to h e a v y i n d u s tr i a l w o rk .

S h i v e ri n g ma y b e s u p p re s s e d v o l u n ta ri l y a t th e b e g i n n i n g . T ra n s mi s s i o n s i g n a l s fo r s h i v e ri n g p a s s e s

th e ru b ro s p i n a l p a th w a y s to - a n d -mo to r n e u ro n s o f a n ta g o n i s t mu s c l e s .

D y n a m i c g a i n a n d s e t p o i n t c o n t r o l

A : A d y n a mi c g a i n s y s t e m r e s p o n d s c o n t i n u o u s l y t o f e e d b a c k s i g n a l s - r e g a r d l e s s o f t h e c o r e

te mp e ra tu re . Wi th r i s i n g t i s s u e te mp e ra tu re , th e n e u ra l a c ti v i ty o f h e a t s e n s o rs i n c re a s e s

l i n e a rl y , w h e re a s th e a c ti v i ty o f c o l d s e n s o rs d e c re a s e s ( F i g . 2 1 - 1 1 A) .

T h i s c o mb i n e d s e n s o ry i n p u t to th e h y p o th a l a mu s i n c re a s e s th e c o re te mp e ra tu re a n d th u s

i n c re a s e s th e a c ti v i ty o f h e a t l o s s e f f e c t o rs , while inhibiting h e a t p ro d u c t i o n e f f e c t o rs (F i g .

2 1 -1 1 A ). T h i s d e te rmi n e s th e re f e re n c e s i g n a l .

T h e d y n a mi c g a i n s y s te m h a s a f l o a ti n g re f e re n c e s i g n a l mo v i n g w i th th e c o n ti n u o u s h e a t

l o s s a n d h e a t p ro d u c ti o n (F i g . 2 1 -1 1 A ).

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B : A s e t -p o i n t s y s t e m d o e s n o t re s p o n d to a r i s e i n te mp e ra tu re b e fo re a c e rta i n s e t p o i n t i s

re a c h e d . T h e s e t p o i n t i s th e c o re te mp e ra tu re a t w h i c h n e i th e r h e a t l o s s me c h a n i s ms o r

h e a t p ro d u c ti o n me c h a n i s ms a re a c ti v e .

Wh e n a th e rma l d i s o rd e r re a c h e s a c e rta i n s e t -p o i n t i n th e h y p o th a l a mu s , s i g n a l s p a s s e s to

th e e ffe c to rs . T h e d e s i re d c o re te mp e ra tu re (t s et = s e t p o i n t t e mp e ra t u re) i s c o mp a re d to th e

a c tu a l v a l u e (t c o r e in F i g . 2 1 -1 1 B). T h e c a u d a l h y p o th a l a mu s w o rk s a s a th e rmo s ta t. E rro r

s i g n a l s - a d e v i a ti o n fro m t s et - e v o k e re s p o n s e s th a t te n d to re s to re c o re a n d h y p o th a l a mi c

te mp e ra tu re to w a rd th e s e t p o i n t. Wh e n th e a c tu a l c o re a n d h y p o th a l a mi c te mp e ra tu re r i s e s

a b o v e th e d e s i re d s e t p o i n t s u c h a s 3 7o

C , e ffe c to rs a re tu rn e d o n , a n d th e c o mp e n s a to ry

h e a t e n e rg y l o s s i s a l mo s t l i n e a r (F i g . 2 1 -1 1 B ). T h e s e c o mp e n s a to ry me c h a n i s ms

(v a s o d i l a ta ti o n , s w e a t, re d u c e d mu s c l e to n e ) d o n o t tu rn o ff u n ti l th e te mp e ra tu re d ro p s to

th e s e t p o i n t ( i e , a n a l l -o r-n o n re s p o n s e ).

Wh e n th e a c tu a l c o re a n d h y p o th a l a mi c te mp e ra tu re i s j u s t b e l o w th e s e t p o i n t, th e

c o mp e n s a to ry me c h a n i s ms (v a s o c o n s tr i c t i o n a n d s h i v e ri n g ) a re re l a ti v e l y i n a c ti v e .

T h e h y p o th a l a mi c s e t p o i n t c h a n g e w i th th e p h y s i o l o g i c a l c o n d i t i o n s a n d i s e l e v a te d i n fe v e r

by py r og en s fro m mi c ro o rg a n i s ms . T h e r i s e i n me ta b o l i s m i s ma i n l y a c c o mp l i s h e d b y

s h i v e ri n g .

7 . T h e h u m a n t h e r m o - c o n t r o l s y s t em

H u ma n te mp e ra tu re c o n tro l e x h i b i ts b o th d y n a mi c g a i n and s e t p o i n t c h a r a c t e r i s t ic s . T h e c o n t r o l

s y s te m i mp l i e s w i d e s p re a d c u ta n e o u s a n d d e e p s e n s o rs . T h e i r a ffe re n ts c o n v e rg e to w a rd s th e

h y p o th a l a mi c i n te g ra to r, w h i c h a c ts a s a t h e rmo s t a t . T h e h y p o th a l a mu s a l s o c o n ta i n s th e rmo s e n s o rs

i n th e p re o p ti c re g i o n , a n d i n h i b i to ry n e u ro n s p e rfo rm c ro s s i n g i n h i b i t io n ( F i g . 2 1 -1 2). T h e c e n t r a l

h e a t d ri v e fro m th e pr eo pt ic hy po t ha la mu s i s ma i n ta i n e d (F i g . 2 1 -1 2 ). T h e s ta b i l i ty o f th e c o re

te mp e ra tu re i s ma i n ta i n e d b y th e l a rg e h e a t c a p a c i t y o f t h e b o d y ma s s , a n d b y th e d e e p

th e rmo s e n s o rs , w h i c h a re d o mi n a n t.

S h i v e ri n g i s re l e a s e d fro m c u ta n e u s c o l d s e n s o rs f i r i n g ma x i ma l l y a t 2 0 o C . T h e s e c o l d s e n s o r s a r e

s i l e n t a b o v e 3 3 o C . T h e c o l d s h e l l (F i g . 2 1 -1 2 ) a c ti v a te s d e e p c o l d s e n s o rs i n th e p re o p ti c

h y p o th a l a mu s . T h i s i n c re a s e s h e a t p ro d u c ti o n b y s h i v e ri n g . T h e p re o p ti c th e rmo s ta t s i mu l ta n e o u s l y

re d u c e s h e a t l o s s b y c ro s s i n g i n h i b i t i o n .

F i g . 2 1 - 1 2: T h e h y p o t h a l a m i c t h e r m o s t a t a n d i t s c o n n e c t i o n s .

S w e a t s e c re t i o n i s re l e a s e d b y p re o p ti c w a rm s e n s o rs a s s o o n a s th e i r te mp e ra tu re i s 3 7 o C or

a b o v e ( t s et ). C u ta n e o u s c o l d s e n s o rs i n h i b i t s w e a t s e c re ti o n a t s h e l l te mp e ra tu re s b e l o w 3 3 o C,

s i n c e th e y a re s i l e n t a b o v e th i s te mp e ra tu re .

In c o n c l u s i o n , p re o p ti c w a rm s e n s o rs s h o w s e t p o i n t c h a ra c te ri s t i c s b e l o w th e s e t p o i n t, a n d p re o p ti c

c o l d s e n s o rs s h o w s e t p o i n t c h a ra c te ri s t i c s a b o v e th e s e t p o i n t.

Ap ar t fr om th at , pr eo pt ic s en s or s s ho w d y n a mi c g a i n: Wi th r i s i n g t i s s u e te mp e ra tu re , th e n e u ra l

a c ti v i ty o f h e a t s e n s o rs i n c re a s e s l i n e a rl y , w h e re a s th e s i g n a l fre q u e n c y o f c o l d s e n s o rs i n c re a s e s

w i th fa l l in g te mp e ra tu re ( F i g . 2 1 - 1 1 A) .

C u t a n e o u s s y mp a t h e t i c v a s o d i l a t a t i o n i s p ro b a b l y a l s o re l e a s e d b y p re o p ti c w a rm s e n s o rs a b o v e s e t

p o i n t (F i g . 2 1 -1 2 ). A fa l l i n s k i n te mp e ra tu re b e l o w 3 3 oC w i l l re d u c e s k i n b l o o d fl o w b y c ro s s i n g

i n h i bi t i o n (F i g . 2 1 -1 2 ) .

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Al c oh ol s ee ms to of f s et th e th er mo c on tr ol ma in ly by in hi bi ti on of th e hy po th al am ic t he r mo s ta t ( F ig .

2 1 - 1 2 ) .

N e w b o rn s , d o w n to p re ma tu re b a b i e s a b o v e 1 0 0 0 g , p o s s e s s c e rta i n th e rmo re g u l a to ry fu n c ti o n s . T h e

n e w b o rn c a n i n c re a s e th e rmo g e n e s i s b y a fa c to r o f th re e w i th o u t s h i v e ri n g s h o w s v a s o mo to r

re a c ti o n s , s w e a t s e c re ti o n , a n d re d u c e s th e s u rfa c e a re a i n c o l d a i r. H o w e v e r th e b a b y h a s s p e c i a l

p ro b l e ms : T h e s u rfa c e -v o l u me ra ti o i s 3 -fo l d h i g h e r th a n th a t o f a n a d u l t. T h e b a b y h a s a th i n s h e l l

d u e to th e th i n s u b c u ta n e o u s fa t l a y e r, s o e v e n a ma x i ma l v a s o c o n s tr i c t i o n c a n n o t l i mi t h e a t l o s s w i th

a c a p a c i ty c o mp a ra b l e to th a t o f a n a d u l t. N e w b o rn s a re s p e c i a l l y e q u i p p e d to p e rfo rm n o n -s h i v e ri n g

th e rmo g e n e s i s (c h e mi c a l th e rmo g e n e s i s ). N o n -s h i v e ri n g th e rmo g e n e s i s i s a n y r i s e i n me ta b o l i s m,

w h i c h i s n o t re l a te d to s h i v e ri n g . In b a b i e s th i s fo rm o f th e rmo g e n e s i s i s p a rt i c u l a rl y l a rg e i n th e i r

b ro w n a d i p o s e t i s s u e . T h i s t i s s u e i s a b u n d a n t a ro u n d v i ta l o rg a n s , i n ne c k a n d me d i a s ti n u m,

b e tw e e n s c a p u l a e a n d i n th e a rmp i ts . B ro w n a d i p o s e t i s s u e c e l l s c o n ta i n s mu l t i l o c u l a r d ro p l e ts i n th e

fa t p h a s e a n d ma n y mi to c h o n d ri a . T h e t i s s u e re c e i v e s s y mp a th e ti c i n n e rv a ti o n a n d i s s t i mu l a te d b y

c a te c h o l a mi n e s a n d th y ro i d h o rmo n e s . C o o l i n g i n c re a s e s th e b l o o d fl o w a n d te mp e ra tu re o f b ro w n

a d i p o s e t i s s u e . N o ra d re n a l i n e i n j e c ti o n s c a u s e v a s o d i l a ta ti o n v i a -re c e p to rs , a n d i n c re a s e th e

me ta b o l i s m to th e s a me e x te n t. T h e c a u s e o f th e i n c re a s e d me ta b o l i s m i s a n i n c re a s e d c e l l

me mb ra n e p e rme a b i l i ty fo r N a +- a n d K+- i o n s , w h e re b y th e N a +- K+-p u mp (h i g h A T P d e ma n d ) i s

a c ti v a te d .

F i g . 2 1 - 1 3 : T h e r m o c o n t r o l i n t h e n e w b o r n .

N e w b o rn s a re i n th e rma l b a l a n c e a t a mi n i ma l me ta b o l i s m o n l y w h e n th e s u rro u n d i n g te mp e ra tu re i s

h i g h (3 2 -3 4 oC ). Wi th o th e r w o rd s , n e w b o rn s h a v e a n e x tre me l y h i g h l o w e r th re s h o l d fo r th e

th e rmo n e u tra l z o n e , n a me l y 3 2 oC . T h e th re s h o l d fo r ma x i ma l u s e o f s h i v e ri n g i s a p p ro x i ma te ly 2 3

o C c o mp a re d to a n a k e d a d u l t a b o u t 5 oC . In g e n e ra l , th e s e th re s h o l d v a l u e s fo r n e w b o rn i n c re a s e

w i th fa l l i n g b o d y w e i g h t i n p re ma tu re . P re ma tu re b e l o w 1 0 0 0 g h a s h a rd l y a n y th e rmo n e u tra l z o n e

(F i g . 2 1 -1 3 ). T h e y a re a c tu a l l y c o l d -b l o o d e d a n d th e i r te mp e ra tu re c o n tro l i s ma i n ta i n e d w i th a

c o u v e u s e.

8 . T h e rmo re g u l a to ry e ffe c to rs

T h e s y mp a t h e t i c a n d th e s o m a t o mo t o r n e r v o u s s y s t e m p a rti c i p a te i n th e rmo r e g u l a tio n ( F i g . 2 1 - 1 4) .

N o ra d re n e rg i c s y mp a t h e t i c n e u ro n s c o n tro l th e b l o o d fl o w th ro u g h f i n g e rs , h a n d s , e a rs , l i p s a n d n o s e .

Ar te r io le s c o n t r a c t a n d a rt e ri o v e n o u s a n a s t o mo s e s c l o s e (th e rma l i n s u l a ti o n ) fo l l o w i n g a n i n c re a s e i n

s y mp a th e ti c to n e , a n d d i l a ta te fo l l o w i n g a d e c re a s e i n to n e . Wh e n a rte ri o l e s a n d a rte ri o v e n o u s

a n a s to mo s e s o p e n , th e b l o o d fl o w i s ma rk e d l y i n c re a s e d a n d th u s th e c o n v e c t i v e h e a t l o s s fro m th e

s k i n i s i n c re a s e d .

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F i g . 2 1 - 1 4: T h e t h e r m o r e g u l a t o r y f e e d b a c k s y st e m .

C h o l i n e rg i c s y mp a th e ti c f i b re s c o n tro l s w e a t s e c re ti o n . T h e v a s o d i l a ta to r b ra d y k i n i n is l iberated in

th e s k i n . T h u s , p ro fu s e s w e a t s e c re ti o n i s a l w a y s a c c o mp a n i e d b y v a s o d i l a ta ti o n .

S y mp a th e ti c a c ti v a ti o n re l e a s e s t h y ro i d h o rmo n e s fro m th e th y ro i d g l a n d a n d c a t e c h o l a mi n e s fro m th e

a d re n a l me d u l l a . T h e s e h o rmo n e s l i b e ra te fa tty a c i d s a n d g l u c o s e fo r c o mb u s ti o n . A re d u c e d

s y mp a th e ti c to n e a l s o re d u c e s th e a c ti v i ty o f th e a d re n a l a n d th e th y ro i d g l a n d .

T h e th e rmo g e n i c re s p o n s e to c o l d a l s o i n v o l v e s a n o n -my o g e n i c or n o n -s h i v e ri n g c o mp o n e n t

p ro b a b l y i n a d i p o c y te s . N o n -s h i v e ri n g h e a t p ro d u c ti o n i s c o n tro l l e d b y th e s y mp a th e ti c n e rv o u s

s y s t e m v i a a d r e n e r g ic -re c e p to rs . T h e n o ra d re n a l i n e (N A i n F i g . 2 1 -1 4 ) re l e a s e d a t th e n e rv e

te rmi n a l s c l o s e to th e a d i p o c y te s , s t i mu l a te s th e l i b e ra ti o n o f fre e fa tty a c i d s a n d th e i r s u b s e q u e n t

o x i d a ti o n . N o n -my o g e n i c h e a t p ro d u c t i o n i n c l u d e s a c o n tr i b u ti o n fro m th e b ro w n fa t o f b a b i e s , b u t i s

i n s i g n i f ic a n t i n a d u l ts .

S h i v e ri n g i s i n d u c e d b y w a y o f th e mo to r s y s te m. T h e c e n t ra l s h i v e ri n g p a t h w a y p a s s e s f r o m t h e

h y p o th a l a mu s to th e mo to r n e u ro n s i n th e s p i n a l c o rd . S h i v e ri n g i s a b o l i s h e d b y b l o c k a d e o f th e

n e u ro mu s c u l a r e n d p l a te w i th c u ra re .

T h e rmo re g u l a t o ry b e h a v i o u r s u c h a s fa n n i n g a n d a d d i n g o r re mo v i n g c l o th i n g i s e ffe c ti v e i n c h a n g i n g

th e th e rma l i n s u l a ti o n . S e v e ra l l a y e rs o f c l o th i n g w i th tra p p e d a i r a c t a s a g o o d i n s u l a to r.

In h e a l th y p e rs o n s , h e a t e n e rg y i s l i b e ra te d fro m c e l l u l a r me ta b o l i s m a n d tra n s fe rre d to th e

e n v i ro n me n t th ro u g h th e s k i n b y s w e a ti n g a n d v a s o d i l a ta ti o n . S w e a ti n g o c c u rs d u ri n g e x e rc i s e , a n d

i ts e v a p o ra ti o n i s th e mo s t i mp o rta n t me c h a n i s m i n ma i n ta i n i n g th e c o re te mp e ra tu re a s c l o s e to 3 7 o

C a s p o s s i b l e . T h e th e rmo re g u l a to ry c e n tre i n th e h y p o th a l a mu s c o n tro l s a l l p ro c e s s e s .

F i g . 2 1 - 1 5: H e a t a n d c o l d a d a p t a t i o n

Cold adaptation i s fo u n d a mo n g A u s tra l i a n a b o ri g i n e s a n d In u i ts i n G re e n l a n d . In u i ts h a v e re l a ti v e l y

mo re s w e a t g l a n d s i n th e fa c e a n d l e s s o n th e b o d y .

Ab or ig in es c an s le ep na k ed on th e gr ou nd ev en at lo w te mp er at ur e. In ui ts ha v e a ba s al me t ab ol ic r at e

5 0 % h i g h e r th a n p e rs o n s l i v i n g i n a te mp e ra te c l i ma te d o . T h e th re s h o l d fo r s h i v e ri n g i s s h i fte d

to w a rd s th e l e ft i n c o l d -a d a p te d p e rs o n s , b u t th e y ma i n ta i n n o rma l fu n c ti o n a t th e n e w s e t p o i n t. V e ry

o l d p e o p l e ma y s h o w th e s a me p h e n o me n o n , a n d l i v e w i th a c o re te mp e ra tu re o f 3 5 oC without

s h i v e ri n g . O b v i o u s l y , c o l d a d a p ta ti o n i mp l i e s n o n -s h i v e ri n g th e rmo g e n e s i s , w h i c h i s o e c o n o mi c

me ta b o l ic h e a t l i b e ra ti o n ( F i g . 2 1 - 1 5) .

H e a t a c c l i ma t i z a t i on i s a c tu a l l y a s w e a t g l a n d a d a p t a t i o n , a n d a 2 -w e e k p ro c e s s fo l l o w i n g a rr i v a l to a

h o t c l i ma te s u c h a s th e tro p i c s o r a d e s e rt. G ra d u a l l y s w e a t-e v a p o ra ti o n i s i n c re a s e d a n d th e N a C l

l o s s i s re d u c e d . T h e s w e a t s e c re ti o n c a p a c i ty ma y re a c h 4 l e a c h h o u r w i th a th i n s w e a t. T h e

a d a p ta ti o n i s c a u s e d b y i n c re a s e d a l d o s te ro n e s e c re ti o n fro m th e a d re n a l c o rte x . A l d o s te ro n e

i n c re a s e s th e re a b s o rp ti o n o f N a C l a n d th e s e c re ti o n o f K+ fro m th e s w e a t, d u ri n g i ts p a s s a g e o f th e

s w e a t g l a n d tu b u l e s . T h e l a rg e r s w e a t l o s s th e th i rs t i e r o n e fe e l s . T h i s i s b e c a u s e th e l a rg e s w e a t

s e c re ti o n re d u c e s th e t i me p e ri o d fo r N a C l - re a b s o rp ti o n i n th e s w e a t g l a n d tu b u l e s . T h e re s u l t i n g

h i g h N a C l c o n c e n tra ti o n i n th e p l a s ma i mp l i e s th i rs t, s o h e a t a d a p te d p e rs o n s h a v e to d ri n k a l o t.

T h i rs t i s a n e x tre me l y l a te i n d i c a to r o f d e h y d ra ti o n d u ri n g w o rk i n a w a rm c l i ma te .

T ro p i c i n h a b i ta n ts a re o f c o u rs e h e a t-a d a p te d . T h e y h a v e a n i n c re a s e d c o re te mp e ra tu re (s e t p o i n t)

a n d th e i r th re s h o l d fo r s w e a t a n d v a s o d i l a ta ti o n i s ty p i c a l l y 0 .5 o C h i g h e r th a n th a t o f a p e rs o n l i v i n g

i n th e t e mp e ra t e z o n e (F i g . 2 1 -1 5 ).

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P a t h o p h y s i o l o g y

T h i s p a ra g ra p h d e a l s w i th 1. H e a t c ra mp s , 2 . H e a t e x h a u s ti o n a n d h e a t s t ro k e , 3 . Ma l i g n a n t

h y p e rth e rmi a , 4 . H y p o t h e r mia, 5. F r o s t b i t e, a n d 6 . F e v e r a n d h y p e rth e rmi a .

A pa r ag r ap h c on c er ni ng nu c le ar en er gy r ad ia ti on is gi v en at th e en d.

1 . H e a t C ra mp s

P a i n fu l c ra mp s i n th e l e g mu s c l e s o c c u r fo l l o w i n g e x e rc i s e , w h e n a th l e te s ru n to o fa s t i n a h o t

c l i ma te . H e a t c ra mp s re s p o n d to s a l t a n d w a te r re p l e n i s h me n t i n a n o rma l d i e t, a n d th e c ra mp s a re

p ro b a b l y c a u s e d b y h y p o n a tra e mi a . D u ri n g p ro l o n g e d s w e a ti n g , th e ru n n e r i s l o s i n g s a l t a n d w a te r. I f

o n l y th e w a te r l o s s i s re p l e n i s h e d , th e re s u l t i s w a te r- i n d u c e d h y p o n a tra e mi a - a p a ra l l e l to th e

c l a s s i c a l mi n e r’ s c ra mp s .

2 . H e a t E x h a u s ti o n a n d H e a t S tro k e

Wh e n th e w a te r-s a l t b a l a n c e i s a t r i s k i n a h o t c l i ma te , i t i s a l w a y s a th re a t to th e c i rc u l a ti o n . P ro fu s e

s w e a t s e c re ti o n , i n a s u b j e c t w h o i s n o t a c c l i ma ti z e d , re s u l ts i n s a l t- a n d w a te r d e p l e ti o n , w i th a d a i l y

l o s s o f mo re th a n o n e mo l o f N a C l a n d mo re th a n 6 l o f w a te r. Wi th i n a p e ri o d o f o n e -h o u r s tre n u o u s

w o rk i n g e n d u ra n c e a th l e te s h a v e l o s t u p to 8 l o f w a te r.

T h e fa l l i n g e x tra c e l l u l a r f l u i d v o l u me a n d i n c re a s i n g b o d y a n d b ra i n te mp e ra tu re to a b o v e 4 0 o C elicit

s e v e re s y mp to ms a n d s i g n s . A s th e v o l u me a n d s a l t d e p l e ti o n d e v e l o p s , th e s w e a t p ro d u c ti o n g o e s

d o w n i n s p i te o f e x tre me v a s o d i l a ta ti o n . T h e fa l l i n g b l o o d p re s s u re s t i mu l a te s th e h i g h -p re s s u re

b a ro re c e p to rs re s u l t i n g i n a r i s i n g h e a rt ra te . T h e d e h y d ra ti o n w i th i mmi n e n t s h o c k fre q u e n tl y re s u l ts

i n c e re b ra l , re n a l a n d h e p a ti c fa i l u re . T h e l o w b ra i n b l o o d fl o w th ro u g h a n o v e rh e a te d b ra i n l e a d s to

fa ti g u e ( h e a t e x h a u s t i o n ), c o n f u s i on a n d u n c o n s c i o u s n es s o r s y n c o p e ( h e a t s y n c o p e). T h e c o n fu s i o n

ma y d e v e l o p i n to a v e ri ta b l e delirium (a n a c u te i mp a i rme n t o f c o n s c i o u s n e s s ) w i th b ra i n o e d e ma .

H e a t s t r o k e - i n th e s u n i t i s c a l l e d s u n s t r o k e - i s h e a t c o l l a p s e th a t o c c u rs s u d d e n l y , h e re b y

c re a ti n g a l i fe -th re a te n i n g c o n d i t i o n . T h i s h e a t c o l l a p s e o fte n o c c u rs i n w a rm, h u mi d e n v i ro n me n ts ,

w h e n a n u n a c c l i ma ti z e d s u b j e c t e x e rc i s e s . T h e s u b j e c t - w i th o u t s w e a ti n g (h y p o th a l a mi c fa i l u re ) -

s u d d e n l y fa l l s i n to c o ma , i f n o t p re c e d e d b y a s h o rt p e ri o d o f c o n fu s i o n a n d d e l i r i u m. T h e c o n d i t i o n i s

fa ta l , i f n o t re l i e v e d b y ra p i d c o o l i n g .

3 . Ma l i g n a n t h y p e rth e rmi a

Ma l i g n a n t h y p e rp y re x i a i s o fte n c a u s e d b y a g e n e t i c d e f e c t (a u to s o ma l d o mi n a n t) i n th e s a rc o p l a s mi c

re ti c u l u m o f s k e l e ta l mu s c l e s . G e n e ra l a n a e s t h e s i a (o fte n h a l o g e n -s u b s ti tu te d e th a n e ) tr i g g e rs a n

a l l e rg i c re a c ti o n w i th s u d d e n o p e n i n g o f C a 2+ - c h a n n e l s i n th e mu s c l e c e l l s . T h e fo l l o w i n g i n f l u x o f

Ca 2+ e l i c i ts g e n e ra l i z e d a n d ma i n ta i n e d mu s c l e c o n tra c ti o n (r i g i d i ty ), w h i c h l i b e ra te s e n o rmo u s

q u a n ti t i e s o f h e a t e n e rg y . T h i s c o n d i t i o n i s l i fe th re a te n i n g a n d o fte n re s u l ts i n s u d d e n d e a th d u ri n g o r

ju s t af te r an ae s t he s ia .

4 . H y p o t h e r m i a

H y p o th e rmi a i s a fa l l i n c o re te mp e ra tu re to v a l u e s b e l o w 3 5

o

C . H y p o th e rmi c s u b j e c ts l o s e

c o n s c i o u s n e s s , w h e n th e c o re te mp e ra tu re fa l l s b e l o w 3 2 oC - a p o te n ti a l l y l e th a l c o n d i t i o n c a l l e d

s e v e re h y p o t h e rmi a.

D u ri n g a n a e s th e s i a a n d s u rg e ry th e c o re te mp e ra tu re o f th e p a ti e n t fa l l s a n d s ta b i l i s e a ro u n d 3 4 -3 5

o C a fte r 4 -5 h o u rs . S u c h a s u r g e r y h y p o t h er m i a i n c re a s e s th e r i s k o f c a rd i a c c o mp l i c a ti o n s , b l e e d i n g

te n d e n c y a n d p ro l o n g e d w o u n d h e a l i n g .

T h e c o n d i t i o n i s a p ro mi n e n t c a u s e o f d e a th i n c l i mb e rs a n d s k i e rs , a s w e l l a s i n p e rs o n s b e i n g

i mme rs e d i n c o l d w a te r o r l i v i n g i n th e A n ta rc ti s . T h e c l i mb e rs a n d s k i e rs a re o fte n e x p o s e d to a c o l d ,

w e t a n d w i n d y e n v i ro n me n t c a rry i n g i n s u ff i c i e n t c l o th i n g . A s th e n e u ro mu s c u l a r fu n c ti o n s u ffe rs , th e y

c a n n o l o n g e r mo v e . G e n e ra l h y p o th e rmi a d e v e l o p s a n d th e y d i e .

In mi l d h y p o th e rmi a th e s u b j e c t c a n s t i l l ta k e a c ti o n to re w a rm b y e x e rc i s e a n d c l o th i n g , b u t a s

c o n s c i o u s n e s s i s l o s t th e c o re te mp e ra tu re fa l l s fu rth e r, b e c a u s e s h i v e ri n g i s a b o l i s h e d . T h e p a ti e n t

fe e l s c o l d to to u c h , i s i n a d e v e l o p i n g c o ma , th e c i rc u l a ti o n a n d re s p i ra ti o n fa l l , a s d o e s th e me ta b o l i c

ra te . T h e d i s s o c i a ti o n c u rv e o f o x y h a e mo g l o b i n i s mo v e d to th e l e ft, a n d th e s o l u b i l i ty o f g a s s e s

i n c re a s e s a s th e b l o o d te mp e ra tu re fa l l s .

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T h e h e a rt i s th e ta rg e t o rg a n i n h y p o th e rmi a . B e l o w 3 0 oC , s p o n ta n e o u s re mi s s i o n i s p ra c ti c a l l y

i mp o s s i b l e , a n d d e a th e n s u e s fro m v e n tr i c u l a r f i b r i l l a t i o n o c c u rri n g a ro u n d 2 8 oC.

C a re fu l mo n i to ri n g o f a l l v i ta l fu n c ti o n s i s re q u i re d d u ri n g re w a rmi n g , w h i c h i s p e rfo rme d e i th e r

p a s s i v e l y (re w a rmi n g b y th e p a ti e n ts o w n me ta b o l i s m) w i th i n s u l a ti o n a n d s p a c e b l a n k e ts o r a c ti v e l y

b y a w a rm w a te r b a th , w h i l e mo n i to ri n g th e p a ti e n t. A g o o d s tra te g y i n tre a ti n g h y p o th e rmi c v i c t i ms i s

th e s l o g a n : “ T h e y a re n o t d e a d u n t i l t h e y a re w a rm a n d d e a d .”

An ar t er ia l bl oo d s am pl e fr om a hy po t he r mi c pa ti en t is r ou t in el y an al y s ed at 37 oC . T h e Pa O 2 and pH a

i s fa l s e l y h i g h e r, th e P a C O 2 i s fa l s e l y l o w e r, th a n i n th e c i rc u l a ti n g b l o o d o f th e h y p o th e rmi c p a ti e n t.

T h i s i s b e c a u s e mo re C O 2 i s b o u n d a l s o a s c a rb a mi n o -h a e mo g l o b i n , a n d l e s s O 2 i s b o u n d i n th e c o l d

b l o o d . B a s e E x c e s s i s d e fi n e d a t 3 7 oC a n d th u s a tru e me ta b o l i c v a ri a b l e (s e e C h a p te r 1 7) .

Ar ti fi c ia lly in du c ed hy po th er mi a i s u s e d i n b ra i n - a n d h e a rt-s u rg e ry , w h e re th e u s u a l th e rmo c o n tro l i s

i n a c ti v a te d b y g e n e ra l a n a e s th e s i a . T h e p ro c e d u re b e c o me s d a n g e ro u s , w h e n i t e l i c i ts v e n t ri c u l a r

f ibri l lat ion.

5 . F r o s t b i t e

F r o s t b i t e i s a l o c a l c o l d i n j u ry d u e to th e fo rma ti o n o f e x tra c e l l u l a r i c e c ry s ta l s i n th e s k i n a n d o th e r

t i s s u e s . T h i s l e a d s to e x tra c e l l u l a r d e h y d ra ti o n a n d h y p e ro s mo s i s , w h e re b y th e c e l l s l o s e w a te r u n ti l

th e y d i e . A s th e s k i n te mp e ra tu re fa l l s below + 7 oC th e s u b j e c ts h a v e l o s t th e i r s e n s o ry fu n c ti o n s ,

a n d th u s d o n o t re c o g n i s e th e d e v e l o p i n g fro s tb i te .

T h e mo s t e ffe c ti v e tre a tme n t i s w a rmi n g o f th e s t i l l f ro z e n a re a b y i mme rs i o n i n 4 0 -4 2 oC h o t w a te r

fo l l o w i n g h o s p i ta l i s a ti o n . T h e p a ti e n t e x p e ri e n c e s s e v e re p a i n (a b o v e + 7 oC ) a n d mo rp h i n e mu s t b e

a d mi n i s te re d . T i s s u e w h i c h i s n o l o n g e r fro z e n mu s t b e tre a te d s te ri l e .

6 . F e v e r a n d h y p e rth e rmi a

F e v e r o c c u rs w h e n th e c o re t e mp e ra t u re o f t h e b o d y i s ra i s e d a b o v e n o rma l s te a d y s ta te l e v e l s . T h e

b o d y re a c ts a s i f i t i s to o c o l d , w h i l e th e te mp e ra tu re r i s e s u p to th e n e w h i g h e r s e t p o i n t. F e v e r

a tta c k s i mp l y s h i v e ri n g c o mb i n e d w i th v a s o c o n s tr i c t i o n , h e a d a c h e , d e d o l a ti o n p a i n s , a n d g e n e ra l

d i s c o mfo rt. F e v e r i s th e re s u l t o f o n e o f tw o p h e n o me n a : th e s e t p o i n t ma y b e s e t to a h i g h e r l e v e l , o r

th e e ff i c a c y o f th e te mp e ra tu re c o n tro l s y s te m ma y b e i mp a i re d . F e v e r i mp l i e s h y p e rt h e rmi a ; h o w e v e r

ma n y c a s e s o f h y p e rth e rmi a d o n o t c o n s ti tu te fe v e r. F e v e r re s u l ts fro m th e a c ti o n o f e n d o g e n o u s

py r og en s o n th e h y p o t h a l a mi c h e a t c o n t ro l c e n t re (th e y i n c re a s e th e s e t p o i n t fo r th e c o re

te mp e ra tu re v i a p ro s ta g l a n d i n s ). E x o g e n o u s p y ro g e n s fro m mi c ro b e s c a u s e th e s e e n d o g e n o u s

po ly pe pt id es to b e re l e a s e d fro m th e d e fe n c e c e l l s o f th e b o d y ( i e , th e re ti c u l o e n d o th e l i a l s y s te m,

R E S ). A n ti p y re ti c d ru g s i n h i b i t c y c l o -o x y g e n a s e a c ti v i ty , h e re b y i n te rfe ri n g w i th th e s y n th e s i s o f

p ro s ta g l a n d i n s a n d th ro mb o x a n e s .

F o l l o w i n g a n a tta c k o f fe v e r, v a s o d i l a ta ti o n a n d s w e a t e v a p o ra ti o n re d u c e s th e c o re te mp e ra tu re .

P h y s i o l o g i c h y p e rt h e rmi a i s a n i n c re a s e i n c o re te mp e ra tu re c a u s e d b y e x tre me h e a t s tre s s o r

e x e rc i s e . D u ri n g w o rk th e b o d y te mp e ra tu re r i s e s u p to 3 9 oC w i th o u t c l i n i c a l c o n s e q u e n c e s .H e re b y ,

th e h e a t l o s s c a p a c i ty i s e x c e e d e d . D u ri n g h y p e rth e rmi a th e h e a t l o s s e f f e c t o rs a re s tra i n e d to th e

u tmo s t. T h e h i g h b o d y te mp e ra tu re s o f e x e r c i s e a c ti v a te c o o l i n g me c h a n i s ms a n d e l i c i t s w e a t l o s s ,

w h i c h s tr i v e to re tu rn th e c o re te mp e ra tu re to i ts n o rma l l e v e l .In e x tre me h y p e rth e rmi a th e c o re

te mp e ra tu re ma y r i s e to mo re th a n 4 1 o C (h e a t s tro k e ). Irre v e rs i b l e p ro te i n d e n a tu ra ti o n o c c u rs

a b o v e 4 4 o C w i th b ra i n o e d e ma a n d d e s tro y e d th e rmo n e u ro n s i n th e h y p o th a l a mu s . C l i n i c a l l y , th e

b ra i n d a ma g e i s s h o w n w i th d i s o ri e n ta ti o n , l a c k o f s w e a t s e c re ti o n , d e l i r i u m a n d u n i v e rs a l c ra mp s

b e fo re d e a th .

I o n i z i n g R a d i a t i o n H a z a r d s

Io n i z i n g ra d i a ti o n i mp l i e s d e s tru c ti o n o f t i s s u e mo l e c u l e s .

D o s a g e s o f a b s o rb e d ra d i a ti o n i s me a s u re d i n J o u l e s p e r k g (1 J k g -1 i s k n o w n a s a g ra y , G y ) . O ne

G y i s e q u i v a l e n t to 1 0 0 ra d s . R a d i o a c ti v i ty i s me a s u re d a s th e n u mb e r o f d e g ra d a ti o n s p e r s e c o n d i n

b e q u e re l s or Bq . O n e d e g ra d a ti o n p e r s fro m ra d i o a c ti v e ma te ri a l e q u a l s o n e B q .

T h e a b s o rb e d d o s e o f ra d i a ti o n i s b a l a n c e d fo r d a ma g i n g i o n i z i n g t i s s u e e ffe c t, s i n c e d i ffe re n t ty p e s

o f ra d i a ti o n h a v e d i ffe re n t d e n s i ty o f i o n i z a ti o n . A d o s e e q u i v a l e n t te rme d s i e v e rt (S v ) c a u s e s a

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ra th e r l a rg e d a ma g e . T h e a n n u a l b a c k g ro u n d ra d i a ti o n i s 2 .5 mi l l i -S v ( 2.5 mSv ). N o n -p e n e tra ti n g

ra d i a ti o n o c c u rs fro m a l p h a - a n d b e ta p a rt i c l e s . T h e s e p a rt i c l e s a re s to p p e d b y p a p e r, b u t w h e n th e y

e n te r a t i s s u e - s u c h a s th e b o n e ma rro w – th e y s ta y th e re a n d s p o i l e v e ry th i n g .

P e n e tra ti n g ra d i a ti o n c o n s i s ts o f e i th e r g a mma ra y s (n e u tro n ) o r X -ra y s . S u rv i v o rs fro m n u c l e a r

p o w e r p l a n t a c c i d e n ts , w i th w h o l e b o d y a b s o rp ti o n g re a te r th a n 1 0 0 ra d s , a re th re a te n e d b y a c u te

a n d c h ro n i c ra d i a ti o n s i c k n e s s .

Ac ut e r ad ia ti on s ic k ne s s a p p e a rs a s v o mi t i n g a n d ma l a i s e fo l l o w i n g e x p o s u re to 1 G y (1 0 0 ra d ) o r

mo re . L y mp h o c y te p ro d u c ti o n i s re d u c e d i mme d i a te l y , s o o n fo l l o w e d b y l e u c o p e n i a a n d

th ro mb o c y to p e n i a w i th b l e e d i n g . T h e v i l l i o f th e g a s tro i n te s ti n a l tra c t a re d e s tro y e d , a b s o rp ti o n o f

n u tr i e n ts i s i mp a i re d , a n d n e w v i l l o u s c e l l s a re n o t p ro d u c e d . D i a rrh o e a , o fte n w i th b l o o d l o s s , re s u l ts

i n d e h y d ra ti o n a n d a n a e mi a . T h e s k i n i s re d a n d b l i s te ri n g , a n d th e h a i r i s l o o s e d . T h e

i mmu n o d e fi c i e n c y s y s te m i s d e s tro y e d , a n d s e c o n d a ry i n fe c ti o n s h a v e a h i g h mo rta l i ty - e s p e c i a l l y

p u l mo n a ry i n fe c ti o n s . C e re b ra l o e d e ma ma y k i l l th e v i c t i m w i th i n h o u rs w h e n e x p o s e d to 3 5 G y o r

mo re .

C o n ta mi n a ti o n w i th ra d i o a c ti v e i o d i n e i s tre a te d b y i mme d i a te i n ta k e o f p o ta s s i u m i o d i d e , w h i c h b l o c k

th e ma j o r p a rt o f th e th y ro i d a b s o rp ti o n . T h e tre a tme n t o f s e ri o u s l y e x p o s e d ra d i a ti o n v i c t i ms i s

s u p p o rt i v e a n d fru s tra n e .

C h ro n i c ra d i a t i o n s i c k n e s s or l a t e ra d i a t i o n d a ma g e i mp l i e s a n i n c re a s e d ra te o f mu ta g e n e s i s , w h i c h

i n c l u d e s a h i g h fre q u e n c y o f l e u c a e mi a , c a n c e r o f th e b ra i n , th e th y ro i d a n d th e s a l i v a ry g l a n d s ,

i n fe rt i l ity a n d c a t a r a c t ( i e , a n e y e d i s e a s e w h e re th e v i s i o n i s b l u rre d b y a n o p a q u e l e n s ). T h e

ra d i a ti o n l i b e ra te s l a rg e a mo u n ts o f h i g h l y re a c ti v e i o n s i n th e c e l l s . T h e re a c ti v e i o n s ru p tu re D N A

s tra n d s a n d c a u s e mu ta ti o n s w i th p ro d u c ti o n o f c a n c e r c e l l s . C a n c e r c e l l s mu l t i p l y e x p o n e n ti a l l y a n d

th e i r e n e rg y d e ma n d a p p ro a c h th e to ta l n u tr i t i v e e n e rg y a v a i l a b l e , c a u s i n g ma l n u tr i t i o n a n d d e a th .

T h e n u c l e a r p o w e r p l a n t a c c i d e n t i n T j e rn o b y l , U k ra i n e , h a d ma n y v i c t i ms fro m ra d i a ti o n e x p o s u re .

T h e n e a rb y to w n , P ri p a tj a , p re v i o u s l y w i th 4 0 ,0 0 0 re s i d e n ts i s n o w a b a n d o n e d .

T h e fre q u e n c y o f th y ro i d c a n c e r a mo n g c h i l d re n i n U k ra i n e i s mo re th a n 1 0 0 t i me s th e e x p e c te d .

Mo s t o f th e c h i l d re n a n d y o u n g p e rs o n s e x p o s e d h a v e d e v e l o p e d l e u c a e mi a o r c a n c e r. T h e i r a i rw a y

e p i th e l i u m a n d re s p i ra ti o n i s s e ri o u s l y a ffe c te d , a n d th e y h a v e a n u n u s u a l h i g h fre q u e n c y o f c e re b ra l

h a e mo rrh a g e .

E q u a t i o n s

T h e me a n b o d y te mp e ra tu re (T b o d y ) i s c a l c u l a te d w i th th e fo l l o w in g e q u a ti o n :

E q . 2 1 -1 : Tb o d y = (0 .7 × Tc o r e + 0 .3 × Ts h e l l ) ,

w h e re th e me a n s h e l l te mp e ra tu re (T s h e l l ) i s e s ti ma te d fro m a s e ri e s o f re p re s e n ta ti v e s k i n

te mp e ra tu re s . T h e o b v i o u s a s s u mp ti o n i n th i s e q u a ti o n i s th a t 7 0 % o f th e b o d y w e i g h t i s c o re (T c o r e ) ,

a n d th e b a l a n c e i s s h e l l , b u t th e s i z e o f th e s h e l l v a ri e s w i th th e e n v i ro n me n ta l te mp e ra tu re .

T h e s to ra g e o f h e a t e n e rg y i n th e b o d y i s c a l c u l a te d a s fo l l o w s :

E q . 2 1 -2: H S T O R E = 3 .4 9 *B O D Y WE IG H T * (T 2 - T1 )

w i th th e u n i t k J p e r h o u r.

Ac c or di ng t o th e fi r s t la w of th er mo dy na mi c s , t he f ol lo wi ng r el at io n is v al id :

E q . 2 1 -3: H S T O R E = H M E T A B O L I C - ( H R A D I A T I O N +H C ON + H E V A P O R A T I O N )

w h e re H C ON i s th e c h a n g e i n h e a t l o s s b y c o n v e c ti o n a n d c o n d u c ti o n .

R a d i a ti v e h e a t l o s s fro m a w a rm o b j e c t (T ob j ) c a n b e c a l c u l a te d fo r a n a k e d p e rs o n w i th a k n o w n

s k i n te mp e ra tu re (T s k i n ) :

E q . 2 1 -4: H R A D I A T I O N = 0.5 × A × (T s k i n - Tob j )

w h e re 0 .5 i s k J mi n -1 m-2 K-1 , A i s th e a re a o f th e h u ma n b o d y (ra d i a ti n g o r re c e i v i n g ra d i a ti o n ), a n d

T ob j i s th e te mp e ra tu re o f th e o b j e c t e x c h a n g i n g e n e rg y . T h i s e q u a ti o n i s a n a p p ro x i ma ti o n o f S te fa n -

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B o l tz ma n n s ru l e .

E v a p o ra ti o n o f w a te r o n th e b o d y s u rfa c e e l i mi n a te s 2 4 3 0 J g -1 . E v a p o ra ti o n o f l a rg e v o l u me

r a t e s o f s w e a t ( V°s w e a t ) i mp l i e s a s u b s ta n ti a l l o s s o f e v a p o ra ti v e e n e rg y (J /mi n ) a c c o rd i n g to th e

equation:

E q . 2 1 -5 : H E V A P O R A T I O N (J mi n -1 ) = 2 4 3 0 ( J g-1 ) × V°s w e a t (g mi n-1 ) .

C h a n g e s i n h e a t c o n d u c ti o n th ro u g h th e s h e l l (c o n d u c ta n c e s h e l l) re f l e c t c h a n g e s i n s k i n

b l o o d fl o w . T h e c o n d u c ta n c e c a n b e c a l c u l a te d b y th e fo rmu l a :

E q . 2 1 -6: C o n d u c ta n c e s h e l l = Me ta b o l ic R a te /(Tc o r e - Ts h e l l ) .

A la r ge te mp er at ur e di ff er en c e im pl ie s an ef fe c ti v e is ol at io n, wh er ea s a s ma ll di f fe r en c e im pl ie s a lo w

i s o l a ti o n c a p a c i ty .

T h e h e a t l o s s o f a n a k e d p e rs o n re s ti n g i n q u i e t a i r b y c o n v e c ti o n ( i n c l u d i n g a mi n o r p a rt b y

c o n d u c ti o n w i th o u t mo v e me n t) i s g i v e n b y th e fo l l o w i n g e q u a ti o n :

E q . 2 1 -7 : H C O N = 0 .5 *(T s h e l l - Tai r ) i n k J p e r mi n .

T h i s e q u a ti o n i s a n a p p ro x i ma ti o n o f N e w to n ’ s l a w o f c o o l i n g .

S e l f - A s s e s s m e n t

M u l t i p l e C h o i c e Q u e s t i o n s

E a c h o f t h e f o l l o w i n g f i v e s t a t e m e n t s h a v e T r u e / F al s e o p t i o n s :

A. H u ma n s c a n s u rv i v e a t a te mp e ra tu re th a t w o u l d c o o k a p i e c e o f s te a k , b e c a u s e th e s te a k

c a n n o t d i s s i p a te c o re h e a t e n e rg y .

B. H e a t c o n d u c ta n c e o f a i r a t h i g h p re s s u re e x c e e d s th a t a t l o w p re s s u re , w h e re b y mo re h e a t

e n e rg y i s l o s t fro m th e d i v e rs b o d y b y c o n d u c ti o n th ro u g h a i r i n s i d e a d i v i n g b e l l d e e p u n d e r

w a te r th a n a t o n e a tmo s p h e re o f p re s s u re .

C. T e mp e ra tu re h o me o s ta s i s i s p re s e n t w h e n h e a t e n e rg y p ro d u c ti o n e q u a l s h e a t l o s s .

D. B a s a l me ta b o l ic ra te (B MR ) i s l o w e r b e fo re th a n a fte r a me a l .

E. T h e n e u tra l e n v i ro n me n ta l te mp e ra tu re d e fi n e s th e l e v e l , w h e re th e re s ti n g me ta b o l i c ra te i s

minimal.

I I . E a c h o f t h e f o l l o w i n g f i v e s t a t e m e n t s h a v e T r u e / F a ls e o p t i o n s .

A . Wa te r-i n d u c e d h y p o n a tra e mi a i s c a l l e d mi n e rs c ra mp s .

B . S u b s ta n ti a l i n f l u x o f C a 2+ to th e c e l l s i s p ro b a b l y i n v o l v e d i n s o me c a s e s o f ma l i g n a n t

h y p e rth e rmi a .

C . H y p o th e rmi a i s a fa l l i n c o re te mp e ra tu re b e l o w 3 2o C.

D . O n e d e g ra d a ti o n p e r s e c o n d fro m ra d i o a c ti v e ma te ri a l e q u a l s o n e b e q u e re l s (1 B q ), w h i c h i s

a l s o e q u a l to o n e c u ri e .

E. Ac ut e r ad ia t io n r ed uc es le uc oc y te an d t hr om bo c y te pr od uc t io n.

C a s e H i s to ry A

A ma le wi th a bo dy we ig ht of 70 k g s to ps hi s ma la r ia pr op hy la x is wi th pr im aq ui ne wh en le av in g t he

e n d e mi c a re a . T h re e w e e k s l a t e r, a s u d d e n a t t a c k o f f e v e r i n c re a s e s h i s c o re t e mp e ra t u re f ro m 3 7 t o

40 oC w i t h i n 3 0 mi n . T h e h e a t c a p a c i t y o f t h e h u ma n b o d y i s 3 . 4 7 k J / k g a n d p e r o C . T h e me t a b o l ic

ra t e o f t h e s u b j e c t i n c re a s e d s u b s t a n t i a l l y d u ri n g t h e r i s e i n t e mp e ra t u re . F o l l o w i n g t h e c o l d s t a g e

w i t h u n c o n t ro l l a b l e s h i v e ri n g , t h e p a t i e n t d e v e l o p s a d e l i r i o u s c o n d i t i o n w i t h s e v e re h e a d a c h e . T w o

h o u rs l a t e r t h e p a t i e n t d e v e l o p s a p ro f u s e s w e a t i n g . P a rt i a l l y e v a p o ra t i o n o f t h e w a t e r i n 3 2 ml

s w e a t / mi n (2 5 % e v a p o ra t e s ) o c c u rs f ro m t h e b o d y s u rf a c e (e l i mi n a t i n g 2 , 4 3 6 J / g ), d u ri n g w h i c h b o d y

t e mp e ra t u re d ro p s .

F

F

F

T

T

T

T

T

T

T

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C a l c u l a t e t h e e x t ra h e a t e n e rg y s t o re d i n h i s b o d y a f t e r 3 0 mi n .

1.

C a l c u l a t e t h e s ma l l e s t p o s s i b l e me t a b o l i c ra t e i n t h e 3 0 -mi n p e ri o d .

2.

Wh a t c a u s e s t h e e x t ra h e a t e n e rg y s t o re d i n t h e b o d y ?

3.

C a l c u l a t e t h e re d u c t i o n i n b o d y t e mp e ra t u re b y i n g e s t i o n o f o n e L o f i c e w a t e r, w h e n t h e

f e v e r i s a t i t s h i g h e s t l e v e l .

4.

C a l c u l a t e t h e t i me i t t a k e s t o l o s e t h e a c c u mu l a t e d h e a t e n e rg y b y e v a p o ra t i o n .

C a s e H i s to ry B

A ma le s ed en ta r y pe r s on , we ig ht 70 k g, ha s a da il y fo od in t ak e of 40 0 g c ar bo hy dr at e ( 17 . 5 k J /g ) ,

1 0 0 g f a t (3 9 k J / g ), a n d 1 0 0 g p ro t e i n (1 7 k J / g ). T h e re i s a me t a b o l i c w a t e r f o rma t i o n o f 3 2 mg / k J .

T h e ma n e x c re t e s 2 1 0 0 ml o f w a t e r ( i . e . , 1 2 0 0 ml i n t h e u ri n e , 1 0 0 ml i n f a e c e s , a n d 8 0 0 ml t h ro u g h

l u n g s a n d s k i n ).

1. C a l c u l a t e t h e me t a b o l ic ra t e ( i n k J / d a y o r MJ / d a y ) .

2 . T h e ma n i s i n w a t e r b a l a n c e b y a w a t e r i n t a k e o f 1 , 7 0 0 ml a s a t o t a l . E x p l a i n t h i s a p p a re n t

i mb a l a n c e .

C a s e H i s to ry C

A 79 - y ea r ol d ma le is f ou nd ap pa r en tl y de ad in th e s no w fo llo wi ng a wi nt er s t or m, wh er e al l t r af fi c

w a s a rre s t e d b y s n o w . H i s mu s c l e s a re s t i f f , a n d t h e h e a rt ra t e i s n o t p a l p a b l e . T h e t e n d o n re f l e x e s

a re d e p re s s e d , a n d t h e p u p i l l a ry a n d o t h e r b ra i n s t e m re f l e x e s a re l o s t .

T h e b o d y i s p l a c e d i n a c h a p e l a t t h e h o s p i t a l u n t i l t h e f u n e ra l . T h e n e x t d a y t h e p e rs o n n e l a re

d i s t u rb e d b y n o i s e s f ro m t h e c h a p e l . O b v i o u s l y , t h e ma n i s a l i v e .

1 . Wh a t h a s a w a k e n e d t h e ma n ?

2 . S u g g e s t a l i k e l y c o re t e mpe ra t u re , at t h e t i me w h e re t h e ma n w a s a d mi t t e d t o t h e h o s p i t a l .

C a s e H i s to ry D

A 20 - y ea r ol d pe r s on , wi t h a bo dy s ur f ac e ar ea of 1. 8 m2 , i s a t re s t w i t h a me t a b o l i c ra t e (MR , o r

h e a t e n e rg y p ro d u c t i o n a n d t ra n s f e r) o f 8 0 Wa t t s . H i s re c t a l t e mp e ra t u re i s 3 7 oC a n d h i s me a n s k i n

t e mp e ra t u re i s 3 3 o C . - S u d d e n l y , a ma l a ri a a t t a c k d e v e l o p s w i t h a 7 -f o l d r i s e i n MR , a n d t h e p a t i e n t

re a c h a t e mp e ra t u re p l a t e a u o f 4 0 oC , w i t h a me a n s k i n t e mp e ra t u re o f 3 4 o C.

T h e c o n d u c t a n c e o f t h e s h e l l (C s h e l l ) is a me as ur e of s k in bl oo df lo w. T hi s c an be c al c ul at ed by t he

f o rmu l a : C s h e l l = MR / (T c o r e - T s h e l l ) .

1 C a l c u l a t e t h e c o n d u c t a n c e o f t h e s h e l l a t re s t .

2. C a l c u l a t e t h e c o n d u c t a n c e o f t h e s h e l l a t t h e f e v e r p l a t e a u .

3. H o w d o e s t h e b o d y a c c o mp l i s h t h i s i n c re a s e ?

T ry t o s o l v e t h e p ro b l e ms b e f o re l o o k i n g u p t h e a n s w e rs . .

H i g h l i g h t s

T h e c o re te mp e ra tu re i s 3 7 oC i n h e a l t h y a d u l t s a t re s t , b u t s ma l l c h i l d re n h a v e l a rg e r d i u rn a l

v a ri a t i o n s .

P a re n ts s h o u l d b e a d v i s e d t o me a s u re t h e re c t a l t e mp e ra t u re i n d i s e a s e s u s p e c t c h i l d re n . T h e

re c t a l t e mp e ra t u re i s a re l i a b l e e s t i ma t e o f t h e c o re t e mp e ra t u re i n re s t i n g p e rs o n s .

A co n st an t co re t em p er at u re d o e s n o t g u a ra n t e e h e a t e n e rg y b a l a n c e , b e c a u s e t h e e n e rg y

c o n t e n t o f t h e s h e l l ma y c h a n g e w i t h t h e s u rro u n d i n g s .

T h e h u m a n c o r e t e m p e r a t u re f a l l s d u ri n g t h e o e s t ro g e n p h a s e o f t h e me n s t ru a l c y c l e a n d

d u ri n g s l e e p . T h e l o w e s t t e mp e ra t u re i s b e t w e e n 1 8 a t n i g h t a n d 6 o ’ c l o c k i n t h e mo rn i n g .

P ro g e s t e ro n e e f f e c t s s e e m t o e x p l a i n t h e h i g h e r t e mp e ra t u re i n t h e l a s t p h a s e o f t h e me n s t ru a l

c y c l e

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T h e te mp e ra tu re c y c l e i s p a rt o f t h e c i rc a d i a n p e ri o d i c i t y . O u r b i o l o g i c a l c l o c k s e e ms t o b e

s y n c h ro n i s e d w i t h t h e ro t a t i o n o f t h e g l o b e . A l s o me a l s , l i g h t a n d t e mp e ra t u re p l a y s a ro l e .

T h e t h e r m a l c o m f o r t p o i n t f o r l i g h t -c l o t h e d , s e a t e d p e rs o n s i s a b o u t 2 6 o C w h e n t h e h u mi d i t y i s

5 0 %, 3 0 o C f o r n u d e p e rs o n s , a n d a b o u t 3 6 o C s i t t i n g i n w a t e r t o t h e n e c k .

V a s o d i l a ta ti o n i n w a rm e n v i ro n me n t s p e rmi t s i n c re a s e d s k i n b l o o d f l o w a s t h e c a rd i a c o u t p u t

a l s o b e g i n s t o r i s e . T h e a rt e ri o -v e n o u s a n a s t o mo s e s a re d i l a t a t e d , a n d t h e b l o o d f l o w c a n r i s e t o a t

l e a s t 1 0 f o l d s i n h a n d s a n d f e e t .

I n t h e m e t a b o l i c z o n e, t h e t o t a l h e a t l o s s r i s e s w i t h f a l l i n g t e mp e ra t u re , b u t b e l o w 5 oC t h e d ry

h e a t l o s s e x c e e d s t h e me t a b o l i c ra t e , a n d t h e b o d y i s c o o l e d d o w n . T h i s i s t h e z o n e o f

h y p o t h e rmi a , w h e re c o l d d e a t h i s i n e v i t a b l e w i t h o u t t h e ra p y .

S w e a t s e c re ti o n . T h re e mi l l i o n s w e a t g l a n d s p ro d u c e s w e a t a t a ra t e o f u p t o 2 l i t re s p e r h o u r

o r mo re d u ri n g e x t re me c o n d i t i o n s . S u c h h i g h s w e a t ra t e s l e a d t o c i rc u l a t o ry f a i l u re a n d s h o c k .

S w e a t re s e mb l e s a d i l u t e u l t ra f i l t ra t e o f p l a s ma .

T h e z o n e o f h y p e r t h e r m i a b e g i n s a t a n e n v i ro n me n t a l t e mp e ra t u re o f 3 7 oC i n h u mi d a i r, w h e re

w e s o o n re a c h t h e ma x i ma l c a p a c i t y f o r s w e a t s e c re t i o n , a n d t h e re i s a h e a t i n f l u x t o t h e b o d y

ending in heat death.

T h e h y p o t h a l a m u s f u n c t i o n s a s a t h e rmo s t a t u s i n g t h e re s t o f t h e b o d y t o s t a b i l i s e i t s o w n

t e mp e ra t u re .

A d yn am ic g ai n sy st em re s p o n d s c o n t i n u o u s l y t o f e e d b a c k s i g n a l s , re g a rd l e s s o f t h e s i z e o f

t h e c o re t e mp e ra t u re . Wi t h r i s i n g t i s s u e t e mp e ra t u re , t h e n e u ra l a c t i v i t y o f h e a t s e n s o rs

i n c re a s e s l i n e a rl y , w h e re a s t h e a c t i v i t y o f c o l d s e n s o rs d e c re a s e s

A se t - p o in t sy st em d o e s n o t re s p o n d t o a r i s e i n t e mp e ra t u re b e f o re a c e rt a i n s e t p o i n t i s

re a c h e d . T h e s e t p o i n t i s t h e c o re t e mp e ra t u re a t w h i c h n e i t h e r h e a t l o s s me c h a n i s ms o r h e a t

pr od uc ti on me c ha ni s ms ar e ac t iv e.

H u m a n t e m p e r a t u r e c o n t r o l e x h i b i t s b o t h d y n a mi c g a i n a n d s e t p o i n t c h a ra c t e ri s t i c s . T h e

c o n t ro l s y s t e m i mp l i e s w i d e s p re a d c u t a n e o u s a n d d e e p s e n s o rs . T h e i r a f f e re n t s c o n v e rg e

t o w a rd s t h e h y p o t h a l a mi c i n t e g ra t o r a n d t h e rmo s t a t .

T h e t h e r m o g e n i c r e s p o n s e t o c o l d a l s o i n v o l v e s a n o n -my o g e n i c o r n o n -s h i v e ri n g c o mp o n e n t

pr ob ab ly in ad ip oc y te s . No n- s hi v er in g he at pr od uc ti on is c on tr ol le d by th e s y mp at he t ic ne r v ou s

s y s t e m v i a a d re n e rg i c - r e c e p t o r s .

N o n - s h i v e r in g t h e r m o g e n e s is i s a n y r i s e i n me t a b o l i s m, w h i c h i s n o t re l a t e d t o mu s c u l a r

a c t i v i t y . I n b a b i e s t h i s f o rm o f t h e rmo g e n e s i s i s p a rt i c u l a rl y l a rg e i n t h e i r b ro w n a d i p o s e t i s s u e .

T h e b ro w n a d i p o s e t i s s u e o f b a b i e s i s a b u n d a n t a ro u n d v i t a l o rg a n s , i n n e c k a n d me d i a s t i n u m,

b e t w e e n s c a p u l a e a n d i n t h e a rmp i t s .

N e w b o r n s a re i n t h e rma l b a l a n c e a t a mi n i ma l me t a b o l i s m o n l y w h e n t h e s u rro u n d i n g

t e mp e ra t u re i s h i g h (3 2 -3 4 o

C) .

T h e r m o r e g u l at o r y b e h a v i o u r s u c h a s f a n n i n g a n d a d d i n g o r re mo v i n g c l o t h i n g i s e f f e c t i v e i n

c h a n g i n g t h e t h e rma l i n s u l a t i o n . S e v e ra l l a y e rs o f c l o t h i n g w i t h t ra p p e d a i r a re g o o d i n s u l a t o rs .

H e a t a c c l i m a t i z a t i o n i s a c t u a l l y a s w e a t g l a n d a d a p t a t i o n , a n d a 2 -w e e k p ro c e s s f o l l o w i n g

a rr i v a l t o a h o t c l i ma t e . G ra d u a l l y s w e a t -e v a p o ra t i o n i s i n c re a s e d a n d t h e N a C l l o s s i s re d u c e d .

T h e a d a p t a t i o n i s c a u s e d b y i n c re a s e d a l d o s t e ro n e s e c re t i o n f ro m t h e a d re n a l c o rt e x .

H y p o v o l a e mi a w i t h l o w b ra i n b l o o d f l o w t h ro u g h a n o v e rh e a t e d b ra i n l e a d s t o f a t i g u e (h e a t

e x h a u s t i o n ), c o n f u s i o n a n d u n c o n s c i o u s n e s s o r s y n c o p e (h e a t s y n c o p e ). T h e c o n f u s i o n ma y

d e v e l o p i n t o a v e ri t a b l e d e l ir i u m w i t h b ra i n o e d e ma .

H e a t s tro k e - i n t h e s u n c a l l e d s u n s t ro k e - i s h e a t c o l l a p s e w i t h h i g h b ra i n t e mp e ra t u re t h a t

o c c u rs s u d d e n l y , h e re b y c re a t i n g a l i f e -t h re a t e n i n g c o n d i t i o n .

H y p o t h e r m i a i s a f a l l i n c o re t e mp e ra t u re t o v a l u e s b e l o w 3 5 oC . H y p o t h e rmi c s u b j e c t s l o s e

c o n s c i o u s n e s s , w h e n t h e c o re t e mp e ra t u re f a l l s b e l o w 3 2 oC - a p o t e n t i a l ly l e t h a l c o n d i t i on c a l l ed

s e v e re h y p o t h e rmi a .

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Ar t if i ci al l y in d u ce d h yp o t h er m ia i s u s e d i n b ra i n - a n d h e a rt -s u rg e ry , w h e re t h e u s u a l

t h e rmo c o n t ro l i s i n a c t i v a t e d b y g e n e ra l a n a e s t h e s i a .

P e n e tra ti n g ra d i a ti o n c o n s i s t s o f e i t h e r g a m m a r a y s ( n e u t r o n s ) o r X - r a y s . S u r v i v o r s f r o m

n u c l e a r p o w e r p l a n t a c c i d e n t s w i t h w h o l e b o d y a b s o rp t i o n g re a t e r t h a n 1 0 0 ra d s a re t h re a t e n e d b y

a c u t e a n d c h ro n i c ra d i a t i o n s i c k n e s s .

Ac u t e ra d i at i o n si ck n es s a p p e a rs a s v o mi t i n g a n d ma l a i s e f o l l o w i n g e x p o s u re t o 1 G y (1 0 0

ra d ) o r mo re . L y mp h o c y t e p ro d u c t i o n i s re d u c e d i mme d i a t e l y , s o o n f o l l o w e d b y l e u c o p e n i a a n d

t h ro mb o c y t o p e n i a w i t h b l e e d i n g . T h e v i l l i o f t h e g a s t ro i n t e s t i n a l t ra c t a re d e s t ro y e d , a b s o rp t i o n o f

n u t r i e n t s i s i mp a i re d , a n d n e w v i l l o u s c e l l s a re n o t p ro d u c e d . D i a rrh o e a , o f t e n w i t h b l o o d l o s s ,

re s u l t s i n d e h y d ra t i o n . T h e s k i n i s re d a n d b l i s t e ri n g , a n d t h e h a i r i s l o o s e d .

C h ro n i c ra d i a ti o n s i c k n e s s o r l a t e ra d i a t i o n d a ma g e i mp l i e s a n i n c re a s e d ra t e o f mu t a g e n e s i s ,

w h i c h i n c l u d e s a h i g h f re q u e n c y o f l e u c a e mi a , c a n c e r o f t h e b ra i n , t h e t h y ro i d a n d t h e s a l i v a ry

g l a n d s , i n f e rt i l i t y a n d c a t a ra c t .

F u r t h e r R e a d i n g

S c i e n t i f ic A me ri c a n . Mo n th l y j o u rn a l p u b l i s h e d b y S c i e n ti f i c A me ri c a n In c ., 4 1 5 Ma d i s o n A v e n u e , N .Y .,

USA.

B e n z i n g e r, T . H . " T h e h u ma n th e rmo s ta t." Sci. Am. 2 0 4 : 1 3 4 -1 4 7 , 1 9 6 1 .

H o n g , S . K . N e w s i n P h y s i o l . S c i . 2 : 7 9 , 1 9 8 7 .

Wa s s e rma n , D .H . a n d A .D . C h e rri n g to n . " H e p a ti c fu e l me ta b o l i s m d u ri n g mu s c u l a r w o rk : R o l e a n d

re g u l a ti o n ." Am . J . Ph y s io l. 2 6 0 : E 8 1 1 , 1 9 9 1 .

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