Transcribed by Joseph Schwimmer

Organ Systems Lecture #56 Thermoregulation 5/15/14

Dr. Joel Schiff Ok, well spend the next hour discussing body temperature regulation, and we are euthermic
individuals, we keep a fairly steady body temperature, with a few exceptions and a little variation. But for the
most part we have a standard body temperature of about 37 degrees celcius, or 98.6 farenheit, and what has
happened is we have evolved a whole bunch of enzymes that work together at that temperature, so that we
kind of reached a point where everything works optimally at 37 degrees and therefore we have to maintain
that 37 degrees, or else something goes wrong. If you have an enzymatic reaction of A going to B with one
enzyme, and another enzyme makes C, if the first enzyme speeds up more than the second when your body
temperature warms up, then youre gonna pile up a lot of B because the second reaction is gonna go more
slowly. On the other hand, if the second enzyme speeds up more than the first, youre gonna be depleted of B.
so things like that go on unless you maintain a steady body temperature. So we maintain a steady
temperature of 37 C, or 98.6 F, and this is called a normal in quotation marks temperature. Some people
run a little warmer, some people run a little cooler. But as long as you maintain whatever your normal
temperature is, youre in pretty good shape.
So in order to maintain a temperature anywhere, in this room for example which theyre not doing a very
good job of you need a reflex, a negative reflex pathway loop of some sort. Basically what you have to do is
detect the temperature, measure it, compare it to whatever the normal is, thats referred to as a set point.
That is what your thermostat is set to, the set point. And if its different from the set point, then you need a
third step to warm it up or cool it down to bring it closer to the set point. And so you have these three legs of a
reflex pathway for negative feedback to maintain body temperature. And the hypothalamus serves as the first
2 of those steps. Because its the sensor, basically what its measuring, what the hypothalamus keeps track of,
is the temperature of the blood flowing through the hypothalamus. And thats basically the body temperature
of the core of your body, or your core temperature. And your core temperature is the temperature present in
your brain, in most of your body minus your extremities. Thats the core of you. And thats the temperature
that you wanna keep at 37 degrees.
Now the other thing to keep in mind and what the hypothalamus then does is it triggers by various output
pathways, various mechanisms we have to speed up heat production, to raise body temperature, or to speed
up ways of getting rid of heat to lower the body temperature, depending on which way youre deviant form
the set point. So what have we got in the way of - the detection and comparing it to a set point is very easy to
set up with very simple circuitry, and your hypothalamus does that very nicely. The main thing that the
hypothalamus has to do then is adjust mechanisms of producing heat, and mechanisms of reducing heat.
We have all sorts of chemical reactions going on in our bodies. This is referred to as our metabolism. Theres a
basal metabolism, this is when were not doing anything in particular, although were not totally at rest, we do
tend to breathe and pump our blood and stuff like that, and if were doing anything active, we generate
additional heat, and that also can be a source of heat. So how do you produce heat? Well as I mentioned in
some other context and I really dont remember right now where or when, just by the first two laws of
thermodynamics, energy is conserved, and in order for any chemical reaction to go it has to be sort of
downhill in respect to free energy. The bigger the drop in free energy, the faster itll go. Water falling off
Niagra moves faster than water running down the gutter in the street, because theres a large drop in
gravitational field potential energy there. And what happens to that energy. A drop of water up here becomes
a drop of water down here. It has lost a certain amount of potential energy in the gravitation field, and by
analogy, the free energy in the chemical realm. And energy is conserved first law. Therefore, what happened
to the energy that it had when it was up here, when it fell down to here? It turns to heat.
How does that happen? Well, as the drop of water falls off Niagra, it travels through air, theres friction with
the air molecules, and thatll warm it up a little bit. And there are other factors going on as well such as
evaporation and well get to that later. But basically, any loss of the free energy as a reaction goes downhill
liberates heat, because thats where the unused part of the energy goes to, thats what the unused part of the
energy becomes. So we have a metabolism that depends on ATP for most of the reactions that are going on in
our bodies. We have to make ATP from metabolism of glucose and other fuels. Mitochondria do a very
efficient job. And by very efficient I mean 50-60% tops. We are not efficient. Otherwise if we werent
inefficient the reactions wouldnt move, because if moving from A to B is on the same level, theres nothing
driving it in either direction.
So what happens is your mitochondria are about 60% efficient, sometimes even 50%, depends on the
circumstances and the adequacy of oxygen supply in turning chemical energy of glucose lets say into
ATP. The ATP then attaches to an ATPase, the phosphate is split off, becomes ADP plus a free phosphate, and
then it does whatever it does, but in order for that reaction to run forwards, it has to be downhill and waste
some energy, it has to be inefficient And most reactions that involve an ATPase are only about 50% efficient.
So you start off with a molecule of glucose, which has a certain amount of free energy - and Ill leave it to the
biochemistry people to come up with numbers for all of that and you lose half of it turning it into ATP, and
then you lose half of that in hydrolyzing the ATP and getting it to do something. Pumping sodium ions, for
example. So what happens? Youve used up - youve gotten sufficient actual work out of 25% of the energy in
that glucose. 75% of it ends up as heat. So we are constantly as our chemical reactions in our body are going
producing heat. We are called warm blooded animals, because we maintain a fairly steady body
temperature, thats the homeostatic mechanisms that Im gonna be talking about.
To be sure, what we referred to as cold blooded animals, or non-warm blooded animals also maintain within/
certain ranges their body temperature. A snake out on the desert doesnt have the kind of metabolism we do,
couldnt afford to because food isnt as plentiful. Occasional rodent of some sort. I mean, thats hell of a way
to generate a lot of heat. So what do they do? Well, theyre out in the sun where its warm, and if they feel too
warm, they move into the shade, where its cooler, and if it gets a little too cool they move out into the sun
again. There are always behavioral ways of helping to adjust your body temperature as well. If youre cold you
put on a sweater. If youre hot, you turn down the thermostat on the air conditioner. Thats a behavioral
response. But we also had responses before we had such technology. And what you have to do, the
hypothalamus is capable of increasing mechanisms that produce heat, or increasing mechanisms that lose
heat.
How do we produce heat? Well any sort of muscle activity generates heat, as I said. Anything that involves
metabolizing stuff to make ATP and then using the ATP to do something wastes of the energy and that
becomes heat. So muscle activity, any sort of chemical activity, this includes your basal metabolism and
basal metabolism remember, keeping your heart beating, and breathing, and such other mechanical activity,
pumping sodium ions out of cells, stuff like that, all these things that are going on even if youre just lying
there, resting. These can be sped up or slowed down to a certain extent, they cant be slowed down too much,
or youre dead. But they can be speeded up. What speeds them up? And what regulates the production of
those hormones? The hypothalamus. Remember, TRH produces TSH, which leads to producing the thyroid
hormones. So, over the long run if your hypothalamus thinks youre too cool, it can increase your basal
metabolism rate by increasing the amount of thyroxin circulating in your blood, and speed up every cells
metabolism.
The second thing your body can do is increase physical activity. Now certain physical activities are voluntary,
but there are some that actually can be triggered by the hypothalamus, and mediated through motor
pathways. If you take a muscle and you contract it very briefly and then relax it, and then contract it again, and
then relax it, and then contract it again, and then relax it, each contraction generates a certain amount of
heat, and each relaxation doesnt. What do you call this rapid alternation of contraction and relaxation of a
muscle? Shivering. So this is a way of producing more heat. And generally we produce more heat than we lose.
Which is why well overall we produce more heat than we lose, because thats the way we stay at a certain
temperature - but we produce more heat than we need to maintain that 37 degrees. So we need ways to lose
heat.
Now, in general just looking at the physics of the situation, how can you lose heat? Well, one way is through
conduction. If youre in touch with something thats cooler than 37 degrees, like this fine fine tabletop, I put
my - 37 degrees or maybe a little less hand on this tabletop, and heat is transferred from my hand to the
other object thats in direct contact with the tabletop. And my hand gets a little cooler, and the tabletop gets
a little warmer. Now how efficient is that? Well, it depends on what the tabletop is made of. If you have an
artificial imitation wooden tabletop, the kind that folds in, that NYU is willing to spend a little bit of your
tuition on what happens? The part where my hand was warms up until its close to the temperature of my
hand, and then theres no more heat transfer. So if I want to keep losing heat to this tabletop I would have to
keep moving my hand around, each time finding a cool spot that I could still transfer heat to, because after it
warms up, the transfer stops. Im also, by the way, in contact with the air around me. And Im losing heat to
the air around me.
Now, conduction depends on a couple of things, how efficient it is. One is as I said, whats that damn
tabletop made of if its artificial imitation wood grain, it doesnt conduct heat very well. But suppose its a
steel tabletop, or something metallic like this. What happens now, this tabletop is still feeling cool to me. Why
is that? Whereas, after a couple of seconds in contact with that tabletop, it felt warm. This frame on this
whatever the hell this is called, still feels cool. Why is that? Because this is metal, metal conducts heat, so the
heat that Im transferring to the part thats covered by my hand is being carried away to other parts of this
frame, and so this doesnt heat up that much. So a lot depends on the conductivity of whatever youre
transferring heat to.
It also depends on the heat capacity of whatever youre transferring heat to. In other words, some things have
a relatively small heat capacity. Air, this pseudo-wooden tabletop. You put a little bit of heat in and it warms
up. Some things have a very large heat capacity. The best and brightest of them all is water. You stick your
hand in a bucket of water and it can absorb a lot of heat with very little temperature change. So, the water will
still stay relatively cool. Thats why its nice to go swimming on a hot summer day, because the water stays
cool despite absorbing all this extra heat from your body. So the other thing is capacity. But if the thing youre
transferring to, through conduction, is a fluid like water, or like the air around us, theres another factor that
comes into play. And that is convection. You saw convection when we were talking about the labyrinth and
the caloric stimulation of horizontal semicircular canals depending on which way your head was turned, and
what the temperature of the water was, and which ear the water was flushed into. And you never know when
in a couple of weeks you might see such a question again. And the reason it worked was convection, you
warm up some of the endolymph in this donut shaped space and the warm goes up and the cool goes down.
Im standing here losing a certain amount of heat to the air immediately surrounding my body, but that hot air
now this warmed air right around me goes up, and gets replaced by cooler air, which I then warm up, and I
keep losing heat by conduction into fresh air, cooler air, because the warmed air gets replaced through
convection. Same thing in the swimming pool. When the water thats immediately around your body got
warmed up, it left and was replaced by cooler water because of convection.
Another factor that gets into this, and we generally here on earth dont think about very much, is radiation.
We are constantly radiating the heat energy in our bodies within the electromagnetic spectrum. We are
glowing with infrared light, which we cant see, but with special goggle and stuff like that we can see it. Were
giving off a certain amount of heat. Now the reason this is not very significant for the most part is that Im
radiating heat which goes where? Well the air around me doesnt really absorb very much infrared or any
light, but eventually it hits the ceiling or the floor, which does absorb. At the same time, that brick wall over
there is a certain temperature, and depending on its temperature, this Kelvin temperature to the 4
th
power,
its radiating infrared light also. And some of that light is hitting me. And Im being warmed by that wall. Not as
much as Im giving heat to that wall. Because if I just stood in a sealed room long enough to die of
asphyxiation, if it were really sealed, you gradually I would warm up the wall and the wall would warm me to
lesser extent so the net transfer would be from me to the wall.
Theres one other factor that we use to a great extent. And that is evaporation. Remember from some
chemistry course you took somewhere, maybe even here, that face changes carry a certain amount of heat.
When liquid water evaporates into water vapor, you have to put in a certain amount of heat to make the
phase change. Similarly when melts into water it absorbs a certain amount of heat. And generally when ice
melts, this is sort of an isothermic thing, you have a glass water mixed with ice and its come to equilibrium
and its 0 degrees celcius, and you put it on a heating pas or you shine some infrared lights on it, or you put it
on a stovetop or stick it in the microwave, and youre pouring energy on it for a little while, and what
happens? The ice melts and its taking in energy to convert from solid water to liquid water.
Im editorializing here. Thats why the phrase global warming is a bad term. Because you look at that glass
after its been in that microwave, and of the ice has melted so now its mostly water, and you stick a
thermometer in and its still 0 degrees celcius, because any time theres equilibrium between ice and water its
gonna be 0 degrees. So these people who say it cant be global warming because the temperatures havent
risen, look at the ice, the ratio of ice to water. There sure as hell has been additional heat absorption in this
whole ecosystem. End of editorial.
Whats evaporating here? Lets go back to the first lecture in the kidney series before I talked about kidneys, I
talked about water. How were losing water. We are losing water every time we exhale because as we breathe
air in it gets saturated with water vapor, and then we breathe it out, its taking some heat with it. But what Im
mainly concerned with here is, we sweat. We are secreting water onto the surface of our skin, and that water
evaporates. In order to change from liquid water to vapor to gas water, it has to absorb a certain amount of
heat for the phase change. And that heat is essentially removed from our body. So the act of the water
changing from liquid to vapor draws heat from the body and gets rid of it in the form of the vapor having more
free energy than the liquid. So as long as you sweat, and your sweat can evaporate, thats a major way of
getting rid of body heat. So well just throw in as a subheading here, sweat.
Ok, so now what? What controls sweat? Sympathetic postganglionic neurons that release acetylcholine.
Everybody remembers that. And the sweat is produced by eccrine glands, and the sweat evaporates and we
lose body heat. The evaporation of sweat by the way is also aided by convection, because if you sweat and the
liquid water becomes water vapor, the water vapor will form a layer of air immediately around your body, that
becomes saturated with water vapor, 100% relative humidity. And then what happens? The additional sweat
that you produce doesnt evaporate because the air surrounding you is saturated. But whats happening is, at
the same time youre heating the air around you, sets up convection, that air goes up, drier air comes is, and
now your sewat can evaporate once more.
Here we have this mechanism, coupling convection with sweating and evaporation as a major major way of
losing body heat. Now, there are 2 problems with that. One is, if you are in an area that has fully saturated
humidity in the air, such as some rain forest somewhere, up the Amazon, or Manhattan in august. Those of
you who are out of town may have gotten a surprise when you came for orientation, if youve never seen this
sort of thing before. But theres a saving grace here, Washington D.C. is worse.
Ok, now so heres what happens. All of these mechanisms; conduction, radiation, sweating followed by
evaporation and convection also helps that depend on, youre losing heat from where? From your body
surface. Youre not directly losing heat from the core of your body. You have to first transfer heat to the
surface of your body, and once its at the surface all of these heat loss processes can work to take the heat
away from the surface of your body. But if the heat doesnt transfer from the core to the surface of your body,
youre not gonna lose it. So how do we transfer heat from the core to the surface of the body? Well, Im
assuming that Dr. Wishe in discussing the integument, described these little capillary loops that go up to very
close to the surface of your body, but which can be bypassed by preferential channels of arterioles, if these
arterioles dilate they can bypass these capillaries and keep the heat away from the surface of your body. So
basically you have to constrict the arteriole to send the heat through the superficial capillaries, and brings the
heat of the core of the body closer to the surface of the skin so that you can then lose it by radiation, by
conduction, by evaporation.
Lets consider the other problem, the other side of the coin. Oh, that evaporation means one of the things you
have to do is replace the water youre losing. Thats why you get thirsty on a hot summer day, youre losing a
lot of water by sweat, youre losing a lot of water probably by hyperventilating a bit. And all this water that
youre losing through your skin as well, you have to replace. Thats just an aside comment.
What happens if youre in a cold environment? Then you have to close down the loss of heat. You dont sweat.
If you wanna keep your body temperature up for whatever reason, because youre out caught in a blizzard,
and you dont want to lost your heat by conduction to the outside world, so youve got these clothing on you,
nice down jacket, sweater under it, stuff like that. But what your body is doing meanwhile is not sweating,
because your hypothalamus knows that it wants to keep the heat, so it doesnt dilate doesnt send blood
though superficial capillaries, but it also doesnt stimulate sweat glands because you want to stay warm after
all. It stimulates your thyroid to step up your metabolism. That of course has the side effect that youre gonna
run out of fuel much sooner. But what you have to do is do the mechanical movement that also help to
generate the heat. Im sure somewhere you have seen an old black and white movie. Two people, usually one
male, one female, who are caught in a blizzard in the woods, and are trying to find some place that they can
get shelter, and theyre walking along, and one of them says usually the female in these movie stereotypes
Ive gotta rest for a few minutes. And the other person the male, usually in an authoritative baritone voice
says we gotta keep moving, if were gonna survive weve got to keep moving, and he puts his arm around her
and they keep hiking, not knowing having any idea in what direction or they may be going in circles, but the
actual physical activity is generating heat, to make up for the heat theyre losing to the environment. By the
way, side comment, one of the things you need to keep your heat is insulation, your nice down jacket and so
on. All of this stuff is a very poor conductor of heat as long as its dry. If it gets wet, water is a very good
conductor of heat, and thats when youre likely to freeze to death in the blizzard is if you get wet. So one
thing you have to do is keep dry. Part of which is, dusting the snow off yourself periodically, because among
other things, the snow is white. So any heat you might be getting from radiation is being reflected away. So
youre not absorbing the heat from radiation if there is a little sun visible.
So all of these mechanisms are what we do to maintain our body temperature at the 37 degrees but
sometimes it varies from that. And one specific way in which it can sometimes vary is fever. You catch some
kind of bug thats going around, influenza virus, some respiratory deal, whatever. And what happens is these
your immune system as part of fighting back against the virus starts generating what are called pyrogens.
There are also pyrogens that can be generated by infectious bacteria. They secrete chemicals that act as
pyrogens, because its part of your immune response to them that increases body heat production. So you
produce heat, all of those things that happen. You get these pyrogens, either from yourself, from y9our own
immune system, or from whatever is infecting you, some bacterial toxins sometimes act as pyrogens. And
what is the effect of a pyrogen and why would we have evolved this kind of response. Well, the why we have
evolved this kind of response is that a lot of viruses, of bacteria, other infectious critters like to infect us
because they like our 37 degrees. And if we go up to 38-39 degrees, it might kill them. So this is part of a
defense mechanism. If you heat up your body, maybe you'll kill a bug. So your immune system starts
generating compounds that act as pyrogens, and what does a pyrogen do? It turns up the thermostat. So
where is it acting? Where is you thermostat? Hypothalamus. So what it does is it increases the set point. And
when you increase your set point, your hypothalamus now thinks, change the definition of normal. Normal is
39 degrees now. So the hypothalamus looks at your body, or at least looks at the blood circulating through it,
and it sees hey this blood is only 37, should be 39. Lets start the heat generating factory. And what do you
do? Well, you close down the superficial capillaries to keep from losing heat, so you look pale. You dont
sweat, your skin is dry. You might be shivering. Your metabolism steps up, and eventually you generate
enough additional energy waste energy, to heat up your body to 39 degrees. So while your temperature is
going up, youre pale, and your skin is dry. Eventually your body temperature reaches 38-39 degrees which
you hypothalamus thinks is normal, and stays that way for whatever amount of time. And then what?
Hopefully, you actually manage to kill off the bug. You eliminate the cause, you fought off the disease. Youve
been victorious in the battle field, and theres no more pyrogens around.
So your body has been staying up at 39 degrees and behaving perfectly normally. And suddenly the pyrogens
are gone, you hypothalamus resets its set point to 37, and then what? Your hypothalamus says why is all this
blood coming in at 39 degrees? Were overheated! Finally realized. So it wants to drop your temperature. So
you sweat, your skin turns red, because youre dilating superficial capillaries, red skin. And you feel just too
weak to move because any movement you do will generate more heat. So you just sort of lie there, all red and
wet. And youre gonna have to replace all that water youre sweating out. Now the trouble with being a
student when this is going on is you may have succumbed to the temptation to go home to mother. Because
what then happens here is this: your mother sees youre all sweaty and wet and red, and feel hot to the touch.
She covers you while youre lying in bed too weak to move, and the first thing you do with all of your energy is
throw off the cover. Because your body knows you gotta lose that heat. And she covers you again, and you
uncover yourself again. And she thinks youre crazy, and meanwhile youre resolving next time Im sick Im not
going home. And eventually you get back to 37 degrees and back to normal again. So this whole cycle of onset
and offset of fever goes through a predictable cycle. And there you have it.
Ok so youre maintaining your body temperature just to try to keep it steady, but sometimes the thermostat
accidentally gets reset. It probably does you some good because that sojourn at 39 degrees may have killed off
whatever that infectious organism was or may have helped to.