TEMPERATURE REGULATION

dr David M.T Simangunsong, M.Kes

 Temperature Regulation
• Temperature varies from organ to organ
• Internal core temperature (inti sentral)
– Abdominal and thoracic organs, CNS, skeletal
muscles
– Tissues function/jaringan inti best at relatively
constant temperature of about 100°F (37,7 C)
– F= 5/9 (F-32)
– Subject to precise regulation
• Outer shell (selubung luar)
– Consists of skin and subcutaneous fat
– Skin temperature varies between 68°F and 104°F
without damage
 Temperature Regulation
• Sites for monitoring body temperature (tempat memantau suhu tubuh)
– Oral and axillary temperatures are comparable (setara)
– Rectal temperature averages about 1° higher
– Eardrum scan (gendang telinga)
• Normal variations in core temperature
– Because of innate biological rhythm/jam biologis, core temperature normally varies
about 1.8°F during the day (suhu terendah pada pagi hari sebelum bangun (jam 6-7
pagi) dan tertinggi sore hari ( jam 5-7 sore)
– Monthly rhythm in core temperature in connection with female menstrual cycle
– Core temperature increases during exercise o.k peningkatan produksi panas oleh otot
– Core temperature may vary slightly with exposure to extremes of temperature
– Semakin tua semakin dingin jadi orang lanjut usia mempunyai suhu yang semakin
dingin
 Maintenance of Core Temperature
• Heat input must balance heat output to maintain
stable core temperature
• Heat input
– Heat gain from external environment
– Internal heat production
• Heat output
– Heat loss from exposed body surfaces to the
external environment
• If core temperature ↓ heat production is increased
• If core temperature ↑ heat loss is increased and
heat production is reduced
Chapter 17 Energy Balance and Temperature Regulation
Human Physiology by Lauralee Sherwood ©2007 Brooks/Cole-Thomson Learning
 Chapter 17 Energy Balance and Temperature Regulation
Human Physiology by Lauralee Sherwood ©2007 Brooks/Cole-Thomson Learning
 Heat Exchange
• Four mechanisms of heat transfer
– Radiation
– Conduction
– Convection
– Evaporation
 Heat Exchange
• Radiation
– Emission of heat energy from a surface in form of
electromagnetic waves (heat waves)
– Human body both emits and absorbs radiant
energy
– Net heat transfer always from warmer objects to
cooler objects
– Humans lose almost half of their heat energy
through radiation
 Heat Exchange
• Conduction
– Transfer of heat between objects of differing
temperatures that are in direct contact
– Heat moves from warmer to cooler object
• Transferred from molecule to molecule
– Rate of heat transfer depends on temperature
difference between touching objects
– Only small percentage of total heat exchange
takes place by conduction alone
 Heat Exchange
• Convection
– Transfer of heat energy by air (or water) currents
– Combines with conduction to dissipate heat from
body
– Convection currents
• Help carry heat away from body
 Heat Exchange
• Evaporation
– Heat required for evaporation is absorbed from skin
– Occurs from
• Passive processes
– Surface of skin
– Linings of respiratory airways
• Active process
– Sweating (berkeringat)
» Under sympathetic nervous control
– Sweat
» Dilute salt solution actively extruded/dikeluarkan to surface
of skin by sweat glands
» Relative humidity – most important factor determining
extent of sweat evaporation / factor terpenting menentukan
tingkat penguapan keringat

Chapter 17 Energy Balance and Temperature Regulation

Human Physiology by Lauralee Sherwood ©2007 Brooks/Cole-Thomson Learning
 MEKANISME PENGELUARAN PANAS
• Radiasi
Perpindahan panas dari permukaan suatu objek ke objek
lain tanpa keduanya bersentuhan. Contohnya :
melepaskan pakaian dan selimut.
• Konduksi
Perpindahan panas dari suatu objek ke objek lain
dengan kontak langsung. Contohnya memberikan
kompres es atau memandikan klien dengan air dingin.
• Konveksi
Perpindahan panas karena gerakan udara. Contohnya
Kipas angin,AC,dan pendingin udara.
 MEKANISME PENGELUARAN PANAS
• Evaporasi
Perpindahan energi panas ketika cairan berubah
menjadi gas contohnya : berkeringat.
• Jika suhu tubuh meningkat, keringat akan
membasahi kulit, selanjutnya keringat akan
menyerap kelebihan panas dari tubuh dan
mengubahnya menjadi uap, setelah keringat
mengering, suhu tubuh turun  
 Hypothalamus
• Serves as body’s thermostat
• Integrates thermosensory inputs
• Thermoreceptors
– Central thermoreceptors
• Located in hypothalamus, CNS, and abdominal organs
• Monitors core temperature
– Peripheral thermoreceptors
• Monitor skin temperature throughout body and transmit
information to hypothalamus
• Centers in hypothalamus for temperature regulation
– Posterior region
• Activated by cold
– Anterior region
• Activated by warmth
 Chapter 17 Energy Balance and Temperature Regulation
Human Physiology by Lauralee Sherwood ©2007 Brooks/Cole-Thomson Learning
 Thermogenesis
• Low core temperature
– Shivering
• Primary involuntary means of increasing heat
production
– Motivated behaviors to generate heat
• Jumping up and down, hand clapping
• High core temperature
– Reduced muscle tone
– Curtain voluntary movement
 Thermogenesis
• Nonshivering thermogenesis
– Important in newborns because they lack ability
to shiver
• Brown fat
• Heat loss
– Adjusted by blood flow through skin
• Heat is eliminated when skin vessels dilate
• Heat is conserved when skin vessels constrict
Coordinated Adjustments in Response to Cold or Heat Exposure
 Thermogenesis
• Thermoneutral zone
– Control of core body temperature by skin
vasomotor activity when environmental
temperature is between the upper 60s and mid
80s
– Below this zone, shivering occurs
– Above this zone, sweating is dominant factor
 Fever
• Elevation in body temperature as result of infection
or inflammation
• Hypothalamic thermostat is “reset” at elevated
temperature
 Chapter 17 Energy Balance and Temperature Regulation
Human Physiology by Lauralee Sherwood ©2007 Brooks/Cole-Thomson Learning
 Chapter 17 Energy Balance and Temperature Regulation
Human Physiology by Lauralee Sherwood ©2007 Brooks/Cole-Thomson Learning
Demam terjadi karena adanya suatu zat yang dikenal dengan nama pirogen. Pirogen
adalah zat yang dapat menyebabkan demam. Pirogen terbagi dua yaitu pirogen
eksogen adalah pirogen yang berasal dari luar tubuh pasien. Jenis lain dari pirogen
adalah pirogen endogen yang merupakan pirogen yang berasal dari dalam tubuh
pasien. Proses terjadinya demam dimulai dari stimulasi sel-sel darah putih (monosit,
limfosit, dan neutrofil) oleh pirogen eksogen baik berupa toksin, mediator inflamasi,
atau reaksi imun. Sel-sel darah putih tersebut akan mengeluarkan zat kimia yang
dikenal dengan pirogen endogen (IL-1, IL-6, TNF-α, dan IFN). Pirogen eksogen dan
pirogen endogen akan merangsang endotelium hipotalamus untuk membentuk
prostaglandin. Prostaglandin yang terbentuk kemudian akan meningkatkan patokan
termostat di pusat termoregulasi hipotalamus. Sehingga akan terjadi peningkatan
produksi panas dan penurunan pengurangan panas yang pada akhirnya akan
menyebabkan suhu tubuh naik ke patokan yang baru tersebut.
Hyperthermia
Peningkatan suhu tubuh di atas normal yang dapat diterima
Elevation in body temperature above normal range
Can occur unrelated to infection /dapat terjadi tanpa infeksi
Causes
Exercise-induced
• Hipertemia patologis
Peningkatan kadar hormone tiroid atau epinefrin
sebagai akibat disfungsi kelenjar tiroid atau medulla
adrenal.kedua hormone ini meningkatkan suhu inti
dengan meningkatkan laju kesluruhan aktivitas
metabolic dan produksi panas
- Malfungsi pusat control hipotalamus (ada lesi)
sehingga mengurangi kemampuan regular normal
thermostat hipotalamus