thermoregulation ppt
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| What is the goal of thermoregulation? | Maintenance of stable core temperature
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| Vasodialation, sweating, pilorelaxation,and stretching are a response to what? | Hot temperature
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| Vasoconstriction, shivering, piloerection and curling up are a response to what? | Cold Temperature
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| Heat production can increase 500% with what mechanism? | Shivering Thermogenesis
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| How is non shivering thermogenesis regulated? | The SNS- it targets the BAT (brown adipose tissue) and skeletal muscle
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| What is that primary thermogenic tissue in adults? | Skeletal tissues
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| what is that primary thermogenic tissue in children? | BAT (brown adipose tissue)
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| what are the mechanisms of heat loss? | Radidation 60%, Evaporation 20%, Convection 15%, and Conduction 5%
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| What type of heat is lost by photons and without physical contact with an object? | Radiation
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| How is evaporation heat loss prevented? | Humidification, covering exposed skin, and using warm preps
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| In the evaporation mechanism, where is at least half of the heat lost? | Respiratory process
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| Which mechanism is heat lost through direct contact with cooler objects? | Conduction
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| How do you minimize conduction heat loss? | Since it's direct heat loss, put things under the pt to protect from cold OR table.(MB slide also says increase ambient temperature, forced warm air, warm solutions)
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| Relating to convection which has a higer specific heat water or air? | Water: therefore warm fluids would act faster than warm air on a pt
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| Afferent tempreture sensors relate to which system Central or Peripheral? | Peripheral sensors
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| What is the terminal organ for cold sensations? Where is it located? | Krauses end bulb : Encapsulated receptor located in connective tissue. Range of stimulation is 15 - 25 degrees Celcius. Anything below these temps are active pain receptors
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| What is the primary terminal organ for warm sensation, and where is it located? | Ruffinis corpuscle: encapsulated receptor located in the subcutaneous tissue. range of stimulation 25-45 degrees celcius
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| _______ sensations are transmitted to the spinal cord by mylinated A delta nerve fibers. | Cold
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| _______sensations are transmistted to the spinal cord by unmylinated C nerve fibers. | Warm
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| Where do the earliest warning signs of external temp changes come from? | Perpheral temperature sensors
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| When do central recpetors take over the body temperature regulation? | Once the skin reaches maximum variability.
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| Efferent system has two primary pathways, what are they? | Neurologic and endocrine
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| ____ regulates cutaneous blood flow and nonshivering thermogenesis through adrenergic efferents adn diaphoresis through cholinergic efferents | SNS
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| Skeletal muscle shivering is stimulated by direct motor response initiated by what? | Posterior hypothalamus
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| What is the most important mechanism for transfering heat from the core to the periphery? | Cutaneouos vasodialation
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| Heat transfer from blood to tissues is what mechanism? | convection
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| In hyperthermia diaphoresis is the major mechanism for which heat loss? | evaporation
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| ____causes and increase of cardiac mortality, post-op infection, and an increase in recovery time and hospital lenght of stay. | hypothermia
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| During hypothermia what happens to the respiratory system? | Initally it increases and then decreases
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| A body temp of 32-33 degrees celcius would lead to what? | the body not being able to counteract heat loss
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| A body temp of 22-24 degress celcius would lead to what ? | the body become poikilothermic
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| A body temp of >33 degrees C would lead to what? | increased HR, BP, and CO
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| A body temp of <31 degress C would lead to what? | atrial and ventricular irritability
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| A body temp of <30 degrees C would lead to what? | sinus bradicardia and v-fib very likely
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| A body temp of 21 - 24 degress C would lead to what? | risk of v-fib very high
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| A body temp of < 20 degrees C would lead to what? | ASYSTOLE :(
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| Cerebral blood flow and O2 consumption decrease what percentage for each degree C drop? | 7%
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| MAC decreases what percentage for each degrees C drop? | 7%
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| During hypothermia what happens to uring output? | It increases
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| Maximum shivering happens at what temperatures? | Between 33-35 degrees C
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| What happens to the the hematologic function during hypothermia? | increases HCT d/t rise in plasma volume and loss of fluid with diuresis, hyperglycemia, and impaired coagulation d/t thrombocytopenia
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| What are contributors to intra-operative hypothermia. | sedative-hypnotics, opioids, volatile agents, and environment(air temp and cold table etc.)
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| Who loses more heat? infants or children | infants, they can lose up to 4 times more heat than adults
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| Why do infants lose more heat than adults? | they have a thin sub cutaneous layer of insulation and also due to large ventilatory minute volume
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| True or False: Aging decreases the ability to compensate for heat loss. | True if >60 the metabolism decreases to less than 1/2
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| What is the best temperature that is not a core temperature measurment? | Tympanic- it is the closest to core temp d/t location being close to the hypothalmus.
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| How long does it take to get a true axillary temp? | 10 -15 min for the axillary artery to equilibrate
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| What is the best way to monitor core temp? | PA catheter, mixed venous blood, but core temp can be effected by CT surgery
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| What are active warming methods we utilize? | Warm blankets, radiant warmness, forced air warmers (bair huggers etc.) <---most effective of these three
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| What are active warming methods for the core that we can utilize? | heated humidifiers, gastric lavage, peritoneal irrigation, fluid warmers (can heat to 42 degrees C with out causing hemolysis)
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| What are passive warming methods we can utilize? | ambient temperature, insulation foam under bony prominences (insulation) and HME's
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