II. Physiology: Nervous system
- Hypothalamus controls Thermoregulation
- Parasympathetic Nervous System controls sweating
-
Sympathetic Nervous System controls skin Blood Flow
- Vasodilation results in heat dissipation
III. Physiology: Temperature variation
- Ideal Body Temperature for physiologic function: 98.6 (37 C)
- Heat
- Core Temperature rises 1 C per 30 C Ambient Temperature
- Core temp. rise 0.6 C, raises basal metabolic rate 10%
- Cellular damage occurs at core Body Temperature above 104 F (40 C)
- Cellular death occurs at core Body Temperature above 107.6 F (42 C)
- Known as Thermal Maximum
- Cell death occurs at variable duration of exposure: 42 C (107.6 F) for 45 minutes to 8 hours
- Cold
- Mild Hypothermia at 95 to 90 F (35 to 32.2 C) presents with shivering, vasconstriction, Tachycardia, cold diuresis
- Moderate Hypothermia 90 to 82.4 F (32 to 28 C) presents with confusion to stupor, Bradycardia, Mydriasis
- Severe Hypothermia 82.4 to 75 degrees F (28 to 24 C) presents with coma, apnea, VT/VF, DIC
- Very Severe Hypothermia < 75 degrees F (24 C) absent Brainstem reflexes, Vital Signs absent and Asystole
IV. Physiology: Heat Dissipation Mechanisms
- Sweat evaporation (primary mechanism at >68F or 20C)
- Optimally dissipates 600 kcal/hour
- Sweat loss maximum 3 Liters/hour
- Endurance athletes lose up to 1.5 Liters/hour
- Rate of perspiration in hot environments is almost exclusively responsible for heat loss
- Perspiration becomes less effective in humid environments
- Heat Conduction
- Cold packs applied to skin
- Cold water emersion is the most expedient way to dissipate heat
- Conductive heat loss is typically minor, but increases 5 fold with wet clothing, and 25 fold with cold water immersion
- Heat Convection (Air or wind flows over skin)
- Body can dissipate heat with greater air circulation
- Cooler air also dissipates heat by providing a larger gradient between Body Temperature and air Temperature
- Permeable clothing allows for greater heat dissipation
- Heat Radiation (Infrared dissipation)
- Radiant energy is resorbed or reflected
- Light-colored clothing reflects away heat
- Half of heat loss is radiative (of which 60% is via the head)
V. Physiology: Heat Adaptation
- Athletes may require 10-14 days to acclimitize to Exercise in hot environments
- Mechanisms
- Improved Sodium retention
- Increased Glomerular Filtration Rate
- Increased cardiovascular performance
- Heat shock Proteins
VI. Physiology: Children and increased propensity for Heat Illness
- Greater surface area to body mass
- Slower sweat rates
- Sweating initiated at a higher Temperature set point
- Sweat is more dilute
- Slower accilimitization to hot environments than adults
- Decreased thirst response