Body temperature mechanism
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The document discusses body temperature regulation and abnormalities. It notes that humans maintain a constant core body temperature of around 37°C through heat gain and loss mechanisms controlled by the hypothalamus. When temperature varies by 0.1°C from the set point, the hypothalamus activates heat conservation or dissipation responses. Disorders include hypothermia, where temperature drops below the normal range, and hyperthermia/fever, where the hypothalamus raises the set point in response to pyrogens like bacterial toxins or cytokines. Heat stroke occurs when temperature exceeds the critical threshold of around 105-108°F.
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- Abnormal temperatures include hypothermia below the normal range and hyperthermia/fever above it, with fever caused by pyrogens raising the hypothalamic set point and heatstroke
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The document summarizes the mechanisms that regulate human body temperature. It discusses how the hypothalamus acts as the thermostat to maintain a normal temperature around 98.6°F by balancing heat production and heat loss. When core body temperature rises above or falls below this set point, the hypothalamus triggers responses like sweating or shivering to bring temperature back to normal. Fever results when pyrogens activate the hypothalamus to raise the set point in response to infection or inflammation. Heat stroke occurs when high temperatures overwhelm the body's ability to cool itself.
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Mechanisms of heat loss
VARIATIONS OF BODY TEMPERATURE
REGULATION OF BODY TEMPERATURE
Thermoreceptors
Hypothalamus: the thermostat
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The Nobel Prize in Physiology or Medicine 2021 was awarded jointly to David Julius and Ardem Patapoutian 'for their discoveries of receptors for temperature and touch.' The document then provides detailed information about the layers of skin, glands of skin, functions of skin, body temperature regulation, factors influencing heat balance in the body, and examples of conditions involving abnormal body temperature regulation like hyperthermia and hypothermia.
Fever.pptx
Fever is a higher than normal body temperature that is part of the body's natural response to infection. The hypothalamus acts as the body's temperature regulator and raises the temperature set point in response to pyrogens like cytokines released during an immune response. This causes changes like reduced blood flow to the skin and shivering that increase core body temperature. A fever limits the growth and spread of pathogens and helps the immune system fight infection more effectively. Common symptoms of a fever include fatigue, body aches, headache, and loss of appetite.
Altered temperature
The document discusses care of patients with altered body temperature. It defines body temperature and how it is regulated in the body. Temperature is controlled by the hypothalamus and can be increased or decreased through various mechanisms like sweating, shivering, and vasodilation. Fever is defined as a temperature above normal, while hypothermia is below normal. Various factors like age, environment, and illness can impact temperature. Nursing care involves assessing temperature, identifying causes of changes, and intervening to restore normal temperature through measures like antipyretics, fluids, and environmental controls.
Fever = Pyrexia = Febrile
Fever is a higher than normal body temperature that is part of the body's natural response to infection. The hypothalamus acts as the body's temperature regulator and raises the temperature set point in response to pyrogens like cytokines released during an immune response. This causes changes like reduced sweating and increased shivering that conserve heat and raise the temperature. A fever benefits the immune system by limiting bacterial/viral growth and activating immune cells. Common symptoms of a fever include fatigue, body aches, loss of appetite and headaches.
Thermoregulation in Human beings
Thermoregulation is the ability of an organism to keep its body temperature within certain boundaries, even when the surrounding temperature is very different.
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This document discusses airway local blocks and awake intubation. It describes the indications for awake intubation including comorbidities, risk of aspiration, difficult airway assessment, and emergencies. It provides details on the pharmacological agents, equipment, personnel, and techniques used for airway local blocks and awake intubation. Specifically, it outlines common methods for anesthetizing different areas of the airway using lidocaine, including dosage calculations and risks of lidocaine toxicity. The goal is to safely anesthetize the airway to allow for awake intubation.
Endotracheal intubation
This document discusses endotracheal tubes and intubation. It covers indications for intubation including airway protection, optimizing gas exchange, decreasing metabolic demand, and reducing work of breathing. Conditions associated with difficult intubation are described such as congenital anomalies, infections, tumors, injuries, and obesity. Proper equipment, tube sizing, intubation technique including positioning and confirmation of placement are outlined. Golden rules of intubation emphasize preparation, oxygenation, skills, confirmation, and monitoring.
Appropriate airway equipment and techniques.
This document provides an overview of airway anatomy, equipment, and techniques for airway management. It discusses:
1. The importance of airway control and the development of advanced cardiac life support.
2. The objectives of reviewing upper and lower airway anatomy, basic and advanced airway techniques, equipment for difficult airways, and clinical management of the airway.
3. Details of upper airway structures including the nose, oral cavity, pharynx, and larynx. It also reviews lower airway structures like the trachea and lungs.
Airway management
- The laryngeal mask airway (LMA) is a supraglottic airway device that is placed in the hypopharynx to control the airway during general anesthesia or ventilation. It provides an alternative to endotracheal intubation or use of a face mask. The LMA has advantages like ease of insertion, reduced hemodynamic response, and improved oxygenation during emergence from anesthesia. Potential complications include sore throat, coughing, laryngospasm, and airway obstruction. Proper selection of size, lubrication, and insertion technique are important for successful use of the LMA.
Biophysics
This document discusses different types of fluid flow and transport mechanisms in cells. It describes laminar and turbulent fluid flow, how they are characterized, and factors that influence each type. It also outlines different transport mechanisms in cells including diffusion, osmosis, facilitated diffusion, active transport, endocytosis, and exocytosis. Active transport uses carrier proteins and cell energy to move substances against a concentration gradient, while passive transport moves substances down a concentration gradient without cell energy.
Theories of anesthesia
1. The document discusses theories of anesthesia including the unitary theory and modern theories involving interactions with membrane proteins and specific ion channels.
2. It describes the stages of general anesthesia from analgesia to surgical anesthesia to medullary respiratory paralysis. However, it notes that the excitement stage is rarely seen with modern anesthesia.
3. GABA receptors are identified as an important target for many anesthetic agents. General anesthetics bind to these receptors, causing chloride channel opening and neuronal inhibition, resulting in anesthesia.
Endotracheal intubation and laryngoscopy part 2
This document discusses various types of endotracheal tubes and laryngoscopy techniques. It describes specialized tubes like armored tubes, RAE tubes, Oxford tubes, and laser-resistant tubes. It covers direct laryngoscopy using curved and straight blades. Optimal conditions for laryngoscopy are outlined, including using the appropriately sized blade and ensuring good muscle relaxation. Reliable signs of correct endotracheal tube placement include capnography, visualization of the tube passing the vocal cords, and fiberoptic bronchoscopy visualization of tracheal rings.
Intubation part 1.
Endotracheal tubes are used to intubate patients and enable ventilation. They are typically made of PVC or rubber and have features like a Murphy eye, size designations, and a pilot balloon-connected inflation system to create a seal in the trachea. Complications can occur during or after intubation and extubation, like trauma, aspiration, or laryngospasm. Nasotracheal intubation has advantages like patient comfort but risks like trauma or sinusitis. Proper preparation, techniques, and monitoring are important for safe endotracheal intubation.
Complications of artificial applications part 5
This document discusses the complications that can arise from mechanical ventilation through either invasive or non-invasive means. Some key complications mentioned include pneumonia, infections, injuries to the face/lips/pharynx and larynx/trachea, gastrointestinal effects like esophagitis and decreased motility, renal effects from reductions in blood pressure/flow, disrupted sleep, and decubitus ulcers. Proper diagnosis and management of these various complications is important for patients receiving mechanical ventilation support.
Difficult airway management
This document discusses endotracheal tubes and intubation. It covers indications for intubation including airway protection, optimizing gas exchange, decreasing metabolic demand, and reducing work of breathing. Conditions associated with difficult intubation are described such as congenital anomalies, infections, tumors, and injuries. Airway assessment techniques like mallampati classification, laryngoscopy view, and thyromental distance are explained. Equipment for intubation and sizing endotracheal tubes are outlined. The technique of intubation is described involving positioning the patient in sniffing position and using a laryngoscope to visualize the vocal cords. Confirmation of proper tube placement is emphasized using methods like auscultation and capnography.
Airway management part 3.
This document discusses various techniques for airway management. It describes mechanical maneuvers like jaw thrust and head tilt-chin lift to clear obstructions. Common airway adjuncts like oropharyngeal and nasopharyngeal airways are also discussed. Guidelines are provided for sizing and inserting these adjuncts safely. Face masks can be used with one, two, or three hands to maintain a patent airway. Risk factors for difficult mask ventilation and potential complications are also outlined.
Airway assesment part 2
This document discusses airway assessment and difficult airways. It outlines various predictors of difficult airways like obesity, short neck, and facial hair. It describes tests to evaluate the airway like thyromental distance, inter-incisor gap, and Mallampati grading. The document emphasizes the importance of a thorough airway assessment prior to intubation to identify potential difficulties and prepare appropriate management strategies for difficult intubations.
Airway assesment part 1
The document discusses preoperative airway assessment for anesthesia. It notes that 1-3 out of 100 anesthetized patients have difficult intubation, while 1 out of 1000 have failed intubation and 1 out of 10,000 experience cannot intubate cannot ventilate scenarios. Factors that can increase intubation difficulty include congenital syndromes, anatomical features like teeth and neck structure, and acquired conditions such as decreased jaw or neck mobility. A thorough preoperative assessment including tests of mouth opening, neck movement, thyromental distance, and Mallampati score can help predict and prepare for a potentially difficult airway.
History of anesthesia.
- Imhotep, an ancient Egyptian priest from around 2600 BC, is considered the first physician and treated many diseases. He extracted medicines from plants and had knowledge of anatomy. Ancient Egyptians used opium and hyoscyamus for anesthesia and performed trepanation surgery.
- In ancient Greece and Rome, mandrake juice was used for its narcotic effects before surgeries to ensure insensibility to pain. Arabic translations of Greek medicine advanced Islamic medicine in the Middle Ages. Physicians like Al Zahrawi described many surgeries and instruments.
- The modern history of anesthesia began with William Morton using ether in 1846 and John Snow advancing the field through publications on ether and chlor
Local and regional anesthesia
This document discusses different types of anesthesia including local, regional, and general anesthesia. It provides details on common regional anesthesia techniques like spinal blocks, epidurals, and caudal blocks. It also describes local anesthesia techniques such as infiltration, nerve blocks, and intravenous regional anesthesia. The document discusses the mechanisms of local anesthetics and some potential complications as well as benefits of local and regional anesthesia compared to general anesthesia.
1d awareness problem during operation
This document discusses the problem of anesthesia awareness during surgery. It defines anesthesia awareness as a patient becoming conscious during a surgical procedure under general anesthesia and having recall of events. Risk factors include women, younger age, use of total intravenous anesthesia, long surgeries, prior awareness history, and natural red hair. Causes can include light anesthesia, increased anesthetic requirements, or anesthesiologist error. Prevention strategies include pre-operative evaluation, prophylactic benzodiazepines, monitoring anesthetic levels, and post-operative interviews. Methods to monitor consciousness include clinical signs, isolated forearm technique, brain monitoring like BIS, and measurements of lower esophageal sphincter contractions.
1c geriatric patients
- The document discusses various physiological changes that occur with aging and their implications for anesthesia in geriatric patients. Some key points discussed include:
- Cardiovascular changes like decreased cardiac output and increased risk of hypertension. Respiratory changes like reduced lung capacity and cough reflex. Genitourinary changes like reduced kidney function and bladder issues.
- Gastrointestinal changes like decreased motility leading to constipation. Endocrine changes like increased risk of hypothyroidism and bone issues.
- The implications of these changes for anesthesia include risks of hypotension, bradycardia, respiratory complications, slower drug metabolism and clearance, and risks of gastric aspiration and constipation. Careful preoperative evaluation and
1b general anesthesia
The document provides information on general anesthesia including:
1) It discusses the history, goals, and levels of sedation for general anesthesia. Different levels include minimal sedation, moderate sedation, deep sedation, and general anesthesia.
2) The pre-anesthetic evaluation process involves taking a medical history, performing a physical exam including airway assessment, and ordering lab tests.
3) Common anesthetic equipment is described including laryngoscopes, endotracheal tubes, airways, monitors, and intravenous and inhalational drugs used for induction and maintenance of general anesthesia.
1a respiratory system
The document provides information on the respiratory system, including its structures and functions. It discusses the processes of ventilation, external respiration, transport of gases, and cellular respiration. It describes the structures of the upper respiratory tract such as the nose, pharynx and larynx. It also details the trachea, bronchi, bronchioles, and alveoli. Furthermore, it examines the muscles involved in inspiration and expiration, respiratory volumes and capacities, and the control of breathing.
Triage
This document discusses triage, which is the process of sorting patients based on the urgency of their condition to prioritize care. It defines triage and outlines its objectives to identify patients, prioritize their needs, track their progress, and identify hazards. It describes different types of triage including simple, advanced, continuous integrated, and reverse triage. It discusses levels of triage from red to green based on factors like vital signs and Glasgow Coma Scale. Finally, it outlines the role and characteristics of EMTs in effectively conducting triage.
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Body temperature mechanism
- 1. BODY TEMPERATURE AND ITS REGULATION Dr Nisar Ahmed Arain Assistant Professor Anesthesia/Critical care/ER
- 2. SLOS -1-Introduction -2-Normal Temperature -3-Heat Loss Mechanism -4-Heat Gain Mechanism -5-Regulation of body Temperature -6-Abnormalities of body Temperature regulation
- 3. INTRODUCTION -Homeo-thermic-Maintaining constant internal body Temperature -Endotherms -Generate their own body Heat Why Temperature should be maintained -1-For normal enzyme activity -2-For normal neuronal activity -3-Rise in high Temperature. cause denature of proteins
- 4. BOY TEMPERATURE -BODY TEMPERATURE Core Temperature measured in -Oral or -Rectal routes -VALUES of Normal body Temperature -1-Oral : 98.6-degree F (97.3 – 98.8-degree F OR 37 degree C(36.3 – 37.1 degree C) -2-Rectal :0.5 degree C more then Oral -3-Axilla :0.5 degree C less than Oral -4-Skin :Depends upon environment -5-101 degree to 104-degree F RECTAL 0.5 degree C > ORAL 0.5 degree C >0.5 degree C > AXILLA
- 6. MAINTAINANCE OF BODY TEMPERATURE Heat Loss Heat Gain =
- 7. HEAT GAIN MECHANISM -1-Shivering -2-Increase in metabolism by Epinephrine nor-epinephrine and Thyroxin -3-Cutaneous vasoconstriction
- 8. HEAT LOSS MECHANISM -1-Evaporation of sweat -2-Radiation -3-Conduction and Convection -4-Cutaneous vasodilation -5-Decrease in Metabolism -6-Through Respiration
- 9. -Receptors: Warmth and Cold receptors from skin, Deep tissues spinal cord and Hypothalamus -Heat loss center – Pre-optic and Anterior Hypothalamic Nuclei -Heat Gain Center – posterior hypothalamus -Set point 37 degree C in Hypothalamus (+-) 0.1 degree C cause Hypothalamus to activate heat loss or heat gain mechanism Regulation of body temperature Role of the Hypothalamus
- 10. Preoptic & Ant. Hypothalamic nuclei Posterior hypothalamus Inhibition of Sympathetic nervous system -Vasodilation Sweating decrease in thermogenesis (heat production). -Increase in body temperature - Warmth receptors from skin deep viscera are stimulated TEMPERATURE-DECREASING MECHANISMS when the body is too HOT Normal body temperature set
- 11. Posterior Hypothalamus Sympathetic stimulation -Skin vasoconstriction throughout the body piloerection -Increase in Thermogenesis (Heat Production) -Normal body temperature Set point: 37D C Decrease in body Temperature Cold receptors from Skin are stimulated -Pre-optic and Anterior Hypothalamic Nuclei Temperature-increasing mechanisms when the body too COLD
- 13. ABNORMALITIES OF BODY TEMPERATURE REGULATION -HYPOTHERMIA :-Decrease in body temperature below normal range -HYPERTHERMIA:- Increase in boy temperature above normal range -HYPERTHERMIA - FEVER -1-Increase n body Temperature above Normal -2-Due to rise in set point of Hypothalamus by pyrogen -3-Pyrogen:-Any substance that raises the “set point” of Hypothalamus a-Bacterial endotoxins:-Cell membrane proteins and their breakdown products b-IL-1 C-Inflamatory mediators;-Kinin, Brady -Kinin, Prostaglandin E -4-Characteristics of febrile condition a-Crisis b-Fever c-Crisis or Flush -5-Anti-Pyretics:-Aspirin blocks PG-E
- 14. HEAT-STROKE -This occurs when body temperature rises beyond the “critical temperature”. It ranges from 105 to 1080F SYMPTOMS -1-Dizziness -2-Abnormal distress -3-Vomiting -4-Delirium -5-Loss of consciousness -6-Circulatory shock -7-Death
- 15. TEPIDS SPONGING
- 16. HYPOTHERMIA -If person is exposed to “Iced water” for 20 to 30 minutes ordinarily dies because of Heart Fibrillation -If the body Temperature has fallen below 85°F,the abilityoftheHypothalamus toregulateTemperature islost FROST BITE -When the body is exposed to extremely low temperatures surface areas can freeze this freezing is called “Frost-bite” -This occurs specially in the a-Lobes of the ears and in the b-Digits of the Hands and Feet