TEMPERATURE
A.KHUDSIYA BANU
13M064
PHYSIOLOGY OF TEMPERATURE REGULATION
Temperature is
maintained by the
hypothalamus which
acts as a thermostat
maintaining the balance
between heat gain and
heat loss.
FEVER / PYREXIA
• It is an elevation of
body temperature
above the maximum
normal temperature.
• Normal - 36.6 - 37.2 C
• Fever - > 37.2 C
MECHANISM OF FEVER PRODUCTION
ACCOMPANIMENTS OF FEVER
• CHILLS –sense of cold during fever , patients even
shiver. It is due to vasoconstriction & is a mode of
heat conservation.
• RIGORS – profound chills accompanied by
muscular contractions and chattering of teeth. It
is a mode of heat production.
• SWEATING - occurs on elimination of fever stimuli
or on reaching a new thermostat point or on
antipyretic therapy. There is rapid dissipation of
heat by therapy.
• OTHERS - Include
headache , myalgia ,
arthralgia ,anorexia
,nausea,etc
• CONVULSIONS triggered in children(<5
yrs) , very old patients ,
hepatic failure .
TYPES OF FEVER
CONTINUOUS / SUSTAINED FEVER- When fever does not
fluctuate more than 1.0’C during the last 24 hrs but at
no time touches the normal.eg-pneumonia ,UTI,
enteric fever ,etc.
REMITTENT FEVER – when temperature remains above
the normal throughout the day but the fluctuation
exceeds 2.0’C in 24 hrs. eg – viral fever , non-infectious
conditions like collagen vascular diseases ,etc.
INTERMITTENT FEVER – fever present only for few hrs in a
day and remits back to normal for the remaining hrs.
Types of intermittent fever
QUOTIDIAN FEVER - When the paroxysms of
intermittent fever occur daily .eg-mixed
infection with malarial parasites.
TERTIAN FEVER - When paroxysms of
intermittent fever occur on alternate days .egvivax or falciparum malaria.
QUARTAN FEVER - When paroxyms of
intermittent fever occur on every fouth day
.eg- malaria by p.malariae.
HECTIC/ SEPTIC FEVER - Temperature between
the mainimum & minimum is large .eg –
septicemia , malignancies , deep seated
systemic infections ,etc.
9 DAY FEVER - Regular alteration in recurrent
bouts of fever & afebrile periods. Temperature
increases for 3 days , remains high for the next
3 days and subsides in the next 3 days .eg –
hodgin’s disease ,brucellosis .
REMEMBER !!!!!!
• FEVER + CHILLS &
RIGORS – malaria ,UTI ,
septicemia ,etc.
• FEVER + RASHES –
chicken pox , measles ,
rubella drug fever ,
infectious
mononucleosis, etc.
• HYPERPYREXIA - body
temperature of more than
41.0’C . In this hypothalamic
thermostat is set at a higher
level.eg – encephalitis ,
malaria, pontine hemorrhage
,etc
• HYPERTHERMIA - elevation of
body temperature without
elevation of hypothalamic set
point . It is due to inadequate
heat dissipation or due to
excessive heat production .eg
– heat stroke ,malignant
hyperthermia ,etc.
Normal temperature =
36.6’C – 37.2’C
Fever= >37.2’C
Hyperpyrexia= >41’C
Hyperthermia= <35’C
MEASUREMENT OF TEMPERATURE
• Is by mercury
thermometer .
2 types – oral & rectal.
• Sites
oral
axilla / groin
rectum
Difference between oral & rectal
thermometers
Oral cavity
• Should be kept for 1 or
2 mins.
• Under the tongue.
• Patient should be
instructed to breathe
through the nose &
keep the lips firmly
closed.
Axilla / Groin
• Kept in the axilla with
the forearm closed to
the side of the chest .
• Kept in the groin with
the thigh flexed on the
abdomen.
Rectum
• Rectal temperature is
usually 0.06’C more
than normal body
temperature.
• Young children &
unconscious patients
THANK YOU