体温调节课件 .ppt
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1、 Energy metabolism and body temperaturePart I Energy metabolism1.The source of energy and its transfer in body2.Method of energy metabolism measurement:direct calorimetry,indirect calorimetry.3.Basal metabolism rate:concept and clinical significance4.Factors affecting energy metabolism:muscle contra
2、ction,environment temperature,food specific dynamic effectWhat is metabolism?All the chemical reactions in all the cells of the body.Catabolism and Anabolism能量代谢(Energy metabolism)Concept:the energy metabolism means the liberation,transformation and utilization of energy produced by the material met
3、abolism in the body.Resource of energySugar:主要的供能物质(提供人体所需能量的70%)Fat:主要的贮能物质 重要的供能物质ProteinTransform,release and utility of energy foodCO2、H2O、尿素、尿酸等能量生物氧化热能肌肉收缩神经传导合成代谢其他热能机械功能贮备能O2ATPC-PADPPiMeasurement of metabolic rate是指定量测定机体单位时间所消耗的能量,即能量代谢率能量代谢率(energy metabolic rate)直接测热法(direct calorimetry)
4、间接测热法(indirect calorimetry)食物热价食物热价(thermal equivalent)食物的氧热价氧热价(thermal equivalent of oxygen)呼吸商(Respiratory quotient,RQ)非蛋白呼吸商(No-protein respiratory quotient,NPRQ)caloric value卡价(热价)The caloric value of the food is the energy released by oxidation of 1 gram of such food.thermal equivalent of oxyg
5、en氧热价The quantity of energy liberated per liter of oxygen used in the body is called thermal equivalent of oxygen.For the average diet,it is about 4.825 calories.代谢率测定结构模式图Factors affecting energy metabolism个体因素体表面积性别与年龄生理活动和环境因素睡眠肌肉活动氧债(oxygen debt)环境温度食物的特殊动力效应精神紧张其他因素基础代谢(Basal metabolism)基础代谢率(B
6、asal metabolism rate)the basal metabolic rate is the metabolic rate determined under basal conditions which includes complete mental and physical relaxation in a room or a comfortable temperature and 1214 hours after the last meal.How to measure basal metabolism rate?基础状态:室温2025、清晨、空腹、清醒、安静Body temp
7、erature and temperature regulation 地球表面各处的温度差别地球表面各处的温度差别很大,范围:很大,范围:-70+60 在地球上,一般生命在地球上,一般生命的温度范围:的温度范围:045变温动物变温动物恒温动物恒温动物 人类的体温必须维持人类的体温必须维持在在 3541body temperature体温The body temperature is often referred to core temperature.The core refers to the central area of the body,including the brain and
8、viscera,which are maintained at a constant temperature.Body temperature and its regulation体表体表温度温度(shell temperature):人体外周组织体温,包括皮肤、皮下组织、肌肉等;不稳定,各部位的差异较大;(一般为头面部较高,一般为头面部较高,胸腹部次之,四肢末端最低胸腹部次之,四肢末端最低)体核温度体核温度(core temperature):机体深部的温度,是指心、肺、腹腔内脏等;较稳定,各部位的差异较小;(肝脏温度最高;脑与之接近;肝脏温度最高;脑与之接近;肾、胰腺、十二指肠等略低;直肠
9、温度更低;循环肾、胰腺、十二指肠等略低;直肠温度更低;循环血液温度可代表内脏器官的平均温度血液温度可代表内脏器官的平均温度)Body temperature是指机体深部的平均温度体温维持:体温维持:来自物质代谢过程种所释放 的能量;物质代谢50%热能 维持体温50%化学能 ATP 热能 体外How to measure body temperature 体温计体温计(thermometer)(thermometer)的选择:的选择:水银体温计、电子体温计和半导体体温计;测量体温的方法:测量体温的方法:直肠温度直肠温度(36.9-37.9)口腔温度口腔温度(36.7-37.7)腋窝温度腋窝温度(
10、36.0-37.4)食管温度食管温度可作为体核温度的指标 鼓膜温度鼓膜温度可作为脑组织温度的指标实实验验临临床床clinicexperimentNormal range of body temperatureNormal range of body temperature 平均值平均值()标准差标准差 正常范围正常范围(95%置信度置信度,)腋窝腋窝口腔口腔直肠直肠 36.79 0.357 36.037.4 37.19 0.249 36.737.7 37.47 0.251 36.937.91030名正常人体温统计名正常人体温统计nurse:Monitoring body temperature
11、 accurately is an important nursing measure.Body temperature reflects the heat content of the body and may provide information of the patient.Student:What is the normal temperature of the human body?N:The normal temperature of the human body is about 37.The rectal temperature is about 36.5-37.5.The
12、mouth temperature is 0.3-0.5 lower than the rectal temperature.The axillary temperature is 0.2-0.4 lower than the mouth.S:Then which is standard?N:The rectal temperature is standard,because it is in the cavity of the body and nearly the temperature of the blood.S:How many times a day do we take temp
13、erature for the patient?N:Some patients are taken temperature twice a day and others every four hours or even every two hours.S:When do we take the temperature for the patients?N:Usually we take it at 8 a.m.And 4 p.M.The feverish patients should be taken their temperature every four hours or every t
14、wo hours daily.S:Should pulse and respiration be taken while the temperature is being taken?N:Yes,the nurse not only takes the temperature but also counts the pulse and respiration.N:Do you know what are the precautions while taking ones temperature orally?S:Yes.We should tell the patients to close
15、their mouths and be careful not to break the thermometer and swallow the glass or mercury.It would be very dangerous.S:How do you treat that if the patients swallow the mercury?N:The patient would take some egg white or milk immediately.MST与与MBT平均皮肤温度平均皮肤温度(mean skin temperature,MST)Tmst0.2(T小腿T大腿)0
16、.3(T胸T上臂)平均体温平均体温(mean body temperature,MBT)TmbtTcore(1)Tmst(Tcore为深部温度,通常以直肠温度代表,为机体深部组织在机体全部组织中所占的比例,1为机体表层组织所占比例。)Normal change of body temperature昼夜节律昼夜节律(circadian rhythm)清晨25时最低,午后25时最高;但波动幅度1circadian rhythm昼夜节律The fluctuations in homeostatically regulated function that repeat in a cyclic pat
17、tern every 24 hours is called circadian rhythm.Sex:女女较男男高0.3女性体温随月经周期呈现节律性波动:排卵前体温较低 排卵时最低 排卵后体温升高 年龄年龄新生儿体温不规则(体温调节能力差)青少年体温较高老年人体温较低(代谢率降低,活动少)情绪和体力活动情绪和体力活动药物作用药物作用季节和地区影响季节和地区影响体热平衡体热平衡1、产热:、产热:2、散热:、散热:人体内化学性产热和物理性散热过程是互相协调、制约的,两者间的协调、制约作用受大脑内的体温调节中枢控制。body heat balancethermolysisheat produceHe
18、at productionHeat production产热器官:安静时主要为内脏器官,以liver为最,其次为肾脏;运动时主要为skeletal muscle人体产热的基本方式基础代谢产热(basal metabolism)食物特殊动力效应(specific dynamic action,SDA)骨骼肌运动(contraction of skeletal muscle)寒战产热与非寒战产热(shivering or non-shivering heat production)specific dynamic effect of food 食物的特殊动力作用After a meal is in
19、gested,the metabolic rate increases as a result of the different chemical reactions associated with digestion,absorption,and storage of food in the body.This effect of food on the metabolic rate is called the specific dynamic effect of food.机体安静和活动情况下各器官组织的产热比例机体安静和活动情况下各器官组织的产热比例占体重的百分比占体重的百分比(%)产热
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