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SUHU TUBUH (ST)

(Pengaturan Homeostatis Suhu Tubuh)


dr. Halinda Sari Lubis, MKKK
Fakultas Kesehatan Masyarakat USU
Medan, Indonesia

Kenapa menjaga keseimbangan Suhu Tubuh
menjadi PENTING ?
Laju aktifitas ENZIM dipengaruhi oleh Temperatur/Suhu
Temperature
Activity
Reversible Non-Reversible
37C
43C
55C
SUHU TUBUH &
METABOLISME
Suhu mempengaruhi metabolisme
organisme dgn mempengaruhi
kecepatan reaksi kimia dan
efektifitas kerja enzim.
Tanpa pengaturan SUHU TUBUH saat
olahraga, suhu tubuh akan meningkat
melebihi batas yang mengakibatkan
kematian.
Beberapa atlit mati karena heat stress
karena alasan ini.
Penting untuk dipahami, bagaimana tubuh
mengatur keseimbangan suhunya.
Manusia adalah homeothermic.
SuhuTubuh internal (core) : 36.1 - 37.8
0
C.
keseimbangan Suhu Tubuh
menyerupai keseimbangan
ENERGY
Heat Gain (HG) = Pembentukan Panas
Heat Loss (HL) = Pembuangan Panas

HG >> HL = + ST meningkat
HG << HL = - ST menurun
HG = HL = 0 ST tidak berubah
Faktor yg mempengaruhi
HG/pembentukan panas
BMR, aktifitas otot, hormon, efek panas makanan,
dan lingkungan. (Total laju metabolisme dpt
meningkat 3-5 kali karena menggigil dan 20-25 kali
selama olahraga berat.
Panas dipertahankan ketika darah lebih banyak di
rongga kranial, thoracic dan abdominal .
Faktor yg mempengaruhi
HL/pengeluaran panas
Radiasi,
Konduksi,
Konveksi,
Evaporasi,
Mekanisme pemindahan
panas
Radiasi:
Pemindahan panas melalui Pancaran
Gelombang (Infrared radiation).
Konduksi:
Pemindahan panas langsung melalui kontak
fisik.
Konveksi:
Pemindahan ke udara sekitar tubuh.
Evaporasi:
Penggunaan panas utk mengubah molekul air
dari cair menjadi uap.
Hypothalamus
Thermostat (pusat pengatur Suhu
Tubuh)
Peningkatan Suhu Tubuh
internal (core
temperature)
hypothalamus Anterior
berkeringat
Vasodilatasi (peningkatan
aliran darah di kulit)

Pemaparan dingin
hypothalamus Posterior
Peningkatan produksi panas
menggigil
Menurunkan pembuangan
panas
Vasokonstriksi
Pengaturan Hypothalamic terhadap
Suhu Tubuh inti (Core Temperature)
Hypothalamus memiliki pusat pengaturan ST. Yang
bertanggungjawab menjaga tubuh dari overheating
atau overcooling
Mekanisme pengaturan panas di aktifkan oleh :
Reseptor suhu di kulit atau
Perubahan suhu darah
Free nerve endings pada kulit yang merespon panas
dan dingin selnjutnya meneruskan ke hypothalamus dan
cerebral cortex.
Major subdivisions of the hypothalamus and pituitary
ST: Inti dan Kulit
COLD HOT
Skin temperature tends to be colder than core temperature at a normal state
Normal
33-34
o
C
27
o
C 47
o
C
37
o
C
27
o
C 47
o
C 37
o
C
Normal
37
o
C
Core Temperature
Skin Temperature
Jika suhu kulit menjadi Panas:
Then body will lose heat:
1. Behavior - e.g. turn on a fan
2. Increase skin circulation
3. Etc...
27
o
C 47
o
C 37
o
C
Hot 38
o
C
27
o
C 47
o
C 37
o
C
Normal
Core temperature
Skin temperature
Then body will gain heat:
1. Behavior - e.g. put on more clothes
2. Decrease skin circulation
3. Etc...
27
o
C 47
o
C 37
o
C
Cold 30
o
C
27
o
C 47
o
C 37
o
C
Normal
Core temperature
Skin temperature
Jika suhu kulit menjadi dingin:
0 - 5
15
32 - 33
33 - 34
35 - 37
35-39
39 - 41
41 - 43
45
Range of SKIN Temperature
Sensation of cold
Sensation of warm
Sensation of heat
Pain
Threshold of burning pain
Rapid tissue damage
Temp*
* in degrees Celcius
No sensation
Comfort Zone
OUCH!!!
AHHH!
OH-OH!
Respon terhadap rangsang Panas
Respon terhadap rangsang Dingin
Beberapa
tempat untuk
mengukur ST
Alat untuk mengukur ST:
Electronik
Membran timpani
kaca
Sekali pakai
Temperature-sensitive patch or tape
Automated monitoring devices
Definitions
Fever elevation of body
temperature due to a resetting of the
hypothalamic thermoregulatory
center
Hyperthermia elevation of body
temperature due to inadequate
compensation by normal heat-loss
mechanisms
Definitions
(cont.)
Hyperpyrexia elevation of
temperature to unusually high
levels, 105.8
o
F (41
o
C) or higher
Fever Without a Focus fever with
no clear cause determined by
history and/or physical exam
Fever of Unknown Origin (FUO)
prolonged fever lasting over 7 10
days without identified cause
Definitions
(cont.)
What is a normal temperature?
Nothing magic about 98.6
o
F
(37
o
C)
Upper limit of normal extends to
100.2
o
F (37.9
o
C) in children
Person-to-person variations of
normal
Circadian variations of normal
100.4
o
F (38.0
o
C) or above is
considered a fever

Pathophysiology of
Fever
Cytokines called endogenous pyrogens
are released in response to various
inciting agents:
Common: Viruses, bacteria
Less common: Immune complexes
i.e. autoimmune
disease Tumor
cells
malignancy
Cytokines reset the hypothalamic
thermostat to a higher set-point.

Pathophysiology of
Fever
Analogy to the thermostat on your
homes heater
In a normal
equilibrium, the
thermostat is
set to an ideal
or normal
temperature
Pathophysiology of
Fever
When someone turns the thermostat up, the furnace
comes on, and the temperature begins to rise:
Pathophysiology of
Fever
Shivering

Goose bumps

Cutaneous
vasoconstricti
on

Sensation of
feeling cold
Similarly, in the human, when a pyrogen resets the
hypothalamic thermostat, the bodys furnace comes on,
and the temperature rises:
Pathophysiology of
Fever
The symptoms of shivering, goose
bumps, cutaneous vasoconstriction
(cold, pale hands and feet), and a
sensation of feeling cold are
collectively known as chills

Chills occur when the fever is
rising
Pathophysiology of Fever
Continuing the analogy to your home
thermostat:
When the
thermostat is
reset to normal,
the furnace goes
off and the house
cools
Pathophysiology of
Fever
Sweating

Cutaneous
vasodilitation

Sensation of
feeling hot

When the hypothalamic thermostat is reset to normal
(such as when antipyretic medication is given, or the
illness ends), the body begins to cool and the temperature
returns to normal:
Pathophysiology of
Fever
The symptoms of sweating, cutaneous
vasodilitation (warm, red skin), and a
sensation of feeling hot are collectively
called sweats

Sweats occur when the fever is breaking