TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
TMU 题-Metabolism
Guyton 14e
Guyton 14e
Guyton 14e
Guyton 14e
TMU 题-Metabolism
Guyton 14e
TMU 题-Metabolism
TMU 题-Metabolism
Normal control
The hypothalamic thermoregulatory centre (preoptic area) defends a set point of ~37 °C by negative feedback.
Raising the set point
Pyrogens (from infection/inflammation), acting via prostaglandin E₂, RAISE the hypothalamic set point above 37 °C.
Onset (chill phase)
The actual temperature is now BELOW the new set point, so the body behaves as if cold: vasoconstriction + shivering generate and conserve heat → the temperature climbs to the new (higher) set point. The patient feels cold despite a rising fever.
Plateau
Temperature is held at the elevated set point.
Defervescence (crisis)
When the set point falls back to normal (recovery or antipyretic), the temperature is now ABOVE it → vasodilation + sweating → the temperature falls.
Definition
The BMR is the metabolic rate (energy expenditure per unit time) measured under standard basal conditions — the minimum energy needed to keep the body alive at rest.
Basal conditions
- Awake but physically and mentally at rest, lying down (not standing).
- Post-absorptive — 12–14 h after the last meal (no specific dynamic action).
- Thermoneutral environment (~20–25 °C, quiet).
- Normal body temperature.
Factors raising BMR
Thyroid hormone (the main determinant), fever (~13% per °C), adrenaline; higher in males, children and in cold climates. It falls with age and in hypothyroidism/starvation.
Energy sources and storage
Immediate fuel is glucose/ATP; the main long-term store is fat (energy-dense). Caloric values: carbohydrate and protein ~4.1 kcal/g, fat ~9.3 kcal/g.
Respiratory quotient
RQ = CO₂ produced ÷ O₂ consumed. Carbohydrate = 1.00, protein = 0.80, fat = 0.70, mixed diet ≈ 0.85. The RQ reveals which fuel is being oxidised (a low RQ indicates fat oxidation, e.g. in fasting).
Specific dynamic action
The extra heat produced after eating, highest for protein (~30%) — which is why the post-absorptive state is required for BMR.
Heat production
- At rest: the liver and other viscera are the main source.
- In cold / during activity: skeletal-muscle shivering is the chief way to raise heat production.
- Also: hormones (thyroxine, adrenaline → non-shivering thermogenesis) and the specific dynamic action of food.
Heat loss
- Radiation — infrared emission; main route at rest in a cool room.
- Conduction — to cooler objects in contact.
- Convection — heat carried away by moving air/water.
- Evaporation (sweat) — uses the latent heat of vaporisation; the ONLY effective route when ambient temperature ≥ skin temperature.
The controller
The thermoregulatory centre in the preoptic area of the hypothalamus compares blood temperature with a set point (~37 °C) and drives negative-feedback responses.
If body temperature is ABOVE the set point (too hot)
- Increase heat loss: cutaneous vasodilation and sweating (evaporation).
- Decrease heat production.
If body temperature is BELOW the set point (too cold)
- Decrease heat loss: cutaneous vasoconstriction and piloerection.
- Increase heat production: shivering (and hormonal/non-shivering thermogenesis).
Result
These opposing responses return the core temperature toward the set point, keeping it nearly constant.