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Chapter: Medical Physiology: Somatic Sensations: II. Pain, Headache, and Thermal Sensations

Thermal Receptors and Their Excitation

The human being can perceive different gradations of cold and heat, from freezing cold to cold to cool to indifferent to warm to hot to burning hot.

Thermal Sensations

Thermal Receptors and Their Excitation

The human being can perceive different gradations of cold and heat, from freezing cold to cold to cool to indifferent to warm to hot to burning hot.

Thermal gradations are discriminated by at least three types of sensory receptors: cold receptors, warmth receptors, and pain receptors. The pain recep-tors are stimulated only by extreme degrees of heat or cold and, therefore, are responsible, along with the cold and warmth receptors, for “freezing cold” and “burning hot” sensations.

The cold and warmth receptors are located imme-diately under the skin at discrete separated spots. In most areas of the body, there are 3 to 10 times as many cold spots as warmth spots, and the number in differ-ent areas of the body varies from 15 to 25 cold spots per square centimeter in the lips to 3 to 5 cold spots per square centimeter in the finger to less than 1 cold spot per square centimeter in some broad surface areas of the trunk.

Although the existence of distinctive warmth nerve endings is quite certain, based on psychological tests, they have not been identified histologically. They are presumed to be free nerve endings, because warmth signals are transmitted mainly over type C nerve fibers at transmission velocities of only 0.4 to 2 m/sec.

Conversely, a definitive cold receptor has been iden-tified. It is a special, small type Ad myelinated nerve ending that branches a number of times, the tips of which protrude into the bottom surfaces of basal epi-dermal cells. Signals are transmitted from these recep-tors via type Ad nerve fibers at velocities of about 20 m/sec. Some cold sensations are believed to be transmitted in type C nerve fibers as well, which sug-gests that some free nerve endings also might function as cold receptors.

Stimulation of Thermal Receptors—Sensations of Cold, Cool, Indifferent, Warm, and Hot. Figure 48–10 shows theeffects of different temperatures on the responses of four types of nerve fibers: (1) a pain fiber stimulated by cold, (2) a cold fiber, (3) a warmth fiber, and (4) a pain fiber stimulated by heat. Note especially that these fibers respond differently at different levels of temperature. For instance, in the very cold region, only the cold-pain fibers are stimulated (if the skin becomes even colder, so that it nearly freezes or actually does freeze, these fibers cannot be stimulated). As the tem-perature rises to +10° to 15°C, the cold-pain impulses cease, but the cold receptors begin to be stimulated, reaching peak stimulation at about 24°C and fading

out slightly above 40°C. Above about 30°C, the warmth receptors begin to be stimulated, but these also fade out at about 49°C. Finally, at around 45°C, the heat-pain fibers begin to be stimulated by heat and, paradoxically, some of the cold fibers begin to be stim-ulated again, possibly because of damage to the cold endings caused by the excessive heat.

One can understand from Figure 48–10 that a person determines the different gradations of thermal sensations by the relative degrees of stimulation of the different types of endings. One can also understand why extreme degrees of both cold and heat can be painful and why both these sensations, when intense enough, may give almost the same quality of sensa-tion—that is, freezing cold and burning hot sensations feel almost alike.

Stimulatory Effects of Rising and Falling Temperature—Adap-tation of Thermal Receptors. When a cold receptor is sud-denly subjected to an abrupt fall in temperature, it becomes strongly stimulated at first, but this stimula-tion fades rapidly during the first few seconds and pro-gressively more slowly during the next 30 minutes or more. In other words, the receptor “adapts” to a great extent, but never 100 per cent.

Thus, it is evident that the thermal senses respond markedly to changes in temperature, in addition to being able to respond to steady states of temperature. This means that when the temperature of the skin is actively falling, a person feels much colder than when the temperature remains cold at the same level. Con-versely, if the temperature is actively rising, the person feels much warmer than he or she would at the same temperature if it were constant. The response to changes in temperature explains the extreme degree of heat one feels on first entering a tub of hot water and the extreme degree of cold felt on going from a heated room to the out-of-doors on a cold day.

Mechanism of Stimulation of Thermal Receptors

It is believed that the cold and warmth receptors are stimulated by changes in their metabolic rates, and that these changes result from the fact that tempera-ture alters the rate of intracellular chemical reactions more than twofold for each 10°C change. In other words, thermal detection probably results not from direct physical effects of heat or cold on the nerve endings but from chemical stimulation of the endings as modified by temperature.

Spatial Summation of Thermal Sensations. Because thenumber of cold or warm endings in any one surface area of the body is slight, it is difficult to judge grada-tions of temperature when small skin areas are stimu-lated. However, when a large skin area is stimulated all at once, the thermal signals from the entire area summate. For instance, rapid changes in temperature as little as 0.01°C can be detected if this change affects the entire surface of the body simultaneously. Con-versely, temperature changes 100 times as great often will not be detected when the affected skin area is only 1 square centimeter in size.

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