Hands and feet: physiological insulators, radiators and evaporators

The purpose of this review is to describe the unique anatomical and physiological features of the hands and feet that support heat conservation and dissipation, and in so doing, highlight the importance of these appendages in human thermoregulation. For instance, the surface area to mass ratio of each hand is 4–5 times greater than that of the body, whilst for each foot, it is ~3 times larger. This characteristic is supported by vascular responses that permit a theoretical maximal mass flow of thermal energy of 6.0 W (136 W m 2 ) to each hand for a 1 °C thermal gradient. For each foot, this is 8.5 W (119 W m 2 ). In an air temperature of 27 °C, the hands and feet of resting individuals can each dissipate 150–220 W m 2 (male–female) of heat through radiation and convection. During hypothermia, the extremities are physiologically isolated, restricting heat flow to