兒科學(xué)英文課件：02 A growth

1、Growth 2013七年制-2Growth an increase in the number and size of cells; results in increased size and weight of the whole or any of its part.(quantity change數(shù)量改變)Definition2013七年制-32013七年制-4Development change in the child that occurs over time. Changes follow an orderly pattern that moves toward greater

2、 complexity and enhances survival.(quality change質(zhì)量改變)growth & development2013七年制-5 growth(physical development)developmentW(weight) gain體重linear growth身高H.C.(head circumference)growth頭圍C.C.(chest circemference)growth胸圍 .sex maturation性成熟dental development牙齒發(fā)育skeletal maturation骨骼發(fā)育 2011七年制-6Periods

3、 of growth & development:Prenatal period: from conception to birthInfancy: age 0 yearToddlerhood: ages 1-2 yrsPreschooler: ages 3-5 yrsSchool age : ages 6-12 yrsAdolescence: Learning objectives Patterns of physical growth before puberty青春期 and in pubertyOther indices of physical growth2013七年制-7Learn

4、ing objectivesPatterns of physical growth before puberty and in pubertyOther indices of physical growth2013七年制-8Indices of growthweight，W height, Hcrown-rump length頂臀長/sitting height坐高h(yuǎn)ead circumference, H.C.chest circumference，c.c.2013七年制-9 Physical Growth pattern before puberty2013七年制-101.Weight g

5、ainIt is probably the best index of nutrition and growth.2013七年制-11weight gain with ageage0m3m1y2y3y4y5y6y7y8y9yw(kg)36912141618202225282013七年制-122. The 1st growth spurt:the 1st year of life第一個(gè)生長高峰Patterns of weight gain 1. Different growth rate in different age2013七年制-132013七年制-14Attention Weight f

6、ormulae（P.13） do not be used in growth assessment .Why?2013七年制-152.Stature Growth身長 Height身高 Length身長 3y3y2013七年制-16age0m3m1y2y3y4y5y6y7y8y9yH(cm)5063758796 103 110 117 123 129 134 stature growth with age 2013七年制-17Pattern of Stature Growth2. The 1st growth spurt: The 1st year of life1. Different gr

7、owth rate in different age2013七年制-182013七年制-19AttentionStature formulae （P.14） do not be used in growth assessment .Why?2013七年制-203.Crown-rump length頂臀長/Sitting height坐高- crown-rump length sitting height3y3y2013七年制-21 sitting height changes with age2013七年制-220m2y6y10y14ySH(cm)33.553.364.773.286.1TH(

8、cm)50.287.9116.2136.6162.5SH/TH0.670.610.560.540.53SH/TH changes with age2013七年制-23ageSH/TH changes with age2013七年制-244.Head circumferenceBe related with the growth of brain and skull顱骨2013七年制-25H.C. growth with age2013七年制-26ageHC（cm）0m343m401y462y483y48.34y495y50 Patterns of H.C. Growth2. 1st growt

9、h spurt: 1st year of life1. Different growth rate in different age2013七年制-272013七年制-285.chest circumferenceAgec.c.（cm）h.c.（cm）Newborn32341yr4646Comparison between C.C.and H.CcmPhysical Growth in Puberty2013七年制-31When does the puberty begin?Secondary sexual characteristics appearGirls begin at age 91

10、1.Boys begin at age 1113.Sexual Precocity性早熟：Secondary sexual characteristics appear Girls8y，Boys14y，Boys16y2013七年制-32 adolescenceGirls begin at age 911,Boys begin at age 1113.individual variation is substantial身體變化很大the 2nd growth spurt 第2個(gè)生長高峰(Peak of height velocity, PHV) in the average girls, th

11、e growth spurt peaks at 11.5 yr at 8.3 cm / yrIn the average boy, the growth spurt peaks at13.5 yr at 9.5 cm / yr.Slowing physical changes permit the emergence of a more stable body image.2013七年制-332013七年制-34Learning objectivesPatterns of physical growth before puberty and in pubertyOther indices of

12、 physical growth2013七年制-35CraniumSpineLong bone growth(physical development)developmentW(weight) gainlinear growthH.C.(head circumference)growthC.C.(chest circemference)growth .skeletal maturationdental developmentsex maturation2013七年制-36Anterior Fontanel前囟Size: 1.5-2cm at birthClosure time: 24mo201

13、3七年制-37Posterior Fontanel后囟Size: 00.5cm at birthClosure Time: 68weeks2013七年制-38 Small size or early closure：Abnormality of anterior fontanel前囟異常Microcephaly小頭,etcHydrocephalus腦積水 ,etcLarge size or delayed closure：2013七年制-39Intracranial hypertension顱內(nèi)壓增高( Encephalitis腦炎, Meningitis腦膜炎,etc)Dehydration

14、脫水Bulging fontanel囟膨隆：Sunken fontanel 囟門凹陷：Abnormality of anterior fontanel2013七年制-40Spinal development脊柱發(fā)育AgeMovementMusclesCurvature彎曲3mCervicalCervical頸曲（anterior） 6mLumbarThoracic胸曲（posterior） 12mLower extremities下肢Lumbar腰曲（anterior）2013七年制-41The sequence of appearance of secondary centers Long

15、bone development長骨發(fā)育2013七年制-42Bone Age骨齡 a persons age measured by matching the bone development (as shown by X rays) with bone development of an average person of known chronological age 實(shí)際年齡according to the number大小, density 密度and morphological features形態(tài)特征 of the osteite 骨化中心.2013七年制-43Method: X-

16、ray of left hand ，+left knee膝關(guān)節(jié)(18yTotal number: 32/28 2013七年制-50Delayed eruption遲萌出 13mo Idiopathic特發(fā)性 , Hypothyroidism甲低, familial家族性的 ,etcCrowding擁擠 or Disorder 混亂 Hypothyroidism , Brain dysplasia 腦發(fā)育不良,etcFailing to erupt Ectodermal dysplasia外胚層發(fā)育不良, Mechanical blockage,etc Abnormality of Dentit

17、ion2013七年制-51CraniumSpineLong bone growth(physical development)developmentW(weight) gainlinear growthH.C.(head circumference)growthC.C.(chest circemference)growth .skeletal maturationdental developmentsex maturation2013七年制-52Tanner stage: The five stages of breast&female genitalia development2013七年制-53Tanner stage: The five stages of male genital development2013七年制-54Milestones in Sexual Developmentfemalebreast budding乳腺發(fā)育growth of pubic hair陰毛growth spurt peak生長高峰change in body shapegrowth of underarm hair腋毛first period (menarche初潮)adult breast sizema