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Growth & Development

Growth & Development. HU Yan Dept. of Child Health Care CHCMU. Growth an increase in size of body. Development increased complexity of function. PHYSICAL GROWTH & ASSESSMENT. OBJECTIVES. Discribe the growth pattern before puberty

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Growth & Development

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  1. Growth & Development HU Yan Dept. of Child Health Care CHCMU

  2. Growth an increase in size of body Development increased complexity of function

  3. PHYSICAL GROWTH & ASSESSMENT

  4. OBJECTIVES • Discribe the growth pattern before puberty • 2. Understand other indices of growth and their clinical applications • 3. List the indices of growth assessment

  5. Patterns of physical growth • Other indices of physical growth • Regularities • Growth assessment

  6. Patterns of physical growth • Other indices of physical growth • Regularities • Growth assessment

  7. Growth pattern before puberty

  8. Weight To evaluate present nutrient state

  9. Weight (kg) Age Weight (kg) Increment（kg） Increment (kg/y ) At birth 3 3/0~3m 3/3~12m 12m 9± 6 3/1~2y 24m 12± 3 >2y ~Puberty 2 10

  10. Growth Patterns of Weight 1. First growth spurt: first year of life 2. Different growth rate in different age

  11. Attention • About formulae • 3~12months: weight(kg)=(age month+9)/2 Do not be used in growth assessment Different growth rate Why? Individual difference

  12. Linear Growth < 3y Supine ---Length ≥3y • ---Height Stand

  13. Age Length or Height (cm) Increment（cm） Increment (cm/y ) At birth 50 11~12 12m 75± 12~13 25 10 10 24m 85± >2y~Puberty 5~7 14

  14. Growth Pattern of Linear Growth 1. First growth spurt: first year of life 2. Different growth rate in different age

  15. Crown-rump Length/Sitting height Supine <3y - Crown-rump length ≥3y Sit • Sitting height

  16. Growth pattern of sitting height

  17. Puberty The ratio of sitting height/total height 19

  18. Differential diagnosis of short stature Proportionate Disproportionate 20

  19. Head Circumference Be related with the growth of brain and skull

  20. Growth Pattern of H.C 1. First growth spurt: first year of life 2. Different growth rate in different age

  21. Abnormality of H.C Cerebral dysplasia, Microcephaly,etc Small —— • increase too fast —— Hydrocephalus,etc

  22. Growth on Puberty The 2nd growth spurt (Peak of Height Velocity,PHV) Girls: age 9~11 Boys: age 11~13 Attention: individual difference

  23. Patterns of physical growth • Other indices of physical growth • Regularities • Growth assessment

  24. Cranium Spine Long bone Skeleton development Dental development

  25. Cranial development 31

  26. Anterior Fontanel Size: 1.5~2cm at birth （0.6～3.6cm） Closure Time: 18~24m (4~26m)

  27. Anterior fontanel development

  28. Abnormality of anterior fontanel Small size or early closure： Microcephaly,etc Large size or delayed closure： Hydrocephalus, Cretinism,etc

  29. Abnormality of anterior fontanel Intracranial hypertension( Encephalitis, Meningitis,etc) Bulging fontanel： Sunken fontanel ： Dehydration

  30. Posterior Fontanel Size: 0~0.5cm at birth Closure Time: 6~8weeks

  31. Spinal development

  32. 38

  33. Long bone development • Endochondral: Length • Intramembranous: Width

  34. The sequence of appearance of secondary osteite

  35. Newborn 19-year-old Development of ring finger

  36. Bone Age It is that the age should be according to the number,density and morphological features of the osteite. Method: X-ray of left hand & wrist left knee(sometimes)

  37. Greulich-Pyle Method 8 yrs 7 mths 17 yrs

  38. Clinical applications of BA • To diagnose diseases • Hypothyoidism, • GHD, etc Delayed： • Congenital adrenal hyperplasia, Precocious puberty, etc Advanced：

  39. Clinical applications of BA • To predicte final height • Others

  40. Dental development • Primary teeth: • Mineralization:fetus • First eruption:4~10m • Last eruption:≤3y • Total number: 20

  41. Permanent teeth • Mineralization:0~2y • First eruption:6y ± • Last eruption:>18y • Total number: 32 47

  42. Abnormality of Dentition • Delayed eruption–>13m • Idiopathic,Hypothyroidism,etc • Crowding or Disorder – • Hypothyroidism, Brain dysplasia,etc • Failing to erupt – • Ectodermal dysplasia,Mechanical blockage,etc

  43. Patterns of physical growth • Other indices of physical growth • Regularities • Growth assessment

  44. continuous, series of distinct stages process Boys Girls

  45. Imbalance development of different • systems and organs

  46. Individual difference

  47. Patterns of physical growth • Other indices of physical growth • Regularities • Growth assessment

  48. Indices of growth assessment • Principles

  49. Indices of growth assessment • Principles

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