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MEASUREMENT OF GROWTH ANTHROPOMETRY

MEASUREMENT OF GROWTH ANTHROPOMETRY. GROWTH. An increase in size of all tissues in the body. Growth is affected by : Genetic Hormonal Nutritional status Environmental factors. GROWTH. Parameters : Anthropometric measurements 1. weight, height, head circumference 2. proportion :

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MEASUREMENT OF GROWTH ANTHROPOMETRY

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  1. MEASUREMENT OF GROWTH ANTHROPOMETRY

  2. GROWTH • An increase in size of all tissues in the body. • Growth is affected by : • Genetic • Hormonal • Nutritional status • Environmental factors

  3. GROWTH • Parameters : Anthropometric measurements 1. weight, height, head circumference 2. proportion : - sitting height - Upper / lower segment ratio • WEIGHT is determined especially by growing of 3 tissues: skeletal muscle, adipose tissue and bone • HEIGHT is determined by growing of the bone

  4. GROWTH • In acute protein and energy malnutrition, protein from skeletal muscle and fat from adipose tissue will be used. Weight will decrease, but not height. • In chronic protein and energy malnutrition, bone metabolism will disturb and could cause linear growth disturbance

  5. GROWTH • Three indices are commonly used in assessing the nutritional status of children:• Weight-for-age (W/A)• Length-for-age or Height-for-age (H/A) • Weight-for-length or Weight-for-height (W/H) • There are 2 type of assessment: • One time assessment • Growth monitoring (trend assessment)

  6. WEIGHING INFANT

  7. INTRODUCTION • Greet the mother & introduce yourself • Explain the procedure to the mother • Identify infant’s data : name, address, sex, date of birth birth weight, birth length

  8. WEIGHING INFANT • Infant is weighed nude or in a clean diaper oncalibrated beam or electronic scale • Older infant is weighed wearing a clean, disposable diaper • Remove infant’s clothing and be sure the diaper is clean and dry  • Center the infant on the scale tray  • Weigh infant to nearest 0.01 kg or 1/2 oz • Write the weight on the infant’s chart

  9. WEIGHING INFANT • Reposition and repeat weighing the infant (3 x) • Compare weights • Weight shoud agree within 0,1 kg or ¼ lb • If infant is too active, postpone the measure • Have parent stand on scale, tare, then read infant weight

  10. MEASURING INFANT LENGTH

  11. MEASURING INFANT LENGTH • Length is measured with a suitable measuring board • Use a calibrated length board with a fixed headpiece & movable footpiece which is perpendicular to the table surface • Measure infant without shoes & wearing light underclothing/diaper

  12. MEASURING INFANT LENGTH • His back in the centre of the length board→ child is lying straight & his shoulders & buttocks are flat. • The child’s eyes should be looking straight up. • Both legs should be fully extended & the toes should be pointing upward with feet flat against the footpiece

  13. MEASURING INFANT LENGTH • While the 2nd measurer hold the infant’s head, the measures aligns the infant’s trunk & legs and bring the footpiece firmly against the heels. • The measurer place one hand on infant’s knees to maintain full extension of the legs

  14. MEASURING INFANT LENGTH • Frankfort horizontal plane is parallel to the fixed headpiece • Frankfort horizontal plane is a line extending from the most inferior point of the orbital margin to the left tragion. The tragion is the deepest point in the notch superior to the tragus of the auricle

  15. MEASURING INFANT LENGTH • Measure length to 0.1 cm • Record measurement on chart • Reposition & remeasure • Measurements should agree to 1 cm

  16. HEAD CIRCUMFERENCE

  17. HEAD CIRCUMFERENCE • Head circumference is measured over the most prominent part of the occiput and just above supraorbital ridge • Use a flexible, non stretchable tape • Position the tape just above the eyebrows, above the ears & around the biggest part on the back of the head • Pull tape snugly to compress the hair

  18. HEAD CIRCUMFERENCE • Read the measurement to the nearest 0.1 cm • Write measurement on the chart • Reposition tape & remeasure • Measures should agree within 0.2 cm

  19. WEIGHING CHILDREN & ADOLESCENTS

  20. WEIGHING CHILDREN & ADOLESCENTS • A child >36 months is weighted standing on a scale • Use a calibrated beam balance/electronic scale • Child must be able to stand without assisstance • Child stands on center of scale platform • Reposition& repeat • Measures should agree within 0.1 kg

  21. MEASUREMENT OF HEIGHT

  22. MEASUREMENT OF HEIGHT • Use calibrated vertical stadiometer with right angle headpiece • Ask the child to take off the shoes • The child stands with heels, buttocks, shoulders & head touching a flat upright surface • Stand with heel together, legs straight, arms at sides, shoulders relaxed • The head should be positioned in the Frankfurt plane

  23. MEASUREMENT OF HEIGHT • Ask the child to take a deep breath, then let it out & relax his shoulders • Bring the perpendicular headpiece down to touch the crown of the head • Measurer’s eye are parallel with the headpiece • Read to nearest 0.1 cm • Reposition & remeasure • Agree within 1 cm • Record on the growth chart WDY

  24. SITTING HEIGHT

  25. SITTING HEIGHT • Use a calibrated vertical stadiometer with right angle headpiece • Ask the child to sit on a stool • The back of the head, thoracic spine & buttock should rest against the wall • The head should be positioned in Frankfurt plane • Ask the child to take a deep breath, then let it out & relax his shoulders • Bring the perpendicular headpiece down to touch the crown of the head • Read to nearest 0.1 cm

  26. SITTING HEIGHT • Upper body segment : height on scale- stool height • Lower body segment : standing height-upper body segment • Calculate the upper to lower segment ratio • Record the ratio on the appropriate curve

  27. UPPER TO LOWER SEGMENT RATIO • Indications • Growth Assessment • Differentiates collagen bone disease (skeletal dysplasia) from primary spine (e.g. Scoliosis) • Technique: Measurement • See Sitting Height for an alternative method of calculating segment heights • Lower segment: Top of pubic symphysis to floor • Upper segment: Top of head to top of pubic symphysis • Calculation: TotalHeight - LowerSegmentHeight • Interpretation: Normal upper to lower ratio • Birth  upper to lower ratio: 1.70 (Greatest ratio) • Postpuberty  upper to lower ratio: 0.89 - 0.95

  28. Perawakanpendek Idiopatik Patologis Variasi normal Familial short stature Constitutional growth delay Proporsional Disproporsional • Postnatal • Malnutrisi • PenyakitKronis • GIT, CP, ginjal, hematologi • Infeksi • Obatobatan • Kelainanpsikososial • Kelainanendokrin • Prenatal • IUGR • Faktoribu • Penyakitplasenta • Infeksi • Teratogen • Sindromdismorfik • Kelainankromosom Displasia skeletal Riketsia

  29. ACHONDROPLASIA

  30. CALCULATION OF MIDPARENTAL HEIGHT • Display father’s height and mother’s height on the growth chart • Boys : mother’s height+12.5 cm+father’s height 2 • Girls : father’s height-12.5 cm+mother’s height 2 • Draw the range in the growth chart

  31. CALCULATION OF MIDPARENTAL HEIGHT

  32. PLOTTING MEASUREMENTS • Select the appropriate chart for the age, sex & measurements • Calculate the child’s age • Plot the weight measurement on the growth chart appropriate for age & sex • Use a plotting aid such as a straightedge • Use the information in the clinical assessment process • Share the information with the family

  33. Grafik pertumbuhan : perempuan 0-36 bulan PB/U dan BB/U

  34. Grafik pertumbuhan : laki-laki 0-36 bulan PB/U dan BB/U

  35. WDY

  36. WDY

  37. WDY

  38. الحمد لله رب العالمين WDY

  39. STADIOMETER

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