生长发育(英文).ppt

生长发育(英文).ppt

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GROWTH&DEVELOPMENTJieShaoM.DDepartmentofPediatricsZhejiangUniversity1.Definition2.Rulesofthegrowth&development3.Physicalgrowth4.Neuro-psychologicaldevelopmentGROWTH&DEVELOPMENTvGrowthImplieschangeinsizeofthebodyaswholeoritsseparateparts.vDevelopmentEmbraceschangesoffunction（differentiationandmaturation）,includingthoselargelyshapedbyinteractionwiththestructural,emotionalorsocialenvironment.1.DEFINITIONvConsecutivewithvariantvelocityvImbalancebetweendifferentsystemsvGeneralsequenceofdevelopmentvInterpersonaldifference2.RULESOFGROWTH&DEVELOPMENTGeneralsequenceofdevelopmentvUpperLowervProximalDistalvClumsyFinevLowergradeHighergradevSimpleComplexvUncoordinatedCoordinatedInterpersonaldifferenceNormalandabnormalarerelativeDynamicobservationismoreimportantAcomplexinteractionbetweengenes（nature）andenvironment（nurture）ContributingFactorsvInherence（Gene）vNutritionvDiseasevMaternalstatusvEnvironmentvCommonparameters&methodsvGrowthbeforepubertyvGrowthonpubertyRelatedSystemsGrowthvOsseousdevelopmentvDentaldevelopment3.PHYSICALGROWTHCommonparameters&methodsvBodyweightvBodylengthvSittingheightvHeadcircumferencevChestcircumferencevUpperarmcircumferenceCommonparametersvBodyweightBirthweight3.23.3kg（2.54kg）Relatedfactors:

GravidityandParity,gestationalage,gender,intrauterinenutritionstatusPhysiologicallossofbodyweight:

Bodyweightdeceasedby3-5%（9%ofbirthweight）overthefirst5to6daysafterbirthasinitiallossofECF,andrecoveredtobirthweightbythe7-10days.Doublebirthweight:

34moTriplebirthweight:

1yrQuadruplebirthweight:

2yrCommonparametersvBodyweightContributingfactors:

NutritionDiseasesThe1stYearthemostrapidgrowthstage1st6MoWt.（kg）=BW+Age（Mo）0.7（kg）712MoWt.（kg）=BW+60.7+（Age-6）0.25212YrWt.（kg）=Age（Yr）2+7（or8）Adolescent:

increasemorerapidlyCommonparametersvBodylength（standingheightorrecumbentlength）:

thelengthofhead,spineandlowerlimbsContributingfactors:

Gene,endocrine,intrauterinedevelopmentAtbirthaverages50cminfullterm1Yr75cm（increase25cm）2Yr85cm（increase10cm）212YrAge7+70（cm）（5-7cm/yr.）3YrshouldbemeasuredbyrecumbentlengthCommonparametersvSittingheight（fromcrowntobuttock）PresentthedevelopmentofheadandspineTrunk-legratio:

Newborn67%oftheBL4Yr60%oftheBLMenarche（girls）14Yr（boys）53%oftheBLDisorders:

Hypothyroidism,AchondroplasiavSpanCommonparametersvHeadcircumference-relatedtodevelopmentofbrainandskull-measurementismostvaluableinthefirst2yrsHeadcircumferenceAtbirth32-34cm3months40cm（increase6cm）1Yr46cm（increase6cm）2Yr48cm5Yr50cm15Yr5458cmHC1Yrlargerthanthatofhead,thedifferencevalueequalstotheyearsofageminus1（HC+Age1cm）CommonparametersvUpperarmcircumference（13.5cmGood12.513.5Medium12.5cmMalnutritionOsseousdevelopmentvCranialbonedevelopmentclosuresofsutures&fontanelsmainsutures3thor4thMoanteriorfontanel11.5Yrposteriorfontanels6th8thWk.lateralfontanels6th8thWk.vClinicalsignificanceOsseousdevelopmentvDevelopmentofSpine（VertebralColumn）Atbirth:

almoststraight3rdMo:

forwardcurvatureatneckcolumn6thMo:

backwardcurvatureatthoraciccolumn12thMo:

forwardcurvatureatlumbarcolumn67YrfixedbyligamentOsseousdevelopmentvOssificationcentersappearance&unionofepiphysealossificationTheossificationcentersoccurinanorderlysequencewithage;theycovertheentireperiodfrombirthtoearlyadulthood;ThechangesassociatedwithprogressivematurityarereadilyvisibleintheX-rayfilm;OsseousdevelopmentvBoneAgeThenumbersandprogressivechangesofossificationcentersaremeasuredbyX-ray,andstandardizedbycorrespondingchronologicalageandsex.Boneageretardationhypothyroidism,dwarfism,malnutritionBoneageadvancedprecociouspuberty,adrenalhyperactivityDentaldevelopmentvDeciduousteeth20begintoerupt78Mo（410Mo）complete22.5YrvPermanentteeth32begintoerupt6YrvIndividualdifferenceGene,endocrine,foodtexturevAbnormalHypothyroidismWhatisbonyage?

DescribemotordevelopmentmilestoneHAVEABREAKDevelopmentofneuro-psychologyvIncludingSensory,Motor,Language,EmotionPersonalityandBehaviorpatternsvIsthesameimportantasphysicalgrowthvDeterminedbyaninterplaybetweennature（geneticendowment）andnurture（predominantlyprovidedbyparents）maturationofneurologicalsystemlearningfromenvironment,resolutionofconflict,cognitivechange,cultural（ecological）adaptation4.NEURO-PSYCHOLOGICDEV.NEURO-PSYCHOLOGICDEVvBrainandNeurologicalSystemvSensoryandperceptionDevelopmentvMotorDevelopmentvSpeechandLanguageDevelopmentvCognitive,Social-emotionalDevelopmentBrain&NeurologicalDevelopmentvBrainweightAtbirth370gm（1012%ofBW）1Yr900gmAdult1500gm（2.5%ofBW）Thinnercotex,lessdendritesincompletemyelinationuntil4YrsSpinalcord2ndlumbarvertebrainneonate1stlumbarvertebraby4Yr.Sensory&PerceptionDevelopm