生长发育(英文).ppt
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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
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