Child And Infant Development

Question 1

Stages of child development -
Period - stage - age

Answer 1

1. Prenatal - germinal - conception-2 weeks
2. Prenatal - embryonic - 2-8 weeks
3. Prenatal - foetal - 8-40 weeks
4. Infancy - neonatal - birth-28 days
5. Infancy - infancy - 1-12 months
6. Early childhood - toddler - 1-3 years
7. Early childhood - pre-school - 3-6 weeks
8. Middle childhood - 6-10 weeks
9. Later childhood - prepubertal - 10-13 years
10. Later childhood - adolescence - 13-18/19 weeks

Question 2

Malnutrition

Answer 2

1. Aspects that are genetically predetermined and will unfold independently of experience
2. They are universal, sequential and relatively imperious

Question 3

Musculoskeletal system

Answer 3

1. Infants are born with more than 300 bones, primarily formed from cartilage
2. Throughout childhood bones begin to form a process of assassination

Question 4

Two divisions

Answer 4

1. Axel skeleton
2. A perpendicular skeletal

Question 5

Ribs and sternum

Answer 5

1. In infancy the barrel shaped chest is circular shaped for the first 2 weeks of life
2. Ribs are in a horizontal position
3. The xipboid process and manubrium consists of hyaline cartilage which do not ossify until late into adulthood potentially interfering which respiration at old age

Question 6

The vertebral column

Answer 6

1. Bones in the vertebral column of the newborn infant form 2 curves, one in the thoracic region and the other one in the sacral region and are both concave
2. As the infant gains head control secondary curves appear in the lumbar region which is convex and mobile
3. As the infant can sustain a sitting position a further secondary curve appear in the lumbar region
4. As the child gain mobility and assumes an upright the bipedal upright position the higher centre of gravity is compensated for by an exaggerated lordosis

Question 7

Skull

Answer 7

1. Bones in the cranium are connected by structures, during the first years of life they interlock and form jagged lines and later in life bones ossify and sutures are obliterated
2. Before birth bones in the skull are separated by membrane connective tissues called fontanelles

Question 8

The skull in 2 regions

Answer 8

1. Neurocranium
2. Viscerocranium

Question 9

Bones

Answer 9

1. Anterior
2. Posterior
3. Anterolateral

Question 10

Growth and maturation of the brain

Answer 10

1. Synaptogenesis occurs rapidly in the cerebral cortex during the first 2 years of life followed by a process of pruning
2. Mutenation occurs rapidly during the first 2 years of life then moves slowly into childhood

Question 11

Birth-5 years

Answer 11

1. Brain development is rapid
2. Most advanced development happens in the brain stem
3. Least advanced development in the cerebral cortex

Question 12

Middle childhood

Answer 12

1. Brain growth occurs in ‘spurts’
2. Two main spurts occur between 6-8 years of age
3. Development of fine motor and eye hand coordination at 10-12 years of age when the frontal loves of the cerebral cortex develop

Question 13

Teenage years

Answer 13

1. Two further spurts occur at 13-15 years of age
2. Development of perception at 17 years of age and continues into adulthood linking to frontal lobe development

Question 14

Cardiovascular system - changes at birth

Answer 14

1. Foetal circulation to neonatal circulation
2. Involves the initiation if respiration and expansion of the lungs and cessation of blood flow through the placenta
3. Closure of the foremen ovale
4. Constriction of the ductus arteriosus

Question 15

Postnatal circulation

Answer 15

1. After birth the cardiovascular and circulatory system assigns of an adult circulation
2. Substantial changes in relation to haemopoiesis in the first year of life
3. At birth the walls of the ventricles are largely the same thickness however with the increased systemic vascular resistance the walls of the left ventricle becomes thicker
4. First 5 months foetal haemoglobin remains present as the level of adult haemoglobin increases steadily

Question 16

Respiratory system - changes at birth

Answer 16

1. Foetal lungs filled with fluid have a high pressure
2. When the ductus arteriosus closes the vascular system becomes low in pressure and high in flow as the two sides of the heart separate and establish adult circulation
3. The lungs held together by foetal lung liquid must stiffen to resist atmospheric pressure and gravity
4. The process of sensitisation begins a few days before term and is mediated by T3 and cortisol where pulmonary epithelium becomes sensitive to stress hormone mainly adrenaline
5. During delivery as the head emerges and the body proceeds along the birth canal the chest wall is compressed increasing intrathoracic pressure which drains the lung of foetal lung fluid

Question 17

Respiratory development of the newborn

Answer 17

1. Alveolisation is completed by 6 months of age
2. Positioning of ribs is horizontal
3. The diaphragm is flatter and has a smaller, less convex curvature into the thorax
4. Smaller resting volume and predisposes to atelecasis
5. Have a prolonged expiratory time and a slight tracheal collapse in the upper airway to maintain end expiratory rate
6. Faster expiratory rate
7. Higher haemoglobin concentration
8. Chemoreceptors in the brainstem and carotid begin from birth to adult and respond to low oxygen and increases carbon monoxide

Question 18

Respiratory development of the infant

Answer 18

1. The chest wall is highly compliant with incomplete ossification of the ribs which are horizontal
2. Adult rib positioning is not complete until 10 years of age

Question 19

Respiratory development in childhood

Answer 19

1. Ages 1-2 years loose delayed expiration
2. A baby has around 20-50 million alveoli at birth and develop rapidly for the first 2 years then slower until 8 years old
3. Hyperactivity in the lung diminishes
4. Throughout childhood the lung volume increases and resistance decreases in a linear relationship to age and height until puberty

Question 20

Gastrointestinal tract development - salivary gland

Answer 20

1. Newborn salivary glands produce only a small amount of saliva containing amylase
2. Fully developed at 2 years of age

Question 21

Gastrointestinal tract development - Oesophagus

Answer 21

1. The pharyngeal Oesophageal swallow is an autonomic reflex for the first 3 months
2. The infant learns discriminative and motor skills as the stratified muscles establish cerebral connections

Question 22

Gastrointestinal tract development - stomach

Answer 22

1. The position and shape is high in the abdomen and is horizontal
2. Stomach capacity triples during the first 2 weeks

Question 23

Gastrointestinal tract development - liver

Answer 23

At birth the liver occupies 40% of peritoneal cavity

Question 24

Gastrointestinal tract development - small intestine

Answer 24

1. Length of small intestine doubles at puberty
2. At birth the intestine is thin walled because the musculature is not well developed
3. In infancy the pelvis is small and can accommodate very little of the small intestine

Question 25

Defecation

Answer 25

1. Occurs involuntary in infancy until around 18-36 months
2. As the nervous system matures the child becomes more aware of anal sensitivity and rectal pressure

Question 26

The renal system - kidneys

Answer 26

Adult valves of glomerular filtration are not reached until 1-2 years of age

Question 27

The kidneys at birth

Answer 27

Structural components of the kidneys have formed and nephrons have been established

Question 28

The kidenys in a newborn

Answer 28

1. Have a short loop of henle which reduces its ability to reabsorb Na+ and H2O creating dilute urine
2. Nephrons are small and immature with many of the tubular sections are not yet dully formed therefore they have a low glomerular filtration

Question 29

The bladder

Answer 29

1. During early childhood cigar shaped and does not taken on the adult pyramid shape until around 6 years of age
2. It is not until puberty that the bladder becomes located in the true pelvis place due to pelvic growth and the maturation of the pelvic bone
3. The neurones to the external urethral sphincter are not yet fully developed at ages 2-3 years of age
4. At 2-3 years old the bladder fills and the micturition reflex causes the bladder to empty
5. Once neurological maturation has occurred the process becomes a controlled central nervous system activity which blocks the reflex arc