General Physical Growth

Question 1

What controls tooth control?

Answer 1

high genetic control

Question 2

Four stages of growth

Answer 2

Prenatal: conception to birth - 40 weeks

Infancy: birth - 2 yrs

Childhood: 2-10 (f) & 2-12 (m)

Adolescence: 10-18 (f) & 12-20 (m)

Question 3

Growth curve

Answer 3

rapid accelerating prenatal -> rapid decelerating postnal growth for 2-3 yrs -> period of relatively slow incremental growth during childhood -> growth acceleration for 2-3 yrs during pubertal adolescence

Question 4

Why are growth charts helpful?

Answer 4

Help visualize an unexpected change in growth pattern

Question 5

Pubertal Growth Spurt

Answer 5

males 2 yrs later than females

females peak: age 12
males peak: age 14

Question 6

Key point about velocity curves

Answer 6

earlier onset = taller

“kids that grow earlier = grow longer

Question 7

Growth Spurt: Height vs. Jaws

Answer 7

On average, growth spurt of jaws is at a similar time as growth spurt of height

Change of 2 or more percentile groups can signal physical or emotional abnormalities

Question 8

Changes in Body Proportions

Answer 8

Head = 2x
Trunk = 3x
Arm = 4x
Leg = 5x

Question 9

Cephalocaudal Growth

Answer 9

Fetus @ 3 months = head at 50% of total body length

Adult = 12%

Question 10

Craniofacial Growth

Answer 10

Infant: large cranium, small face

Question 11

Classic way to determine growth of patient

Answer 11

hand/wrist radiographs

radiographs assess skeletal age by comparing the degree of ossification of wrist, hand, and finger

Skeletal maturity indicators (SMIs) are used to identify maturation levels

Question 12

Four Stages of Maturation Used

Answer 12

Epiphyseal widening on phalanges

Ossification of adductor sesamoid of thumb

Capping of epiphyses over their diaphyses

Fusion of epiphysis and diaphysis

Question 13

Hand-Wrist vs. Skeletal Growth

Answer 13

Ossification of sesamoid adductor prior to pubertal growth spurt (S, SMI 4)

Note complete union of epiphysis and diaphysis of the distal phalanx of middle finger signifies end of pubertal growth spurt (DP3f, SMI 8)

Note complete union of epiphysis and diaphysis (fusion) of radius at near completion of skeletal growth (Rf, SMI 11)

Question 14

Cervical Vertebral Maturation

Answer 14

determines skeletal development

Acceleration: Fishman’s Stage 3 and 4
Concavities C2 & C3, Lower border C4 flat, C3/C4 rectangular

Deceleration: Stage 7 and 8
Noticeable concavities C2/C3/C4, Shape of C3/C4 square

Finalization: Stage 11
Deep concavities C2/C3/C4, C3/C4 predominance of height over width

Question 15

Can tooth development be used?

Answer 15

Variations in factors such as sex, race, and environment, chronologic age is unreliable for the prediction of human growth and development

Question 16

What are stages D,E,F, and G

Answer 16

Stage D: Crown formation complete to CEJ, root formation begins

Stage E: root length shorter than crown height, root bifurcation has begun

Stage F: root length greater than crown height

Stage G: walls of the root canal are parallel, open apex

Question 17

Pediatric Vital Signs

Answer 17

Respirations: dec w/ age
HR: dec w/ age
BP: inc w/ age

Premature Pulse to over 14: 145-70
Premature Resp to over 14: <40, 12-18

Question 18

Normal Vitals for Children

Answer 18

Pulse: (3)-110, (5)-100, (12)-75, (Adult)-70
Sys BP: (3)-100, (5)-100, (12)-110, (Adult)-120
Dia BP: (3)-65, (5)-65, (12)-70, (Adult)-75
Resp: (3)-25, (5)-20+, (12)-20-, (Adult)-15

Question 19

Hypertension for a child

Answer 19

Avg systolic bp and/or diastolic bp that is >95th percentile for gender, age, and height on 3+ occasions

Age 5: 110/70
Age 12: 120/80
Age 16: 130/85