Growth and physical development of children. Flashcards
what are the 4 phases in human growth ?
intrauterine/ fetal phase - fastest period of growth
infantile phase - rapid but decelaarting growth
childhood phase
pubertal phase - growth rate peaks again
intrauterine growth is determined by ?
the size of the mother and
health and nutrient intake and age of the mother
intrauterine abnormalities
normal placenta
infections
imprinting of genes - causing one gene to be inactive through methylation
11b oh steroid dehydrogenase type 2 - where only 20 percent of cortisol passengers to the fetus
what are the fetal hormonal / growth factors ?
insulin growth factor 2
cortisol
human placental lactogen - has anti insulin sensitivity properties so sending more nutrients and glucose to the fetus
insulin
in the infantile phase there is a gain in what metric system but but lack in the other
gain in weight but lack in height gain
what contributes to growth in the childhood phase ?
growth hormones are secreted by the pituitary glands which is then converted to insulin growth factor 1 in the liver which is the main determinant of growth in this phase
pitutory gh - to produce IGF-1 at the epiphysis
thyroid hormone
vitamin d
steroids - affects cartilage
which hormones causes the fusion of plates and therefore terminating any more growth ?
sex hormones
put the phases to the the contribution in percentage to the final height ?
intrauterine growth = 30 percent of final height
infancy = 15 percent
childhood = 40 percent
pubertal = the last 15 percent
what are the main measurement classifications for growth ?
weight
height
head circumference
BMI
height in children less than 2 years old is measured how ?
measured lying horizontally
height in children moe than 2 is measure how ?
measured while standing
when measuring the weight of the child what is very important ?
should be naked wearing a diaper can make a huge difference
why is important to not measure the parameters of growth independently and they should be plotted on a growth centile(SD) chart ?
a child’s low weight can be proportionate to the height if hors but abnormal if tall and should be in context with the family height
what are the physical specification for 1-4 months ?
height 50-70cm
growth : 2.5cm per month
weight : 4-8kg
weight gain : 100-200g per week
resp rate : 30-40 per minute
chest circumference bigger than the head , at birth 2,3cm less than head circumference
head circumference 35cm at birth
increase by 2cm per month till two months of age
then 1.5 cm per month till 4 months
at 3 months head circumference is 40 cm
abdominal muscles used to breath
legs slight bowed
what are the physical specification for 4-8 month old
height :70-75cm
growth 1.3cm per month
average weight :
weight gain 500g per month
5 MONTH DOUBLE THE BIRTH WEIGHT
resp rate -25-50
uses abdominal muscle
head and chest circumference are qual
head circumference increases by 1 cm per month until six month
at 6 month the head circumference is around 43cm
posterior fontanelle should fully closed at around 2 months
teeth appears at around 6 - 7 months - incisors first - gums red and swollen
what are the physical specification for 8-12 month old
approx 1.5 times birth length
weight -9.6kg
TRIPLE the birth weight
growth -500g per month
resp rate in one year (12 months) = 30-60bpm
head and chest circumference are equal
at 12 months the head circumference is 45cm
anterior fontanelle begins to close
what are the physical sepcification for 1-23month years old ?
height : 80-90cm
growth : 5-8cm per year
weight : 9-13kg
weight gain :130-250g per month
ONE YEAR FOUR TIMES THE BIRTH WEIGHT
resp rate : 24-40bpm
head size increases slowly approx 1.3cm every six months
chest circumference higher than the head circumference
2 years old physical specification ?
height -85-95cm
growth -7-13cm
weight :12-15kg
4times birth weight when reaching two years
resp :24-40bpm
around first year of age chest circumference is greater than the head circumference by 2.5cm
weight gain 1kg per year
brain reaches 80 percent of the adult size
at 2 years the head circumference is around 48cm
baby teeth have almost finished growing
at what BMI are you underweight ?
below 18.5
at what BMI are you overweight and then obese
over 25
obese over 30
at what age does the head circumference becomes almost as same to an adult ?
12 years = 52cm
what should be suspected is the head circumferences increases by more than 1cm in two weeks during the first 3 months ?
hydrocephalus
how is the head circumference measured ?
ordinal tap
placed over occipital protuberance at back
then above the ear on the side
just above the supraorbital ridges (where the height is measured)
how is chest circumference measured ?
measuring tape placed on one nipple and entwined around to be brough back to the same nipple
what is the resp rate and pulse in 3-6 years old
resp =22-34
pulse = 80-40
what’s the resp and pulse in 6-12 yrs old ?
resp = 18-30
pulse =70-120
what the resp and pulse for 12-18 yrs old
resp =12-16
pulse = 60-100
when are the two stages in life rapid growth occurs ?
infancy
and adolescent - second fastest
size at birth is heavily dependant on ?
father’s height and the growth hormone
low birth weight gives a higher chance to what ?
later metabolic risk for childhood obesity
in the infantile phase growth is driven by ?
nutrition and thyroid function
what drives pubertal growth spurt ?
testosterone
oestradiol
causing the back to lengthen and boosts GH secretion
describe the limits of the bands on the growth reference chart ?
2/3rd of the SD apart 25th 9th 2nd 0.4 gentiles below the mean
75th
91st
98th
99.6th gentiles above the mean
further away from the sd there is a pathological cause for the height (such as 0.4th and 99.6th)
