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pediatrics > Growth and physical development of children. > Flashcards

Growth and physical development of children. Flashcards

1
Q

what are the 4 phases in human growth ?

A

intrauterine/ fetal phase - fastest period of growth

infantile phase - rapid but decelaarting growth

childhood phase

pubertal phase - growth rate peaks again

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2
Q

intrauterine growth is determined by ?

A

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

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3
Q

what are the fetal hormonal / growth factors ?

A

insulin growth factor 2

cortisol

human placental lactogen - has anti insulin sensitivity properties so sending more nutrients and glucose to the fetus

insulin

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4
Q

in the infantile phase there is a gain in what metric system but but lack in the other

A

gain in weight but lack in height gain

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5
Q

what contributes to growth in the childhood phase ?

A

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

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6
Q

which hormones causes the fusion of plates and therefore terminating any more growth ?

A

sex hormones

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7
Q

put the phases to the the contribution in percentage to the final height ?

A

intrauterine growth = 30 percent of final height
infancy = 15 percent
childhood = 40 percent
pubertal = the last 15 percent

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8
Q

what are the main measurement classifications for growth ?

A

weight
height
head circumference
BMI

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9
Q

height in children less than 2 years old is measured how ?

A

measured lying horizontally

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10
Q

height in children moe than 2 is measure how ?

A

measured while standing

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11
Q

when measuring the weight of the child what is very important ?

A

should be naked wearing a diaper can make a huge difference

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12
Q

why is important to not measure the parameters of growth independently and they should be plotted on a growth centile(SD) chart ?

A

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

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13
Q

what are the physical specification for 1-4 months ?

A

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

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14
Q

what are the physical specification for 4-8 month old

A

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

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15
Q

what are the physical specification for 8-12 month old

A

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

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16
Q

what are the physical sepcification for 1-23month years old ?

A

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

17
Q

2 years old physical specification ?

A

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

18
Q

at what BMI are you underweight ?

A

below 18.5

19
Q

at what BMI are you overweight and then obese

A

over 25

obese over 30

20
Q

at what age does the head circumference becomes almost as same to an adult ?

A

12 years = 52cm

21
Q

what should be suspected is the head circumferences increases by more than 1cm in two weeks during the first 3 months ?

A

hydrocephalus

22
Q

how is the head circumference measured ?

A

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)

23
Q

how is chest circumference measured ?

A

measuring tape placed on one nipple and entwined around to be brough back to the same nipple

24
Q

what is the resp rate and pulse in 3-6 years old

A

resp =22-34

pulse = 80-40

25
Q

what’s the resp and pulse in 6-12 yrs old ?

A

resp = 18-30

pulse =70-120

26
Q

what the resp and pulse for 12-18 yrs old

A

resp =12-16

pulse = 60-100

27
Q

when are the two stages in life rapid growth occurs ?

A

infancy

and adolescent - second fastest

28
Q

size at birth is heavily dependant on ?

A

father’s height and the growth hormone

29
Q

low birth weight gives a higher chance to what ?

A

later metabolic risk for childhood obesity

30
Q

in the infantile phase growth is driven by ?

A

nutrition and thyroid function

31
Q

what drives pubertal growth spurt ?

A

testosterone
oestradiol

causing the back to lengthen and boosts GH secretion

32
Q

describe the limits of the bands on the growth reference chart ?

A 
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)

pediatrics (19 decks)

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