L1: Growth Flashcards
Def of Growth
Def of Development
- Both growth & development are not separable (i.e., go parallel to each other).
- On the other hand: Delay or dissociation between them occurs in many pathological conditions.
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Factors affecting growth & development
Stages of Growth & Development
Pre-Natal
- Stages
Embryonic stage
- Period of
- Duration
- Affected by
Fetal stage
- Period of
- Duration
- Affected by
Peri-Natal Stage
From the 24th week of fetal life to the 7th day after delivery.
Post-Natal Stages
What is the Most critical stage of Post-Natal Stages?
Neonatal period
Neonatal period
- Period of
- Duration
- Affected by
Infancy
- Period of
- Duration
- Affected by
Childhood
- Period of
- Duration
- Affected by
Adolesence
- Period of
- Duration
- Affected by
Growth patterns
Def of Optimal Growth
Assessment of growth
A) History
B) Anthropometry
C) Dental eruption
D) Osseous maturation
E) Sexual development
Hx Taking in Assessment of growth
Methods of Pediatrics Anthropometry
- Comparison of this single measurement with average for age and sex.
- Plot this measurement on percentile charts/tables.
Methods of Weight Measurment
Weight at Birth
Weight Change at birth
Weight during infancy
Weight Change During Infancy
Weight in early childhood
Weight in Late childhood
Methods of Height Measurment
Height at birth
50 cm
Height During Infancy
Hight after 2 years
When do both weight & Height double & triple?
Methods of Measurment of Body Proportions
Def of (U/L ratio)
What does (U/L ratio) reflect?
(U/L ratio) in Cretenism
Normal (U/L ratio)
Significance of BMI in Pediatrics
BMI in Pediatrics
Method of Calculating Body surface area
What Does Head circumference (Occipitofrontal circumference) Depend on?
◈ Brain growth “not affected by malnutrition”
If the brain doesn’t grow adequately ⇢ Skull will be small “microcephaly”
Measurment of Head circumference (Occipitofrontal circumference)
Measuring Tape
Procedure of Head circumference (Occipitofrontal circumference)
The tape is applied over the glabella and supraorbital ridges anteriorly Over the occipital protuberance posteriorly.
Normal Measurments of Head circumference (Occipitofrontal circumference)
Rate of growth of head During 1st year (average)
Rate of growth of head During Rest of life
Measurments of Anterior fontanelle
At birth 2.5 X 2.5 cm.
When does Anterior fontanelle close?
Closes between 6 & 18 months
Method of Measurment of Chest circumference
Nipple line, person sitting, in the midway between inspiration & expiration.
Normal Chest circumference
Method of Measurment of Mid arm circumference
The Non-dominant arm Midway between the acromial & Olecranon process.
Values of Mid arm circumference
Sub Cutaneous skin fold thickness
Percentile meaning
How are Percentile tables Made?
obtained by measurements of thousands of normal children of same age, sex and ethnic group
Def of Percentile growth charts
They are a simplified graphic representation of the growth parameters (weight, height, head circumference, etc…) plotted against age.
- Horizontal axis ⇢ represents the age.
- Vertical axis ⇢ represents the growth parameter data (weight, …)
Value of Percentile growth charts
Types of Percentile growth charts
How to use percentile charts to assess growth?
Def of Growth Velocity
The change in growth over time.
Significance of Growth Velocity
A more sensitive index of growth than a single measurement.
Current growth point should be compared with previous ones to determine the interval growth velocity
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Def of Failure to Thrive
FTT is not a final diagnosis
…
Milk tooth eruption generally starts at …..
6 Months
Toddlers have the full complement of 20 teeth ……
by age of 2 years
The first permanent tooth erupts …..
at 6 years.
In most Egyptian children: Deciduous teeth (20 in number) & permanent teeth (32 in number) erupt
….
Order of Deciduous (milk) teeth
Order of Permanent teeth
irst milky teeth ⇢ lower central incisors (7-8 months)
…
irst permanent teeth ⇢ first molars (6-7 years
…
elayed teething ⇢ if there is no teething till age of ……
13 months.
Causes of delayed eruption of teeth
…… is the most important lab test in the evaluation of growth.
- t’s determined radiologically.
Bone age
Ossification centers present at birth in full terms ……
OC of distal end of femur & proximal end of tibia are absent in …..
congenital hypothyroidism.
Hand wrist X-ray ⇢ useful at ……
all ages of childhood.
Lower limb X-ray ⇢ useful in …….
early infancy.
Carpal centers Ossification & Age
Regarding Carpal Centers, The following data are usually assessed …..
Causes of Retarded bone age
Hypothyroidism.
Pituitary dwarfism.
Malnutrition.
Causes Advanced bone age
Thyrotoxicosis.
Congenital adrenal hyperplasia.
Iatrogenic (androgen medications).
Sexual Development
