Normal Growth & Pubertal Development Flashcards
1
Q
Measurements Techniques for Growth in Children
A
Height
Length
Sitting Height
Head Circumference
Pubertal Staging
Target Height & Mid-Parental Height
Bone Age
2
Q
What Does Pubertal Staging Consist of?
A
- BREAST DEVELOPMENT (B): 1-5
- GENITAL DEVELOPMENT (G): 1-5
- PUBIC HAIR (PH): 1-5
- AXILLARY HAIR (AH): 1-3
- TESTICULAR VOLUME (T) 2mL-20mL, v. closely correlated to amount of testosterone
3
Q
What further History & Examination must be done to asses growth of children?
A
- BIRTH WGT. & GESTATION
- PMH
- FHx/SHx/SCHOOLING
- SYSTEMATIC ENQUIRY (looking for syndromes)
- DYSMORPHIC FEATURES (looking for syndromes)
- SYSTEMIC EXAMINATION
4
Q
Normal Growth Definition
A
No precise definition as various factors can affect growth e.g. ethnic subgroups & inequalities in health & nutrition
5
Q
Factors Influencing Height
A
- AGE
- SEX
- RACE
- NUTRITION
- PARENTAL HEIGHTS
- PUBERTY
- SKELETAL MATURITY (BONE AGE)
- GENERAL HEALTH
- CHRONIC DISEASE
- SPECIFIC GROWTH DISORDERS
- SOCIO-ECONOMIC STATUS
- EMOTIONAL WELLBEING
6
Q
Shape of Normal Growth (& which 3 categories does growth fall into in children)?
A
- INFANTILE: GROW V. FAST, MAINLY DRIVEN BY NUTRITION, COULD BE UP TO 20cm per year
- CHILDHOOD: GROW STEADILY, 5-6cm per year
- PUBERTAL: BIG GROWTH SPURT, SEX STEROIDS & GROWTH HORMONE, OCCURS FOR ~ 2-3 YEARS & THEN STOP GROWING; GIRLS START EARLIER THAN BOYS (10yrs compared to ~11yrs)
7
Q
Relationship between Growth & Other Changes in Puberty
A
- GIRLS DO GROWING AT BEGINNING OF PUBERTY - AS SOON AS BREAST BUDDING OCCURS (Tanner Stage B2), MENARCHE OCCURS LAST
- BOYS START GROWING LATER DURING ADVANCED STAGES of PUBERTY - TESTICULAR GROWTH (Tanner Stage G2 - T3-4mL) & PENILE GROWTH OCCURS 1ST
- CHILDREN WHO ARE OBESE ARE TALLER (for their FAMILIAL BACKGROUND), BUT THEY MAY NOT STILL BE TALL AFTER PUBERTY
