Pediactric Exam 2 - Toddler to Adolescent Flashcards
by 4 years
100% of their speech understandable
head circumference
1-3 years old
BMI
started at age 2
concrete operational
5-10 years old
school-aged
school aged middle childhood
5-10 years old
school issues self esteem respect modesty examine on table describe exam
stills murmur
grade 2/6
musical
vibratory midsystolic
normal
venous hum
soft, continuous, louder in diastole
normal
carotid bruit
midsystolic
louder on left
eliminated by compression of carotid
normal
scoliosis check
into 8-10 year olds
visual acuity
starting at 3 years
cover/uncover test
9 months to 3 years old
to see if eyes remain midline if cover one
ear exam
otoscopic exam
pull straight back on children
puberty female
8-13 yo
**african american before - don’t know why
puberty male
9-13.5 yo
early adolescent
10-14 yo
focus on present
- am i normal?
- peers important
middle adolescent
15-16 yo
females more comfortable, males more akward
transitional phase cognitive - concrete to formal
social - who am i - introspection
-independence - limit testing, experimenting, dating
late adolescence
17-20 yo
formal operational
adult appearance
toward real independence
adolescent behavior
related to developmental stage not necessarily to chronological age or physical maturity
BMI underweight
< 5th percentile
BMI at risk of overweight
> or = 85th percentile
BMI overweight
> or = to 95th percentile
HPV
recommended for boys and girls
fundoscopic exam
eye exam
pelvic/breast exams
not until patient reaches 21 years or 3 years after onset of sexual activity
adrenarche
activation of adrenal medulla for production of adrenal androgens
gonadarche
earliest gonadal changes of puberty- GnRH release
boys - LH - testosterone / FSH - sperm
girls - FSH - estrogen and follicle / LH - corpus luteum after ovulation
thelarche
beginning of breast development
pubarche
beginning of pubic hair
menarche
beginning of period
tanner stages
sexual maturity ratings
description of development of secondary sexual characteristics
5 stages
girls - breast and pubic hair
boy - genital and pubic hair
tanner 1 breast
preadolescent - elevation of nipple only
tanner 2 breast
elevation of breast and nipple as small mound
tanner 3 breast
further enlargement of breast/areola, no separation of contour
tanner 4 breast
projection areola/nipple to form secondary mound
tanner 5 breast
mature stage, projection of nipple only
female pubic hair tanner 1
no hair
female pubic hair tanner 2
long, downy hair, straight along labia
female pubic hair tanner 3
darker, coarser, curlier hair, over pubic symphysis
female pubic hair tanner 4
coarse and curly
not including thighs
female pubic hair tanner 5
hair adult in quantity and quality
-medial surfaces of thighs, not over abdomen
order of female puberty changes
breast buds
pubic hair
growth spurt peaks age 12
menarche at tanner 4
complete puberty in 1.5-8 years (average 4 years)
tanner stage male 1
no pubic hair
tanner stage 2 male
pubic hair sparse, straight
penis slight enlargement
testes larger slightly reddened
tanner stage 3 male
pubic hair dark, coarse, curlier
-over pubic symphysis
penis larger in length
testes further enlargement
tanner stage 4 male
pubic hair coarse and curly
not no thighs
penis further enlargment length and breadth
testes firther enlarged scrotum darkens
tanner stage 5 male
pubic hair on medial thigh
penis adult size and shape
testes adult size and shape
order of changes male puberty
testicular growth
pubic hair
penile enlargement
growth spurt peaks age 14
complete in 2-5 years (average 3 years)
