生长发育(英文).ppt

GROWTH DEVELOPMENT JieShaoM DDepartmentofPediatricsZhejiangUniversity 1 Definition2 Rulesofthegrowth development3 Physicalgrowth4 Neuro psychologicaldevelopment GROWTH DEVELOPMENT GrowthImplieschangeinsizeofthebodyaswholeoritsseparateparts DevelopmentEmbraceschangesoffunction differentiationandmaturation includingthoselargelyshapedbyinteractionwiththestructural emotionalorsocialenvironment 1 DEFINITION ConsecutivewithvariantvelocityImbalancebetweendifferentsystemsGeneralsequenceofdevelopmentInterpersonaldifference 2 RULESOFGROWTH DEVELOPMENT Generalsequenceofdevelopment UpperLowerProximalDistalClumsyFineLowergradeHighergradeSimpleComplexUncoordinatedCoordinated Interpersonaldifference NormalandabnormalarerelativeDynamicobservationismoreimportantAcomplexinteractionbetweengenes nature andenvironment nurture ContributingFactors Inherence Gene NutritionDiseaseMaternalstatusEnvironment Commonparameters methodsGrowthbeforepubertyGrowthonpubertyRelatedSystemsGrowthOsseousdevelopmentDentaldevelopment 3 PHYSICALGROWTH Commonparameters methods BodyweightBodylengthSittingheightHeadcircumferenceChestcircumferenceUpperarmcircumference Commonparameters BodyweightBirthweight3 2 3 3kg 2 5 4kg Relatedfactors GravidityandParity gestationalage gender intrauterinenutritionstatusPhysiologicallossofbodyweight Bodyweightdeceasedby3 5 9 ofbirthweight overthefirst5to6daysafterbirthasinitiallossofECF andrecoveredtobirthweightbythe7 10days Doublebirthweight 3 4moTriplebirthweight 1yrQuadruplebirthweight 2yr Commonparameters BodyweightContributingfactors NutritionDiseasesThe1stYearthemostrapidgrowthstage1st6MoWt kg BW Age Mo 0 7 kg 7 12MoWt kg BW 6 0 7 Age 6 0 252 12YrWt kg Age Yr 2 7 or8 Adolescent increasemorerapidly Commonparameters Bodylength standingheightorrecumbentlength thelengthofhead spineandlowerlimbsContributingfactors Gene endocrine intrauterinedevelopmentAtbirthaverages50cminfullterm1Yr75cm increase25cm 2Yr85cm increase10cm 2 12YrAge 7 70 cm 5 7cm yr 3Yrshouldbemeasuredbyrecumbentlength Commonparameters Sittingheight fromcrowntobuttock PresentthedevelopmentofheadandspineTrunk legratio Newborn67 oftheBL4Yr60 oftheBLMenarche girls 14Yr boys 53 oftheBLDisorders Hypothyroidism AchondroplasiaSpan Commonparameters Headcircumference relatedtodevelopmentofbrainandskull measurementismostvaluableinthefirst2yrs Headcircumference Atbirth32 34cm3months40cm increase6cm 1Yr46cm increase6cm 2Yr48cm5Yr50cm15Yr54 58cmHC X 2SD MicrocephalyHC Hydrocephalus Commonparameters Chestcircumference CC Atbirth32cm1Yrequalstoheadcircumference 1Yrlargerthanthatofhead thedifferencevalueequalstotheyearsofageminus1 HC Age 1cm Commonparameters Upperarmcircumference 13 5cmGood12 5 13 5Medium 12 5cmMalnutrition Osseousdevelopment Cranialbonedevelopmentclosuresofsutures fontanelsmainsutures3thor4thMoanteriorfontanel1 1 5Yrposteriorfontanels6th 8thWk lateralfontanels6th 8thWk Clinicalsignificance Osseousdevelopment DevelopmentofSpine VertebralColumn Atbirth almoststraight3rdMo forwardcurvatureatneckcolumn6thMo backwardcurvatureatthoraciccolumn12thMo forwardcurvatureatlumbarcolumn6 7Yrfixedbyligament Osseousdevelopment Ossificationcentersappearance Osseousdevelopment BoneAgeThenumbersandprogressivechangesofossificationcentersaremeasuredbyX ray andstandardizedbycorrespondingchronologicalageandsex Boneageretardationhypothyroidism dwarfism malnutritionBoneageadvancedprecociouspuberty adrenalhyperactivity Dentaldevelopment Deciduousteeth20begintoerupt7 8Mo 4 10Mo complete2 2 5YrPermanentteeth32begintoerupt6YrIndividualdifferenceGene endocrine foodtextureAbnormalHypothyroidism Whatisbonyage Describemotordevelopmentmilestone HAVEABREAK Developmentofneuro psychologyIncludingSensory Motor Language EmotionPersonalityandBehaviorpatternsIsthesameimportantasphysicalgrowthDeterminedbyaninterplaybetweennature geneticendowment andnurture predominantlyprovidedbyparents maturationofneurologicalsystemlearningfromenvironment resolutionofconflict cognitivechange cultural ecological adaptation 4 NEURO PSYCHOLOGICDEV NEURO PSYCHOLOGICDEV BrainandNeurologicalSystemSensoryandperceptionDevelopmentMotorDevelopmentSpeechandLanguageDevelopmentCognitive Social emotionalDevelopment Brain NeurologicalDevelopment BrainweightAtbirth370gm 10 12 ofBW 1Yr900gmAdult1500gm 2 5 ofBW Thinnercotex lessdendritesincompletemyelinationuntil4YrsSpinalcord2ndlumbarvertebrainneonate1stlumbarvertebraby4Yr Sensory PerceptionDevelopment VisualDevelopmentAuditoryDevelopmentTasteandOlfaction MotorDevelopment NeurologicalDevelopment Tone deeptendonreflexes primitivereflexesclearlyelicitableinthenewbornthroughages3 4moGrossMotorMilestonesFineMotorMilestones GrossMotorDevelopmentTimetable Prone lifthead Headup1moChestup2moUponelbows3moUponhands4mo GrossMotorDevelopmentTimetable RollingLateraltoback1 2moFronttoback3 5moBacktofront4 5mo6 8mo GrossMotorDevelopmentTimetable SittingSitwithsupport tripod 5 6moSitwithoutsupport7 8moGetuptosit8mo GrossMotorDevelopmentTimetable CreepingCrawlingbydraggingrestofbody pelvisonfloor8moCreeps handsandkneesonfloorwithfeetandtrunkraised pointreciprocal10 12moCreepsupstairs18mo GrossMotorDevelopmentTimetable StandWalkingSteppingreflexPositivesupportreflexBounce5 6moPulltostand8 9moCruise9 10moStand11moWalkalone12 15moJumpinplace24mo 二抬四翻六会坐 七滚八爬周会走 FineMotorDevelopment 1stmonthfist3rd 4thmonthgraspobject6th 7thmonthtransfersobject9th 10thmonththumb fingergrasp pincer 12th15thmonthscribbles18 24thmonthplay FineMotorDevelopment Speech Language DefinitionsPerceptionExceptionPhonologySemanticsSyntaxPragmaticsMetalinguistics ReadingCtr Visualconnectcortex PrimaryVisualCortex Reception processing Wernicke Primary