湘雅儿科精品-Growth-and-DevelopmentPPT课件

生长发育GrowthandDevelopment,第二章,中南大学儿科学教研室,Tounderstandtheregularruleofgrowth,development&theaffectingfactorsTomasterthecriteriaofthegrowth&thedevelopment,PURPOSE,RegularRuleofGrowth&Development,acontinuousprocessunbalancedgrowthofeachsystemrulesingeneraldifferenceamongindividuals,uppertolowerproximaltodistalroughtofineinferiortosuperiorsimpletocomplication,AffectingFactorsofPhysicalGrowth,遗传因素geneticfactors环境因素environmentalfactors营养nutrition疾病disease孕母情况pregnancy生活环境livingenvironment,体重BodyWeight(BW)Criterionofgrowth&nutritionconditiondifferinspeedofBWincreasetheyounger,thefasterfirstpeak:newborn-1yearsecondpeak:adolescence,atbirthboy（3.30.4）kggirl（3.20.4）kg-1monincreased1-1.5kg-3monsincreasedto6kg-1yearincreasedto9kgBW(kg)(ageofmons+9)/2-2yearsincreasedto12kg2-6yearsBW(kg)ageofyrs287-12yearsBW(kg)(ageofyrs7-5)/2,身高（长）BodyHeight(BH),CriterionofbonegrowthThesameregularrulesasBWatbirthBH50cm1yearBH75cm2yearsBH85cm2-12yearsBH(cm)ageofyrs677,上部量upperpart从头顶至耻骨联合上缘下部量lowerpart从耻骨联合上缘至足底,3yrs(crown-rumplength)Criterionofskull&spinegrowthSH/BHatbirth0.6714years0.53下肢增长速度随年龄增长而加快,坐高SittingHeight(SH),指距fingerdistance,Criterionoflongbonegrowthofupperlimb,Normalvalue:fingerdistanceisscarcelylessthanBH,头围HeadCircumference(HC),Criterionofskull&braingrowthatbirth33-34cm1year46cm2years48cm5years50cm15years54-58cm,胸围ChestCircumference(CC),Criterionofthorax&lungsgrowthatbirthCC32cm1year=HC1yearCCHC,上臂围UpperArmCircumference,Criterionofmuscle,bone,fat,&skingrowthinupperarmCriterionofnutritioncondition1yrgainrapidly1-5yrsgainslowly5yrs13.5cmbestnutrition12.5-13.5cmbetternutrition12.5cmmalnutrition,骨骼发育,头颅骨发育GrowthofSkull,颅骨缝cranialsutureclosedin3-4monsafterbirth前囟anteriorfontanelleclosedin1-1.5yrs后囟posteriorfontanelleclosedin6-8weeksafterbirth,脊柱的发育GrowthofSpine,toreflexgrowthofvertebrae3physiologicarcuations3monsraisinghead颈椎前凸6monssitting胸椎后凸1yearwalking腰椎前凸,骨骼发育,长骨的发育GrowthofLongLone,1-9yrsossificcenterage(yrs)+1骨龄：骨化中心与标准图谱比较，相当于某一年龄标准图谱时，该年龄即为骨龄。,骨骼发育,牙齿的发育GrowthofTeeth,6yrseruption20-30yrscompletion7-8yrsexchange,骨骼发育,乳牙primaryteeth20,4-10monseruptioncompletionby2.5yrs2yrsnumberage(mons)（46）,恒牙permanentteeth32,体格生长的评价evaluation,发育水平developmentallevel生长速度growthspeed匀称程度equabledegree,神经反射的发育NerveReflexes,existingbybirth,persistingforalife,角膜反射cornealreflex结膜反射conjunctivalreflex瞳孔反射pupillaryreflex咽反射pharyngealreflex吞咽反射deglutitionreflex,notexistingbybirthbutappearinggraduallyafter4-6mons,腹壁反射abdominalreflex提睾反射cremastericreflex腱反射tendonjerk,神经反射的发育NerveReflexes,notexistingbybirthbutappearinggraduallyafter4-6mons,腹壁反射abdominalreflex提睾反射cremastericreflex腱反射tendonjerk,神经反