湘雅儿科精品课件-Growth and Development

1、第二章中南大学儿科学教研室To understand the regular To understand the regular rule of growth,development & rule of growth,development & the affecting factorsthe affecting factors To master the criteria of To master the criteria of the growth & the developmentthe growth & the development a continu

2、ous processa continuous process unbalanced growth of each unbalanced growth of each system system rules in rules in general general difference among individuals difference among individuals upper to lowerupper to lower proximal to distal proximal to distal rough to fine rough to fine inferior to sup

3、erior inferior to superior simple to complication simple to complication 遗传因素 genetic factors 环境因素 environmental factors 营养 nutrition 疾病 disease 孕母情况 pregnancy 生活环境 living environment Criterion of growth & nutrition Criterion of growth & nutrition conditioncondition differ in speed of BW inc

4、reasediffer in speed of BW increase the younger, the faster the younger, the faster first peak: newborn-1 year first peak: newborn-1 year second peak: adolescence second peak: adolescence at birth at birth boy boy （3.33.30.40.4）kgkg girl girl（3.23.20.40.4）kgkg increased 1 increased 1-1.5 kg-1.5 kg i

5、ncreased to 6 kg increased to 6 kg increased to 9 kgincreased to 9 kg BW(kg) BW(kg)(age of mons + 9)/2(age of mons + 9)/2 increased to 12 kg increased to 12 kg BW(kg)BW(kg)age of yrsage of yrs2 28 8 7-12 years7-12 years BW(kg) BW(kg)(age of yrs(age of yrs7-5)/27-5)/2 Criterion of bone growthCriterio

6、n of bone growthThe same regular rules as BWThe same regular rules as BWat birthat birth BH 50cm BH 50cm1year 1year BH 75cm BH 75cm 2years2years BH 85cm BH 85cm 2-12years2-12years BH(cm) BH(cm)age of yrsage of yrs6 67777上部量上部量 upper part upper part 从头顶至耻骨联合上缘从头顶至耻骨联合上缘下部量下部量 lower part lower part 从耻

7、骨联合上缘至足底从耻骨联合上缘至足底 3yrs (crown-rump length)3yrs (crown-rump length)Criterion of skull & spine growthCriterion of skull & spine growth SH/BH at birth 0.67 SH/BH at birth 0.67 14 years 0.53 14 years 0.53 下肢增长速度随年龄增长而加快下肢增长速度随年龄增长而加快 指距指距 finger distancefinger distanceCriterion of long bone gro

8、wth of upper limbNormal value: finger distance is scarcely less than BHCriterion of skull & brain growthCriterion of skull & brain growth at birth 33-34 cm at birth 33-34 cm 1 year 46 cm 1 year 46 cm 2 years 48 cm 2 years 48 cm 5 years 50 cm 5 years 50 cm 15 years 54-58 cm 15 years 54-58 cmC

9、riterion of thorax & lungs growthCriterion of thorax & lungs growth at birth CC 32cm at birth CC 32cm 1 year =HC 1 year =HC 1 year CC1 year CCHCHC Criterion of muscle, bone, fat, & Criterion of muscle, bone, fat, & skin growth in upper armskin growth in upper arm Criterion of nutriti

10、on condition Criterion of nutrition condition 1yr1yr gain rapidly gain rapidly 1-5yrs1-5yrs gain slowly gain slowly 5yrs5yrs 13.5cm best nutrition 13.5cm best nutrition 12.5-13.5cm better nutrition 12.5-13.5cm better nutrition 12.5cm malnutrition12.5cm malnutrition 骨骼发育颅骨缝 cranial suture closed in 3

11、-4 monsclosed in 3-4 mons after birth after birth前囟 anterior fontanelle closed in 1-1.5 yrsclosed in 1-1.5 yrs后囟 posterior fontanelle closed in 6-8 weeks closed in 6-8 weeks after birth after birth to reflex growth of vertebraeto reflex growth of vertebrae 3 physiologic arcuations 3 physiologic arcu

12、ations 3 mons raising head 3 mons raising head 颈椎前凸颈椎前凸 6 mons sitting 6 mons sitting 胸椎后凸胸椎后凸 1 year walking 1 year walking 腰椎前凸腰椎前凸骨骼发育1-9yrs1-9yrs ossific center ossific centerage(yrs) +1age(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 6yrs eruption 6yrs eruption 20-30yrs completion 20-30yrs c

13、ompletion 7-8yrs exchange 7-8yrs exchange骨骼发育乳牙乳牙 primary teeth 20 4-10mons eruption4-10mons eruption completion by 2.5yrs completion by 2.5yrs 2yrs number 2yrs numberage(mons)age(mons)（4646）恒牙恒牙 permanent teeth 32体格生长的评价体格生长的评价 evaluation 发育水平发育水平 developmental level 生长速度生长速度 growth speed 匀称程度匀称程度

14、equable degreeexisting by birth, persisting for a lifeexisting by birth, persisting for a life 角膜反射角膜反射 corneal reflex 结膜反射结膜反射 conjunctival reflex 瞳孔反射瞳孔反射 pupillary reflex 咽反射咽反射 pharyngeal reflex 吞咽反射吞咽反射 deglutition reflexnot existing by birth but appearing not existing by birth but appearing gradually after 4-6 monsgradually after 4-6 mons 腹壁反射腹壁反射 abdominal reflex 提睾反射提睾反射 cremasteric reflex 腱反射腱反射 tendon jerknot existing by birth but appearing not existing by birth but appearing gradually after 4-6 monsgradually after 4-6 mons 腹壁反射腹壁反射 abdominal reflex