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Paediatric Interventions > Growth and Development > Flashcards

Growth and Development Flashcards

1
Q

How is growth achieved by cell growth specifically?

A
  1. An increase in cell number (hyperplasia)
  2. An increase in cell size (hypertrophy)
  3. An increased in intercellular substances (accretion)
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2
Q

What are the three life stages of growth and development?

A
  • Prenatal
  • Childhood
  • Adulthood
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3
Q

What are the five systems that make up child development?

A
  • Gross motor
  • Fine motor and play
  • Speech and language
  • Cognition and learning
  • Psychosocial and emotional
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4
Q

What factors can affect growth and development?

A
  • Genes e.g. genetic disorders
  • Hormones e.g. growth hormone
  • Nutrition e.g. failure to thrive
  • Mechanical e.g. fractures, spasticity
  • Environmental e.g. parenting
  • Physical activity e.g. skill development
  • Illness e.g. preventing early practice of skills
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5
Q

What three measurements do growth charts track?

A
  • Height
  • Weight
  • Head circumference
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6
Q

What can a fall below the percentile line on a head circumference chart represent?

A
  1. Microcephaly: abnormal smallness of the head, usually associated with intellectual disability
  2. Cranial stenosis: premature closure of the cranial sutures
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7
Q

What can an increase above a percentile line on a head circumference chart represent?

A

Hydrocephalus: increased CSF resulting in dilation of the ventricles and raised intracranial pressure.

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8
Q

If left untreated, but does hydrocephalus cause?

A

Results in corticol atrophy and related cognitive and functional impairment.

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9
Q

When are children approximately half of their adult height?

A

Two years of age

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10
Q

In what pattern does musculoskeletal growth occur in childhood and adolescence?

A

Distal to proximal

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11
Q

What are the defined periods of most rapid growth, for females and males?

A

Females: starts 8-10, peaks 11-12 years of age
Males: starts 10-12, peaks 13-14 years of age

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12
Q

What age range do growth charts generally cover?

A

2 - 18 years of age

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13
Q

What are the four types of growth plates in bones?

A
  1. Long bone epiphysis
  2. Ring epiphysis e.g. carpal bone
  3. Apophysis e.g. iliac crest
  4. Traction apophysis e.g. muscle action on bone
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14
Q

What are the contribution of bone growth from proximal/distal ends for the three main bones of the arm and leg?

A 
Humerus: 80/20%
Radius: 25/75%
Ulna: 20/80%
Femur: 30/70%
Tibia: 55/45%
Fibular: 60/40%
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15
Q

What three joints have the highest contribution to growth?

A

Shoulder, wrist and knee (bath tub position)

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16
Q

How is skeletal age determined?

A

Determined by an x-ray of the hand & wrist, to compare amount of cartilage to bone development of the carpal bones relative to reference data for health children.

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17
Q

What is the Risser sign?

A

It is the extent of ossification of the iliac crest apophysis that is used to indirectly assess the skeletal maturation of the spine in patients with scoliosis.

18
Q

What are the five grades of the Risser sign?

A

Grade 1: ilium is calcified at a level of 25% (corresponds to prepuberty or early puberty)
Grade 2: 50% (before or during growth spurt)
Grade 3: 75% (slowing of growth)
Grade 4: 100% (almost cessation of growth)
Grade 5: 100% and the iliac apophysis is fused to iliac crest (end of growth)

19
Q

What is Osgood Schlatter’s syndrome and when does it occur?

A

Inflammation of the growth centre (apophysis) that forms the tibial tubercle, occurring during peak height velocity.

20
Q

What is the Salter-Harris classification and how many classification levels does it involve?

A

System used to classify growth plate injuries

21
Q

What are the Salter Harris classification levels and what do they involve?

A
  1. Avulsion or shearing fracture - good prognosis as growing cells are undisturbed. Resting cartilage cells are fractured.
  2. Fracture passes through the metaphysis into the epiphyseal plate, but no fracture into the epiphysis.
  3. Fracture passes through epiphysis into the articular surface.
  4. Fracture through the epiphysis, physis and metaphysis.
  5. Compression or crush injury of the epiphyseal plate with no associated epiphyseal or metaphyseal fractures.
22
Q

What are the four main phases of neuromuscular development?

A
  1. Axonal outgrowth
  2. Myogenesis
  3. Synaptogenesis
  4. Synapse elimination
23
Q

What occurs during axonal outgrowth in neuromuscular development?

A

Axons from motor neuron cell bodies grow out to innervate the myotome region of the somite.

24
Q

What is myogenesis and how does it occur?

A

Myogenesis is the formation of muscle cells. Muscle tissue develops from mesoderm when mesoblasts differentiate into myoblasts.

25
Q

What is synaptogenesis and how does it occur?

A

It is the formation of neuromuscular junctions.

  • ACh receptors sprout over the surface of the muscle fibre.
  • As spinal nerves sprout and target individual myoblasts, motor end plates are formed.
26
Q

How does synapse elimination occur?

A

Elimination of extra synapses occur through neuronal death and axon retraction.

27
Q

When do slow and fast twitch muscle fibres become distinct?

A

Week 18 - 20

28
Q

What causes an increase in initial gross muscle size?

A

Increase in muscle cell size, but not cell number

29
Q

What occurs during the post-natal growth of the brain?

A
  • Increase in size of neurons
  • Increase in number of supporting cells (glia)
  • Continued development of neural processes and synapses
  • Continued myelination
30
Q

When is maximum density of synapse formation reached?

A

Approximately 6 - 12 months of age

31
Q

Where do neonates show greatest metabolic activity in the brain?

A

Sensory-motor cortex and brain stem

32
Q

Where is activity most prominent in the brain at 2-3 months of age?

A

Visual and parietal cortex, for development of visuo-spatial integrative function.

33
Q

Where is activity most prominent in the brain at 6-12 months of age?

A

Frontal cortex, for the development of higher cortical function.

34
Q

When does neuron myelination begin during development and when is it completed?

A

Begins in the fourth fetal month and most completed by the end of the third year of life.

35
Q

When can disturbances to the developing brain occur?

A
  • Prenatal
  • Perinatal
  • Postnatal
36
Q

What are some prenatal causes of brain disturbance?

A
  • Genetic
  • Fetal malformation during growth
  • Maternal infection
  • Toxins
  • Vascular/hypoxia/thrombic episodes
  • Metabolic-iodine deficiency/maternal thyroid disease
37
Q

What are some perinatal causes of brain disturbance?

A
  • Problems during labour and delivery e.g. obstructed labour, antepartum, haemorrhage, cord prolapse
  • Neonatal problems e.g. untreated jaundice, hypoglycemia, infection, IC haemorrhage, HIE
38
Q

What are the post natal causes of brain disturbance?

A
  • Infection e.g. meningitis
  • Hypoxia e.g. drowning
  • Trauma
39
Q

What are the basic mechanisms that support brain plasticity in children?

A
  • The persistence of neurogenesis
  • The elimination of neurons through programmed cell death
  • Postnatal proliferation and pruning of synapses until 16 years of age
40
Q

What factors influence the brain’s recovery from damage?

A
  • Size of lesion
  • Position of lesion
  • Type of insult
  • Timing of lesion
  • Integrity of areas surrounding/contralateral to region
  • Presence and duration of epilepsy
41
Q

Is there a linear relationship between the size of a brain lesion and the extent of damage caused?

A

There is no linear relationship, but larger lesions may include white matter and grey matter, creating visual/epilepsy/cognitive problems.

42
Q

Why does the site of a brain lesion influence the extent of damage?

A

Different areas of the brain have different metabolic demands, therefore some are less equipped to recover e.g. poor blood supply.

Paediatric Interventions (23 decks)

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