linear growth or recumbent length - use from birth to 3 years - measure to nearest 0.5cm or 1/4in

most common method used to assess nutritional status 85% over weight >95% obese

module 3 peds growth and development Flashcards by Chelsey Miller

pediatric PMH

chronic illness
problems with organs
cancers
food allergies
any medication

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pediatric birth hx

full term
SGA?
LGA?
any complications prenatally or after delivery? infection?

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pediatric family hx

obesity
short or tall?
delayed puberty
genetic or metabolic disorders?

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hormones affecting growth during childhood

insulin-like growth factor 1
- birth till 20
- pulsatile secretions, 70% during sleep
thyroid hormone
- birth till 20
- stimulates GH, bone formation and reabsorption
Growth Hormone
- low at birth, peak around 5 and slow decline
Gonadal hormone
- 10-20, puberty

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organ systems and weight

closely related to growth in stature and organ development.

influenced by: nutrition -> inc. number and size of adipose cells.

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organ systems and length

skeletal growth is complete with epiphyses of long bones fuse: 90% or more of skeletal mass is present by 18.

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lymph system growth

well developed at birth
grows rapidly, adult size by age 6, peak at 10-12
during adolescence the tissues decrease and stabilize

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reproductive organ growth

grow slowly in prepubertal child but double in size during adolescence, full function and maturation during this time.

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organs with quickest physical development

brain
skull
eyes
ears

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fetal period growth of what dominates

head

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infant period growth of what dominates

trunk

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fat content and fetus

fat content of body increases slowly during fetal development, then rapidly accelerates the first 9 months of life

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fastest growing during childhood

legs

- wt gained at a steady rate

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fat and child growth

fat tissue inc. slowly until 7 years of age, then a prepubertal “fat spurt” occurs prior to the true linear growth spurt of puberty

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adolescence growth

trunk and legs elongate
skeletal mass and organ systems double in size
males: broader shoulders and greater musculature
females: wider pelvic outlets

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Height for infants

linear growth or recumbent length

use from birth to 3 years
measure to nearest 0.5cm or 1/4in

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head circumference

measure until 3 years old

put tape around occipital protuberance and the supraorbital prominence

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BMI and children

most common method used to assess nutritional status
< 5th percentile underwt
>85% over weight
>95% obese

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CDC growth chart

2 years and up

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WHO growth chart

birth to 2 years

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arm span in children

arm span = height in most children

failure to gain wt or ht may be due to

inadequate calories
congenital problems
constitutional delays
familial or other endocrine problems

age where height is most predictive

2, 3, 4

puberty for females

age at which breast is stage 2 or pubic hair is stage 2
complete by breast stage 4 or pubic hair stage 5
Peak height velocity occurs the year before menarche

puberty for males

external genital changes usually precede pubic hair development Ejaculation occurs at Tanner 3, semen production by Tanner 4 Peak height velocity is at a mean age of 13.5 years of age

precocious puberty female

development of breast tissue or pubic hair in girls - younger than 6 years for black females - younger than 7 years for white females

precocious puberty male

development of genitals or pubic hair in boys younger than 9

Tanner 1 breast

preadolescent | Only the nipple is raised above the level of the breast

Tanner 2 breast

Budding stage bud-shaped elevation of the areola areola increased in diameter and surrounding area slightly elevated

Tanner 3 breast

breast and areola enlarged | no contour separation

Tanner 4 breast

inc. fat deposits | areola forms a secondary elevation above that of the breast, this occurs in half of all girls.

Tanner 5 breast

Adult stage | areola is part of general breast contour and is strongly pigmented, nipple projects.

Tanner 1 female pubic

preadolescent | no pubic hair

Tanner 2 female pubic

Initial scarcely pigmented straight hair | along medial border of labia

Tanner 3 female pubic

sparse dark visibly pigmented curly pubic hair on labia

Tanner 4 female pubic

hair coarse and curly | abundant but less than adult

Tanner 5 female pubic

lateral spreading | type and triangle spread of adult hair to medial surface of thighs

Tanner 6 female pubic

further extension laterally, upward, or dispersed.

Tanner 1 testes

testes, scrotum, and penis are the same size and shape as in the young child

Tanner 2 testes

enlargement of scrotum and testes skin of scrotum becomes redder, thinner, and wrinkled. Penis no larger.

Tanner 3 testes

Enlargement of the penis, especially in length | further enlargement of testes, descent of scrotum

Tanner 4 testes

continued enlargement of penis and sculpturing of the glans. inc. pigmentation of scrotum

Tanner 5 testes

Scrotum ample | penis reaching nearly to bottom of scrotum

Tanner 1 male pubic

preadolescent | no growth of hair

Tanner 2 male pubic

slightly pigmenting longer straight hair often still downy. | usually at the base of penis, sometimes on scrotum

Tanner 3 male pubic

dark pigmented curly pubic hair around base of penis

Tanner 4 male pubic

Pubic hair definitely adult in type but not in extent | no further than inguinal fold

Tanner 5 male pubic

adult distribution | hair spread to medial surface of thighs but not upward

Tanner 6 male pubic

hair spread along linea alba

turner syndrome

absence of one of X chromosomes | - short stature: 5-10 percentile

klinefelter syndrome

1/1000 male birth - defect found in puberty ``` frontal baldness absent fewer chest hairs breast development female type pubic hair small testicular size poor beard growth narrow shoulders hide hips long arms and legs ```

Marfan syndrome

1/5000 births tall slender loose joints heart/aortic issues