1、Growth Lecturer LIU Xiao Dept.of Primary Child Health CareCHCMU2013七年制-2l Growth an increase in the number and size of cells;results in increased size and weight of the whole or any of its part.(quantity change数数量改变量改变)Definition2013七年制-32013七年制-4l Development change in the child that occurs over ti
2、me.Changes follow an orderly pattern that moves toward greater complexity and enhances survival.(quality change质量改变质量改变)growth&development2013七年制-5 growth(physical development)developmentW(weight)gain体重体重linear growth身高身高H.C.(head circumference)growth头头围围C.C.(chest circemference)growth胸胸围围 .sex matu
3、ration性成熟性成熟dental development牙齿发育牙齿发育skeletal maturation骨骼发育骨骼发育 2011七年制-6Periods of growth&development:Prenatal period:from conception to birthInfancy:age 0 yearToddlerhood:ages 1-2 yrsPreschooler:ages 3-5 yrsSchool age:ages 6-12 yrsAdolescence:Learning objectives Learning objectives Patterns of p
4、hysical growth before puberty青春期青春期 and in puberty Other indices of physical growth2013七年制-7Learning objectivesLearning objectives Patterns of physical growth before puberty and in puberty Other indices of physical growth2013七年制-8Indices of growthnweight，W nheight,Hncrown-rump length顶臀长顶臀长/sitting h
5、eight坐高坐高nhead circumference,H.C.nchest circumference，c.c.2013七年制-9 Physical Growth pattern before puberty2013七年制-10It is probably the best index of nutrition and growth.2013七年制-11weight gain with ageageage0m0m3m3m1y1y2y2y3y3y4y4y5y5y6y6y7y7y8y8y9y9yw(kg)36912141618202225282013七年制-122.The 1st growth
6、 spurt:the 1st year of life第第一个生长高峰一个生长高峰Patterns of weight gain 1.Different growth rate in different age2013七年制-132013七年制-14Attention nWeight formulae（P.13）do not be used in growth assessment.nWhy?2013七年制-15 Height身高身高 Length身长身长 3y3y2013七年制-16ageage0m0m3m3m1y1y2y2y3y3y4y4y5y5y6y6y7y7y8y8y9y9yH(cm)
7、5063758796 103 110 117 123 129 134 stature growth with age 2013七年制-17Pattern of Stature Growth2.The 1st growth spurt:The 1st year of life1.Different growth rate in different age2013七年制-182013七年制-19AttentionnStature formulae（P.14）do not be used in growth assessment.nWhy?2013七年制-20-crown-rump length-s
8、itting height3y3y2013七年制-21 sitting height changes with age2013七年制-220m0m2y2y6y6y10y10y14y14ySH(cm)33.553.364.773.286.1TH(cm)50.287.9116.2136.6162.5SH/TH0.670.610.560.540.53SH/TH changes with ageSH/TH changes with age2013七年制-23SH/TH changes with ageSH/TH changes with age2013七年制-244.Head circumferenc
9、eBe related with the growth of brain and skull颅骨颅骨2013七年制-25H.C.growth with age2013七年制-26ageageHCHC（cmcm）0m343m401y462y483y48.34y495y50 Patterns of H.C.Growth2.1st growth spurt:1st year of life1.Different growth rate in different age2013七年制-272013七年制-285.chest circumferenceAgec.c.（cm）h.c.（cm）Newborn
10、32341yr4646Comparison between C.C.and H.CPhysical Growth in Puberty2013七年制-31nWhen does the puberty begin?Secondary sexual characteristics appearGirls begin at age 911.Boys begin at age 1113.nSexual Precocity性早熟：性早熟：Secondary sexual characteristics appear Girls8y，Boys14y，Boys16y2013七年制-32 adolescenc
11、eGirls begin at age 911,Boys begin at age 1113.individual variation is substantial身体变化很大the 2nd growth spurt 第2个生长高峰(Peak of height velocity,PHV)in the average girls,the growth spurt peaks at 11.5 yr at 8.3 cm/yrIn the average boy,the growth spurt peaks at13.5 yr at 9.5 cm/yr.Slowing physical change
12、s permit the emergence of a more stable body image.2013七年制-332013七年制-34Learning objectivesLearning objectives Patterns of physical growth before puberty and in puberty Other indices of physical growth2013七年制-35 growth(physical development)developmentW(weight)gainlinear growthH.C.(head circumference)
13、growthC.C.(chest circemference)growth .skeletal maturationdental developmentsex maturation2013七年制-36Anterior Fontanel前囟前囟Size:1.5-2cm at birthClosure time:24mo2013七年制-37Posterior Fontanel后囟后囟Size:00.5cm at birthClosure Time:68weeks2013七年制-38 Small size or early closure：Abnormality of anterior fontan
14、el前前囟异常囟异常Microcephaly小头小头,etcHydrocephalus脑积水脑积水,etcLarge size or delayed closure：2013七年制-39Intracranial hypertension颅内压增高颅内压增高(Encephalitis脑炎脑炎,Meningitis脑膜炎脑膜炎,etc)Dehydration脱水脱水Abnormality of anterior fontanel2013七年制-40Spinal development脊柱发育脊柱发育AgeAgeMovementMovementMusclesMusclesCurvatureCurva
15、ture弯弯曲曲3mCervicalCervicalCervical颈曲颈曲（anterior）6mLumbarThoracicThoracic胸曲胸曲（posterior）12mLower extremities下肢LumbarLumbar腰曲腰曲（anterior）2013七年制-41The sequence of appearance of secondary centers Long bone development长骨发育长骨发育2013七年制-42Bone Age骨龄骨龄 a persons age measured by matching the bone development
16、(as shown by X rays)with bone development of an average person of known chronological age 实际年龄实际年龄according to the number大小大小,density 密度密度and morphological features形态特征形态特征 of the osteite 骨化中心骨化中心.2013七年制-43Method:X-ray of left hand，+left knee膝关节膝关节(18yTotal number:32/28 2013七年制-50Delayed eruption迟萌
17、出迟萌出 13mo Idiopathic特发性,Hypothyroidism甲低,familial家族性的,etcCrowding拥挤拥挤 or Disorder 混乱混乱 Hypothyroidism,Brain dysplasia 脑发育不良,etcFailing to erupt Ectodermal dysplasia外胚层发育不良,Mechanical blockage,etc Abnormality of Dentition2013七年制-51 growth(physical development)developmentW(weight)gainlinear growthH.C.
18、(head circumference)growthC.C.(chest circemference)growth .skeletal maturationdental developmentsex maturation2013七年制-52Tanner stage:The five stages of breast&female genitalia development2013七年制-53Tanner stage:The five stages of male genital development2013七年制-54femalebreast budding乳腺发育growth of pub
19、ic hair阴毛growth spurt peak生长高峰change in body shapegrowth of underarm hair腋毛first period(menarche初潮)adult breast sizemalegrowth of testes 睾丸growth spurt peaklengthening of the penis阴茎growth of pubic hairgrowth of underarm hairchange in voice range变声growth of facial hair 胡须2013七年制-55Case Anan,girl2013七年制-56Age Age LengthLengthWeightWeightCrown-Crown-rump rump lengthlength21mo83.1cm10.6kg48cm9 mo71.5 cm8.7kgHave a break!2011七年制-57
