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1、生长发育 Growth and Development,第二章,中南大学儿科学教研室,To understand the regular rule of growth,development & the affecting factors To master the criteria of the growth & the development,PURPOSE,Regular Rule of Growth & Development,a continuous process unbalanced growth of each system rules in general differenc
2、e among individuals,upper to lower proximal to distal rough to fine inferior to superior simple to complication,Affecting Factors of Physical Growth,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,体重 Body Weight (BW) Criterion of growth
3、& nutrition condition differ in speed of BW increase the younger, the faster first peak: newborn-1 year second peak: adolescence,at birth boy （3.30.4）kg girl（3.20.4）kg -1 mon increased 1-1.5 kg -3 mons increased to 6 kg -1 year increased to 9 kg BW(kg)(age of mons + 9)/2 -2 years increased to 12 kg
4、2-6 years BW(kg)age of yrs28 7-12 years BW(kg)(age of yrs7-5)/2,身高（长） Body Height(BH),Criterion of bone growth The same regular rules as BW at birth BH 50cm 1year BH 75cm 2years BH 85cm 2-12years BH(cm)age of yrs677,上部量 upper part 从头顶至耻骨联合上缘 下部量 lower part 从耻骨联合上缘至足底,3yrs (crown-rump length) Criteri
5、on of skull & spine growth SH/BH at birth 0.67 14 years 0.53 下肢增长速度随年龄增长而加快,坐高 Sitting Height (SH),指距 finger distance,Criterion of long bone growth of upper limb,Normal value: finger distance is scarcely less than BH,头围 Head Circumference(HC),Criterion of skull & brain growth at birth 33-34 cm 1 yea
6、r 46 cm 2 years 48 cm 5 years 50 cm 15 years 54-58 cm,胸围 Chest Circumference(CC),Criterion of thorax & lungs growth at birth CC 32cm 1 year =HC 1 year CCHC,上臂围 Upper Arm Circumference,Criterion of muscle, bone, fat, & skin growth in upper arm Criterion of nutrition condition 1yr gain rapidly 1-5yrs
7、gain slowly 5yrs 13.5cm best nutrition 12.5-13.5cm better nutrition 12.5cm malnutrition,骨骼发育,头颅骨发育 Growth of Skull,颅骨缝 cranial suture closed in 3-4 mons after birth 前囟 anterior fontanelle closed in 1-1.5 yrs 后囟 posterior fontanelle closed in 6-8 weeks after birth,脊柱的发育 Growth of Spine,to reflex grow
8、th of vertebrae 3 physiologic arcuations 3 mons raising head 颈椎前凸 6 mons sitting 胸椎后凸 1 year walking 腰椎前凸,骨骼发育,长骨的发育 Growth of Long Lone,1-9yrs ossific centerage(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 Growth of Teeth,6yrs eruption 20-30yrs completion 7-8yrs exchange,骨骼发育,乳牙 primary
9、teeth 20,4-10mons eruption completion by 2.5yrs 2yrs numberage(mons)（46）,恒牙 permanent teeth 32,体格生长的评价 evaluation,发育水平 developmental level 生长速度 growth speed 匀称程度 equable degree,神经反射的发育 Nerve Reflexes,existing by birth, persisting for a life,角膜反射 corneal reflex 结膜反射 conjunctival reflex 瞳孔反射 pupillary
10、 reflex 咽反射 pharyngeal reflex 吞咽反射 deglutition reflex,not existing by birth but appearing gradually after 4-6 mons,腹壁反射 abdominal reflex 提睾反射 cremasteric reflex 腱反射 tendon jerk,神经反射的发育 Nerve Reflexes,not existing by birth but appearing gradually after 4-6 mons,腹壁反射 abdominal reflex 提睾反射 cremasteric reflex 腱反射 tendon jerk,神经反射的发育 Nerve Reflexes,一哭二笑三咿呀 四月哈哈望妈妈 五抓六坐握足玩 七翻八爬九叫爸 十站对指十二走 看图说话在十八 两岁能用勺吃饭 喜怒分明命令发 三岁学穿鞋和袜 长成大娃别娇他,生长发育歌谣,Ballad for Growth & Development,谢谢,Thank You,
