湘雅儿科—医学课件

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1、生长发育GrowthandDevelopment第二章中南大学儿科学教研室Tounderstandtheregularruleofgrowth,development&theaffectingfactorsTomasterthecriteriaofthegrowth&thedevelopmentPURPOSERegularRuleofGrowth&Developmentacontinuousprocessunbalancedgrowthofeachsystemrulesingeneraldifferenceamongindividualsu

2、ppertolowerproximaltodistalroughtofineinferiortosuperiorsimpletocomplicationAffectingFactorsofPhysicalGrowth遗传因素geneticfactors环境因素environmentalfactors●营养nutrition●疾病disease●孕母情况pregnancy●生活环境livingenvironment体重BodyWeight(BW)Criterionofgrowth&nutritionconditiondifferinspeed

3、ofBWincreasetheyounger,thefasterfirstpeak:newborn-1yearsecondpeak:adolescenceatbirthboy（3.3±0.4）kggirl（3.2±0.4）kg-1monincreased1-1.5kg-3monsincreasedto6kg-1yearincreasedto9kgBW(kg)＝(ageofmons+9)/2-2yearsincreasedto12kg2-6yearsBW(kg)＝ageofyrs×2＋87-12yearsBW(kg)＝(ageofyrs×7-

4、5)/2身高（长）BodyHeight(BH)CriterionofbonegrowthThesameregularrulesasBWatbirthBH50cm1yearBH75cm2yearsBH85cm2-12yearsBH(cm)＝ageofyrs×6＋77上部量upperpart从头顶至耻骨联合上缘下部量lowerpart从耻骨联合上缘至足底＜3yrs(crown-rumplength)Criterionofskull&spinegrowthSH/BHatbirth0.6714years0.53下肢增长速度随年龄增长而加快坐高Sit

5、tingHeight(SH)指距fingerdistanceCriterionoflongbonegrowthofupperlimbNormalvalue:fingerdistanceisscarcelylessthanBH头围HeadCircumference(HC)Criterionofskull&braingrowthatbirth33-34cm1year46cm2years48cm5years50cm15years54-58cm胸围ChestCircumference(CC)Criterionofthorax&lungsgrowth

6、atbirthCC32cm1year=HC＞1yearCC＞HC上臂围UpperArmCircumferenceCriterionofmuscle,bone,fat,&skingrowthinupperarmCriterionofnutritioncondition＜1yrgainrapidly1-5yrsgainslowly＜5yrs＞13.5cmbestnutrition12.5-13.5cmbetternutrition＜12.5cmmalnutrition骨骼发育头颅骨发育GrowthofSkull颅骨缝cranialsuturec

7、losedin3-4monsafterbirth前囟anteriorfontanelleclosedin1-1.5yrs后囟posteriorfontanelleclosedin6-8weeksafterbirth脊柱的发育GrowthofSpinetoreflexgrowthofvertebrae3physiologicarcuations3monsraisinghead颈椎前凸6monssitting胸椎后凸1yearwalking腰椎前凸骨骼发育长骨的发育GrowthofLongLone1-9yrsossificcenter＝age(

8、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GrowthofTeeth6yrseruption20-30yrscompl