Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
2012
Pediatrics I
Dra. M. San Pedro
08.13/09.08.09
Specific Objectives
To define & differentiate growth & development
To discuss the principles of development and its effects on the
child
To discuss the factors affecting growth and development
To discuss prenatal and organ development
PRENATAL DEVELOPMENT
0-280 days
Growth
An increase in size & mass
Quantitative
Development
An increase in function/skills
Qualitative
More complex & broader
May or may not be interchangeable but actually inseparable
from growth
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Intrauterine Nutrition
One Month
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Three Months
One month
Fetal Stage
Four Months
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Seven Months
Five Months
Six Months
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ORGAN DEVELOPMENT
Nine Months Early Postnatal Development
Alveoli inflate at birth (breathing begins)
The cardiovascular system changes at birth
The immune system becomes operative
Myelinization, layering, and CNS tract formation continue
Formation and growth of epiphyseal plates continue
Muscle mass and control increase
Hair changes in consistency and distribution
General Type
Growth spurt till 6 years, leveling off by late childhood
followed by another growth spurt towards adolescence
Neural Type
Rapid growth in 1 st 3 years then gradual slowing by mid-
childhood to 10 years followed by a small terminal increase at
adolescence then plateaus
Lymphoid Type
Lymphoid organs grow very rapidly, peaking at 12 years
then undergoing relative reduction after
Genital Type
An early plateau during childhood then growth peaks at
adolescence to adult life
Sensory Development
Periods Vision Hearing Others
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Preschool By 6 yr, Over 5 yr old, child 4 years of age Neutrophils = lymphocytes
Child macula complete can immediately 8 years Leukocyte count similar to
development locate a sound made adults
directly over his
head
Immunity
School By 7 yr of age, Newborn almost entirely IgG
Child visual acuity Maternal antibodies 1 st 6-9 months
20/20
Immunity of prematures < terms
Antibodies
IgM 1st to develop, 1 yr adult levels
IgG 4 years
Nervous System IgA Adolescence
6-12 months Myelinization completed
(some nerves 2 yr old)
Relative size of brain to total body weight
At birth 10% Lymphatic System
5 years 5% Lymphoid tissue
Adult 2% 6-7 years Peak growth (hypertrophy of
10 years Pineal body calcifies tonsils & adenoids) coincides w/
greatest susceptibility to ARI & GIT
infections
After puberty Relative reduction
Circulatory System Spleen
Normal FHB 140-160/min somewhat > in females At birth Largest lymphoid organ relating to
Heart horizontal, apex beat at 4 th ICS versus adults at 5 th ICS body
Complete Anatomical Closure At adult life Increases in weight to 12x,
Ductus venosus & foramen ovale 8 months or more does not atrophy like the nodes
Ductus arteriosus 1-3
months
Normal Cardiac Rate Digestive System
At 1-7 years 100-110/min Stomach Capacity
From 7 years <100/min Birth 30-90 ml
Blood pressure changes daily, increases w/ age 1 month 90-150 ml
1 year 210-360 ml
2 years 500 ml
Later childhood 750a-900 ml
Thereafter depends on feeding habits
Small Intestines
Birth 300-350 cm
1 year 1.5x increase in length
Puberty 700 cm
Large Intestines at birth
Ascending colon Short & increases w/ age
Sigmoid High in abdomen w/ meconium
Rectum Relatively longer
Urinary System
Kidney size
6 months old 2x birth size
1 year old 3x birth size
5 years old 5x birth size
Puberty 10x birth size
Glomerular function
12-24 hrs Normally may not void
5-6 years Mature function
Skeletal System
Respiratory System Ossification centers
Sinuses At 8-9 weeks AOG Primary
Newborn Small maxillary, ethmoidal Last 2 fetal mo Secondary at distal epiphyses of femur;
& sphenoidal absence at birth evidence of prematurity
3-7 years Frontal sinus appears Other secondary 400 at birth, 400 after
7-14 years Ethmoidal maximum size Skeletal age
After puberty Others maximum size 0-5 years Presence of ossification centers
Larynx 5-14 years Calcification of the cartilaginous areas
At birth 1/8 adult size but size relative to 14-25 years Epiphyseal fusion
body same as adult Stature measures Reflect only linear growth of bone
3 years Longer & wider in boys Shoulders, ribs & neck
Trachea Newborns 4 cm long, of adults Birth Shoulders elevated, neck hardly seen
Bifurcation of trachea 3-10 years Ribs slope down,
At birth T3-T4 neck appears longer
4 years T5 Vertebral Spine
12 years T5-T6 Birth Two concavities
3 months Cervical convexity appears
Walking Lumbar curvature shows
Blood 3 years Lumbar curvature fully developed
Hemoglobin
At term 80% fetal hemoglobin Muscular System
5 months of age 5% fetal hemoglobin
Muscles
WBC Birth 1/5 to of total body size
At birth Neutrophil predominant Early adolescence 1/3 of total body size
After 1 week of life Lymphocytes predominant Early adulthood 2/5 of total body size
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12-16 years Strength doubles ==>> asus.;-)
Growth in muscle mass
after maximal height Sometimes, in our relentless efforts to find the person we love we fail to recognize and
appreciate the people who love us. We miss out on so many beautiful things and simply
because we allow ourselves to be enslaved by our own selfish concerns. Go for the man
Cutaneous Structures of deeds and not for the man of words for you will find rewarding happiness not with the
man you love but the man who loves you more.
Skin & Hair
Newborn With vernix caseosa, also lanugo The best lovers are those who are capable of loving from a distance, far enough to allow
At 1 mo Sweat glands temperature function the other person to grow, but never too far to feel the love deep within your being. To let
By 2 years Scalp hair replaced by coarser hair go of someone doesn't mean you have to stop loving, it only means that you allow that
Subcutaneous Fat person to find his own happiness without expecting him to come back. Letting go is not
just setting the other person free, but it is also setting yourself free from all bitterness,
About 9 months Greatest hatred, and anger that is kept in your heart.
During 1st year Increases then diminishes
Adolescence Increases again girls > boys Do not let the bitterness lure away your strength and weaken your faith, and never allow
Second decade Body fat continually increases pain to dishearten you, but rather let yourself grow with wisdom in bearing it. You may
find peace in just loving someone from a distance not expecting anything in return. But
in girls while boys tend to
be careful, for this can sustain life but can never give enough room for us to grow. We
decrease after age 14 can all survive with just beautiful memories of the past but real peace and happiness
comes only with open acceptance of what reality is today.
There comes a time in our lives when we chance upon someone so nice and beautiful and
we just find ourselves getting so intensely attracted to that person. This feeling soon
becomes a part of our everyday lives and eventually consumes our thoughts and actions.
The sad part of it is when we begin to realize that this person feels nothing more for us
than just friendship. We start our desperate attempt to get noticed and be closer but in the
end our efforts are still unrewarded and we end up being sorry for ourselves.
You don't have to forget someone you love. What you need to learn is how to accept the
----------------------------- end of lecture-------------------------------- verdict of reality without being bitter or sorry for yourself. Believe me, you would be
better off giving that dedication and love to someone more deserving. Don't let your heart
run your life, be sensible and let your mind speak for itself. Listen not only to your
feelings but to reason as well.
Always remember that if you lose someone today, it means that someone better is coming
tomorrow: If you lose love that doesn't mean that you failed in love. Cry, if you have to,
but make sure that the tears wash away the hurt and the bitterness that the past as left you.
Let go of yesterday and love will find its way back to you. And when it does, pray that it
may be the love that will stay and last a lifetime........
--------------------------------------------
Next game daw sec a vs sec b a mjust see game daw.. goodluck sa
team ni piolo as well as sa team ni jethro!! Go go go;-)
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