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58 Cards in this Set
- Front
- Back
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What is the pathway for GH secretion, and what cofactor is required for uptake in tissue?
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Hypothalamas secretes GHRH, pituitary secretes GH, Liver secretes IGF-1 (stimulates uptake into muscle and skeleton)
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Where is somatostatin produced, and what is its function/
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Hypothalamus, transported to pituitary to inhibit GH release.
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What hormone made by adipose tissue is thought to trigger Puberty?
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Leptin: informs the CNS that adequate nutritional requirements are met to support puberty
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Role of sex hormones in puberty
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testosterone secreted during puberty triggeres the release of gonadotropins (LH, FSH), which stimulates more sex hormones.sex hormones stimulate GH which in turn increases IGF-1.
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What is the mean ages when skeletal muscle growth is complete? (closure of epiphyses)
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17.5 +- 2 years in men and 14.5 +- 2 years in women, but skeletal mass continues to increase till 30 with appositional growth
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Age range where stature is stationary
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30 to 50 years, then it begins to decline
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At what age is Lymphatic a tissue at its peak, and what is its size in relation to adult lymphatic tissue?
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10-12, and is double adult size
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What is the most rapid and critical time period of brain growth?
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birth to 2 years. is 80% complete by then. (will continue to grow remainder until 12 to 15)
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Growth of skull after age 15 is due to what
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growth of air spaces in sinuses, and thickening of skull bones and scalp
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Which body parts grow fastest during childhood?
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Legs
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Of the adults who are obese, what % were obese during childhood, adolescence?
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30% during childhood, 70% during adolescence.
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How much of the total weight gained during pregnancy is the growing fetus?
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5 to 10 pounds. the remainder is from placenta, blood and fluid volume, amniotic fluid, breasts, and fat reserves.
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During what stage of gestation is the fetus most susceptible to NTD's due to folate deficiency?
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conception to 8 weeks
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Period of gestation when mothers should most definitely avoid certain antibiotics (tetracycline) due to their effects on enamel
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6-9 weeks enamel is most susceptible to hypoplasia and staining
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Women who gain excess weight during pregnancy may be at risk for what?
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future obesity and its associated consequences
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Physical signs of osteoporosis and thinning of vertebral bones
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increased kyphotic curve, shortening stature, increased cervical lordosis to compensate, patient seems to be sinking into their hips
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Which body fat distribution is considered pathologic and what problems can it lead to?
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central obesity (apple shape) associated with type II diabetes, hyperlipidemia, stroke, ischemic heart disease.
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Percentage of adult population that is overweight/obese?
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65% are overweight, 30% are obese, and 5% are morbidly obese
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What % of body fat is in the subcutaneous tissue layer. (this is how the triceps skinfold test works?
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50%
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What is the normal deviation of weight in healthy term infants born to parents of the same weight?
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6 ounces
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Babies greater than 10 lbs at birth, or significantly larger than siblings are at risk for what?
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acute lymphatic leukemia
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Length measurement of choice for infants?
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recumbent length. infant is supine on measuring device, legs are stretched
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Normal length of term newborns falls in what range
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45 and 55cm, 18 to 22 inches
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Black babies normally weigh how in comparison to white babies?
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181-240 grams less
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Variation of weight in healthy term newborns?
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2500 to 4000 grams, or 5 lbs 8 ounces to 8 lbs 13 ounces
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Babies should triple their birth weight by what age
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12 months
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How often should you measure the childs head circumference until age 6?
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every visit until 2, then once a year until 6. at birth should be 12.5 to 14.5 inches. at 2 is 2/3 of adult size
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relationship of the head to the chest circumference
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head >chest by 2cm until 5 mths, head=chest 5 mths till 2 years. after 2 years chest>head
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Based on the neuromuscular maturity chart, how can you distinguish a premie and term infant
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premies, based on degree of prematurity will favor extension of limbs, term infants will flex and resist extension. #s are assigned based on levels of this
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Length of gestation for black babies as opposed to white babies, and degree of maturity
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gestation is 9 days shorter, and they are more mature for gestational age
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What is considered pre term, term and post term?
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pre term, <37 weeks, term 37-41 weeks, and post term >41
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What percentiles for weight is considered appropriate for gestational
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10 to 90% is considered AGA, <10% is SGA, >10% is LGA
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At what age is standing age measured in a toddler
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24 to 36 months, if you use the length, you must plot it as length instead of height, as it will be longer, due to toddler lordosis
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What are the expected growth patterns for african american babies?
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fastest growing to 9-10 years boys, 14-15 girls, leanest, tallest (tied with white kids), first to puberty
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What are the expected growth patterns for white babies?
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slower than black kids to 9-10 years boys, 14-15 girls, tallest (tied with black kids), fatter at birth than black babies, 2nd leanest, 2nd fastest in growth.
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Growth patterns for Asian and Mexican babies
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mexicans, fattest at birth, slowest growing, last to puberty, second shortest Asians: smallest at birth, thin, smallest breasts after puberty,
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Height based on socioeconomic status in same race .
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wealthy children are taller
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What is the percentage of overweight and obese children in the US
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16% of children and adolescents 5-20, an additional 31% are at risk for being overweight. this continues to rise
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How often should height measurements be made to determine height velocity
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12 months apart, no closer than 10 months, no more than 14
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How is arm span measured? what disases can altered arm span to height ratio indicate?
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middle fingertip of one hand with arms outstretched to the middle fingertip to the other. >marfan or kleinfelters syndrome
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In what % of girls will breasts begin developing before appearance of pubic hair
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66%
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What SMR stage does menarche usually occur?
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SMR 4, or breast stage 3 to 4
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What are the P tanner stages in men?
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stage P1 to P6: Describe pubic hair texture, amount and distribution (1 is no hair, 6 is adult distribution with hair along linea alba)
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What are the G tanner stages in men?
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G1-G5, measures length, thickness, and descent of the penis, testicles, and scrotum. (1 is childlike, 5 is full adult stage)
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What are the P tanner stages in a female?
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P1-P6, describes pubic hair texture, distribution, and amount. (1 is no growth, 6 is full lateral and upward extension(seen in only 10% of women))
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What are the M tanner stages in women?
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M1-M5, (1 only nipple is raised, 5 is adult, areola is part of breast contour and is strongly pigmented, nipple projects.
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Development of breast tissue or pubic hair in girls before what ages should be investigated?
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6 for black girls, 7 for white girls
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Development of genitals or pubic hair before what age in boys should be investigated?
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9 years
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The normal woman should gain how much weight during pregnancy?
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25 to 35 pounds total. 2-4 lbs for 1st trimester, then 1 lb per week for 2nd/3rd trimester. women who start below weight should gain more, fat women should gain less
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How much weight should a woman with twins or a woman with triplets gain?
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twins:35-45 lbs total, triplets 50 lbs
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Clinical features of acromegaly
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exaggerated brow, course features, huge hands and feet
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Clinical features of cushings
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buffalo hump fat distribution, pendulous fat pad on chest and abdomen covered with striae, moon facies, thin extremities
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Clinical features of hydrocephalus
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in infant will have head enlargement, widening sutures, and bulging fontanels, lethargy, irritability, weakness, and setting sun eyes (caused by paresis of upward gaze)
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Failure to thrive features.
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slow or retarted physical, mental, and emotional growth, increased susceptibility to infections. think of possible abuse
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Achondroplasia
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normal trunk, head, wrists, feet, but tiny stubby long bones. may have spinal stenosis causing paresis, and central obstructive apnea
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hypopituitary dwarfism
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(growth hormone deficiency) child with short stature who appears younger than stated age.
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precocious puberty
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secondary sexual characteristics before their time. could be caused by pituitary tumor, adrenal tumor, or gonadal tumor
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Turner syndrome
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absence of 2nd X chromosome in women. absence of sexual development. webbed neck, low posterior hairline, small mandible, epicanthal folds, high arched palate, shield shaped chest with hypoplastic nipples, short stature, >carrying angle of elbow. heart and urinary tract congenital abnormalities
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