GROWTHASSESSMENT

KEERTHIKA.MIII BDS

INTRODUCTIONFACTORS AFFECTING AND DEVELOPMENTGROWTH PATTERNDIFFERENTIAL GROWTHGROWTH SPURTSGROWTH ASSESSMENT PARAMETERSSKELETAL AGEDENTAL AGECOMPUTERISED GROWTH FORECASTING

CONTENTS

• Growth and development are an extremely complex series of events that are best evaluated by careful examination at different stages

introduction

Factors affecting growth and development

• The regulation of growth in terms of rate, timing, form and character depend upon a combination and interactions of genetic and environmental factors

Genetic factors• The gene contained within the nucleus of

each cell are said to be necessary to produce an entire organism

• Polani indicated that size at birth relates as

18%Genome of fetus

20%Maternal genome

30%Unknown factors

• Any factor affecting physical growth is expected to be associated with effect on size & shape of cranial vault

Extracranial & intracranial pressure

• The size of a full term infant correlates well with the size of mother

Maternal factors

• Lack of nutrition delays growth ,affects size of body part, body properties , body chemistry ,quality & texture of some tissues

• Malnourished fetus wait for better time & with return of good nutrition growth takes place unusually fast until genetically determined curve is neared once mire it is called as catch up growth

nutrition

Rich childrenChildren living in

favourable socioeconomic condition tend to be

larger , display different types of growth & show variations in timing of

growth

Poor childrenLeachtig A et al concluded

that lower the socioeconomic Status

shorter are the children

SOCIOECONOMIC FACTORS

Group I[SKELETAL BONE GROWTH]

• GROWTH HORMONE• INSULIN• THYROTROPIC HORMONE

Group II[OSSIFICATION OF BONE]

• PARATHORMONE

Group III[PUBERTAL GROWTH SPURT]

• ANDROGENS• PROGESTRONE• OESTROGEN

Group IV[MISCELLENOUS]

• POLACTIN

HORMONES

• The close relation between the muscle and the bone growth is seen due to the fact that muscles influence the growth both as tissue affecting vascular supply &as a force element

MUSCULAR FUNCTION

• These are peptides that transmit signals within and between the cells

• They regulate mechanisms like generegulation, migration & differentiation

Growth factors

• There are various factors like nutrition and environment that may lead to difference in growth in different races

RACE

• Any systemic disease or prolonged debilitating disease has a profound affect on growth process of child

illness

People living in cold climate tend to have more of adipose tissue where as those living in hot climate are thinner

Growth also varies according to the season like it is faster in spring and summer; comparatively slower in winter

Climate and seasonal effects

• There exists a definite relation between physique and development according to somatotype

ADULT PHYSIQUE

• It is useful for fitness and increase in muscles mass but has no relation with linear growth

EXERCISE

• In a family there will always exist a difference between the various members of a family with respect to their individual size,maturation level & intelligence

FAMILY SIZE & BIRTH ORDER

• Size and maturational changes in a large population can be shown to occur with time

SECULAR TRENDS

• These can lead to inhibition of growth depending on the severity the severity of psychological disturbance

• This is due to the fact that in stress full condition children will display inhibition of growth hormone

Psychological disturbance

Growth pattern, variability and timing concept

• The physical arrangement of the body at any one time is a pattern of spatially proportioned parts

2 month fetus•Head takes about 50% of total body length•Limbs are rudimentary; trunks not developed

At birth•30% of body is occupied by head•Since trunk & head grows faster than head

adult•12% of body is occupied by head•Limb represents half of the body .lower limb > upper limb

Variability: since everybody is not alike it is very difficult but very Important to decide whether an individual is merely at the extreme of normal variation or falls outside the normal range . Thus it is expressed quantitativelyTiming : variation from timing arises because the same event happens for different individuals at different time

The human body does not grow at the same rate throughout the life

Different organs grow at different rates at a different amount and at different times called as differential growth

DIFFERENTIAL GROWTH

lymphoid

• It increases rapidly in late childhood & reaches almost 200% in adult

• By 18 years it undergoes involution to reach adult size

neural• Grows very rapidly and reaches adult size by 6

– 7 yrs• Very little growth occurs after that

genital• This shows negligible growth until puberty• But after that grows rapidly till adult level is

achieved

general

• Grow rapid upto 2-3 yrs & a slow phase till 10 yrs

• Growth again enters a rapid phase at 10 yrs & continues till terminating at 18-20 yrs. ‘s’ shaped curve

SCAMMON’S CURVE