Pediatrics Pathological and Situational Questions – Answer

1. At the time of birth, the skin is covered:

A. Blood

B. Curd grease

C. Scales

D. Hair

E. Papules

 

2. For skin color in children in the neonatal period is characteristic:      

A. The highest intensity of jaundice on 2-3 days after birth

B. Jaundice increases by the 9th day after birth

C.  Physiological catarrh of the skin appears at 1 month

D. Pale skin in the early days

E. Cyanosis

 

3. What muscle tone is characteristic of children in the first months of life:

A. physiological hypotension of the flexor muscles

B. decreased muscle tone in the hands

C. physiological hypertension of the flexor muscles

D. Decreased muscle tone in the legs

E. physiological hypertension of the extensor muscles

 

4. By what age does the physiological hypertonicity of the limb flexors disappear?

A. 3-4 months

B. 1-2 months   

C. 5-6 months   

D. 7-8 months

E. 9-10 months

 

5. The number of permanent teeth in children is determined by the formula, where n – age in years

A. x = n – 20

B. x = 3n – 20

C. x = 5n – 20

D. x = 4n -20

E. x = 6n – 20

 

6. Between the coronary and sagittal suture is located:

A. large fontanel

B. small fontanel

C. lateral fontanelles

D. open coronal suture

E. open sagittal suture

 

7. In a child of 8 months with palpation of the chest, the doctor found thickenings called “Harrison’s groove.” What pathological changes in the bones are characteristic of this condition?

A. thickening in the area of the radial bone epiphyses

B. thickening of the epiphyses of the fibula

C. Thickening in the area of the phalanges of the fingers

D. thickening of the occipital bones

E. Thickening in the area of transition of the bone part of the rib to the cartilaginous

 

8. What is the average monthly increase in body weight of a child in the second half of the first year of life?

A. 400g

B. 500g

C. 600g

D. 700g

E. 800g

 

9. The following methods are used to assess the physical development of children, except:

A. Sociological

B. Somatoscopy

C. Anthropometric standards

D. Physiometry

E. indicative calculations

 

10. What method does not assess the condition of skin capillaries?

A. tourniquet breakdown

B. hydrophilic test

C. Hammer symptom

D. pinch break

E. dermographism

 

1. By what time does the physiological trait reach the the free edge of the nail:

A. at 3 months

B. at 6 months

C. at 5 months

D. at 7 months

E. there is no right answer

 

2. The neonatal period is called:

A. Period from birth to 15 days of postnatal life

B. From the time of bandaging the umbilical cord to 7 days of life

C. The period from 8 days to 1 year

D. The period from birth to 4 weeks. postnatal life

E. The period from 1 month of life to 1 year

 

3. Where especially in newborns, the skin is covered with fluffy hair:

A. on the shoulders and back

B. on the hips

C. on the face

D. on the feet

E. on the abdomen

 

4. The skin features in young children include:

A. weakened bactericidal activity

B. thick epidermis

C. inferiority of elastic and collagen fibers

D. prevalence of heat production over heat transfer

E. High skin pH

F. low activity of the sebaceous glands

G. low sweat gland activity

H. not subject to maceration

 

5. The main difference between the pre-school period of child development

A. ends the eruption of milk teeth

B. thymus and lymph node mass reduction

C. rapid physical, motor, and mental development

D. starts walking on his own

E. immune protection reaches a sufficient degree of maturity

 

6. Anthropometry is:

A. blood pressure measurement

B. study of psycho-motor development

C. physical development study

D. mental state examination

E. Age determination

 

7. For breast milk is characteristic:

A. high casein content.

B. high buffering.

C. the presence of alpha-lactose.

D. low lipase content.

E. the presence of immunological protective factors

 

8. The first application of a healthy newborn baby to the mother’s breast is carried out:

A. Immediately after birth

B. The next day

C. One hour later

D. Two hours later

E. During the day

 

9. The activity of skeletal muscles and the maintenance of muscle tone in a child of the 1st year is necessary to ensure:

A. Heat production (contractile thermogenesis)

B. development of internal organs

C. Anabolic muscle processes

D. Anabolic processes in bone tissue

E. Anabolic processes in the body

 

10. Philippine test in a child at 4 years old

A. negative

B. positive

C. Doubtful

D. not verified

E. False positive

 

1. mimic and chewing muscles in a newborn:

A. poorly developed, strengthen after eruption of milk teeth

B. poorly developed, strengthen after eruption of permanent teeth

C. well developed immediately after birth

D. well developed, hardened after teething of permanent teeth

E. absent, do not develop

 

2. The basis for periodization of childhood are:

A. social features

B. nutrition Features

C. features of the day

D. heredity

E. functional features

 

3. The symptom of “rope” evaluates:

A. muscle stiffness

B. muscle hypotension

C. degree of active muscle resistance

D. muscle hypertonicity

E. degree of muscle development

 

4. When examining the muscular system evaluate:

A. degree of muscle development

B. muscle relief

C. muscle tone and strength

D. relationship to previous injury

E. muscle activity

F. muscle volume

G. joint damage

H. local soreness

 

5. The preschool period is characterized by:

A. first physiological elongation

B. establishment of the second signaling system

C. formation of behavioral reactions

D. complete replacement of primary teeth with permanent teeth

E. the proportions of the parts of the body change.

 

6. The degree of muscle development:

A. satisfactory, unsatisfactory

B. tense, relaxed

C. hypertrophied

D. hypotrophied

E. good, medium, weak

 

7. One of the main functions of the skin is:

A. chemical

B. protective

C. exchange

D. physical

E. biological

 

8. The symptom of the tourniquet and pinch is used to determine:

A. skin temperature

B. white dermographism

C. vascular wall condition of the skin

D. red dermographism

E. skin moisture

 

9. Advantages of breast milk over cow’s milk:

A. high carbohydrate content

B. contains all the food ingredients necessary for the child and

C. besides in the most suitable quantities and ratios

D. low fat

E. The presence of immune complexes

F. high Protein

G. high Vitamin Content

H. breast milk contains 15-25 times more lipase, which greatly facilitates the digestion of fats

I. high calorie content

 

10. The Chulitskaya index (fatness index) in children of the first year of life with normotrophy is:

A. 0 cm

B. 20-25cm

C. 20 cm

D. 10-15 cm.

E. 5-10 cm.

 

1. Indicate which of the following items are secondary:

A. flake

B. peel

C. erosion

D. tubercle

E. knot

F. blister

G. abrasions

H. abscess

 

2. The body length of the child of the first year of life increases in the 2nd quarter

A. 3.5 cm monthly

B. 2 cm monthly

C. 2.5 cm monthly

D. 1-1.5 cm monthly

E. 3 cm quarterly

 

3. At the next appointment, the pediatrician examines a 3-year-old child, while capturing the skin fold on the front surface of the chest with the thumb and forefinger of both hands and beginning to shift parts of it across the length of the fold in opposite directions. What symptom did the pediatrician have for the child?

A. tourniquet symptom

B. Hammer symptom

C. Nikolsky symptom

D. pinch symptom

E. dermographism

 

4. The pre-school period is the period:

A. from 1 year to 3 years

B. from 6 months to 3 years

C. from 1 year to 6 years

D. from 6 months to 1 year

E. from 1.5 years to 4 years

 

5. The Chulitskaya index (fatness index) in a child 2-3 years old with normotrophy is:

A. 0 cm

B. 20-25cm

C. 20 cm

D. 10-15 cm.

E. 5-10 cm.

 

7. At the full-term newborn baby at the reception revealed small white millet spots in the nose. Name this entity.

A. melena

B. lanugo

C. petechiae

D. milia

E. purpura

 

8. Muscle mass after birth increases mainly due to:

A. increase their number

B. striated muscle

C. abundant nuclei

D. Thickening of muscle fibers

E. rich circulatory system

 

9. What skills does a child of a preschool development period have?

A. subtle coordinated movements appear

B. individual interests and hobbies are formed

C. improved coordination of movements

D. appears the ability to find the source of sound by view

E. improving speech

F. speaks his native language correctly

G. repeats individual syllables

H. pronounces the first words

 

10. The large fontanel is located at the intersection of the coronal and occipital sutures, and its measurement is carried out:

A. between the coronary and occipital bones

B. between the parietal and occipital bones

C. between the edges of the bones

D. between the parietal and temporal bones

E. between coronas and frontal bones

 

 

1. Erisman Index –

A. the difference between the circumference of the chest and half the length of the body (height).

B. the difference between the circumference of the chest and head.

C. 3 shoulder circumference (cm) * hip circumference (cm) * lower leg circumference (cm) – body length (cm).

D. “Philippine Test” (relative arm length)

E. the ratio of body weight (g) to body length (cm).

 

2. In a child of 8 months with chest palpation, the doctor found thickenings called “Harrison’s groove”. What pathological changes in the bones is characteristic of this condition?

A. thickening in the area of the radial bone epiphyses

B. thickening of the epiphyses of the fibula

C. thickening in the area of the phalanges of the fingers

D. thickening in the area of transition of the bone part of the rib to the cartilaginous

E. thickening of the occipital bones

 

3. Intranatal period:

A. 2 to 10 hours

B. 5 to 15 hours

C. 6 to 18 hours

D. 3 to 20 hours

E. 2 to 16 hours

 

4. For the anatomical and physiological features of the skin in a newborn is characteristic

A. gray

B. cyanotic

C. pink, transparent

D. expressed dryness

E. not sensitive to cold

 

5. Indicate what a formula determines the body length of children over 4 years old.

A. 75-5xn

B. 5xn-20

C. 100 + 6 (n-4)

D. 110 + 6xn

E. 75 + 5xn

 

6. The body length of the child of the first year of life increases in the 3rd quarter

A. 3.5 cm monthly

B. 2 cm monthly

C. 2.5 cm monthly

D. 1-1.5 cm monthly

E. 3 cm quarterly

 

7. The features of the structure of the bone tissue of the child include the following:

A. contains less water, more organic matter, less minerals

B. contains more water, less organic matter, less mineral matter

C. contains more water, more organic matter, less mineral matter

D. contains more water, more organics, more minerals

E. contains more water, less organic matter, less mineral matte

 

8. Muscle mass after birth increases mainly due to:

A. increase their number

B. striated muscle

C. abundant nuclei

D. Thickening of muscle fibers

E. rich circulatory system

 

9. The diet of the newborn:

A. 5 times a day

B. 6 times a day

C. after 3.5 h

D. on-demand

E. after 4 hours

 

10. What are the ways to assess muscle strength?

A. Try to take away the seized toy

B. Bend the leg in the child’s hip joint

C. Put the baby on its back

D. Try to put the child on his feet

E. Ask for resistance when lowering the raised leg

F. Ask to make rotational movements in the elbow joint

G. Ask for resistance when extending the arm

H. Asked to stand on one leg with his eyes closed

 

1. Tour Index –

A. the difference between the circumference of the chest and half the length of the body (height).

B. The difference between the circumference of the chest and head.

C. 3 shoulder circumference (cm) hip circumference (cm) lower leg circumference (cm) – body length (cm).

D. “Philippine Test” (relative arm length)

E. The ratio of body weight (g) to body length (cm).

 

2. “Cross” – alignment of the circumference of the chest and head of a child of 1 year of life occurs to

A. 1 month

B. 2 months

C. 3 months

D. 4 months

E. 1 year

 

3. Physiological erythema in full-term newborns reaches a maximum:

A. on the 1-2nd day of life

B. on the 2-3rd day of life

C. on the 5-6th day of life

D. on the 4th-5th day of life

E. on the 7-8th day of life

 

4. What do you mean by soft tissue turgor:

A. feeling of elasticity when squeezing all soft tissues

B. sensation of resistance obtained by squeezing the skin and subcutaneous tissue

C. sensation when pressing soft tissues to a closely lying bone

D. feeling of elasticity when squeezing all soft tissues

E. feeling of flexibility

F. the feeling of a peculiar crack of crepitus when pressed

 

5. In what period of childhood is the smallest thickness of subcutaneous fatty tissue observed?

A. from birth to 9 months.

B. to 5 years

C. at 1.5-2 years

D. at 6-9 years old

E. puberty

 

6. Breast kyphosis develops after the child begins:

A. hold your head

B. get up

C. crawl

D. walk

E. sit

 

7. The body length of the child of the first year of life increases in the 4th quarter

A. 3.5 cm monthly

B. 2 cm monthly

C. 2.5 cm monthly

D. 1-1.5 cm monthly

E. 3 cm quarterly

 

8. A hormone that raises the level of calcium in the blood

A. Adrenocorticotropic

B. Calcitonin

C. Follicle-stimulating

D. Parathyroid

E. vasopressin

 

9. The advantages of breast milk over cow’s milk include:

A. contains  all the necessary food ingredients for the child in the most appropriate quantities and ratios

B. high protein content

C. the high content of vitamins

D. high calorie

E. low fat content

 

10. Features of the muscular system in children:

A. in newborns, a flexor tone predominates

B. neonatal extensor tone predominates in newborns

C. In newborns, the bulk of the muscles are in the limbs.

D. In newborns, muscles do not relax in sleep

E. In newborns, the bulk of the muscles are in the body

F. Increased sensitivity to electric current

G. the nervous apparatus of the muscles are fully formed

H. local soreness noted

 

1. The fat layer on the face after birth is represented by:

A. Parotid fat

B. Suboccipital body fat

C. Fat on the chin

D. Fat bodies – Bisha Lumps

E. On the face, the fat layer is not developed

 

2. The growth of children in 4 years are equal to:

A. 90 cm

B. 95 cm

C. 100 cm

D. 105 cm

E. 110 cm

 

3. What are the psychometric indicators of physical development?

A. chest circumference

B. body length

C. growth measurement

D. lung capacity

E. hip circumference

 

4. The frequency of anthropometric studies in children under the age of one year

A. daily

B. weekly

C. once a year

D. monthly

E. quarterly

 

5. Assessment of the muscular system should include:

A. tendon reflexes

B. degree of muscle development

C. muscle excitability

D. tone and strength

E. Bioelectric muscle activity

F. estimation of the range of motion of the joints

G. range of motion

H. degree of development of muscle innervation

 

6. How much does a child grow up during the first year of life?

A. 20 cm

B. 15 cm

C. 25 cm

D. 30 cm

E. at 35 cm

 

7. What are the morphological features of muscle tissue of children:

A. more nuclei in muscle cells

B. low excitability

C. Lighter muscle fiber thickness

D. large thickness of muscle fibers

E. fewer nuclei in myocytes

F. More connective tissue

G. characteristic hypotension

H. less connective tissue

 

8. For the anatomical and physiological characteristics of the skin in a newborn are characteristic

A. gray

B. cyanotic

C. marked dryness

D. pink, transparent

E. not sensitive to cold

 

9. The primary morphological elements of the skin are

A. atrophy

B. ulcer

C. stain

D. peel

E. erosion

 

10. The following are related to the structural features of the child’s bone tissue:

A. contains less water, more organic matter, less minerals

B. contains more water, less organic matter, fewer minerals

C. contains more water, more organic matter, less minerals

D. contains more water, more organic matter, more minerals

E. contains more water, less organic matter, less minerals

 

1. The body weight of children in 10 years on average is:

A. 20 kg

B. 25 kg

C. 30 kg

D. 35 kg

E. 40 kg

 

2. The frequency of anthropometric studies in children aged from one to 3 years

A. weekly

B. once a year

C. every 3 months

D. once every 6 months

E. every 3 years

 

3. Changes in bone tissue during osteomalacia:

A. thickening of the bones

B. bone curvature

C. bifurcation

D. softening of bones

E. bone deformation

 

4. Skin of a healthy infant

A. grayish with anicteric hue

B. smooth

C. pale pink

D. pink

E. dry

F. icteric with peeling

G. gray earthy color

H. velvety

 

5. Periods of prenatal development:

A. initial period – from the moment of fertilization to 2 weeks

B. thoracic period

C. late neonatal

D. embryonic period – 3-8 weeks

E. Fetal period – from the 9th to 38-40th week

F. Intranatal – from the appearance of contractions to the bandaging of the umbilical cord

G. early neonatal

H. neonatal period

 

6. The condition of the blood vessel wall is determined by the following symptoms:

A. Ropes

B. tourniquet

C. Return

D. Hammer

E. slip

F. pinch

G. knee-calcaneal

 

 

7. Differences in the composition of colostrum compared with mature milk:

A. Lower protein, more fat, lower Ig A concentration, lower essential fatty acids

B. Higher protein, fat, carbohydrate content

C. Lower protein, fat, carbohydrate content

D. Higher protein, less fat, higher Ig A concentration, higher essential fatty acids

 

8. The duration of the period of infancy

A. up to 3 months

B. up to 6 months

C. up to 1 year

D. up to 1.5 years

E. up to 2 years

 

9. Children’s skin color depends on

A. amount of pigment

B. blood composition (white blood cell count)

C. age

D. thickness of the granular layer

E. Prickly layer thickness

 

10. Sweating in a healthy child begins with:

A. birth

B. 1-2 months

C. 5-6 months

D. 3-4 weeks

E. 7-8 months

 

1. The frequency of anthropometric studies in children aged 7 to 14 years

A. Weekly

B. Monthly

C. Annually

D. 1 time in 6 months

E. 1 time in 3 years

 

2. Millet small nodules of yellowish color on the skin of the nose is

A. Milena

B. sweating

C. Milia

D. diaper rash

E. pemphigus of the newborn

 

3. The average monthly weight gain in children for the second half of 1 year of life:

A. 400.0

B. 500.0

C. 600.0

D. 350.0

E. 650.0

 

4. Hypostatura is:

A. mass lag compared to growth

B. uniform lag of mass and growth

C. excess weight about growth

D. normal physical development

E. Depletion of school children

 

5. Dates of the closure of the lateral fontanelles

A. 1-2 month

B. 3-6 month

C. 10-12 month

D. in utero

E. 18 month

 

6. The eruption of all milk teeth ends by age (in years):

A. 1.5–2

B. 2

C. 1–1.5

D. 2.5–3

E. 3

 

7. Cervical lordosis develops after the child begins:

A. sit

B. get up

C. hold your head

D. crawl

E. walk

 

 

8. Indicate the dates of the pre-school period

A. 6 months – 4 years

B. 1 – 3 years

C. 1 – 4 years

D. 2 to 5 years

E. 2 – 6 years

 

9. The body length of the child of the first year of life increases in the 3rd quarter

A. 3.5 cm monthly

B. 2 cm monthly

C. 2.5 cm monthly

D. 1-1.5 cm monthly

E. 3 cm quarterly

 

10. Body weight in children at 12 months on average is:

A. 8.kg

B. 10 kg

C. 15 kg

D. 20 kg

E. 18 kg

 

1. Hypotrophy of young children is characteristic:

A. lagging body weight from growth

B. uniform lag of body weight and growth

C. evenly overweight and growth

D. predominance of height over body weight

E. predominance of body weight over height.

 

2. Indicate the timing of the intrapartum period.

A. From the beginning of fertilization to the birth of a baby

B. From the beginning of labor until the birth of the baby

C. From birth to 28 days of life

D. from 28 to 40 weeks of fetal development

E. from the moment of birth to 7 days of life

 

3. The early neonatal period covers

A. from 28 weeks of fetal development to 7 days of life

B. From the time of bandaging the umbilical cord to the end of 7 days of life

C. From birth to day 7 of life

D. from the beginning of fertilization to the birth of a baby

E. from birth to 10 days

 

4. Hypostatura is:

A. mass lag compared to growth

B. excess weight in relation to growth

C. normal physical development

D. uniform lag of mass and growth

E. Depletion of school children

 

5. The average monthly increase in body weight during the first half of the year in children is:

A. 500.0

B. 600.0

C. 700.0

D. 400.0

E. 800.0.

 

6. The biological age of the child is:

A. set of anthropometric features

B. set of functional features

C. The individual rate of biological development in general

D. Health status of the child

E. set of anthropometric and functional features

 

7. Which of the following methods are used to assess physical development:

A. physiometric

B. laboratory

C. Somatoscopic

D. biochemical

E. analytical

F. somatometry

G. instrumental

H. functional

 

8. Indicate which of the following elements are secondary:

A. scar

B. tubercle

C. vegetation node

D. blister

E. abrasion

F. lichenification

G. abscess

 

9. Bone age is determined by:

A. level of Ca and P in the blood

B. physiological curvature of the spine

C. by the timing of the the occurrence of ossification points

D. level of development of muscle strength

E. by the number of permanent teeth

 

10. Correspondence of the number of milk teeth to the child’s age is calculated by the formula (n – age in months)

A. X = n – 2

B. X = n – 6

C. X = n – 8

D. X = n – 5

E. X = n – 4

 

 

 

 

1.Extrauterine and intrauterine stages and periods of human development.

intrauterine

Embryonic period (1st 8 weeks): – In this Duration of this period, the fertilized ovum divides and forms most of the organs of the body by rapid differentiation, So this period is known as the organogenesis period. In this period any abnormal situation or event can change and disturb the formation of the normal pattern of organs and as result, Heredity or congenital anatomical malformation or abortion will occur.

 

Fetal period (9th – 40th weeks): –  In this period, (development)  and increase in size (known as growth) of fetus which was already organized (formed). In fetal, nutrition was provided by placenta (Important role to give nutrition to the fetus) – So that’s why it is also known as the “placental period”. If any abnormality event happened in this period, this will not able to affect organogenesis but in fetal,  growth and development of fetus might be cause of miscarriage by greatly disturbed, premature delivery, stillbirth or intrauterine growth retardation.

 

The fetal period is divided into:- It is characterized by 1) Early FP and 2) Late FP

1.        Early fetal period (9th weeks to 28th weeks): – firstly More growth can be seen in the length (35 cm) and then in weight (1 kg). Due to incomplete development of PAS (pulmonary alveolar system), the Fetus is pre-viable.

2.        Late fetal period (28th weeks to 40th weeks): – Firstly More growth can be seen in weight (3.35 kg) and then in length (50 cm). In this period – The Fetus is viable.

Important substances (e.g. calcium, iron, vit D, Vit K, coagulation factors and gamma globulins) pass through placenta in fetus by mother during that period  (which is also known as the formation of body stores).

 

 

Extra-uterine stage

It is described as self responsibility and full activity of the developing organism.

This stage is divided into two periods:-

A. Neonatal period (1st 4 – weeks) – To the new extrauterine environment, Physiological adjustment, and adaptation are described in this period.

B. Infancy period (1st 2 – years) – in this period some character

a)        Feeding and weaning.

b)        Higher rate of growth & development.

c)        The eruption of all milk teeth.

d)       Immunity against many of the infectious diseases.

e)        Development of most of milestones.

 

 

2. At the reception of the pediatrician in the clinic mom with a girl of 3 years. The child is registered in kindergarten. Bodyweight 15.1 kg, body length 98 cm.

1. Indicate the empirical formula for calculating body length over 1 year

At 4 years old, the child’s height is 100 cm,

for each the missing year is deducted by 8 cm:100 – 8 x (4- n)

for each subsequent 6 cm is added.100 +6 x (n-4)

 2. Indicate the empirical formula for calculating body weight over 1 year

The average body weight of a child at 1 year is 10, 5 kg.For each year over 1 year, 2 kg are added:10.5 + 2 x (n-1)

 2-5 years: DMT = 2n + 9

4-7 years old: DMT = 10.5 + 2n

 3.        Estimate the length of the child’s body

The child’s height will 100 cm at 4 years old.

 4.        Estimate the bodyweight of the child

The bodyweight of a 4-year-old child is 17 kg

 5. Assess the physical development of the child on centile tables.

The severity of the subcutaneous fat layer more objectively allows estimating the sum of four Brook folds measured at standard points(above m.biceps, m.triceps, m.subscapularis, and above the pupar ligament). results measurements are evaluated according to centile distribution tables. Normal fat deposition is said if the value obtained is is located in the region from the 25th to the 75th centile. Probable redundancy fat accumulation is determined in the area of ​​90-95 centile, and reliable – at crossing the border of the 95th centile. By analogy, a conclusion is made about insufficient fat deposition.

 Chulitskaya index (fatness) = 3 (shoulder circumference) + (circumference thigh) + shin circumference) – (height), in cm.

 

Erisman index – assesses the degree of development of the chest and organs

chest, determined up to 15 years

Erisman index = (chest circumference) – (half-height).

 

Height-to-age correspondence table (height – age): age – 3 years, height -100 cm, corresponds to corridor No. 2

 

3.Patterns of physical development of children. Factors determining physical development. Features of the physical development of infants and young children.

 The growth rate is highest during the prenatal period, especially from 8up to 25 weeks of gestation. The inhibition of growth energy is well traced in the first two years of a child’s life. Subsequently, a drop in the growth rate is intermittent in nature. This is reflected in the following law.

 – Seasonal and daily growth period with predominance at night days and summer months of the year

 – asymmetry of growth with a the predominance of growth shifts and some advancing on the side of the dominant manual activity

 – period of the first “completeness” or first “rounding” (turqor primus): from 1 to 4 years of life. It is characterized by predominant weight gain over the body length;

– the period of the first “pulling out” (proceritas prima): from the 5th to the 7th years of life. There is a predominance of growth in body length in comparison with its weight;

– period of the second “completeness” or second “rounding” (turqor Secunda): 8 – 10 years life;

– period of the second “stretching” (proceritas Secunda): from 11 to 15 years;

– a period of very slow growth: from 15 to 18-20 years

 

The law of sex specificity of growth. Manifested in the fact that boys have higher final growth rates, although girls are relatively earlier (1-2 years) enter the period of puberty stretching.

 

 

 

 

4.The woman gave birth on time. The condition of the child is satisfactory. Bodyweight at birth 3300gr, length 55 cm. The boy is applied to the chest after 6 hours. I took the breast well, feeding 7 times a day. The physiological weight loss by 6th was 300g. By the 10th day of life, bodyweight is 3100g.

1. Indicate the percentage of physiological loss of body weight

From Birth to 6th day – Weight loss by 9% approx

From Birth to 10th day – Weight loss by 6.06% approx

 2. Assess the physiological loss of body weight

From Birth to 6th day – Weight loss by 300 gm approx

From Birth to 10th day – Weight loss by 200 gm approx

 3. Evaluate weight gain by 10th day of life

Bodyweight gain evaluate from the 6th day to 10th day by 200 gm

 4. Tactics?

The average weight of the normal newborn baby is approx 3500 gm

 5. Recommendations for a mom of the child?

We will Recommend breast feeding to newborn everyday and regularly.

  

 

5. Embryogenesis, anatomy physiological features of the muscular system in children.

Skeletal musculature develops from the dorsal part of the middle embryonic layer – the mesoderm, which at 3-4 weeks of embryogenesis is divided into 40-42 pairs of primary segments (somites): 3 preauricular, 4 occipital, 8 cervical, 12 thoracics, 5 sacral and 3- 5 coccygeal.

The striated musculature develops from the dorsomedial sections of the somites called myotomes. Spinal nerves and arteries of the same level grow into each myotome. Each myotome is divided into dorsal and ventral parts.

From the dorsal part of the myotomes, the suboccipital muscle group, and deep back muscles develop.

From the ventral parts of myotomes, as a result of differentiation, muscles are formed that attach to the the hyoid bone, deep muscles of the neck, superficial muscles of the back, muscles of the anterior and lateral sections of the chest and abdomen, diaphragm, muscles of the upper and lower extremities.

 

The sources of development of these muscles are myotomes of the following levels:

Neck muscles and diaphragm – the first to fifth cervical (C 1 -C 5 ), segments;

Muscles of the chest – the first-twelfth pectoral (Th 1 -Th 12 ), segments;

Abdominal muscles – eleventh, twelfth pectoral, first, second lumbar (Th 11 -Th 12, L 1 -L 2 ), segments;

Muscles of the upper limb – the fifth to eighth cervical, the first pectoral (C 5 -C 8, Th 1 ), segments;

The muscles of the lower limb – the first to fifth lumbar, the first to fourth sacral (L 1 -L 5, S 1 -S 4 ), segments.

 

he level of the anlage of muscles (myotomes) can be determined by the level of the spinal nerve that innervates this muscle.

The external muscles of the eye develop from 3 preauricular myotomes. The muscles of the tongue are formed from 4 occipital myotomes. The chewing muscles develop from the mesoderm of the 2nd visceral arch

Fascia formation occurs in parallel with muscle development. In the early stages of embryogenesis, fascia develops from mesenchymal cells that concentrate around muscles.

 

 

 

6.The boy was born 10.09.1997. examined 10.04.2009, has a height of 132 cm, weight 37 kg, head circumference 54 cm, chest circumference 75cm.

1.         Determine age group

The age group is 12 years old; the child is 11 years old and 7 months old.

 2.                  Rate the anthropometric indices according to the standards of the Central type

 Evaluation by centile tables

Index

Measurement results

Centile interval

Indicator score

Height, cm

 

0-3 centiles (1st corridor)

very low

Weight, kg

 

25-50 centiles (4th corridor)

middle

Head circumference, cm

 

50-75 centiles (5th corridor)

middle

Chest circumference, cm

 

75-90 centiles (6th corridor)

above average

Conclusion – Physical development is very low, because growth is very low. Additional analysis is required to assess harmony.

 

Assessment of body weight by height using centile tables.

 

Actual weight 37 kg (Corridor 8) – very high, i.e. there is an excess of mass for growth.

 

Thus, in terms of height (1st corridor) and weight (8th corridor), the child belongs to the group of high risk for pathology. High-risk assessment group for pathology, the in-depth examination is necessary.

 

3.         Evaluate anthropometric indicators by empirical formulas

Index

Measurement results

Calculation by formula

Deviation from the average

Deviation assessment

Indicator score

Height, cm

 

130 + 5 × (12-8) = 150

-18

Over 3 ages intervals

Pathological

Weight, kg

 

12 × 5-20 = 40

-3

Within 1 age interval

Middle

Head circumference, cm

 

50 + 0.6 × (12-5) = 54.2

-0.2

Within 1 age interval

Middle

Chest circumference, cm

 

63 + 3 × (12-10) = 69

+6

1 to 2 ages intervals

Above average.

 

Physical development is pathologically low, since the growth is pathologically low, disharmonious since the indicators of growth and weight are in different evaluative categories. Assessment of physical development requires clarification by more objective methods. High-risk assessment group for pathology.

 4.         Estimate the weight of the length of the centile tables

 The average height (50th centile) is 149 cm. There is a growing deficit of 17 cm.

 149 cm – 100%

 17 cm – X X = (17 * 100): 149 = 11.5%.

 Conclusion: there is a moderate growth retardation

5.         When identifying deviations of growth and/or weight, estimate their degree as a percentage.

 Calculation of the growth deficit by age.

The average height (50th centile) is 149 cm. There is a growing deficit of 17 cm.

149 cm – 100%

17 cm – X X = (17 × 100): 149 = 11.5%.

Conclusion: there is a moderate growth retardation.

 

Calculation of the percentage of weight by height.

Average weight in height (50 centile) – 28 kg. An excess of 9 kg is noted.

28 kg – 100%

9 kg – X X = (9 × 100): 28 = 32%.

Conclusion: the excess weight is 32% – obesity of the II degree.

 

The child has a moderate delay in physical development, possibly due to pathological reasons, and excess body weight (obesity II degree). High-risk assessment group for pathology. An in-depth examination is required to determine the causes of deviations in physical development.

 

 

 

7.Healthy child nutrition. Principles of breastfeeding. Benefits of breastfeeding.

Healthy child nutrition

1.                  Protein is a food that contains a relatively high percentage of proteins

2.                  Carbohydrates  –  includes starches, sugars, syrups, and sweet fruits

3.                  Vitamins are organic compounds

4.                  Mineral salts and water

For the normal the functioning of the body, its growth, and development, a regular intake of food containing complex organic substances (proteins, fats, carbohydrates, mineral salts, vitamins, and water) is necessary. All these substances are necessary to meet the body’s need for energy, for the implementation of biochemical processes occurring in all organs and tissues of the human body. In the reproduction of new cells and the growth of any organism, Organic compounds are also used as building material instead of dying ones.

 

Principle of breastfeeding

1. Wash the breast and mammary gland under running water, and remove all long hair,

2. Sitting in a comfortable position – means lying on your side

3. Confirmed that nothing distracts (I.e (clean, dry, warmly dressed) him to feeding and the baby is in a comfortable position and environment.

4. Confirmed about baby’s nasal that baby can breathe freely and normally (remove all crusts from the nose if necessary).

5. Observed when baby suck the nipple.

6. If the baby is sucking greedy and there is an active flow of milk in a stream then in this duration  hold the baby from upright for some tomes and reapply it again and again to the breast.

7. With sluggish sucking, falling asleep, the baby during feeding, wake him up (stroking the cheek, tickling the heels)

8. First feedings duration is usually approx 30-40 minutes (This period is known as lactation formation Period), After that it takes on average 20 minutes.

9. Changed the mammary gland If the amount of milk in not enough in one mammary gland to meet the needs of the baby.

10. To prevent regurgitation, hold the child for 3-5 minutes vertically.

11. And the the last one, wash the mammary gland

 

Benefits of breastfeeding

Children who are breastfed by their mother are much less likely to get sick:

– allergic diseases;

– diseases of the respiratory system;

– diseases of the gastrointestinal tract;

– infectious intestinal diseases;

– diabetes mellitus;

– overweight and obese.

– colonization of the newborn’s body with maternal bifidobacteria and lactobacilli, which will determine the physiological formation of microflora and immunity in a child;

– the formation of a feeling of attachment of the mother to the child;

– the formation of a sense of security in a newborn.

 

1. contain all the essential amino acids

2. Contains protective antibodies

3. Contains more unsaturated fatty acids

4. More lactose (milk sugar)

5. Less mineral salts

6. Contains lecithin – promotes the multiplication of brain cells

 

Breastfeeding has important benefits for maternal health: it reduces the risk of bleeding, anemia, prevention of purulent-septic diseases, prevention of mastitis. Breastfeeding is a reliable physiological method of preventing an unplanned pregnancy during the first 6 months (before the introduction of complementary foods).

 

 

 

 

8.Girl 13 years old examined by a pediatrician at school. Bodyweight 42 kg, body length 155 cm, head circumference 55 cm, chest circumference 67 cm, Erisman index 10.5 cm. The philippine test is positive.

1. Rate indicators of physical development on centile tables

Body length 75 centile, bodyweight 25-75 centile, head circumference 25-75 centile, chest circumference 10-25 centile. Physical development is average, harmonious.

2.                  Assess the Erisman Index

Erisman’s index = chest circumference minus ½ body length, within normal limits.

3. What is the Philippine test and how to evaluate it?

The Filipino test in children becomes positive after 5 years, ie. the child can reach the ear with the opposite hand around the head.

 

 

8.Embryogenesis, anatomical and physiological characteristics of the musculoskeletal system in children.

The first nuclei of ossification in the cartilaginous tissue are laid at 7-8 weeks of intrauterine development of the embryo. After the birth of a child, the bone skeleton increases, while the structure of the bone tissue is reconstructed. It has a fibrous structure In newborn or fetus and 3-4 years a lamellar structure of bones will appear.

 The skull of a newborn has a more developed cerebral part compared to the front part and consists of paired and unpaired bones, which are separated by sutures. The sutures are closed by the neonatal period, completely overgrown by the age of 7, In which, bones join, fontanelles to form in certain places:

1)      large – between the frontal and parietal bones, measuring 2.5 * 3 cm;

2)      small – between the parietal bones and occipital,

3)      lateral – two on each side.

 

If there is an early closure of the large fontanelle and infection of the sutures, this may indicate microcephaly.

 

Features of the child’s spine –

1. Cervical lordosis (anterior bending) occurs when the child begins to hold his head;

2. Thoracic kyphosis (posterior bending) occurs when the child sits down on his own;

3. lumbar lordosis which is mainly appears after 9-12 months, when the child is beginning to walk.

 

Features of the child’s chest –

His chest has a barrel-shaped in the first year of life of any child (shape of chest: wide, the ribs are horizontal).

 

Features of the long bones of the child –

1. tubular bones are composed of certain parts

2. The diaphysis and pineal gland are interconnected by a layer of metaphysis cartilage.

 

Features of the pelvic bones of a child –

The pelvic bones in children of the first year of life are like a funnel. The female and male pelvic bones develop during puberty.

 

 

 

 

9.At the appointment with the pediatrician, the child is 8 months old. Born with a bodyweight of 3450g, a body length of 53cm, a head circumference of 35cm, a chest circumference of 34 cm.

1. Indicate the main criteria for the physical development of the child

Physical development is average, because of average growth; harmonious, because the estimates of mass and height are the same. The evaluation group is a variant of the norm.

 2. Calculate body weight using empirical formulas

8200 + 400 * (8-6) = 9000

3. Calculate body length using empirical formulas

66 + 1.5 * (8-6) = 69.00

4. Calculate head circumference using empirical formulas

43 + 0.5 * (8-6)  = 44

5. Using empirical formulas, calculate the circumference of the chest.

45 + 0.5 * (8-6)= 46

 

 

10. Feeding and nutrition of children. Principles of natural feeding up to 1 year. Benefits of breastfeeding.

a.         The actual food supply, optimal in terms of quantity

b.        he mother produces as much milk as the baby needs

c.         Unsaturated essential fatty acids prevail.

d.        When breastfeeding, it is not required to supplement the baby with water

e.         Proteins of human milk are almost identical to proteins of blood serum of a child

f.         Higher coefficient of assimilation of fat

 

 

l  Wash the breast and mammary gland under running water, and remove all long hair,

l  Sitting in a comfortable position – means lying on your side

l  Confirmed that nothing distracts (I.e (clean, dry, warmly dressed) he to feeding and the baby is in a comfortable position and environment.

l  Confirmed about baby’s nasal that baby can breathe freely and normally (remove all crusts from the nose if necessary).

l  Observed when baby sucks the nipple.

l  If the baby is sucking greedy and there is an active flow of milk in a stream then in this duration hold the baby from upright for some tomes and reapply it again and again to the breast.

l  With sluggish sucking, falling asleep, the baby during feeding, wake him up (stroking the cheek, tickling the heels)

l  First feedings duration is usually approx 30-40 minutes (This period is known as lactation formation Period), After that, it takes on average 20 minutes.

l  Changed the mammary gland If the amount of milk is not enough in one mammary gland to meet the needs of the baby.

l  To prevent regurgitation, hold the child for 3-5 minutes vertically.

l  And the last one, wash the mammary gland

 

 

Benefits of breastfeeding:

Ø  more protein in cow’s milk

Ø  contain all essential amino acids

Ø  Breast milk is sterile milk which means a lower risk of intestinal infections

Ø  sexual development are faster in artificial people

Ø  The subcutaneous fat better components of breast milk which accumulates (deposits) the child.

 

 

11. At the doctor’s mother with a child of 1.5 years. Bodyweight 12kgbody length 87 cm

1.         methods of assessing the length of the child’s body

130 – 7 * (8 – 1.5) = 84.5

2.         methods of assessing the bodyweight of the child

19 + 3 * (1.5 – 5) = 8.5

3.         a method of measuring head circumference

50 – 1 * (5 – 1.5) = 46.5

4.         a method of measuring the circumference of the chest

63-1.5 * (10-1.5) = 50.25

5.         evaluate the indicators of physical development on the centile tables

Physical development is low because growth is low. The mass is pathologically low, therefore, the assessment of harmony requires clarification by other methods, including the assessment of mass by height. Also, there is a pathologically low chest circumference. After specifying the assessments, decide the question of which assessment group to include the child and the tactics of medical actions.

 

 

12. Methods of studying the muscular system in children. Assessment of muscle tone in newborns.

Methods of studying the muscular system in children

a)        Muscular System Study is carried out by instrumentally and visually

b)        The degree and uniformity of development of muscle groups, their tone, strength, and motor activity are assessed visually and palpably.

c)        Muscle strength in young children is determined by trying to take away a toy. In older children, manual dynamometry is performed.

d)       During the instrumental examination of the muscular system, mechanical and electrical excitability is measured using electromyographs, chronometers.

 

Assessment of muscle tone in newborns

The main challenge with these exercises is to find the muscles you need and feel them. This can be done as follows – try to stop the flow of urine. The muscles that are used for this are the perineal muscles.

The set of exercises consists of three parts: · slow contractions: tighten the muscles, as to stop urination, slowly count to three, relax; · Contractions: tighten and relax the same muscles as quickly as possible; Pushing out: pushing, as in a bowel movement or childbirth.

Only after the restoration of the muscle tone of the perineum, the postpartum women are allowed exercises to restore the tone of the abdominal muscles.

When examining the external genital organs, one should pay attention to the condition of the scar on the perineum (in the case of ruptures or episiotomy) and the presence of signs of failure of the pelvic floor muscles.

Apgar scale is mainly used to check the severity of a newly born child (Used in obstetrics and pediatrics). The Apgar scale is a method for assessing the condition by examining the respiratory rate, heart rate, muscle tone and activity of movements, skin color. 

The muscular system is already formed but developed very poorly, which is known as the bulk of the muscles in the newborn and all are falls on the muscles of the trunk which is are about the weight of the whole body (the muscle mass of any newborn is 1/4 and the Diameter of  muscle fiber is on approx about 7 microns).

Due to the weak development of the respiratory muscles and the horizontal position of the ribs, breathing in a newborn is shallow and due to also largely due to the diaphragm.

Muscle tone in newborns is often weakened. Sign of prematurity or immaturity can be a sharp decrease or absence of muscle tone.

Proboscis reflex: –  When anyone hit the lips with a finger, the muscle of the mouth is known as the circular muscle will contracts, causing the lips to be pulled out by the proboscis.

 

 

 

13. The woman gave birth on time. The condition of the child is satisfactory. Bodyweight at birth 3300gr, length 55 cm. The boy is applied to the chest after 6 hours. I took the breast well, feeding 7 times a day. The physiological weight loss by 6th was 300g. By the 10th day of life, bodyweight is 3100g.

1. Indicate the percentage of physiological loss of body weight

From Birth to 6th day – Weight loss by 9% approx

From Birth to 10th day – Weight loss by 6.06% approx

2. Assess the physiological loss of body weight

From Birth to 6th day – Weight loss by 300 gm approx

From Birth to 10th day – Weight loss by 200 gm approx

3. Evaluate weight gain by 10th day of life

Bodyweight gain evaluate from 6th day to 10th day by 200 gm

4. Tactics?

The average weight of the normal newborn baby is approx 3500 gm

5. Recommendations for a mom of the child?

We will Recommend  about breastfeeding to new born every day and regularly.

 

 

14. Joint research technique, shape, size, range of motion, pain

I.         Configuration. Swelling. The condition of the skin over the joints.

II.      Local temperature. Soreness to palpation.

III.   Joint movements: active and passive.

IV.   Measurement of the amplitude of movements is carried out using a protractor based protractor.

V.      The counting is carried out from the initial position of the limb, which is characterized by the state of the joint with a free vertical position of the body and limb.

VI.   The range of motion in the joint is indicated in degrees.

VII.The analysis of the results obtained is carried out in comparison, first of all, with a healthy limb, as well as with normal (average) data of a healthy person of the same sex and age. If the range of motion is limited, indicate its cause (pain, ankylosis, contracture, etc.).

 

 

 

Determine the physical development of a 6-year-old child (boy) by the following indicators, using cential tables: body weight 19.8 kg, length 113.8 cm, chest circumference 56.2 cm.

1. Evaluate anthropometric data

Anthropometric measurements make it possible to obtain objective data on the morphological parameters of a person – body length and weight, chest circumference, etc. They are the basis of somatometric methods for studying human physical development.

 2. In what period of childhood is the child, give his description

To assess the physical development, each indicator measured in a child is compared with the average age calculated according to any given empirical formulas for children 1 year of age, and then its deviation from the calculated value is determined. The form of recording the measurement results is the same as for children over a year old, but the assessment of the results is slightly different.

3. What other methods are used to evaluate anthropometric indicators

Index – Empirical formulas,  n – age in months

1.        Body length, cm

a)        from 1 to 11 years old – Body weight at 5 years is 19 kg.

i.          up to 5 years, the annual increase is on average 2 kg

ii.        after 5 years, the annual increase is on average 3 kg

2.        Height over 1 year old, cm

i.          up to 8 years of age, the annual growth averages 7 cm

ii.        after 8 years, the average annual growth is 5 cm

3.        Head circumference, cm

i.          up to 5 years, the annual growth is on average 1 cm

ii.        after 5 years, the annual growth averages 0.6 cm

4.        Chest circumference, cm

i.          up to 10 years, the annual growth is on average 1.5 cm

ii.        after 10 years, the annual growth averages 3 cm

 

Morphological indicators:

a.         body length and weight,

b.        chest circumference, and 

c.         in children under three years of age – head circumference.

d.        Functional indicators:

e.         vital capacity of the lungs,

f.         muscle strength of the hands, etc.

g.        Musculature and Muscle tone Development and Determined Their Posture, musculoskeletal system Development, subcutaneous fat development, tissue trigger.

4. What is acceleration and its causes?

According to I.M. Vorontsov, the somatotype reflects the tempo characteristic of growth: the microsomatotype is slow, the macrosomatotype is accelerated, the mesosomatotype is the average growth rate. In this interpretation, the somatotype can be determined even easier. If the anthropometric indicators have approximately close estimates and fall into 1, 2, and 3 corridors (up to 25 centile), this characterizes the slowed down rates of age development (microsomatotype), and in corridors 6, 7, and 8 (from 75 centile and above) – accelerated rates (macrosomatotype).

5. List the factors that affect the growth and development of the child.

A.      Genetic factors,

B.       Environmental factors,

C.       Mental tension,

D.      Depression, trauma

E.       Acute and chronic diseases of the child

F.        Influence of various climatic and geographical conditions

 

 

15.Anatomical and physiological features of the skin and its appendages in children. Characteristics of the various properties of the skin.

The total surface area of the skin of newborns is approximately 0.25 m2, by the year it increases to 0.43 m2.

The thickness of various layers of the skin in children under 3 years old is 1.5-3 times less than in adults, and only by the age of 7, it reaches the parameters of an adult. The thickness of the epidermis in newborns ranges from 0.15 to 0.25 mm, and in an adult 0.25 to 0.36 mm.

The skin of infants contains up to 80% water. With age, its amount decreases, mainly due to the extracellular fluid. In adults, the skin contains only 62% water.

From the age of 4 months, the first elements of elastic fibers appear in the baby’s skin. Only by 6 years of age the histological structure of the dermis approaches that of adults, although the collagen fibers remain thin and the elastic ones are relatively poorly developed.

A distinctive feature of the skin of children, especially newborns, is a weak connection between the epidermis and the dermis, which is primarily caused by the lack of quantity and poor development of anchor fibers. With various diseases, the epidermis easily exfoliates from the dermis, which leads to the formation of blisters.

 

I.         Granular layer is poorly expressed, which explains the significant transparency and its pink color.

II.      the base layer is well developed, epithelial cells multiply rapidly in it to replenish the rejected keratinized elements.

III.   the base layer is well developed, epithelial cells multiply rapidly in it to replenish the rejected keratinized elements.

IV.   Basal membrane between the epidermis and dermis is very delicate due to the poor development of connective tissue, which determines the weak connection between the epidermis and the dermis and easy rejection of the epidermis.

V.      Derm has a predominantly cellular structure. Only by 6 years of age the histological structure of the dermis becomes as in adults.

VI.   the skin of children is highly elastic. Collagen fibers are thin.

VII.Melanocytes in children are underdeveloped, little melanin pigment is produced, which makes the skin more sensitive to UV rays and a tendency to sunburn.

VIII.       The skin is abundantly supplied with blood due to a well-developed network of capillaries. The abundant blood supply and the richness of the skin with water tends to materration, exudation.

 

Sebaceous glands

The sebaceous glands begin to function in utero. Their secret forms a curdled lubricant that covers the entire skin of the fetus. It protects the skin from the effects of amniotic fluid and makes it easier for the fetus to pass through the birth canal. 

 

Sweat glands

The formation of eccrine sweat glands does not end at birth. Their excretory ducts are underdeveloped and closed by epithelial cells. During the first 3-4 months, the glands do not function well. Sweating begins from the age of 3-4 weeks.

 

Hair

Primary hair is replaced by vellus hair before birth or shortly after birth, with the exception of the eyebrows, eyelashes and scalp. Hair in full-term newborns does not have a core, and the hair follicle is underdeveloped, which causes slight loss of the hair shaft and does not allow the formation of boils with a purulent shaft.

 

Nails

The nails of full-term newborns are well developed and reach the fingertips. In the first days of life, a temporary delay in nail growth is observed, in connection with which a so-called “physiological line” is formed on the nail plate. At the 3rd month of life, it reaches the free edge of the nail.

 

 

16.Girl 13 years old examined by a pediatrician at school. Body weight 42 kg, body length 155 cm, head circumference 55 cm, chest circumference 67 cm, Erisman index 10.5 cm. Philippine test is positive.

1. Rate indicators of physical development on centile tables

Body length 75 centile, body weight 25-75 centile, head circumference 25-75 centile, chest circumference 10-25 centile. Physical development is average, harmonious.

2. Assess the Erisman Index

Erisman’s index = chest circumference minus ½ body length, within normal limits.

 3. What is the Philippine test and how to evaluate it?

The Filipino test in children becomes positive after 5 years, ie. the child can reach the ear with the opposite hand around the head.

  

17.Extrauterine and  intrauterine stages and  periods of human development.

intrauterine

Embryonic period (1st 8 weeks): – In this Duration of this period, fertilized ovum divides and form most of the organs of the body by rapidly differentiation, So this period is known as organogenesis period. In this period any abnormal situation or event can change and disturb the formation of normal pattern of organs  and in result, Heredity or congenital anatomical malformation or abortion will occur.

 

Fetal period (9th – 40th weeks): –  In this period, (development)  and increase in size (known as growth) of fetus which was already organized (formed). In fetal, nutrition was provided by placenta (Important role to give nutrition to fetus) – So that’s why, it is also known as “placental period”. If any abnormality event happened in this period, this will not able to affect organogenesis but in fetal,  growth and development of fetus might be cause of miscarriage by greatly disturbed, premature delivery, still birth or intrauterine growth retardation.

 

Fetal period is divided into:- It is characterized by 1) Early FP and 2) Late FP

5.        Early fetal period (9th weeks to 28th weeks) : – firstly More growth can be seen in length (35 cm) and than in weight (1 kg). Due to incomplete development of PAS (pulmonary alveolar system), Fetus is pre-viable.

6.        Late fetal period (28th weeks to 40th weeks): – Firstly More growth can be seen in weight (3.35 kg) and than in length (50 cm). In this period – The Fetus is viable.

Important substances (e.g. calcium, iron, vit D, vit K, coagulation factors and gamma globulins) pass through placenta in fetus by mother during that period  (which is also known as formation of body stores).

 

 

Extra-uterine stage

It is described as self responsibility and full activity of the developing organism.

This stage is divided into two periods :-

C. Neonatal period (1st 4 – weeks) – To the new extra uterine environment, Physiological adjustment and adaptation are described in this period.

D. Infancy period (1st 2 – years) – in this period some character

a)        Feeding and weaning.

b)        Higher rate of growth & development.

c)        Eruption of all milk teeth.

d)       Immunity against many of the infectious diseases.

Development of most of milestones.

 

 

 

18.A child aged 4.5 months, examined by a pediatrician, was born with a body weight of 3400g, a body length of 53cm, a head circumference of 33cm, a chest circumference of 32cm.

1. Indicate the main criteria for the physical development of the child

Physical development is low, because growth is low, possibly harmonious, because weight and length are in the same scoring category, however, for clarification, weight per body length should be calculated. The assessment group for determining medical tactics is borderline. For a final conclusion, an assessment of anthropometric indicators is required with more accurate methods (centile or others).

2. Calculate body weight using empirical formulas

 8200-800 * (6-4.5) = 7000.00

3. Calculate body length using empirical formulas

66-2.5 * (6-4.5) = 62.25

4. Calculate head circumference using empirical formulas

43-1.5 * (6-4.5) = 40.75

5. Using empirical formulas, calculate the circumference of the chest.

45 – 02 * (6- 4.5) = 42.00

 

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