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Fetal growth
Embryonic period (0-8 wk):
By the end of wk 8, as the embryonic
period closes; the average embryo weight
9 gr and has a crown-rump length of 5cm.
Macroenvironment
Infectious agents (TORCH-S)
Diet and nutrion
Social and emotional stress
Drug and smoking
Teratogens and toxins
Altitude and temperature
Ionizing radiation
Preschool years
Middle childhood
Growth during the period :3-3.5 kg and 56 cm per year.
Growth of the midface and lower face
occurs gradually.
Middle childhood
Weight
1-6 yr: age (yr)x2+8
7-12 yr: age(yr)x7-5/2
Height
2-12 yr: age(yr)x6+77
Or
3-6 yr: age(yr)x5+80
6-11yr: age(yr)x5+84
Probability of a normal
measurement deviating from
mean by this amount
SD
1
%
68.3
SD
1
%
16
95.4
2.3
99.7
0.13
10 % of observations
fall below the 10th
percentile,
90 % below the 90th
percentile.
Target Height
Prediction of target height
For girls: (Father height- 13)+mother height/2
For boys: (Mother height+13)+ father height/2
This gives the range of adult height (+/- 10cm)
that would occur in 95% of the offspring of the
parents in question.
It is of diagnostic importance if predicted adult
height falls below this target range.
Techniques of physical
measurements
Accurate measurement of weight and
length is of obvious importance. Scales
should be calibrated regularly.
Height
Supine measurement- length
In the younger child who can not stand
less than 3 years of age.
Techniques of physical
measurements
Supine measurement- length
One person ensures the head is correctly
positioned with the fixed upright
headboard.
A movable upright footboard is brought
firmly against the heel.
The feet should be flat against the
footboard
Techniques of physical
measurements
One point to remember for accurate
measuremets is the diurnal variation in height.
As a consequence of gravity on the
intervertebral discs, the diurnal variation in
stature can be as much as 20 mm although the
average variation is about 7-8 mm.
Diurnal variation in height can be overcome by
exerting firm but gentle pressure on the mastoid
processes during measurements to stretch the
spine.
Techniques of physical
measurements
Weight preferably in the nude or in
minimal underclothes
Techniques of physical
measurements
Chest circumference
Measurement is made midinspiration at
the level of the xiphoid cartilage or
substernal notch. Measurement is made
with the child recumbent up to age 5 year
and standing thereafter