生長發(fā)育GROWTHANDDEVELOPMENT第二章中南大學(xué)兒科學(xué)教研室TOUNDERSTANDTHEREGULARRULEOFGROWTH,DEVELOPMENTTHEAFFECTINGFACTORSTOMASTERTHECRITERIAOFTHEGROWTHTHEDEVELOPMENTPURPOSEREGULARRULEOFGROWTHDEVELOPMENTACONTINUOUSPROCESSUNBALANCEDGROWTHOFEACHSYSTEMRULESINGENERALDIFFERENCEAMONGINDIVIDUALSUPPERTOLOWERPROXIMALTODISTALROUGHTOFINEINFERIORTOSUPERIORSIMPLETOCOMPLICATIONAFFECTINGFACTORSOFPHYSICALGROWTH遺傳因素GENETICFACTORS環(huán)境因素ENVIRONMENTALFACTORS營養(yǎng)NUTRITION疾病DISEASE孕母情況PREGNANCY生活環(huán)境LIVINGENVIRONMENT體重BODYWEIGHTBWCRITERIONOFGROWTHNUTRITIONCONDITIONDIFFERINSPEEDOFBWINCREASETHEYOUNGER,THEFASTERFIRSTPEAKNEWBORN1YEARSECONDPEAKADOLESCENCEATBIRTHBOY（3304）KGGIRL（3204）KG1MONINCREASED115KG3MONSINCREASEDTO6KG1YEARINCREASEDTO9KGBWKGAGEOFMONS9/22YEARSINCREASEDTO12KG26YEARSBWKGAGEOFYRS28712YEARSBWKGAGEOFYRS75/2身高（長）BODYHEIGHTBHCRITERIONOFBONEGROWTHTHESAMEREGULARRULESASBWATBIRTHBH50CM1YEARBH75CM2YEARSBH85CM212YEARSBHCMAGEOFYRS677上部量UPPERPART從頭頂至恥骨聯(lián)合上緣下部量LOWERPART從恥骨聯(lián)合上緣至足底3YRSCROWNRUMPLENGTHCRITERIONOFSKULLSPINEGROWTHSH/BHATBIRTH06714YEARS053下肢增長速度隨年齡增長而加快坐高SITTINGHEIGHTSH指距FINGERDISTANCECRITERIONOFLONGBONEGROWTHOFUPPERLIMBNORMALVALUEFINGERDISTANCEISSCARCELYLESSTHANBH頭圍HEADCIRCUMFERENCEHCCRITERIONOFSKULLBRAINGROWTHATBIRTH3334CM1YEAR46CM2YEARS48CM5YEARS50CM15YEARS5458CM胸圍CHESTCIRCUMFERENCECCCRITERIONOFTHORAXLUNGSGROWTHATBIRTHCC32CM1YEARHC1YEARCCHC上臂圍UPPERARMCIRCUMFERENCECRITERIONOFMUSCLE,BONE,FAT,SKINGROWTHINUPPERARMCRITERIONOFNUTRITIONCONDITION1YRGAINRAPIDLY15YRSGAINSLOWLY5YRS135CMBESTNUTRITION125135CMBETTERNUTRITION125CMMALNUTRITION骨骼發(fā)育頭顱骨發(fā)育GROWTHOFSKULL顱骨縫CRANIALSUTURECLOSEDIN34MONSAFTERBIRTH前囟ANTERIORFONTANELLECLOSEDIN115YRS后囟POSTERIORFONTANELLECLOSEDIN68WEEKSAFTERBIRTH脊柱的發(fā)育GROWTHOFSPINETOREFLEXGROWTHOFVERTEBRAE3PHYSIOLOGICARCUATIONS3MONSRAISINGHEAD頸椎前凸6MONSSITTING胸椎后凸1YEARWALKING腰椎前凸骨骼發(fā)育長骨的發(fā)育GROWTHOFLONGLONE19YRSOSSIFICCENTERAGEYRS1骨齡骨化中心與標(biāo)準(zhǔn)圖譜比較，相當(dāng)于某一年齡標(biāo)準(zhǔn)圖譜時，該年齡即為骨齡。骨骼發(fā)育牙齒的發(fā)育GROWTHOFTEETH6YRSERUPTION2030YRSCOMPLETION78YRSEXCHANGE骨骼發(fā)育乳牙PRIMARYTEETH20410MONSERUPTIONCOMPLETIONBY25YRS2YRSNUMBERAGEMONS（46）恒牙PERMANENTTEETH32體格生長的評價(jià)EVALUATION發(fā)育水平DEVELOPMENTALLEVEL生長速度GROWTHSPEED勻稱程度EQUABLEDEGREE神經(jīng)反射的發(fā)育NERVEREFLEXESEXISTINGBYBIRTH,PERSISTINGFORALIFE角膜反射CORNEALREFLEX結(jié)膜反射CONJUNCTIVALREFLEX瞳孔反射PUPILLARYREFLEX咽反射PHARYNGEALREFLEX吞咽反射DEGLUTITIONREFLEXNOTEXISTINGBYBIRTHBUTAPPEARINGGRADUALLYAFTER46MONS腹壁反射ABDOMINALREFLEX提睪反射CREMASTERICREFLEX腱反射TENDONJERK神經(jīng)反射的發(fā)育NERVEREFLEXESNOTEXISTINGBYBIRTHBUTAPPEARINGGRADUALLYAFTER46MONS腹壁反射ABDOMINALREFLEX提睪反射CREMASTERICREFLEX腱反射TENDONJERK神