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Growth and Development of Children

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© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION CHAPTER 3 Growth and Development of Children OUTLINE KEY TERMS Overview Achondroplasia: A type of dwarfism that is usually a Growth and Development sporadic mutation. Prenatal Growth and Development Amniotic fluid: A liquid produced by and contained Embryonic Development within the fetal membranes during pregnancy. Fetal Development Blastocyst: A thin-walled, hollow structure that contains Birth Weight and Gestational Age the inner cell mass (embryoblast), from which the Abnormal Intrauterine Growth embryo arises. Small for Gestational Age Cleavage: The process of mitotic cell divisions that Large for Gestational Age produces a blastula from a fertilized ovum. Growth of Organ Systems Ductus arteriosus: The shunt that connects the Nervous System pulmonary artery to the aortic arch in developing Thermoregulation infants. Cardiovascular System Embryo: The developing offspring, from the 2nd through Respiratory System Gastrointestinal System the 8th week of pregnancy. Urinary System Embryoblast: The inner cell mass, from which the Summary embryo arises. Review Questions Fertilization: The union of a male sperm and a female Case Studies ovum; also called conception. Websites Fetus: The developing offspring, from the 8th week until birth. LEARNING OBJECTIVES Foramen ovale: The second shunt in a fetal heart; it allows blood to enter the left atrium from the right After completion of the chapter the reader should be able atrium. to Full term 1. Describe the major events that occur during : A fetus that has reached 37 weeks of prenatal growth and development. development and is essentially able to survive outside 2. Define the embryonic period. of the womb. 3. Define the terms “low birth weight,” “small for Grasp reflex: A pathologic reflex induced by stroking gestational age,” and “large for gestational age.” the palm, with the result that the fingers flex in a 4. Identify the reasons for abnormal intrauterine grasping motion. In newborns and young infants the growth. tonic grasp reflex is normal. 5. Describe the grasp and Babinski’s reflexes. Hyperplasia: An abnormal increase in cells that causes 6. List four methods of heat loss in the newborn. enlargement of a tissue or organ. 7. Explain the major cardiovascular changes after Hypokalemia: Lower than normal potassium in the blood. birth. Implantation: The process by which a fertilized egg 8. Describe the immaturity of the urinary system after implants in the uterine lining. birth. 23 84409_ch03_6058.indd 23 2/24/12 1:12:27 PM © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION 24 CHAPTER 3 Growth and Development of Children KEY TERMS CONTINUED Morula: The round mass of blastomeres that results from increased heartbeat and respiration, closing of the cleavage of the fertilized ovum; it forms the blastula. eyes, and flexion of the trunk muscles. Polycythemia: Increased numbers of erythrocytes in the Sucking reflex: Involuntary sucking movements of blood circulation. the circumoral area in newborns in response to Sepsis: A potentially serious systemic inflammatory stimulation. response, affecting numerous parts of the body, Trophoblast: Also called the “trophoderm”; it is the commonly caused by septicemia (the presence of outermost layer of cells of the blastocyst that pathogenic microorganisms in the bloodstream). attaches the fertilized ovum to the uterine wall, Startle reflex: A reflex response to a sudden providing nutrition to the embryo. unexpected stimulus. The reaction may be Zygote: The cell formed by fertilization, before the accompanied by physiologic effects, including occurrence of cleavage. Overview approximately at age 12), and is the period when children Growth and development influence which illnesses may affect begin to develop strong peer relationships. Adolescence is a children and their response to these illnesses. Today, infant transitional period, between childhood and adulthood, con- mortality rates are lower than ever before because of great sidered to be from ages 13 to 19. It begins with the develop- advances in the development of medications and other treat- ment of secondary sex characteristics and continues until the ments. Mortality rates for infants are higher today in Black, end of somatic growth. At puberty, growth spurts cause rapid non-Hispanic people than for other groups of people. The development of specific areas of the body at certain times. incidence of premature births continues to cause higher Linear growth results from skeletal growth, and it stops numbers of infant deaths because the bodies of these infants when the skeleton is fully mature. Beginning at age 3 years a may not be mature enough to survive. Infants with very low normal child grows between 5 and 6 centimeters for the next birth weight (less than 3.3 pounds) are increasing in number, 9 years. Growth then slows down, and most organ systems partially because of an increase of twin, triplet, and higher- reach maturity. To reach adult height, growth spurts occur order multiple births. during adolescence. Boys gain about 20 centimeters and girls 16 centimeters during adolescence. Growth and Development Prenatal Growth and Development Growth and development include changing from a fertilized ovum (zygote) to an embryo, fetus, infant, child, and adult. Human growth and development begin when an ovum is fer- Physical growth consists of changes in the body or its individ- tilized by a sperm cell (Figure 3–1). Fertilization is also known ual parts. Changes in body function or psychosocial behaviors as conception. When a developing offspring is implanted into are termed development. Rapid growth occurs during the first the wall of the uterus, pregnancy begins. A pregnancy consists year of life, continuing throughout childhood. of three periods, called trimesters. At least several hundred Middle to late childhood is the period from beginning sperm cells must be present to produce enough enzymes to school (approximately age 6) through adolescence (beginning allow one sperm cell to penetrate the ovum. (A) (B) Figure 3–1 (A) Normal sperm in vaginal secretions. The darkly staining head containing the genetic material is covered by a lightly staining head-cap that contains the enzymes needed to penetrate the ovum during fertilization. The long narrow tail provides propulsion (original magnification 1,000). (B) Mature ovum with adherent granulosa cells. The nucleus is seen near the center of the cell. The homogeneous band surrounding the ovum is the zona pellucida (original magnification X 400). 84409_ch03_6058.indd 24 2/24/12 1:12:29 PM © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Growth and Development 25 In just 24 hours the one-celled organism divides into two Embryonic Development cells. Within 72 hours it further divides into 16 cells and is When the blastocyst is implanted and days go by, a tiny space called a morula. These mitotic divisions are referred to as appears in the embryoblast. This becomes the primordium cleavage. Peristaltic movements propel the morula down of the amniotic cavity. A flat, semiround embryonic disk the oviduct to the uterus. About 4 days after fertilization forms, which becomes all three germ layers of the embryo the morula is divided into two parts by uterine fluids. The (ectoderm, mesoderm, and endoderm). Development placenta (trophoblast) forms from the outer layer, and the increases during the 3rd week as the embryonic disk matures embryo (embryoblast) forms from the inner layer. The struc- (gastrulation) (Figure 3–4). The ectoderm differentiates to ture that is now developed is called the blastocyst, which become the epidermis and nervous system. The endoderm attaches to the endometrium of the uterus by the 6th day develops into the epithelial linings of the respiratory and (Figures 3–2 and 3–3). This implantation period continues digestive tracts as well as glandular cells of the liver, pancreas, during the 2nd week of development. and other organs. The mesoderm forms many structures, There are two main periods of prenatal development. The including the connective and smooth muscle tissues, skeletal embryonic period takes place from the 2nd week to the 8th tissue, striated muscle tissue, RED FLAG week after fertilization, with blood cells and vessels, bone RED FLAG It is vital that the pregnant female main organ systems develop- marrow, and the reproduc- If a pregnant woman requires consume the recommended ing and functioning at mini- tive and excretory organs. physical therapy, the physical dietary amounts of folic therapist assistant (PTA) must mal levels. The fetal period, The axial skeleton and acid for normal neural tube follow the established plan of care beginning during the 9th neurologic system also begin development. The neural tube in regards to educating her about week, involves growth and to form during the 3rd week. develops fully during week 4 of prenatal exercise, proper nutrition differentiation of the organ Many neural-related struc- pregnancy. Incomplete neural and rest, and avoiding smoking tube development can result in a systems of the body until tures form during the 4th condition known as spina bifida. and drinking alcohol. birth. week, and during this period (b) 4-cell stage (c) 8-cell stage (a) 2-cell stage (d) Morula Zona pellucida Polar body (e) Blastocyst (early) Zona pellucida� begins� to degenerate Ovulation Ovary Endometrium (f) Blastocyst (late) Implantation� Inner cell � of blastocyst mass Uterus Trophoblast Figure 3–2 The blastocyst contacting the uterine wall. 84409_ch03_6058.indd 25 2/24/12 1:12:32 PM © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION 26 CHAPTER 3 Growth and Development of Children Endometrium Capillary Cords of trophoblastic cells Decidua Capillary Decidua Capillary Surface of � Surface of � Inner cell mass uterine� uterine� Inner cell mass Developing embryo Surface of uterine� Trophoblast lining lining lining (a) (b) (c) Figure 3–3 The blastocyst beginning to implant. THREE GERM LAYERS the 12th week. Most red blood cells are formed in the liver ECTODERM MESODERM ENDODERM before this point, and this process (erythropoiesis) now trans- fers into the spleen.
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