Билет 15

Вопрос 43. Особенности физического развития детей на 1 году жизни.

(Features of physical development in children 1 year of age.)]
The main criteria for a child's physical development are::

• body weight;
• Body length (length);
• Head circumference;
• chest circumference;

The most intensive development of the child occurs at the prenatal (gestational) stage.

Body weight reflects the degree of development of internal organs, muscle and bone tissue, and fat. The average
weight of a newborn is 3500 g.

In most full-term children, body weight is restored by the 10th day after birth, doubles by the age of 4-4.5 months.
and triples by the year. At 1 year, the child's body weight is approximately 10.5 kg.

Body length is an indicator that characterizes the state of plastic processes in the body.

The growth of a healthy child increases during the 1st year by 25-30 cm (the average length at birth is 50 cm).

The circumference of the head at birth is 34-36 cm. For the first year, it increases by 12 cm, and for a one-year-old
child it is 47 cm.

breast circumference;in a 6-month-old child, the chest circumference is 45 cm, 2 cm is taken for each missed month,
and 0.5 cm is added for each subsequent month.

The large Fontanelle increases in size after birth, but then (usually by 6 months) it shrinks and closes completely at
the age of 9-18 months. The small Fontanelle is mostly closed by the 4th month of life.

Ossification of bone tissue . In the first year of life, ossification nuclei appear in some bones of the wrist, in the
epiphyses of the humerus, at the age of 4-8 months - in the ossification nucleus of the femoral head.

Вопрос 44. Врожденные пороки сердца у детей: этиология, клиника дефектов перегородки
сердца. Лечение.
(44. Congenital heart defects in children: etiology, clinic of heart septum defects. Treatment.)
Congenital heart defects are a group of diseases that are United by the presence of anatomical defects of the heart,
its valvular apparatus or vessels that occurred in the prenatal period, leading to changes in the intracardiac and
systemic hemodynamics.

Etiology ;

congenital heart disease may be caused by;

 chromosomal abnormalities (5%),

 gene mutation (2-3%),
 influence of environmental factors (1-2%),
 polygenic-multifactorial predisposition (90%).
 polygenic-multifactorial predisposition (90%).

An interstitial septum defect is a permanent connection between two Atria that occurs as a result of abnormal
development of the secondary or primary Atria.
 A defect between the ventricular septum - a permanent connection of the left and right ventricles through
an abnormal opening in the interventricular septum is undeveloped.A defect between the ventricular
septum - a permanent connection of the left and right ventricles through an abnormal opening in the
interventricular septum is undeveloped.
Clinic;
In newborns with cyanotic congenital heart defects, cyanosis (cyanosis) of the skin and mucous membranes
is noted.
They develop sweating, tachycardia, arrhythmia, shortness of breath, edema and pulsation of the neck
vessels.
With chronic circulatory disorders, children lag behind in weight gain, growth and physical development.
In congenital heart diseases, as a rule, the heart Noise is heard immediately at the place of birth. Further
signs of heart failure (edema, cardiomegaly, cardiogenic hypotrophy, hepatomegaly, etc.) were found.
Diagnostics -.
Electrocardiography (ECG), phonocardiography (PCG), chest radiography , echocardiography
( Echocardiography).
Treatment;
Congenital heart defects in childhood are treated in two ways:
• Surgery.
• Therapeutic procedure.

Вопрос 45.Вегето-сосудистая дистония: этиология, патогенез, классификация.

(Vegetative-vascular dystonia: etiology, pathogenesis, classification.)
Vegetative-vascular dystonia is a complex of functional disorders, which is based on a violation of the
regulation of vascular tone by the autonomic nervous system.
Etiology;
• genetic predisposition
 malformations of the Central nervous system.
 malformations of the endocrine glands.
• personal characteristic.

Pathogenesis

Prolonged combined or isolated effects of etiological and predisposing factors causing emotional stress, increased
activity of adaptive-compensatory reactions in which the important role played by the autonomic nervous system
(ANS). ANS, providing homeostatic regulation of all organs and systems of the body, closely connected with the
activity of hormonal and metabolic reactions and psycho-emotional state of a person. Being in the Center of the
organization of adaptive and compensatory processes of the body, the ANS constantly reacts to all life situations and
therefore often experiences overload. Emerging autonomic disorders are crucial in the formation of somatoform
disorders in psychoemotional overstrain.

Classification

To date, a single classification of vegetative-vascular dystonia has not been developed. According to various authors,
autonomic dysfunction differs in a number of criteria:

• According to the predominance of sympathetic or parasympathetic effects: sympathicotonic, parasympathicotonic

(vagotonic) and mixed (sympato-parasympathetic) type of vegetative-vascular dystonia;

• According to the prevalence of vegetative disorders: generalized (with the interest of several organ systems
simultaneously), systemic (with the interest of one organ system) and local (local) forms of vegetative-vascular
dystonia;

• According to the severity of the course: latent (hidden), paroxysmal (paroxysmal) and permanent (permanent)
variants of the course of vegetative-vascular dystonia;
* By severity of manifestations: light, medium-heavy and severe;

* Etiology: primary (constitutionally conditioned) and secondary (due to various pathological conditions) vegetative-
vascular dystonia.

Treatment;

Positive results in the treatment of vegetative-vascular dystonia are observed from therapeutic massage,
reflexotherapy and water procedures . The applied physiotherapy effect depends on the type of vegetative
dysfunction: in vagotonia, electrophoresis with calcium, mezaton, caffeine is shown; in sympathicotonia, with
papaverine, aminophylline, bromine, and magnesium).