Periods of childhood

IWS 2
Khamitova Dilnaz
Batkalova Aruzhan
262 GM
 Periods of childhood:

•Neonatal period (from birth to 4 weeks of life).

•Infancy (from 29 days to the end of 1 year of life).

•Pre-school age (from 1 year to 3 years).

•Preschool age (from 3 to 7 years).

•Junior school age (7-11 years).

•Senior school, or teenage, age (from 12 to 17-18 years).

 Antenatal period
(from Latin ante - before + natalis - relating to birth) -
the period of intrauterine development of the fetus
from the formation of the zygote to the onset of labor
(40 weeks).
 There are two main periods in the
antenatal period:

1)embryonic(from the beginning of zygote

formation to the 12th week);

2) fetal.
 Fetal is divided into:

1)Early:
(from the beginning of the 12th week to the 29th
week);
2)Late:
(from the beginning of the 29th week to the onset
of labor - the 40th week) prenatal periods.
 During the embryonic period, tissues are laid
down and differentiated, organs and body
parts are formed, and the heart begins to
function.
 FIRST TRIMESTER OF PREGNANCY

4 WEEKS OF PREGNANCY

•The child's head is formed

•The heart, arms and legs are formed.
Blood circulation is established, which
is visible on ultrasound.
•The brain and spine are formed
6 WEEKS

•The heart now has four compartments.

•Fingers and toes are forming
•Reflex activity begins with the formation of
the brain and nervous system.
•Eyes, ears, jaw begin to be visible; The lungs,
stomach and liver are formed.
8 WEEKS OF PREGNANCY

•All important parts of the baby's body

are present, although they are not yet
fully formed.
•The child's eyes, ears, arms and legs are
clearly visible.
•The child's muscles and skeleton
continue to form.
•The nervous system is becoming more
and more refined
12 WEEKS OF PREGNANCY

•The baby begins to swallow, the

kidneys produce urine, and blood
forms inside the bones.
•Formed muscles allow the child
to make full movements
•The baby's eyelids are formed.
•You can determine the sex of the
child
SECOND TRIMESTER OF PREGNANCY
14 WEEKS OF PREGNANCY

•The head, arms and legs of a person

are formed.
•The baby's skin appears transparent.
•Hair begins to grow on the baby's
head
•The baby's movements become more
and more coordinated.
THIRD TRIMESTER OF PREGNANCY
24 WEEKS OF PREGNANCY

•The baby reacts both to external sounds and to sounds

that occur inside the uterus.
•Reflex movements improve and body movements
become stronger.
•The lungs continue to develop.
The child now falls asleep and wakes up.
•The skin becomes reddish and covered with wrinkles
and fine hairs.
•Approximately eight out of ten babies born at this time
survive (in IT wards)
38 WEEKS OF PREGNANCY

•The child’s height (from head to buttocks) is

30cm, and full height is up to 50cm,
weight – from 2.6 to 4 kg.
•By the time of birth, a child has developed
more than 70 different automatic reflex
movements necessary for survival.
•The child is sufficiently developed and
prepared for birth.
 Basic anatomical
physiological characteristics of newborns.

Premature baby–
baby born
for a period of less than 37
full weeks
pregnancy.
Post-term baby -
born at 42

weeks

pregnancy and

more
 Full term baby
Baby born
on time
from 37 weeks to 42 weeks.
 Features of CNS:
⦿The formation of the neural tube occurs
in the 4th week of intrauterine
development.
⦿The brain has all the grooves and
convolutions,
 Features of CNS:
The highest rates of growth and
differentiation of cerebral cortex
cells are observed in the last 2
months of pregnancy and in the first
months after birth.
 Features of the musculoskeletal system:

• Bone tissue contains a lot of water

and is poor in mineral salts,
• The periosteum is thick,
• Large skull (1/4 body length),
 Features of the musculoskeletal system:

• The sutures are wide, the small fontanel is open

in 25% of children,
• Skeletal muscles are less developed
• Hypertonicity of the flexor muscles.
 Features of the respiratory system:

• The ribs are characterized by a slight bend

and almost horizontal position;
• Relative weakness of the intercostal muscles;
• Predominance of diaphragmatic breathing;
 Features of the respiratory system:

⦿ The formation of the respiratory

center has not yet been
completed, but it ensures a
rhythmic change of inhalation
and exhalation (respiratory
cycle);
 Features of the respiratory
system:
• The excitability of the respiratory
center is low;
• Breathing is frequent and shallow;
 Features of the digestive system:
Functional immaturity due to:

• Small capacity of the oral cavity and stomach;

• Low content of specific enzymes in saliva (mucin,
amylase, maltase);
 Features of the digestive system:
• Weak digestive ability of the stomach;
• The gastrointestinal tract is practically
sterile before the first application to the
breast.
 Features of the urinary system:

• The ureters have many bends, their diameter

is 0.3-0.4 cm;
• The bladder has poorly developed muscle and
elastic layers with a well-developed mucosa;
 Features of the urinary system:

• Bladder capacity 30 ml;

• The MP is located anatomically higher than in an
adult, so when filling it is accessible to palpation;
 Diseases (conditions) characteristic of the
newborn period
Asphyxiaand its consequences, obstetric birth trauma (clavicle fractures,
cephalohematoma, etc.), congenital malformations, hemolytic disease
and other hyperbilirubinemia.
Purulent-septic diseases– omphalitis, pyoderma, pemphigus, phlegmon of
newborns, purulent mastitis,
sepsis.
Pneumopathy.
Congenital deformities of the musculoskeletal system:
1) congenital dislocation of the hip 2) congenital clubfoot 3) torticollis
Chromosomal diseases: 1) Down disease 2) Shereshevsky-Turner
syndrome
Genetic diseases:1) phenylketonuria.
Infancy (from 29 days to the end of 1 year of life)
Major events during infancy.

1. During the infancy period, the child’s body length increases

by 50%, and weight more than triples.
2. The relative energy requirement of children of this age is 3
times higher than that of an adult.
3. Tissue differentiation processes occur, most significant in
the nervous system.
4. Motor functions appear and improve:
A). at 1.5 years the child begins to hold his head up.
B). At 6-7 months he begins to sit.
IN). At 6 months the first teeth appear. And by the end of the
year there are eight of them.
 Major events during infancy (continued)
5.The child’s psyche develops intensively:

A) from the first month, the child fixes his gaze on bright objects.

B) by the end of the second month, monitors the movement of an object.

C) after 2-3 months differentiated
perception of objects.

D) formation of speech function by 6 months (pronounces individual syllables).

D) by the end of the first year pronounces the first words.

 Diseases (conditions) characteristic of the period
infancy
The first place in infancy (infancy) is occupied by diseases
that arise in connection with defects in nutrition, regimen, and
environment.
These are rickets, anemia, malnutrition.
This is followed by ARVI, acute digestive disorders and
intestinal infections, including those caused by opportunistic
microflora.
Various manifestations are observedconstitutional
anomalies(exudative-catarrhal, neuro-arthritic diathesis,
etc.), as well asconsequences of perinatal
pathology(encephalopathy, cerebral palsy, congenital
malnutrition, purulent-septic processes, etc.).
 Pre-school age (from 1 year to 3 years)

Main events of this period:

1. The rate of weight and length gain gradually slows down.

2. By the age of 2, the eruption of 20 baby teeth is completed.

3. By the end of 3 years, children speak in long phrases and reason.

4. Motor capabilities expand - from walking to running,

climbing and jumping.

5. Individual character traits begin to emerge.

Diseases characteristic of the pre-preschool period
childhood
I. Diseases of the digestive system.

II. Acute respiratory infections, infections: measles,

chicken pox, scarlet fever, pneumonia,
obstructive bronchitis, croup.

III. Drug poisoning.

IV. Diseases of the nervous system: cerebral palsy.

V. Diseases of the musculoskeletal system: clubfoot,
dysplasia, torticollis.
VI. Foreign bodies in the nose, ear, lungs, stomach
and intestines.
 Preschool age (from 3 to 7 years)
Main events of this period

1. The child’s contacts with the outside world are expanding.

2. The first physiological traction occurs
in length.
3. The replacement of baby teeth with permanent ones
begins.
4. There is a rapid increase in attention span.
5. At this time, children begin to attend kindergarten.
6. Differences in the behavior of boys and girls appear.
7. The greatest activity belongs to the thyroid hormones and
somatotropic hormone.
 Diseases characteristic of preschool age

The incidence of ARVI remains high.

Infections:chickenpox, infectious hepatitis,

scarlet fever, rubella (as contact with the
environment and children increases).

Injuries(lack of experience, lack of adult control).

Nervous system diseases(enuresis).

 Junior school age (7-11 years)
Main events of this period
• Structural differentiation of tissues is completed.
• The complete replacement of baby teeth with permanent
ones occurs.
• By the age of 12, the formation of the nervous system ends.
• Physiological parameters of the respiratory and
cardiovascular systems approach those of adults.
• Functional and adaptive capabilities increase
child.
• The gradual development of the reproductive sphere begins.
 Diseases characteristic of primary school
age
Main health problems
are disorders of posture and vision, the
occurrence of functional disorders of the
nervous system (neuroses,
neuropathies).

Due to poor isolation and overcrowding of

premises, outbreaks of respiratory
infections, influenza, and childhood
infections occur - mumps, rubella, scarlet
fever.
Foci of chronic infection (caries, tonsillitis) are often found.

The most common pathology at this age is diseases of the

digestive system (gastritis, gastroduodenitis,
dyskinesia of the gallbladder and intestines).

Trauma (comes in 1st place, 25-45% are skull injuries).

Senior school, or teenage, age (from 12 to 17-18 years)
Main events of this period

• Coincides with puberty.

• The reproductive system is maturing.
• Intensive sexual differentiation occurs.
• Body size increases rapidly.
• Non-simultaneous growth spurt in boys and girls.
• Significantly increases muscle strength and performance.
• Physical and sexual development occurs faster
intellectual development.
 Diseases characteristic of adolescence

Often found:

A) functional disorders of the cardiovascular and autonomic nervous

systems (“adolescent heart”, “adolescent hypertension”),

B) nutritional disorders (obesity, dystrophy),

C) gastrointestinal diseases (gastritis, peptic ulcer),

D) defects in the development of the reproductive apparatus (dysmenorrhea,

amenorrhea, etc.),

D) endocrinopathies,
E) exacerbation of infectious and allergic diseases).
•
Skin Features:
Elastic fibers appear from 4 months.
• The protective function is weaker than in adults
• The skin is richly vascularized
• Children under one year of age react to heat and cold by dilating
blood vessels
• Sweating begins at 1 month.
• The sebaceous glands function in utero. Most active at 1 year of age
and during puberty
• The number of fat cells increases at 1 year of life, and the size
increases from birth to 6 years.
• Fat at an early age is more dense because... contains more saturated
 Features of bone
systems
• Bones are softer, more elastic, bend and deform
easily, and are less brittle
• Newborn bones contain a lot of water and little
salts
• Physiological condition at 1 year - flat feet and
slight clubfoot
 Features of organs
breathing
1. NOSE:
• Relatively small size
• Narrow nasal passages
• The lower nasal meatus is missing
• The mucous membrane is loose and swells easily
• Paranasal sinuses are formed by 2 years of age
• Wide nasolacrimal duct
2. PHARYNX:
• Poorly developed crypts and vessels of the tonsils
• Frequent hyperplasia of lymphoid tissue by the end of 1 year
3. LARYNX:

Narrow lumen with narrowing in the subglottic

space
Grows rapidly at 1 year of age and during
puberty
False vocal cords grow from 3 to 7 years
 Bronchopulmonary system
1. The angle of origin of both bronchi at an early age is the same
2. The chest is relatively small, the main place is occupied by the mediastinum
3. The ribs are located horizontally
4. Lung tissue and bronchial tree are richly vascularized
5. Short distance between the epiglottis and the bronchial bifurcation
6. Weak mechanisms for clearing the tracheobronchial tree
7. There are more collagen fibers in the lung parenchyma
8. Diaphragmatic breathing
 Features of respiratory
systems
• The depth of breathing, the absolute and relative volumes of one breath are
less than that of an adult
• The younger the child, the higher the respiratory rate
• Gas exchange occurs more vigorously than in adults
Age Breathing rate
1 month 48
6 months 40
1 year 35
3 years 28
6 years 26
10 years 20
14 years 17
 Features of the cardiovascular system:
1. Heart:
• The Batalli duct closes by 6 weeks, the Arantium duct by 2-3
months, and the oval window by 6-7 months.
• Uneven enlargement of the heart
• Horizontal until 2-3 years, then by 3-4 years – oblique
arrangement of the heart
• Up to 2 years there is a loose type of blood supply, up to 5-7
years – reduced and after 7 years – mainline
2. Vessels:
The lumen of the vessels is relatively wide, the
arteries are equal to the veins
The walls of the arteries are more elastic and
blood pressure is therefore lower
Veins grow more rapidly
Capillary permeability is higher in children
Functional features of the cardiovascular
system:
1. High level of endurance and performance of the children's
heart
2. The heart performs relatively more work than in an adult
3. Physiological tachycardia
4. Limited reserve capacity of the heart at an early age due to
myocardial rigidity, short diastole, tachycardia
5. Uneven growth of individual parts of the heart
 Heart rate in children (per minute)
Age Average Bradycardia Tachycardia
Newborn 140 110 170
10-30 days 140 110 170
1-12 months 132 102 162
1-2 years 124 94 154
2-4 years 115 90 140
4-6 years 106 86 126
6-8 years 98 78 118
8-10 years 88 68 108
10-12 years 80 60 100

SBP up to one year = 76+2n; SBP after a year =

90+2n
 Features of the digestive system
1. Features of the oral cavity:
• Small volume of the oral cavity,
• Relatively large tongue
• Well-developed muscles of the mouth and cheeks
2. Salivary glands up to 3-4 months. do not function sufficiently
3. The stomach is located horizontally, the fundus and cardia are poorly
developed, and the pyloric sphincter is well developed.
4. The secretory apparatus is poorly developed at 1 year of age, acidity and
enzymatic activity are lower
5. Growth and differentiation of the pancreas continues up to 14 years of age
6. The liver is relatively large in size, differentiation is completed by 8 years of
age.
7.The intestine is relatively longer, the mesentery is longer.
8. The sigmoid colon is relatively longer
9. The mucous and submucosal layers of the rectum are weakly
fixed
10. The activity of the intestinal secretory apparatus is lower
11. Suction capacity is higher
12. The transit time of food masses in children is shorter.
13. The intestinal biocenosis is easily disrupted.
 Features of the urinary system
1. Morphological maturation of the kidney cortex ends by 3-5
years, the entire kidney - by 7 years.
2. Children require more water to eliminate the same amount of
waste than adults, so they become dehydrated more quickly.
3. The ureter at an early age is relatively wider, more tortuous,
and hypotonic, which predisposes to urinary stasis and
infection
4. At an early age, the effectiveness of the kidney in regulating
CBS is lower than in adults.
 Features of the blood system
1. Features of the stages of blood circulation in the process of development of
the fetus and child (yolk sac, liver, spleen, bone marrow and lymph nodes,
thymus)
2. Transformation of red bone marrow to yellow at 4 years of age
3. Easily occurring metaplasia and transition to embryonic circulation
4. Metaplasia of lymphoid tissue
5. There are 2-4 times more undifferentiated blasts and myeloblasts in the
bone marrow than normal in adults
6. For 3-4 months. fetal hemoglobin circulates
7. Crossover of neutrophils and leukocytes on the 5th day of life and at 4-6
years of life
Age dynamics of changes in neutrophils and
lymphocytes
 Features of the nervous system
1. Myelination of peripheral nerve trunks continues for up to 5
years.
2. The neonatal cortex is immature, the main function is the
thalamo-pallidal system
3. The development of all reflexes depends on the maturity of
the nervous system and the receptors themselves.
4. Newborns react to taste stimuli, hear, and have photophobia
• The newborn has a pronounced total food reflex, there are Moro, Robinson,
Babinsky reflexes
• At 2-3 weeks - reflex to position when feeding and when rocking in the cradle
• From 2 months – indicative reactions, holds his head well
• At 3 months natural visual reflex, recognizes mother, begins to walk
• At 4 months distinguishes colors and sounds, rolls over, stretches arms
• At 5 months recognizes loved ones, sits.
• At 6 months emotional, vocal and facial reactions are expressed
• At 7 months plays with a rattle, babbles, sits well
• At 8 months looks for an object with his eyes, sits and stands
• At 9 months looking for toys, trying to walk
• At 10 months navigates the names of objects, repeats syllables and sounds
• Says up to 8-10 words per year, walks, squats
 Bibliography

∙ Propaedeutics of childhood diseases, edited by R.R. Kildiyarova,

2012