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Файл:Physiology of the development of the reproductive system of girls. Standards for determining physical and sexual maturity. Study aid
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41
Table 14
Regional age and sex standards for girls aged 15
Grade
body length
Body
length,
cm
Body weight assessment
Harmonious (normal) physical development
From М – 1σR to М + 2σR
Low М – 2,1σ
144
Body weight, kg
below
average from
М – 1,1σ to
М – 2σ
145
33,5
58,4
146
34,2
59,1
147
34,9
59,8
148
35,7
60,6
149
36,4
61,3
150
37,1
62,0
151
37,8
62,7
152
38,6
63,5
153
39,3
64,2
Average
М ± 1σ
154
40,0
64,9
155
40,8
65,7
156
41,5
66,4
157
42,2
67,1
158
43,0
67,9
159
43,7
68,6
160
44,4
69,3
161
45,1
70,0
162
45,9
70,8
163
46,6
71,5
164
47,3
72,2
165
48,1
73,0
166
48,8
73,7
167
49,5
74,4
168
50,3
75,2
169
51,0
75,9
170
51,7
76,6
171
52,4
77,3
172
53,2
78,1
higher
average from
М + 1,1σ to
М + 2σ
173
53,9
78,8
174
54,6
79,5
175
55,4
80,3
176
56,1
81,0
177
56,8
81,7
178
57,6
82,5
179
58,3
83,2
180
59,0
83,9
181
59,7
84,6
High М + 2,1σ
182
–
–
M
163,0
–
54,9
–
–
σ
9,4
–
–
R
–
0,73
–
σ
R
–
8,3
–
42
Table 15
Regional age and sex standards for girls aged 16
Grade
body
length
Body
length,
cm
Body weight assessment
Harmonious (normal) physical development
From М – 1σR to М + 2σR
Low
М – 2,1σ
149
Body weight, kg
below
average
from
М – 1,1σ
to
М – 2σ
150
34,3
62,5
151
35,1
63,3
152
35,9
64,1
153
36,7
64,9
154
37,5
65,7
155
38,3
66,5
156
39,1
67,3
Average
М ± 1σ
157
39,9
68,1
158
40,7
68,9
159
41,6
69,8
160
42,4
70,6
161
43,2
71,4
162
44,0
72,2
163
44,8
73,0
164
45,6
73,8
165
46,4
74,6
166
47,2
75,4
167
48,0
76,2
168
48,8
77,0
169
49,7
77,9
170
50,5
78,7
171
51,3
79,5
higher
average
from
М + 1,1σ
to
М + 2σ
172
52,1
80,3
173
52,9
81,1
174
53,7
81,9
175
54,5
82,7
176
55,3
83,5
177
56,1
84,3
178
56,9
85,1
High
М + 2,1σ
179
–
–
M
163,8
–
55,0
–
–
σ
6,7
– – R
–
0,81
–
σ
R
–
9,4
–
43
Table 16
Regional age and sex standards for girls aged 17
Grade
body
length
Body
length,
cm
Body weight assessment
Harmonious (normal) physical development
From М – 1σR to М + 2σR
Low
М – 2,1σ
152
Body weight, kg
below
average
from
М – 1,1σ
to
М – 2σ
153
39,9
63,9
154
40,5
64,5
155
41,1
65,1
156
41,7
65,7
157
42,3
66,3
158
43,0
67,0
Average
М ± 1σ
159
43,6
67,6
160
44,2
68,2
161
44,8
68,8
162
45,4
69,4
163
46,1
70,1
164
46,7
70,7
165
47,3
71,3
166
47,9
71,9
167
48,5
72,5
168
49,2
73,2
169
49,8
73,8
170
50,4
74,4
171
51,0
75,0
higher
average
from
М + 1,1σ
to
М + 2σ
172
51,6
75,6
173
52,3
76,3
174
52,9
76,9
175
53,5
77,5
176
54,1
78,1
177
54,7
78,7
High
М + 2,1σ
178
–
–
M
165,2
–
55,3
–
–
σ
6,2
– – R –
0,62
–
σ
R
–
8,0
–
44
Table 17
The level of biological development of girls
Age,
years
Body length, cm
M ± 1σ
Annual increase
in body length,
cm
Number of
permanent
teeth, pcs.
The degree of sexual
development, points
7
116,9–128,7
3,0–6,0
6–12
Ax0 P0 B0 Me-
8
118,6–132,6
3,0–7,0
9–15
Ax0 P0 B0 Me-
9
120,3–136,5
4,0–7,0
12–18
Ax0 P0 B0 Me-
10
124,5–142,3
4,0–8,0
16–22
Ax0 P0 B0 Me-
11
131,4–149,8
5,0–8,0
18–24
Ax
0-1 P0-1 B0-1
Me-
12
131,6–151,4
5,0–9,0
22–28
Ax
1-2 P1-2 B1-2
Me±
13
139,8–160,4
6,0–10,0
27–28
Ax
2-3 P2-3 B2-3
Me+
14
142,3–162,7
4,0–8,0
28
Ax
2-3 P3 B3
Me+
15
153,6–170,4
2,0–6,0
28
Ax3 P3 B
3-4
Me+
16
157,1–170,5
1,0–3,0
28
Ax3 P3 B
3-4
Me+
17
159,0–171,4
0,5–2,0
28
Ax3 P3 B4 Me+
45
SECTION 4. MATERIALS FOR SELF-CONTROL
4.1. TEST FOR KNOWLEDGE CONTROL
Instruction: “Test is presented in the form of questions with proposed answers.
You should choose right answers from proposed options. Right answers can be more
than on, there are no questions without correct answers. Recording of chosen
answers should be made in a line separated by commas, after indicating the number
of question”.
1. What is manifestation of hormonal crises in girl in neonatal period?
(several answers possible)
A. desquamation vulvovaginitis.
B. The appearance of colostrum and engorgement fo mammary gland.
C. Nonspecific vulvovaginitis.
D. Mastopathy.
E. Bloody discharge from genital tract.
2. What are age limits of neutral period?
A. 6–7 years.
B. 7–8 years.
C. 8–9 years.
D. 9–10 years.
3. The prepubertal period is characterized by: (several answers possible).
A. Mammary gland enlargement.
B. Menarche.
C. Adrenarche.
D. Appearance of pubic and axillary hair growth.
4. Puberty period is characterized by:
A. Growth “jump”.
B. Mammary gland enlargement.
C. Appearance of the first menstruation.
D. Appearance of pubic and axillary hairiness.
E. All above mentioned.
46
5. Signs of physiological menstrual cycle:
A. acyclity.
B. two-phase.
C. dysmenorrhea.
D. duration of 21–42 days.
E. points B, D.
6. What stage of development of mammary glands is shown in the picture?
A. B 1.
B. B 2.
C. B 3.
D. B 4.
E. B 5.
7. What stage of sex hairiness is shown in the picture?
A. P 1.
B. P 2.
C. P 3.
D. P 4.
E. P 5.
47
8. How many layers of squamous intermediate epithelium does vagina of
newborn girl consist of?
A. 2.
B. 3–4.
C. 5–6 .
D. 7–8.
9. At what month of pregnancy does the intrauterine development of fetal
vagina end?
A. 2.
B. 3.
C. 5.
D. 6.
10. What microorganisms predominate in newborn girl?
1. (Lactobacillis spp.).
2. (Bifidobacillis spp.).
3. (Peptostreptococcis).
11. Which рН of vagina is peculiar for the girls under 8 years old?
A. рН = 4,0–4,5.
B. рН = 7,0–8,0.
C. рН = 5,0–6,0.
4.2. ANSWER TEMPLATE
1. A, B, E.
2. B.
3. A, C, D.
4. A, B, C.
5. E.
6. D.
7. C.
8. C.
9. C.
10. A, B.
11. B.
48
4.3. TASKS FOR KNOWLEDGE CONTROL
Task 1
A 15-year-old girl is visiting a pediatrician. Height — 165 cm, weight — 44,
has been professionally engaged in ballet at the choreographic school since the age
of 10. When examining the armpit — the growth of sparse vellus hair, growth of
long, slightly pigmented hair is noted along the labia majora. The mammary glands
protrude slightly above the chest, there is an increase in the diameter of the areola.
On palpation of the mammary gland, a lobular structure is determined. According to
the girl, there is no menstruation.
Assess sexual development. Make a diagnosis. Tactics for what to do next?
Task 2
At the annual preventive examination by a pediatrician, a girl aged 13 years
10 months. He studies diligently, attends art school. Family history is not burdened,
social conditions are satisfactory. Height — 157 cm, weight — 48 kg. In the axillary
region, long pigmented hair. Pubic hair as in adults, but does not extend to the
perineum and inner thighs. When examining the mammary glands, the nipple and
areola form a secondary tubercle above the surface of the mammary gland. On
palpation, the mammary gland is soft, painless. Menstruation came at 12 years
6 months, established 1 year after menarche. The cycle is regular — 30 days,
menstrual bleeding is moderate, for 5 days.
Assess the sexual development of the girl. Make a diagnosis.
Task 3
At the appointment with a pediatrician, a girl, date of birth December 13, 2001,
examination date November 20, 2016, has a body length of 168 cm, body weight
50 kg, permanent teeth 28, annual increase in body length — 2 cm. Ax3P3B2 Me+.
The girl has no chronic diseases, this year she suffered from infectious hepatitis, the
duration of which was 2.5 months.
Assess the level of the physical by the method of regression scales and the
level of the biological development of the girl, determine the health group.
49
Task 4
On a preventive examination by a pediatrician, a 7-year-old girl, body length
117 cm, body weight 21 kg. She has grown by 5 cm in a year, she has 8 permanent
teeth, sexual development is Ax0P0, the girl has no chronic diseases, this year she
suffered from infectious hepatitis.
Assess the level of the physical by the method of regression scales and the
level of the biological development of the girl determine the health group.
Task 5
At the pediatrician's appointment, the girl was born on September 13, 2002;
commission examination date August 25, 2014. Body length 151 cm, weight 49.6 kg,
increased by 7 cm over the previous year, permanent teeth 23. Ax1, P0, B0, Me-. The
girl is often and for a long time ill, from chronic diseases, diabetes mellitus, drug
allergy attracts attention.
Assess the level of the physical by the method of regression scales and the
level of the biological development of the girl, determine the health group.
4.4. SAMPLE RESPONSES
Task 1
Ax2P2B2Me0. Delayed sexual development. Deficiency in body weight.
Consultation of a pediatric gynecologist. Laboratory studies: KLA, OAM,
hormones (estradiol, FSH, LH, prolactin, ACTH). Instrumental studies: Ultrasound of
the pelvic organs.
Task 2
Ax3P4B4Me1. Timely sexual development.
Task 3
2 health group. 15 year old age group.
The sexual development of Ax3P3Ma2Me+ lags behind the age in Ma.
Biological development lags behind age, disharmonious physical development
due to a lack of body weight.
50
Task 4
2 health group. Annual increase in height — 5 cm — corresponds to age, the
number of permanent teeth — corresponds to age. Sexual development Ax0P0, —
corresponds to age.
Biological development corresponds to age, harmonious (normal) physical
development.
Task 5
3rd health group. 12-year-old age group, Annual increase in height — 7 cm —
corresponds to age, the number of permanent teeth 23 — corresponds to age, sexual
development Ax1, P0, Ma0, Me-, — lags behind age in Ax and P.
Biological development does not correspond to age, harmonious (normal)
physical development.
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