25131 - Growth & Development in Adolescence KN AGARWAL...

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KN AGARWAL , President Healthcare & Research Association for Adolescents E mail : adolcare@hotmail.com
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1. Succession of events in development of secondary sexual characteristics during puberty is consistent. 1. There is individual variation in the age of onset, duration and tempo of Growth.
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Ethnic & Sibling variability in the onset and duration of Puberty 1. Ethnic- American Blacks enter puberty earlier than Whites: Breast Stage-2 at 8 years of age Blacks 48%( average age 8.8yr; PH- 8.7yr); Whites-only 15%( Av age 9.9yr; PH 10.7 yr). However, “Menarche” same time 12.2yr and 12.8yr, respectively. 1. Besides racial “Onset of Puberty” is different in an individual child, as well as in case of siblings (Ann Hum Biol 2005; et al Das Gupta)
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Puberty encompasses- - Somatic 1. Adolescent growth spurt, 2. Development of secondary sexual characteristics. 3. Attainment of fertility. 4. Establishment of individual sexual identity. 5. Timing for Puberty onset has wide variability- 6. Girls- 8-12 years and Boys- 9-14 years of age.
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Adolescent Growth Spurt 1. Begins distally with enlargement of Hand and Feet, followed by the Arms & Legs and finally by the Trunk and Chest. 2. Larynx, pharynx and lungs—Voice 3. Androgens- a) Sebaceous glands- Acne, b) Optic globe-myopia and c) dental- jaw growth, loss of deciduous teeth eruption of permanent cuspids, premolars, and finally molars.
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Puberty -GIRLS 1. First sign of ovarian estradiol secretion is breast development “Thelarche”.SMR-B-2 (Breast budding)- GROWTH IN HEIGHT. 2. Estradiol is a good stimulator of “GH” it doubles the growth velocity “PEAK HEIGHT VELOCITY’(9-10 cm / yr). Coincident with B-3. Follows B-2 by 1 yr. 3. Change in body shape 4. Growth under arm hair followed by secretion 5. Menarche follows PHV by 14-18 months. 6. Adult size breast
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Development of breast and pubic hair in girls - (Indian Data) Development of breast and pubic hair in girls - Sexual maturity Breast Pubic hair (Mean age = 13.6yr) Stages (SMR) 1. Preadolescent Pre-adolescent 2. Bud stage and papilla elevated sparse lightly pigmented straight as small mould (10.2 yr) around medial border of labia (22%) 3. Areola enlarged no contour darker, more and curly + (92%) separation(11.6 yr) 4. Areola and papilla form secondary coarse curly mound (13.6 yr) abundant (98.8%)
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The growth in the post menarche period is limited as girls can gain 5-6 cm in linear growth, only. Thus the maximum gain in height is pre-menarche in SMR- stages –B-2 & B-3.
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Puberty- BOYS 1. Adrenarche is the ONSET & CONTINUITY of male PUBERTY 2. Testosterone/dihydrotestosterone are needed in large concentration to initiate “GH” via the androgen receptors. (Thus later than girls by 1-2 yr). 3.
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This note was uploaded on 02/26/2012 for the course PHARM 210 taught by Professor Staff during the Fall '10 term at Rutgers.

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25131 - Growth & Development in Adolescence KN AGARWAL...

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