Periods of the chidrens life

Pediatrics studies
The laws of a child’s development
Rules of child’s feeding
Etiology and pathogenesis of children’s diseases
Ways of their diagnostic, treatment and prophylaxis

Proupaedeutics studies
The features of growth, development, and formation all systems of child’s organism in different period of life
Methods of examination, palpation, percussion, auscultation of internal organs and systems of healthy or sick children
Semiotics of lesion of different organs and systems
Clinical processing of date obtained after general and additional examination of patients

Periods
of the children’s life
Intrauterine period
Extra uterine period
Breast – feeding (infancy) period
Pre-preschool period
Preschool period
Junior school period
Senior school period

Intrauterine period
Continues from fertilization up until birth of child - 270 days (in practice - first day of the last menstrual cycle of the mother- 280 days (40 weeks))
Subdivided into following phases
1)Embryonal growth phases
2)Placental growth phases

Embryonal growth phases
is characterized by organogenesis,
highest rate of tissue differentiation
formation of almost all internal organs of future
child
This period is critical stage of human
development and contains the maximum risk of
the developing embryopathies (severe anatomical defects)

Unfavorable factor
Exogenous
Endogenous (genetic)
Combination of exogenous and endogenous

Unfavorable factor during the pregnancy
Non adequacy fetal nutrition
Acute diseases and reactivation diseases of mother
Mother’s heavy physical activity
Professional hazards of mother
Alcohol intake and smoking habits of parents
Bad socio-economic conditions

Teratogenic agents
Infection rubella virus, the cytomegaly virus and the toxoplasmosis parasite (toxoplasma gondii).
chemical substance
ionizing radiation
trauma (amniotic bands, which led to an amputation of upper extremities or lower extremities )

Embryopathies
Agenesia:
The absence of organ
Defect in the structure of the organ or part of organ or anomaly in its development
Cleft lip
Congenital heart defect
Cephalocele
Congenital esophageal obstruction

Agenesis of lung

Pelvic agenesis

Agenesis upper extrimites

Agenesis lower exrimites

Cleft palate
Cleft palate

Cleft lip

Placental growth phases
is characterized by
maturation of all systems and organs,
increase of body length and weight of fetus,
divided into two periods
early fetal period – from beginning of the 9-th week up to the end of 28-th week
Late fetal period – after the 28-th week until the child’s birth

Early fetal period
Is characterized by intensive development of body and differentiation of fetal organs and systems
Unfavorable factors can slow down the development of the organs and tissue differentiation
This period are called early fetopathy minor anomalies and physiological defects)

Early fetopathy
Hypoplasia of organs
Dysplasia:
Abnormal organization of the cells in a tissue (e.g., osteogenesis imperfecta
a hereditary disease, characterised by fragility of the skeleton which results in fractures and deformities Also called: brittle bone syndrome
Numerous dysplasias are genetically caused (e.g., achondroplasia)

Late fetopathy
Intrauterine fetal hypotrophy
Fetal hypoxia
Fibroelastosis of myocard
Diabetic fetopathy
Fetal alcohol syndrome
Infectious fetopathy

Late fetal period
Pathological factors do not affect the already formed fetal organs, but could cause early deliveries and birth of the pre-mature babies with low body mass – late fetopathies

Late fetopathy
Intrauterine fetal hypotrophy
Fetal hypoxia
Fibroelastosis of myocard
Diabetic fetopathy
Fetal alcohol syndrome
Infectious fetopathy

A six year-old girl with several skeletal deformities and cutaneous lesions

Fetal alcohol syndrome

Fetal alcohol syndrome

babies with Down syndrome
people funny

Congenital geniralization cytomegaly infection

Congenital geniralization cytomegaly infection

A six year-old girl with several skeletal deformities and cutaneous lesions

Intra – natal period
Lasts (from the uterine contractions till clamping of the umbilical cord, from 2-4 hours to 18 -20 hours)
Dangers of this period
Central and peripheral nervous system trauma
Disturbances in umbilical blood supply
Respiratory disorders

Extra uterine period
Neonatal period
Early – first7 days
Late – 8 – 28 days
Breast-feeding period (from 29 day to 1 year of life)
Pre-preschool period ( 1 -3 year of life)
Preschool period (from the 4-th till 6-th year of life)
Junior school period ( 6-10 years – girls, 6-12 years – boys)
Senior school period ( from 12- th year to 18 - th year
of life)

Adolescence
Prepubescent 10-12 years girl
12 – 14 years boys
Pubescent 12 – 14 years girl
14 -16 years boys
Postpubescent 14 – 18 years girl
16-20 years boys

In practic used
Antenatal period (whole period of pregnancy)
Perinatal period ( from the 28-th week of intrauterine development till the 7-th day of life)
Postnatal period (from birth to 18 years of age)

Neonatal period
basic physiological features
The main characteristic of this period – it is period of adaptationto oututerine conditions of life.
The newborn makes first his breath. The air fills his lungs.
The pulmonary circulation begins its action. The hole between right and left atrium became closed.
Just the same the duct of Batallo is closing after birth.

Neonatal period
basic physiological features
Beginning of alimentary feeding
Immaturity of digestive tract, spreading of microflora in intestines, feature of stool
Features of 1-ststage of nervo –psychlogical development( the newborn period is characterized by some automatic or unconditioned reflexe).
Changes in energy exchanges
Physiological features of blood component
Urine components and frequency of its evacuation
Features of thermo-regulation

What pathology is characteristic for newborn period?
The first of all it is intrauterine infections. Such as citomegalovires, hepatitis B, viruses rubella, measles, virus flu, toxoplasmosis and some others
The second. It is delivery trauma, especially dangerous is intracranial delivery trauma, hypoxemia
And the third – anomalies or vices of development are another kind of pathology in newborn period. It may be congenital anomalies of heart, kidneys, lungs and so on.

Neonatal period
Attributes of pathological conditions
All kinds of fetopathies
Non-compatibility of maternal and fetal blood
Immaturity and preterm child
Congenital hypotrophy
Hereditary diseases ( Down’s syndrome, phenylketonuria
Manifestation of pylorospasm, pylorostenosis

Breast-feeding period
In this period a child grows as fast as he never does later
He doubles his weight in six month of age and trebles to an end of first year of age
He increased increased his length of body on 25 cm
Formation of skeletal system, eruption of milk teeth

Breast-feeding period
basic physiological features
Obliteration of the closed channels of blood circulation, heart rate, changes in BP
Features of gastrointestinal tract, dependence of the type feeding
Physiological features of blood components
Loss of passive immunity

Brest-feeding period
Pathological conditions
Disorders of physical development (hypotrophy, hypostature, paratrophy)
Disease of the nervous system such as encephalopathy, hydrocephaly, cerebral palsy
Appearance of symptom of congenital and hereditary diseases
Rickets
Atopic dermatitis

Paratrophy

Hypotrophy

Rickets

Atopic dermatitis

Breast-feeding period
Pathological conditions
Very often respiratory diseases of viral and bacterial etiology characterized by fast development and generalization of process
Very often occurrence of “false croup”
Purulent illnesses of skin
Pylorospasm, pylorostenosis whith many symptom
Inflammatory diseases of digestive system such as gastroenterocolitis

Pre- preschool and preschool periods
basic physiological features
Decrease in speed of the physical development
Final psychological development, maturity of the upper nervous activity. In this period infant begins to speak, and has very much moving.
Formation of skeletal system, eruption of milk teeth and growth permanent teeth

Pre- preschool and preschool periods
pathological conditions
Endocrine disorders of physical development (nanism, obesity)
Final statement of the diagnosis in the development of psychlogical disordes
High frequency of respiratore disordes
Very often false croup( in the pre-preschool period)

Pre- preschool and preschool periods
pathological conditions
Very often diseases of allergic origin (obstructive bronchitis, bronchial asthma
Among gastrointestinal diseases occur function dyspepsia, biliary dyskinesia
High frequency of infectious diseases such as chicken pox, measles, rubella

Chicken pox

Chicken pox

Measles

Mumps

Mumps

Junior and senior school periods
basic physiological features
The final stage of physical development
Replacement of milk teeth to permanent ones
Formation of vegetative nervous system
Emotional and psychological maturity, formation of personality
Sexual development
Features of functions of endocrinal glands

Adolescence
Prepubescent 10-12 years girl
12 – 14 years boys
Pubescent 12 – 14 years girl
14 -16 years boys
Postpubescent 14 – 18 years girl
16-20 years boys

Junior and senior school periods
pathological conditions
Endocrine deaserdes (obesity, nanism, thyrotoxicosis, deaserdes of sexual development
Deaserdes of nervous system (central and vegetative )
Mental [emotional] illnesses
Sceletal deaserdes ( caries, scoliosis)
Gastrointestinal disease ( gastroduodenitis, cholecystitis, peptic ulser)

Peptic ulcer