2012013学年上学期-绪论、生长发育和儿童保健

1、右江民族医学院教案2011 至 2012 学年上学期课程名称：儿科学任课教师：潘红飞职称：教授授课专业及层次 ：08 临本 7-10 班、全科、心理合班课类型：理论课授课日期：2011年 10 月 11、19 日教研室正、副主任或课程负责人审阅意见：签名：绪论、生长发育和儿童保健（第一章、第二章和第三章）一、授课学时： 120分钟二、教学目的：（一）了解儿科学的特点 To understand the pediatric features（二）掌握儿童年龄分期及各期特征 To master the age stages and features in children（三）了解生长发育规律 T

2、o understand the regular rule of the growth and the development（四）掌握生长发育的指标 To master t he indexes of the growth and the development.（五）掌握儿童神经心理发育 To master t he development of nerve and psychology in children（六）了解各年龄分期保健重点（七）掌握婴儿期保健重点三、重点讲述 儿童年龄分期及各期特征 the age stages and features in children 长发育的指标

3、 the indexes of the growth and the development 掌握婴儿期保健重点基础免疫四、难点：儿童年龄分期及各期特征 the age stages and features in children 长发育的指标 the indexes of the growth and the development 婴儿期的基础免疫五、教具或电教设备： 多媒体 media mix六、教学法： 课堂讲授 lecture method七、讲授内容纲要、要求及时间分配绪论（一）儿科学的任务和范围（ 2 分钟）-举例、启发式讲解导言 Introduction儿科学的定义与范围 D

4、efinition and range of pediatrics（二）儿科学的特点（ 6分钟）-举例讲解（1）基础医学方面 Basic medical features:解剖 Anatomy ；生理 Physiology ；生化 Biochemistry ；病理 Pathology ；免疫功能 Immunology ；营养 与代谢 Nutrition & metabolism（2）临床方面 Clinical medical features:病种 Category of disease；临床表现 Clinical manifestations ；诊断 iagnosis；治疗 Treatmen

5、t；预后 Prognosis ； 预防 Prevention（三）小儿年龄分期及各期特点（15 分钟）举例、启发式、讨论式讲解2胎儿期 Fetal period: 从受孕到分娩共 280 天 From fertilized ovum formed until to delivery (about 40 weeks) Feature: easy abortion or malformation formed by any risk factorsHealth care: pregnant woman and fetus围生期 Perinatal period孕 28 周至生后 1 周 From

6、28 weeks of gestational age (wt1000g) until to 7th day after birth Features: Born from intrauterine to the external worldTo meet a lot of risk factors Highest mortality.Health care: Enough nutrition Prevention of diseases新生儿期 Neonatal period 出生至生后 28 天 From umbilical ligation to 28th day after birth

7、 Features: beginning independent livingThe physiological regulation ability and adaptation to circumstances are very poor. The morbidity and mortality are very highHealth care: enough nutrition proper nursing care prevention of diseases婴儿期 Infancy: 生后至 1 周岁(包括了新生儿期) After delivery until 1 year-oldFe

8、atures: Rapid growth periodFastest brain growth Nutrition and energy requirement are more. Digestion and absorption functions are poor Passive immunity gradually dropsHealth care: enough nutrition Prevention of diseasesBasic immunity幼儿期 Toddler age 1至 3岁 From 1 to 3 year-old Features: growth becomes

9、 slower more vigorously, contact more objects. intelligence develops faster poor ability of identifying damage.Health care: enough nutrition Prevention of diseases Prevention of accident学龄前期 Preschool age3至 6岁 From3 years old until 6-7 years old Features: growth becomes slower, more mature intellige

10、nce.Strong desire for knowledge, imitating adult s behavior Poor ability to identify damageCharacter forming.Health care: enough nutrition prevention of diseasesprevention of accident a good habit training学龄前 School age6 岁至青春期开始 From 6-7 years old until adolescence Features: growth becomes relativel

11、y steady more mature intelligence developed increasing desire for knowledge decreasing incidence of diseasesHealth care: enough nutrition prevention of myopia and dental caries prevention of problems in psychology, emotion and behavior青春期 Adolescence男 13 至 20 岁女 11 至 18 岁 个体相差 2-4 岁From 2nd sexual c

12、haracter appearing until sexual mature and growth stopped Girl: from 11-12 yrs to 17-18 yrsBoy: from 13-14 yrs to 18-20 yrsFeatures: the second fastest period of growth and development neuroendocrine regulation unsteady having problems in psychology, emotion, behaviorHealth care: enough nutrition he

13、alth care of adolescence education生长发育小儿生长发育的规律( 6 分钟) 举例、启发式讲解生长发育的概念(concept)生长发育规律 Regular rule of growth and developmentIt is a progress processGrowth of each system is not parallel.General rules : upper to lower near to distant rough to fine elementary to high-ranking simple to complexDifferenc

14、es between individuals影响小儿生长发育的因素( 3 分钟) GeneticsSexNutritionDiseasesMother s health in the pregnant stage Environment体格生长(50分钟)举例、启发式、讨论式讲解体格生长常用指标图示及举例讲解、提问体重 Body weight (BW) It is a milestone of growth and nutrition condition. Rules: BW raise speed is not equal in different age. the younger, the

15、 faster first peak: newborn to 6 months second peak: adolescence at birth boy (3.3+0.4) kggirl (3.2+0.4) kg 0-3mons 700-800g/mon -6mons 500-600g/mon -12mons 300-400g/mon 0-6mons BW=BW at birth + age of mons 0.7 6-12mons BW=6kg + age of mons 0.25 2-12yrs BW=age of yrs 2 + 8 at birth 3kg 1yr 9kg 2yrs

16、12kg身高 Body height (BH) It is a milestone of bone growth.The regular rule is the same as BW at birth BH 50cm 1yrBH 75cm2yrsBH 85cm2-12yrs BH=age of yrs 7 + 70 upper part of the BH lower part of the BH坐高 Sitting height (SH) It is a milestone of skull and spine growth 1yr CCHC上臂围 upper arm circumferen

17、ceA milestone of muscle, bone, fat, and skin growth in upper armA milestone of nutrition condition 1yr gain rapidly1-5 yrs gain slowly13.5 cmbest nutrition12.5-13.5 cm better nutrition 2yrs number = age (mo) (mo of erupts) fixed teeth 326 yrserupts20-30 yrs completely7-8 yrs exchange神经心理的发育 (18 分钟)

18、举例，图表1. 大脑的发育 Brain development2. 神经反射的发育(1) 条件反射 being at born, persisting for a life corneal reflex conjunctival reflex pupillary reflex pharyngeal reflex deglutition reflex(2) 先天性非条件反射 being at born, but disappearing gradually after 3-4 mons rooting reflex sucking reflex grasping reflex embracing reflex条件反射 not exist at born, but appearing gradually after 4-6 mons abdominal reflex cremasteric reflextendon jerk病理反射 clinically pathologic reflexesBabinski signKerning signBrudzinski signNuchal rigidity2感知的发育 Sensory and Perce