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Competencies-Based Curricullum
    4th Semester 7th Block
Growth is defined as an increase in size




    Development is defined as a progression

    toward maturity

    Thus the terms are used together to describe

    the complex physical, mental, and emotional
    processes associated with the “growing up” .
adolescence is derived from the Latin word

    “adolescere” meaning to grow, to mature

    a period of human development encompassing

    the transition from childhood to adulthood.
biological changes and sexual maturation that

    occur during the transition from childhood to
    adulthood.

    Average age of onset:


     10 (range 8-13) years in Girls
     12 (range 10-15) years in Boys
Two processes contribute to physical manifestations of

    puberty: adrenarche & gonadarche
    Adrenarche :


    - 6th - 8th years of age, adrenal androgen secretion
    - accompanied by :
       a. Change in pilosebaceous
       b. Transient growth spurt and the
       c. Appearance of axillary & pubic hair but no sexual
          development
    Gonadarche :


    production of sex steroids for the development of secondary
    sexual characteristics, permits the emergence of fertility, and
    mediates a wide range of other physiologic effects.
Female Puberty
OVARIAN REGULATION
             Hypothalamus


              GnRH release

            Pituitary gland


      FSH                     LH

                Ovary


Inhibin                       estrogen
FSH increase in girls on puberty

    associate with ovarian activation
    LH & FSH secretion occurs

    throughout day & night
    FSH controlled mural granulosa

    cell to produce estradiol (most
    potent estrogen)
    LH controlled theca cell to

    produce androstenedione
Estrogens produced by ovaries induce/maintain
secondary sexual characteristics and sustain germ
                 cell production


           • Breast development
           • Libido
           • Body composition
           • Bone mineralization
8   Age (year)   14 14
Stage      Breast Development (B)       Anterior   Lateral

 1      Prepubertal; no breast tissue



 2      Areolar enlargement with
        breast bud


 3      Enlargement of breast &
        areola as single mound




 4      Projection of arola above
        breast as double mound



 5      Mature adult breast with
        single contour
Stage        Pubic Hair (PH)               Picture

  1     None                        None

  2     A few darker hairs along
        labia


  3     Curly pigmented hairs
        across pubes


  4     Small adult configuration



  5     Adult pubic hair
        configuration
24

                                                      • Pubertal growth accounts for
                    22

                                                        about 20% of final adult height
                    20
Height Gain (cm/year)




                    18

                                                      • Pubertal total gain ~ 20-25cm
                    16

                                                        in females and 30cm in males
                    14

                    12

                    10
                                                      • Growth spurt & Fat deposition :
                        8
                                                        - 10-13 years girls taller & more
                        6
                                                         developed than same age boys
                        4
                                                       - Later stimulation of growth due
                        2
                                                         to increasing testosterone
                        0   246    8 10 12 14 16 18
                                  Age (years)
The average lean body mass of teen females falls

    from 80%-74% to 16%-27% by the end of adolescence

    Females experience a 120% increase in body fat

    during puberty

    Teen females acquire approximately 1.14 kg of body

    fat mass each year during puberty.
Male Puberty
TESTICULAR REGULATION
                             Hypothalamus


                           GnRH release

                            Pituitary gland


                  FSH                            LH

                                Testis

       Inhibin                                 Testosterone
(From the Sertoli cells)                      (From the Leyding cells)
v

            LH acts primarily on leydig
        
            cell to stimulate testosteron
            synthesis

            FSH acts on sertoli cell to
        
            reglate spermatogenesis
9   Age (years)   15
Stage      Genital Maturity               Pubic Hair      Gambar

  1     Pre pubertal, testis 2ml   None


  2     Enlargement testis > 4ml, A few darker hairs at
        reddening of the scrotum the basis of the penis



  3     Lengthening of the penis; Curly pigmented hair
        Further enlargement of across pubes
        the testis to 6-10cm


  4     Broadening of the glands Small adult
        penis; Growth of testis to configuration
        10-15ml
Testosterone –Deepens the voice and increases

    body muscle mass (lean body mass).

    Change of body shape


    Body fat levels decrease among males during
    adolescence, dropping to an average of 12%
    body fat by the end of puberty.
Thank
                       You
Puberty, 1894 Munch

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Growth and Changes During Puberty

  • 1. Competencies-Based Curricullum 4th Semester 7th Block
  • 2. Growth is defined as an increase in size  Development is defined as a progression  toward maturity Thus the terms are used together to describe  the complex physical, mental, and emotional processes associated with the “growing up” .
  • 3. adolescence is derived from the Latin word  “adolescere” meaning to grow, to mature a period of human development encompassing  the transition from childhood to adulthood.
  • 4. biological changes and sexual maturation that  occur during the transition from childhood to adulthood. Average age of onset:   10 (range 8-13) years in Girls  12 (range 10-15) years in Boys
  • 5. Two processes contribute to physical manifestations of  puberty: adrenarche & gonadarche Adrenarche :  - 6th - 8th years of age, adrenal androgen secretion - accompanied by : a. Change in pilosebaceous b. Transient growth spurt and the c. Appearance of axillary & pubic hair but no sexual development Gonadarche :  production of sex steroids for the development of secondary sexual characteristics, permits the emergence of fertility, and mediates a wide range of other physiologic effects.
  • 6.
  • 8. OVARIAN REGULATION Hypothalamus GnRH release Pituitary gland FSH LH Ovary Inhibin estrogen
  • 9. FSH increase in girls on puberty  associate with ovarian activation LH & FSH secretion occurs  throughout day & night FSH controlled mural granulosa  cell to produce estradiol (most potent estrogen) LH controlled theca cell to  produce androstenedione
  • 10. Estrogens produced by ovaries induce/maintain secondary sexual characteristics and sustain germ cell production • Breast development • Libido • Body composition • Bone mineralization
  • 11. 8 Age (year) 14 14
  • 12. Stage Breast Development (B) Anterior Lateral 1 Prepubertal; no breast tissue 2 Areolar enlargement with breast bud 3 Enlargement of breast & areola as single mound 4 Projection of arola above breast as double mound 5 Mature adult breast with single contour
  • 13. Stage Pubic Hair (PH) Picture 1 None None 2 A few darker hairs along labia 3 Curly pigmented hairs across pubes 4 Small adult configuration 5 Adult pubic hair configuration
  • 14. 24 • Pubertal growth accounts for 22 about 20% of final adult height 20 Height Gain (cm/year) 18 • Pubertal total gain ~ 20-25cm 16 in females and 30cm in males 14 12 10 • Growth spurt & Fat deposition : 8 - 10-13 years girls taller & more 6 developed than same age boys 4 - Later stimulation of growth due 2 to increasing testosterone 0 246 8 10 12 14 16 18 Age (years)
  • 15. The average lean body mass of teen females falls  from 80%-74% to 16%-27% by the end of adolescence Females experience a 120% increase in body fat  during puberty Teen females acquire approximately 1.14 kg of body  fat mass each year during puberty.
  • 17. TESTICULAR REGULATION Hypothalamus GnRH release Pituitary gland FSH LH Testis Inhibin Testosterone (From the Sertoli cells) (From the Leyding cells)
  • 18. v  LH acts primarily on leydig  cell to stimulate testosteron synthesis FSH acts on sertoli cell to  reglate spermatogenesis
  • 19. 9 Age (years) 15
  • 20. Stage Genital Maturity Pubic Hair Gambar 1 Pre pubertal, testis 2ml None 2 Enlargement testis > 4ml, A few darker hairs at reddening of the scrotum the basis of the penis 3 Lengthening of the penis; Curly pigmented hair Further enlargement of across pubes the testis to 6-10cm 4 Broadening of the glands Small adult penis; Growth of testis to configuration 10-15ml
  • 21. Testosterone –Deepens the voice and increases  body muscle mass (lean body mass). Change of body shape  Body fat levels decrease among males during adolescence, dropping to an average of 12% body fat by the end of puberty.
  • 22. Thank You Puberty, 1894 Munch