Term
| prenatal/perinatal development |
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Definition
| prior to birth mother, father, and extended family prepare psychologically to endow the child with desired attributes adn characteristics |
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Term
| pregnant women prior to birth |
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Definition
| her attention turns inward to the child, she dreams of what it will be like and may worry about the pain of childbirth and how she will manage |
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Term
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Definition
| thinks what it will be like to be a father and what to do with the new son or daughter and both parents anticipate the shift to triadic relationship with realignment of families of origin |
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Term
| maternal smoking, alcohol, and illicit drug use |
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Definition
| fetal alcohol spectrum is most common cause of non-genetic MR; no alcohol should be consumed during pregnancy; smoking cigarettes associated with low birthweight infants, disruptive behavior disorders in offspring and a lot of children are exposed to 2nd hand smoke |
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Term
| prenatal brain development |
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Definition
| at week 20-sulci and gyri visble on fetal MRI; week 28 the number of neurons peak and dendritic growth and arborization accelerates rapidly; week 34 there are 40000 new synapses formed per second |
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Term
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Definition
| ideally the mother is alert, knows what to expect and supported emotionally by a partner and has trusting warm relationship with the healthcare professionals; immediately after birth the child needs to be in close proximity to the parents so attachment and bonding processes may begin |
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Term
| initial infant appearance |
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Definition
| has little subcu fat, is covered with vernix caseosa, enlarged genitals and possible profuse hair that grows low on the forehead and head may have abnormal shape due to molding from birth |
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Term
| throiditis autoimmune in new mothers |
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Definition
| may occur and mimic the mood symptoms of major depression and hormone replacement therapy is readily available and highly effective |
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Term
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Definition
| evalutating the status of a newborn; 1. heart rate-absent to over 100; 2. respiratory effort-absent to good and crying; 3. muscle tone-flaccid to active motion; 4. reflex irritability-no response to vigorous cry; 5. color-blue, pale to completely pink |
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Term
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Definition
| extension of great toe when lateral surface of sole is stroked and it disappears at age 1 |
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Term
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Definition
| hand closes over finger placed on it; appears 28wks gestation and disappears at 2 months |
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Term
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Definition
| when head is turned, same-side leg extends and other-side arm and legs flex appears 15 wks and peaks at 44 wks and disappears 7-8 months |
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Term
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Definition
| with arms uplifted make body erect, neonate takes steps; disappears at 2-4 months |
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Term
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Definition
| responding to loud noise or startling event, neonate extends and abducts arms and then flexes and adducts them complete at 37 wks and disappears at 3-6 months |
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Term
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Definition
| constriction of pupils when lights shines on them appears at 32 wks and doesnt disappear |
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Term
| landmarks of normal behavioral development |
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Definition
| 1 year-walks with one hand held and cooperates in dressing; 2 years-runs well and kicks large ball, builds tower of 6 cubes, and feeds self but is messy; 3 years-rides tricycle, builds tower of 9-10 cubes, puts on shoes; 6 years-rides 2 wheel bicycle, prints name, and ties shoelaces |
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Term
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Definition
| more primative parts of brain mature first and frontal and association areas develop later; synaptic pruning occurs from years 2-16 where there is a decrease in gray matter and increase in white matter; goes seonsory to motor and association |
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Term
| Piaget Sensorimotor period |
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Definition
| from birth to 2 years of age and child is preverbal and earliest thinking is simply reflec and uncoordinated action which later becomes elaborated, more complex and leads to symbolic thought at the end of the period |
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Term
| six substages of sensorimotor period |
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Definition
| 1. reflex and uncoordinated action (0-1 month)-child grasps or sucks the breast; 2. primary circular reactions (1-4 months)-repetitions of sensory-motor responses; 3. secondary circular reactions (4-8 months)-repetition of motor habits leading to effects in the environment which are of interest to the child; 4. coordination of secondary schemas, object permanence (8-12)-intentionality in moving an object to get to something behind it or use and object to get another object and searching for hidden object which prior assume it ceases to exist; 5. tertiary circular reactions, new discoveries (12-18 months)-repetition with deliberate variations as an experiment; 6. symbolic thought (18-24 months)-infant discovers new means, through internal, mental manipulations |
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Term
| Sigmund Freud psychosexual stages of development |
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Definition
| 1. oral period- 1st year of lifee and childs interests focus on the mouth; 2. anal period-2nd year of life-focuses on toilet training and develops obsessive characteristic with order, holding, expelling, and smells; 3. phallic oedipal-3-5 years of life and child is interested in genitals and has romantic fantasies about the parents |
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Term
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Definition
| derived from psychosexual stages of development; oral period-denial-avoiding awareness of some aspect of reality and projection-reacting to internal stimuli as if it were external; anal period-intellectualization-avoiding affect by excessively using intellectual processes, and passive-aggressive behavior-using lateness, passivity and masochism; phallic-oepidal period-displacement is shifting an emotion from one idea or object to another and sexualization-endowing an abject with sexual significance that it did not have |
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Term
| Margaret Mahler Seperation/Individuation |
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Definition
| development as seperate sense of self from the caretaker; seperation-representing the childs ability to understand themselves as a seperate fusion with the primary caretake and individuation-realization of himself with individual characteristics |
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Term
| phases of seperation/individuation |
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Definition
| 1. normal autistic phase-0-1 months-infant is in disorganized half awake state or asleep unless hunger awakes child; 2. symbiotic phase 2-4 months-begins to be dimly aware of another agency that takes care of needs but not clear where boundaries are; 3. differentiation 5-9 months-awareness of mother as seperate entity aka hatching and smile for mother signals specific bond; 4. practicing subphase 10-16 months locomotion allows infant to move away from mother and come back for emotional refueling and unaware of danger of physical injury and has love affair with world when able to walk independently; 5. rapprochement subphase 18-36 months-sense of invulnerabilty and omnipotence undercut by increasing awareness that mother a seperate being who will not always be there for protection and nuturance and needs mother to be closer; 6. individuation complete 36-60 months sense of being a distinct entity and has sense of object constancy (maintainance of the respresentation of the absent love object) |
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Term
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Definition
| described stages of entire lifecycle in psychosocial terms and described the outcome of the successful negotiation of the period and contrasted that with the consequences of an inability to complete the task; first year-trust vs mistrust; 2nd year-autonomy vs shame and doubt; preschool years-initiative and guilt; elementary school-industry vs inferiority; adolescence-identity vs identity diffusion; toung adulthood-intamicy vs isolation |
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Term
| Temperament of Drs Thomas and Chess |
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Definition
| relatively consistent basic disposition of a person; 9 temperament dimensions and 40% of infants were easy meaning had high rhythmicity, positive mood, high approach,, high adapability, and low intensity; 10% were difficult-irregular in biologic features, slow to adjust to change, negative mood, excessive crying, difficult to soothe; 15% slow to warm up-active, withdrawing, slow to adapt, negative mood, low intensity; remainder were mixtures |
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Term
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Definition
| attachement used to signify the childs relationship to the parent and bonding refers to the parents relationship to the child; normal attachment is essential for healthy development through studies in orphanage-lowered intelligence, lowered resistance to disease, psychiatric problems |
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Term
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Definition
| when children who were normally attached but then seperated from their parents show a pattern of behavior where they were withdrawn, depressed, likely to become ill and showed recovery when reunited with their primary caretakers |
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Term
| behavior when seperated from caretaker for more than 3 months |
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Definition
| 1.protest-child cries out for lost person, searches, actively tries to reunite; 2. despair-when child is not successful in finding the caretake she ceases active efforts and appears to give up; 3. detachment-child has emotionally seperated herself form the mother and ongoing development is impaired |
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Term
| Ainsworth strange situation |
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Definition
| infant subjected to seven steps to test attachment and caretake and child enter a strange room and caretaker leaves the room and then the dyad is reunited a type A-anxious avoidant attachment; type B-securely attached; type C anxious resistant attachment |
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Term
| other aspects of first year of life |
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Definition
| social smile-2months of age; stranger anxiety-7-8 months child fears strangers; transitional object-important when going to sleep, at stressful times, marker between attachment to primary person and seperation; sleep-prior to 6 months of age infant went from awake to directly to REM sleep |
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Term
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Definition
| McGoldrick; 1. early stages-forming and nesting becoming three arrival of first child/dependent member; substage A-development of paretnal identity and enhancement of bonding; substage B-enhancement of autonomy and gender role and identity; substage C-differential interaction with parents of each sex and enhancement of identification with parent of same sex |
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Term
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Definition
| usually achieved between 2-3 years of age, the child has voluntary control of sphincter and is a test of flexibility, empathy, creativity of both child and parent |
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Term
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Definition
| often occurs in parents with impulse control problems, lack of appropriate support system, substance abuse and may resort to harsh physical or verbal punishment or child abuse; usually the one who is not abusing doesnt take effective action to prevent the abuse |
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Term
| attributes of abused toddlers |
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Definition
| impaired attachment to their primary caregivers, lack of pleasure in usual activities, indiscriminant sociability, frequent outbusts of anger and distress and impaired self perception |
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Term
| role of physician in prevention of child abuse |
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Definition
| discussing and counseling patients about appropriate use of sicipline for children; need to be cautious about recommending it to parents it might be heard as an endorsement of harsh physical punishment or abuse; must report suspected physical/sexual child abuse and within 48 hours of report a written report must be made to county agency and they must begin an investigation within 24 hours |
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Term
| penalties for failing to report suspected child abuse |
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Definition
| commits a summary offense for the first bviolation and a misdemenaor of the thrid degree for a second or subsequent violation |
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Term
| Piaget preoperational stage |
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Definition
| ages 2-7; child develops true symbolic tought but does not have structure needed for abstract or logical thought; not able to distinguish clearly between herself and the world and between physical and psychological events |
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Term
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Definition
| sees the world primarily from his own point of view and has difficulty understanding the perspective of another; shown in communication, visually, and an inability to observe himself or his own thinking processes |
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Term
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Definition
| child believes that inanimate objects are alive and have will, motivations and consiousness like human beings |
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Term
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Definition
| childs tendency to ascribe physical animate form to things that are psychological events and what is real to the child is expected to be real to others |
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Term
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Definition
| child believes that humans make all the events and objects of the world for their own purposes |
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Term
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Definition
| child centers or focuses on one aspect of an object or situation while ignoring other important aspects and has lack of understanding of conservation of mass, length, are, volume or numbers |
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Term
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Definition
| illogical thinking that is associational and ideas are connected which may not be logically related |
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Term
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Definition
| by 2-3 years of age can correctly say whether they are boys or girls (gender labeling) gender stability child knows they always were and lways will be same gender; learn sex stereotypes and try to follow them and voluntary erotic gratification |
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Term
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Definition
| distress/pain and 8-12 months social referencing using others emotional expression to interpret ambiguous situations; empathy seen in 2nd year of life; and fear first noter 8-9 months during stranger anxiety and other situations |
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Term
| speech and language of toddler years |
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Definition
| telgraphic 2 word phrases; by 36 months 8-9 word sentences, relates events of 2-3 days ago, knows 2 colors, uses words and and but and can follow 3 commands and stuttering is common before age 3 years and should be referred for evalulation if persists |
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Term
| social development of toddler years |
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Definition
| includes play which evovles way of mastering functions, has rehearsing adult roles, associative play-use same materials and talk together or share toys and imitate each other but do not take different roles |
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Term
| physical development of preschool child |
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Definition
| age4-walks down stairs one step, repeats 4 digits, associative play; age 5-skips, copies a square, dresses self; age 6-rides two wheel bicycle, prints name, ties shoelaces |
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Term
| Kohlberg Moral development preconvential morality |
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Definition
| Level 1-preconventional morality birth to 8 years of age; stage 1-obedience to avoid punishment from superior authority; stage 2-solutions to moral dilemmas based what is most advantageous to the individual and moral reaslism is belief in immediate justice and inevitable punishment does not consider intent or motive or social norms when making normal decisions |
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Term
| level 2 conventional morality |
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Definition
| 8-14 years; stage 3-the individual should take the action society expects-good boy; stage 4-individual should try to uphold the social order takes intent or motive into account |
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Term
| level 3 postconventional morality |
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Definition
| 14 years thru adulthood; stage 5-individual should uphold values necessary to a moral society; stage 6- universal principles require the individual to consider multiple points of view and to act in an honorable manner in all situations |
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Term
| speech and language of pre school child |
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Definition
| by age 3 rapid grwoth in expressive and recentive language ability; 4 years normal child fully intelligibl producing 100% of speech sounds correctly; receptive understanding of spoken language is greater than the ability to express him/herself; using language to talk about language |
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Term
| affective development in preschool child |
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Definition
| object relations-consolidation of sense of self as distinct from others from 3-5 years; normal fears of dark, animals, monsters; imaginary companions; guilt and envy at 3-4 years; insecurity, humility and confidence by 5-6 years |
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Term
| gender and sexuality of pre school child |
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Definition
| knowledge of sexual stereotypes increases as they grow older; sex games and masturbation; by 6 years of age identifies with parent of same sex; confuse adult sexual behavior with aggression |
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Term
| social development in preschool child |
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Definition
| initiative vs guilt; cooperative play-social pretend play constructive play in which children work on different parts of a structure; popularity relates to childrens social behavior and fir between childs characteristics and peers characteristics |
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Term
| myelination during middle years of childhood |
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Definition
| most tracts are myelinated by 2-3 years, total brain size does increases significantly after age 5 but white matter significantly increases due to myelination of axons, pattern proceeds from inferior to superior and posterior to anterior; cortical gray matter decreases in volume during this period due to pruning and cell death of neurons and glial cells; |
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Term
| EEG changes during middle years of childhood |
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Definition
| peak in EEG coherence and phase and EEG alpha activity suggesting accelerated development of right hemispheric frontal-temporal connections |
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Term
| middle childhood motor skill development |
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Definition
| annual weight gain is about 5lbs between 2 years and puberty and average height is 2-3 inches per year from 4 to puberty; body proportions change with head growing smaller relative to the rest of the body; able to do complex gross and fine motor tasks including sports, double-dutch, and musical intruments; also able to make sophisticated drawings and their writing skills improve |
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Term
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Definition
| rate of psychiatric disorders twice as high in inner city as in suburban areas; ADD twice as high in low income families; and deficient language, speech, and cognitive skills occuring with lower SES families |
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Term
| development of drawing skills |
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Definition
| preschool scribble more important in movement and as progresses goes to head with appendages and then eventually head body and elboration and detail, and this allows child to fantasize and communicate trauma |
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Term
| Piaget Stage of Concrete Operations |
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Definition
| ages 7-11 and the child understands reversibility and conservation because of ability to organize and understand systems of action, understands classes, subgroups within classes and manipulate these groups, limited to those things that are concrete and formally present |
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Term
| aspects of stage of concrete operations |
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Definition
| 1. conservation tasks and the child understand conservation; 2. syllogistic thinking where logical deductive reasoning is understood and utilized; 3. reversibility-able to reverse his/her thinking mentally and retrace his thinking and recalculate; 4. transivity by doing class inclusion task (tulips or more flowers) which is longer A or B the B or C etc |
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Term
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Definition
| in latency period; increased inhibition of drives and greater ability to control feelings; child has greater attention span and can postpone gratification more effectively |
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Term
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Definition
| Erik Erikson of middle years of childhood, children are aware of their strengths and weaknesses; have same gender chums and are rule bound with emphasis on obsessive concerns, more ability to use language and have empathy and start to have interest in persons outside of family |
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Term
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Definition
| around 8 years of age have a better understanding, may lead to anxiety, if death of family member at this time then a greater emotional reaction |
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Term
| speech and language of middle childhood age |
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Definition
| learning 7500 wrds/yr and understand exceptions to grammatical rules can read in between the lines, by 9 yrs can understand metaphoric language and proverbs, understands concepts of temporal relations, spatial relations, number markers, abstract ideas, child can keep a conversation going and can tell stories, provide examples, take perspectives, discuss problems and look at alternatives |
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Term
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Definition
| sex hormones begin to rise and sexual exploration and play continue and sexual feelings and masturbation continue should be aware of rules of society regarding appropriate sexual speech and activity; fantasies elaborate and may contains sexual themes, sexual identity typically well |
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Term
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Definition
| ADHD and post tramautic stress disorder, |
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Term
| family life cycle McGoldrick |
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Definition
| middle stages-family expansion/seperation process; entrances-exit of first child from family to larger world and dependence to facilitation of beginning separations-partial expansion; expansion-marker is entry of last child into community and support and facilitation of continuing separations/expansions; exits-first complete exit of dependent member from family with setting up of independent household/marriage, partial seperation to complete independence |
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Term
| psychologic tasks of adolescence |
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Definition
| psychological separation from ones parents, conflicts over homework, grooming, friends, curfews etc showing struggle for autonomy; consolidation of ones sense of self; development of capacity for intimate love relationships; development of ability to control sexual and aggressive impulses |
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Term
| puberty neurologic maturation |
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Definition
| pruning occurs decreases synaptic density; EEG mature alpha rhythms seen during this period; intracortical esp frontal connectivity; sexual dimorphism differences in brain development-males larger gray matter in left amyglada and females-large right striatal and bilateral hippocampal volume increases; pubertal hormonal changes might have organizational effects of developing brain |
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Term
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Definition
| pineal gland secretes melatonin as daylight wanes but teen response is delayed so go to bed later and sleep in later |
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Term
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Definition
| grows during preteen years and shrinks during pruning process in adolescence, later maturation contributes to higher order thinking like inhibitory control over behaviors and emotions, process wont be completed until 3rd decade of life |
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Term
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Definition
| accelerated gray matter loss going from back front direction and excessive pruning |
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Term
| cortical maturation in ADHD |
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Definition
| delay of pattern of cortical development, most prominent in prefrontal cortex mediating higher order cognitive functions |
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Term
| excutive functions of prefrontal cortex |
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Definition
| planning and purposeful goal directed actions, inhibitions and resistance to distractions, problem solving and strategy development, maintanence and persistence in achieving a goal, |
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Term
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Definition
| staging of external physical changes at puberty, 5 stages, breast development, pubic hair, penis and scrotum |
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Term
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Definition
| rate of growth increases dramatically two years before puberty and girls gain about 11 lbs and grow 3-4 per year and boys gain 13-14 lbs and grow 4-5 inches per year |
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Term
| female physical development during puberty |
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Definition
| 12-18 months ahead of male development, first breast buds develop then pubic and axillary hair, broadening of the hips, average age of menses is 11 and have irregular menses for 18 months and age dropping about 6 months every decade |
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Term
| male physical development during puberty |
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Definition
| penis and testes grow to adult size and pubic and axillary hair becomes prominent and voice becomes deeper; seminal emissions occur about age 14 when known as nocturnal emissions; muscle mass strength doubles from ages 12 to 17 |
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Term
| ritual mark of adolescence |
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Definition
| drivers license and adolescence is longer is industrialized nations and main goal is independence from parents |
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Term
| early adolescence in males and females |
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Definition
| males-erections without sexual thoughts, masturbation as a general tension releaser, anal interests with bathroom jokes, little interest in appearance; females-not as open about masturbation, crush on rock star or other unavailable male, find ego ideal, concern about appearance and concern re menses |
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Term
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Definition
| 13-17; males reduce fat stores relative to muscle mass, peak sex drive around 17-18; metabolic rates are higher in males and greater strength and athletic ability in males, adult EEG by 14, peer group becomes of greater importance |
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Term
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Definition
| gender idenity fully established, physical growth complete around 16-17, ability to postpone gratification toward longer term goals, seperation from family origin |
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Term
| Piaget stage of formal operations |
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Definition
| ability to think abstractly, manipulate abstract ideas, use formal logic; hypothetico-deductive-formulates a hypothesis and then gathers data to prove or negate the hypothesis; thinking is propositional-assertions are structured as propositions and these are manipulated using the rules of formal logic; variables are submitted to combinatorial analysis-systematically orders all the possible variables in addition to all the possible combinations of variables to test; not all teens or adults reach this stage |
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Term
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Definition
| genital period of development and struggles with dependence and independence from family, behavioral liscense vs internal control; loyalty to family vs peer group; sharing thoughts and feelings vs privacy; idealization vs devaluing of adults, peers; risk-taking behaviors; omnipotence and invulnerability; accidents, substance abude, violence, suicide |
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Term
| identity vs identity diffusion |
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Definition
| teen should be moving toward a consolidated sense of self and of sexual identity, goals for adult life, planning for a life partner, role models to work toward and ready to prepare for independent functioning; teens who dont develop this will struggle as a young adult |
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Term
| gay, lesbian and bisexual youth |
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Definition
| these youth are at increased risk for depression and suicide, 2-3x more likely to attempt suicide, |
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Term
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Definition
| decreased # of teens in sexually activity and decrease in teenage pregnancy; but increase in STDs and 20% of americans ages 11 and over have genital herpes |
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Term
| children of unmarried teens |
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Definition
| 50% more likely to be of low birth weight, 2x likely to be victims of abuse, scholastic failure likely, teen sons 2.7 times more likely to spend time in prison |
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Term
| Family life cycle last stages |
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Definition
| becoming smaller/extended-last child leaves the household and task is to continuing expansion of independence, endings include death of one spouse/partner thru death of other partner |
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Term
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Definition
| accidents, homicides, and suicides are leading causes of death of teenagers, MVA are leading cause and for black males its homicide; other problems include ashma, acne, migraine headaches, and auditory and visual problems |
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Term
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Definition
| 1. authoritative-high warmth, high responsiveness and high demands; 2. authoritarian- low warmth, low responsiveness and high demands; 3. indulgant-high warmth, high responsivness and low demands; 4. indifferent-low warmth, low responsiveness, and low demands |
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Term
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Definition
| hypothalamic neurons concerned with the release of GnRH; these neurons differentiate outside the brain in olfactory placode and migrate to the hypothalmus along the olfactory tract and go to medial arcuate nucleus of hypothalamus and axons in median eminence |
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Term
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Definition
| defects in the KAL-1 gene that provide the migration of neurons of GnRH secreting neurons |
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Term
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Definition
| sexual differentiation takes place by 10th week and initial secretion of high levels of GnRH and inhibition by GABA another spurt of GnRH occurs in early infancy |
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Term
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Definition
| levels of GnRH are low so sex hormones and FSH and LH are low as well and gonads are small and immature as well; however pulsatile secretions occuras early as age 4; IGF1 increases size of immature gonads |
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Term
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Definition
| gonadostat sensitivity to LH, FSH, and sex hormones begins to lower as approaching puberty and slow increases will become apparent |
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Term
| pulsatile release of GnRH |
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Definition
| result of intrinsic property of GnRH secreting nerves and the inhibitory and stimulatory action of nerves and continuous activity actually decreases FSH and LH bc GnRH acts as an autocrine inhibiting its own secretion |
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Term
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Definition
| event in later childhood and its involvement in hypothalamic-adrenocortical axis and initiates phenotypic events in boys and girls (6-7 in girls and 8-9 in boys) due to maturity of zona reticularis (IGF1, insulin and HGH) synthesis of DHEAS and androstendione 1-2 years later |
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Term
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Definition
| requires coordination and synchronization of 3 mechanisms including nutrition, GPR54 plus kisspeptin-10 and maturation of limbic hypothalamus axis over several months |
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Term
| nutrition in restting the gonadostat |
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Definition
| associated with early onset of puberty girls, not boys; third trimester growth retardation is associated with impaired testicular function (may delay puberty); leptin can stimulate GnRH release thought to be a permissive (necessary but not sufficien) effect, supplements other hypothalamic factors which stimulate GnRH release-obesity can cause early onset of puberty in girls not boys |
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Term
| GPR54 on resetting gonadostat |
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Definition
| cell bodies in arcuate nucleus express GPCR (GPR-54) and synaptic regions of GnRH secreting nerves; associated event is unmasking of gene KiSS-1 in nearby nerves in the amygdala; abnormalities in gene for GPR-54 related to hypogonadotropic hypogonadism; under influence of Kiss-1 gene kisspeptin-10 expressed within other nerves originating near to or withing the amygdala and synapse onto GnRH releasing nerves |
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Term
| maturity of limbic system-hypothalamic axis |
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Definition
| event 1-arcuate nucleus is stimulate by nerves near or within the amygdala where there is increased neuronal dendritic branching and glial cell numbers and decreases threshold to GnRH, FSH, LH and sex hormones and becomes more sensitive to leptin, glutamate, norepinephrine, dopamine, etc; event 2-in hypothalamus, Cl- balance controlled by GABA receptors on GnRH secreting nerves undergo modification and prepubertal expression of the Cl transporter KCC-22 transporting Cl out of the nerve and results in lessened GABA inhibition of GnRH secreting nerves and nerve becomes more sensitive to stimuli |
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Term
| general considerations of puberty |
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Definition
| secretion of GnRH increases at night; but melatonin inhibits GnRH secretion and increased melatonin secretion at night but gonadostat secretion of GnRH is becoming more robust, nocturnal melatonin levels decreases, lag between increased nocturnal melotonin and its effect on inhibiting GnRH out of phase by about 8-12 hrs; intially GnRH increases occurs nocturnally but pulsatile secretion becomes nearly continuous per 24 hours as adulthood approaches |
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Term
| as GnRH increases nocturnally |
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Definition
| LH secretion is stimulated first and followed by FSH secretion but LH concentrations are low and as secretory values increase LH and FSH approach adult values |
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Term
| mechanism for earlier onset of puberty in girls |
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Definition
| brake hypothesis-prepubertal negative feedback inhibition on the gonadostat is less fully applied in femlaes than in males; female GnRH levels are intially slightly higher than in males during the prepubertal period and pulsing can more easily reach adult levels in females compared to males=earlier onset of puberty |
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Term
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Definition
| synergism between HGH, insulin, IG1 and sex hormones during puberty overall growth of body parts will occur but dis-synchrony develops between parts that have a more rapid rate of growth and slower growing parts-larger hands and feet and chest and shoulder size eventually assume adult proportions; estrogen concentration increases near end of puberty and the epiphyses of long bones fuse retarding growth; girls growth spurt is initiated earlier but stops earlier because of the higher levels of estrogen |
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Term
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Definition
| GnRH increases and circulating FSH levels increase to effective concentrations and Lh reach levels about one year later and menstrual cycle flucuations start to appear and plasma estradiol from maturing ovaries increases as FSH concentrations increase and concentrations fluctuate indicating various follicular stages; and as estradiol concentrations fluctuate FSH and LH plasma concentrations will fluctuate due to negative feedback control loops |
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Term
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Definition
| ovulation does not initially occur but induces endometrial proliferation and undergoes proliferative and regressive stages; eventually substantial endometrial growth occurs and as estrogen levels drop the endometrium is shed resulting in menarche and the first ovulation is delayed 6-9 months as positive feedback loop for estradiol is still developing which initiates the LH surge |
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Term
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Definition
| GnRH secretion increases followed by increases in FSH and LH and FSH stimulates testicular growth-increase spermatogenesis and synthesis of inhibin by sertoli cells; LH induces differentiation of interstitial cells to leydig cells and testosterone concentrations increase |
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Term
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Definition
| induces secondary male characteristics-deepening of voice, muscle development, fat pad volume decreases, pubic hair forms diamond shape, male calp pattern of hair and EPO and increased hematocrit and increased libido and aggressiveness |
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Term
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Definition
| boys-pubic hair, testicular length and penile length; girls-pubic hair and breast development; enables clinicians to determine if development occurs within normal time limits or is precocious or delayed; 5 stages |
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Term
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Definition
| in early puberty have highest level neuronal development-synaptic density increased to maximal levels, diffusive stimulation of the cortex and learning new things accomplished rapidly; in late puberty and early adulthood-establishment of frontal lobe and intra cortical pathways and pruning of nerves, dendrites and receptors and synaptic density decreases and more focal stimulation of specific portions of the cortex and learning curve begins to slow and EEG alpha wave patterns by age 14 |
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Term
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Definition
| characterized by aggressiveness, risk taking, and argumentativeness can result in antisocial behavior and as neural pruning continues better self image is gained and mood swings are modulated to adult levels and impulsive behavior is gradually replaced by a more focused behavior; strive for adulthood |
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Term
| adolescent parent interactions |
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Definition
| usually become troubled during early adolescence and attempts to maintain successful communications between adult and adolescent require patience and informed support but relationship improve in late teens to early twenties |
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Term
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Definition
| GnRH secreting tumors from optic glioma or hypothalamic astrocytoma; boys-virilizing adrenal neoplasm or adrenal hyperplasia (CYP21 defect) or leydig cell adenoma; girls-estrogen secreting ovarian tumor, congential adrenal hyperplasia or adrenal adenoma either CPY21 (decreased cortisol synthesis and lack of mineral corticoids=hypotension) and CYP11B1 (decreased cortisol synthesis and increased mineral corticoid synthesis leading to vascular hypertension) |
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Term
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Definition
| hypogonadic hypogonadism-GnRH secretion is not synthesize or not released, CNS tumors, idiopathic gonadotropin deficiency, Kallmanns syndrome or hypergonadic hypogonadism-primary gonadial failure with increased GnRH secretion, Klineflelter syndrome (seminiferous tubular dysgenesis), LH resistance, cryptorchidism-failure of testicular descent into scrotum (defect in IGF-3-HOXA10), defective CYP17 genes resulting in adrenal hyperplasia and combined estrogen and androgen deficiency leading to sexual ambigous genitalia and vascular hypertension and low aldosterone; girls-ovarian mal development is main etiology- gonadal dysgenesis Turner syndrome, polycystic ovary or resistant ovary |
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Term
| hormonal effects on the brain |
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Definition
| have organizational effects (esp direct effects on early brain development); also activational effects-can effect the five sense, BMR, perception, serotonin levels; ie estrogens effect how one can problem solve usually go with normal way of doing things with high estrogen and with low estrogen think of novel ways to do something; the individuals had no difference in cognition but rated themselves as such and thought they felt less smart and more irratible |
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Term
| drug level changes during menstraution |
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Definition
| in both alcohol and Li studies there is a narrow window where the drug has varying levels of effect and can cause a dramatic change in the blood level of that drug |
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Term
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Definition
| is constantly changing and as a result the gonadosteroidal effect is reflecting back on the brain and eliciting effects |
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Term
| role of estrogen in brain |
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Definition
| changes how the brain talks to itself from one area to another area; not just important in recognizing its role in synaptic transmission but the communication of the brain as a whole |
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Term
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Definition
| does not have to do with basal effects of hormone levels but have to do with the changes of those hormones; the luteal phase is usually 14 days and the variability in period comes from differences in follicular phase; and PMS is defined by an absence of symptoms in the follicular phase of the menstrual cycle |
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Term
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Definition
| include anxiety, depression, mood lability, irritability, increased masturabatory activity, bloating, breast tenderness, headache, temperature intolerance, pain sensitivity; to be classified as such must result in the deterioration of interpersonal relationships and/or interference with normal activities |
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Term
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Definition
| signifies around menses, this refers to symptoms when a woman is on menstrual stage |
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Term
| premenstrual magnification |
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Definition
| patients with psychiatric disorders also complain of worsening of their symptoms around the premenstrual phase; seen with women who attempt more suicide during this phase in luteal cycle |
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Term
| behavioral and physical symptoms of PMS |
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Definition
| behavioral-fatigue, irritability, labile mood, depression, oversensitivty, crying spells, social withdrawl, forgetfulness; physical-abdominal bloating, breat tenderness, acne, appetite changes and food cravings, swelling of the extremities, headache, GI upset |
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Term
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Definition
| pattern 1-symptoms can begin at ovulation with gradual worsening of symptoms as luteal phase continues; pattern 2-can begin during second week of luteal phase; pattern 3-brief, time-limited episode of symptoms at ovulation followed by symptoms free days and recurrence of premenstrual symptoms late in luteal phase; pattern 4-have symptoms that at ovulation worsen across the luteal phase and remit only after menses cease |
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Term
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Definition
| include psychiatric disorders, medical disorders, premenstrual exacerbation, or psychosocial spectrum (including past history of sexual abuse which can impact neuronal development) |
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Term
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Definition
| at least 5 of the symptoms with at least one being a core symptoms and present a week before menses and remit after the onset of menses; depressed mood, anxiety or tension, affective lability, irritability, decreased interst in usual activities; concentration difficulties, marked lack of energy, change in appetite, overeating, or food cravings, hypersomnia or insomnia, feeling overwhelmed; these symptoms must interfere with work, school , usual activities or relationships symptoms should not be an exacerbation of previous problems and must have for 2 out of 3 months with a 30% change in follicular vs luteal phase symptoms |
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Term
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Definition
| oral contraceptives-work/have affect for about 1/3 of patients, vitamin b6 has worked but need dose that might be neurotoxic, bromocriptine-used for breat tenderness, MOIs can be used but have strict dietary restrictions; sprinolactone-impact for bloating, primrose oil-omega 3 FAs, fluxetine-approved by FDA for depression |
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Term
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Definition
| ranging from 20-50% and is essential that a doubleblind randomized trials be conducted to assess therapeutic effectiveness |
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Term
| estrogen replacement in perimenopause |
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Definition
| WHI study did a trial to see whether or not it worked; predictors include genetics, but need to know how long to keep someone on it with the risks of developing breast cancer and mechanism of action is not known but the study that showed it shouldnt be used had smokers, heart diease, those over 60, and obese individuals in it and those may skew the results; has a cardioprotective role by digesting clots but in those with CVD already it may dislodge them; the window of opportunity is only the mid 50s or so around perimenopause |
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Term
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Definition
| ages 45-60; start of chronic illness, sets stage for medical adherence, changes in family structure with accompanying stressors |
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Term
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Definition
| achieving adult and civic responsibility, establishing and maintaining an economic standard of living, developing adult-leisure activities, assiting teenage children to become responsible/happy adults, relating to ones spouse as a person, adjusting and accepting changes of middle age physiologically, adjusting to aging parents |
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Term
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Definition
| bridge between two generations, have to adjust relationships with young adult children and their aging parents, and issues such as finances, emotional support, home care, aging in laws become important and a point of conflict |
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Term
| middle age patients expectations of physcians |
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Definition
| have their fears relieved, to be educated about the illness future and options, and not to be told or patronized |
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Term
| Erikson model in middle age |
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Definition
| individuals become aware of death and question whether they are living well; generativity vs stagnation where there is transmission of knowledge to the future |
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Term
| factors which influence ease in midlife transition |
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Definition
| health, status, personality, prior accomplishments; go throught physical changes, health status diminishes, sexuality, cognitive decline, work and leisure, love and marriage, intergenerational relationships |
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Term
| strengths of middle adulthood |
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Definition
| consolidation of identity, humanization of relationships and values, experience in crisis resolution, generativity and expansion of caring, self-transcendence and spirituality |
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Term
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Definition
| 1 in 8 baby boomers will be diagnosed with Alz and chance on developing Alz doubles every 5 years after 65 |
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Term
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Definition
| realize youthful dreams will never materialize, begin to experience pressure of time, coping with the aging process, death of the parents, realization that life is not always just and fair and often do not get what we expected, martital crisis, children grow up and leave home, lose job or are demoted, woman leaves home and goes to work |
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Term
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Definition
| the highest rate of suicide is in elderly caucasian males |
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Term
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Definition
| age 65 and older and increasing in numbers and have major impact on health care |
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Term
| biological effects associated with aging |
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Definition
| immune system, musculoskeletal, integument, GU/reproductive/CNS, cardiovascular, GI, endocrine, respiratory |
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Term
| chronic conditions for persons over 65 |
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Definition
| arthritis, HTN, orthopedic, sinusitis, hearing changes, diabetes, heart disease, visual changes |
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Term
| exercise, diet, and health in aging individuals |
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Definition
| prevention/amelioration of chronic diseases, increases strength of ligaments, bones, muscles and there are less fractures and improved ambulation, less arthritic degeneration; maximizes cardiovascular/respiratory fitness-preseverse independence and quality of life |
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