puberty
female peak height velocity chart
11y fastest growth (6mo before menarche)
male peak height velocity chart
14y fastest growth
what is menarche?
1st period usually 2.5y post-thelarche
how much of bone calcium is set pre-puberty?
50% in F 50-66% in M
what is adrenarche?
=pre-pubescent adrenal medulla activation = Tanner stage I -> adrenal androgen production -> goadarche/puberty
what part of the brain matures last?
DLPFC: executive thinking, planning, coord
what is considered delayed puberty?
F 13, M 14 wo Sx of puberty (>2SD from avg) common: constitutional, largely FHx rare: hypo/hypergonadotropic hypogonadism
when does premature thelarche occure?
F 6mo-3y
when does premature adrenarche occure?
F <6-7yo M <9yo
what is considered precocious puberty?
F<8, M<9 central: premature HPG axis activation periph: gonadarche/adrenarche wo HPG axis
what is gonadarche?
FSH, LH-stimulated gonad activation: puberty
what are the biochemical changes associated with puberty?
Hb: anemia in M/F, ^Hb in males (^testosterone) gynecomastia in 50% M acne psych changes: depression higher in F M/S injury, esp Osgood-Schlatter (patellar lig) gyn: DUB myopia scoliosis
what is Tanner stage IV?
M: genitals mature F: areola + papilla raised about breast
what is Tanner stage III?
M: penile growth F: breast growth
what is Tanner stage II?
M: testicular volume F: thelarche
what is the Tanner stage I?
adrenarche/prepuberty
which grow first: distal or proximal?
distal growth >> proximal
what are the 3 age stages of adolescence?
early 11-14: concrete thinking, same sex peers middle 15-17: abstract thinking, M/F, risk late 17-21: formal thinking, planning, partners
what is Tanner stage V?
full adult development of genital tissues
what may be the biochemical initiator of puberty?
leptin
how to calculate predicted height?
midparental F: (Father-13cm+Mother)/2 M: (Father+Mother+13cm)/2
what is thelarche?
the development of breast tissue 1st sign of puberty in females predates menarche by ~2.5y
what is pubarche?
the development of pubic hair