NUR304 Exam3.txt

Period of transition with gradual appearance of secondary sex characteristics at about 11-12 years of age with cessation of body growth at 18-20 years

Maturational, hormonal, and growth process occurring when the reproductive organs begin to function and the secondary sex characteristics develop

Three Stages of Puberty
#1: The period of about 2 years immediately before puberty when child is developing preliminary physical changes that herald sexual maturity

Three Stages of Puberty
#2: The point at which sexual maturity is achieved

Marked by the first menstrual flow in girls but by less obvious indications in boys

Three Stages of Puberty
#3: A 1-2 -year period following puberty during which skeletal growth is completed and reproductive functions become fairly well established

External and internal organs that carry out the reproductive functions (e.g., ovaries, uterus, breasts, penis)

Changes that occur throughout the body as a result of hormonal changes (e.g., voice alterations, development of facial and pubertal hair, fat deposits) but play no direct part in reproduction

Usual Sequence of Maturational Changes in Girls (Box 40-1)

Usual Sequence of Maturational Changes in Boys (Box 40-1)

The events of puberty are caused by hormonal influences and controlled by:

Stimulation of the gonads has a dual function:

Responsible for the small amounts of sex hormones secreted before the pubescent years

This feminizing hormone is secreted in slowly increasing amounts until about age 11 years. In males this gradual increase continues through maturation.
In females the onset of its production in the ovary causes a pronounced increased that continues until about 3 years after the onset of menstruation, at which time it reaches a maximum level that continues throughout the reproductive life of the female.

This masculinizing hormones are also secreted in small and gradually increasing amounts up to about 7 or 9 years of age, at which time there is a more rapid increase in both sexes, especially boys, until about age 15 years.
These hormones appear to be responsible for most of the rapid growth changes of early adolescence. With the onset of testicular function, the level of this hormone (principally testosterone) in males increases over that in females and continues to increase until a maximum level is attained at maturity.

These stages of development of secondary sex characteristics and genital development have been defined as a guide for estimating sexual maturity

In most girls the initial indication of puberty is the appearance of breast buds, which occurs between 9 and 13 1/2 years of age.

Following the breast buds, in approx. 2 to 6 months, is the growth of pubic hair on the mons pubis. In a minority of normally developing girls, however, pubic hair may precede breast development.

The initial appearance of menstruation occurs about 2 years after the appearance of the first pubescent changes, approx. 9 months after attainment of peak height velocity, and 3 months after attainment of peak weight velocity.

The normal age range of menarche is usually 10 1/2 to 15 years, with the average age being 12 years, 9 1/2 months for North American girls.
Ovulation and regular menstrual periods usually occur 6 to 14 months after menarche.

Girls may be considered to have this if breast development has not occurred by age 13 or if menarche has not occurred within 4 years of the onset of breast development.

The first pubescent changes in boys occurs between 9 1/2 and 14 years of age. Boys who exhibit no enlargement of the testes or scrotal changes by 13 1/2 to 14 years of age, or genital growth is not complete 4 years after the testicles begin to enlarge are considered this

Temporary breast enlargement and tenderness are common during mid-puberty, occurring in up to one third of boys. For most boys, breast enlargement disappears within 2 years

The final 20%-25% of height is achieved during puberty, during a 24-36-month period.

The growth spurt begins earlier in girls, usually between ages 9 1/2 and 14 1/2 years; on the average it begins between ages 10 1/2 and 16 years in boys.
During this period, the average boy gains 10-30 cm (4-12 in.) in height and 7-30 kg (15 1/2-66 lb) in weight. The average girl gains 5-20 cm (2-8 in.) in height and 7-25 kg (15 1/2-55 lb) in weight.
Growth in height typically ceases 2-2 1/2 years after menarche in girls and at age 18-20 years in boys.

The sequence of growth produces a long-legged, gawky early adolescent child.
Growth in length of extremities and neck, a few months later in hip and chest breadth, followed several months later by increase in shoulder width. Then comes increases in length of the trunk and depth of the chest.

Sebaceous glands become extremely active at this time, and are extremely important in the pathogenesis of a common problem of puberty

Present almost everywhere on the human skin, becoming fully functional and responding to emotional and thermal stimulation

Limited in distribution and grow in conjunction with hair follicles in the axillae, around the areola of the breast, around the umbilicus, on the external auditory canal, and in the genital and anal regions
Secrete a thick substance as a result of emotional stimulation that, when acted on by surface bacteria, become highly odoriferous

Erikson: Developing a Sense of Identity
The adolescent comes to see themselves as distinct individuals, somehow unique and separate from every other individual

Group Identity vs Alienation
Personal Identity vs Role Diffusion