Growth and Disorders of Muscles in Children
As skeletal development is responsible for linear growth, muscle growth accounts for a significant portion of the increase in body weight.
The number of muscle fibers is established by the fourth or fifth month of fetal life and remains constant throughout life.
Difference in muscle size between individuals and differences in one of the separate muscle size between individuals and differences in one person at various times during a lifetime are the result of the ability of the separate muscle fibers to increase in size.
The increase in muscle fiber length that accompanies growth is also associated with an increase in the number of nuclei in the fibers.
This increase is most apparent during the adolescent growth spurt.
At this time the increase in secretion of growth hormone and adrenal androgens stimulates the growth of muscle fibers in both sexes, but the growth in boys is further stimulated by the secretion of testosterone.
At about 6 months of prenatal life, muscle mass constitutes approximately one sixth of the body weight; at birth, about one fourth, and at adolescence, one third.
The variability in size and strength of muscle is influenced by genetic constitution, nutrition, and exercise.
At all ages muscles increase in size with use and shrink with inactivity.
Consequently maintaining muscle tone to minimize the amount of atrophy in skeletal muscle through active or passive range or motion exercises is an important protective nursing function.
Peculiarity of musculoskeletal system in newborn At birth, the skeletal system contains larger amounts of cartilage than ossified bone, although the process of ossification is fairly rapid during the first year.
The nose, for example, is predominantly cartilage at birth and is frequently soft and not yet joined.
The sinuses are incompletely formed at birth.
Growth in the size of muscular tissue is caused by hypertrophy, rather than hyperplasia of cells.
Duchenne Muscular dystrophy Inherited disorder is characterized by gradual degeneration of muscle fibers.
1.
Manifestations of duchenne muscular dystrophy • Waddling gait • Marked lordosis.
• Frequent falls.
• Gower sign (the child turns onto side and abdomen, flexes knees to assume a kneeling position, then with knees, extended gradually pushes torso to an upright position by "walking" the hands up the legs).
• Enlarged muscles especially thighs and upper arms) • It is felt unusually firm or woody on palpation.
2.
Later signs • Profound muscular atrophy • Mental deficiency (common), usually mild.
• Complications (contracture deformities of hips, knees and ankles, diffuse strophy, obesity).
Paraclinic diagnostic procedures • Serum enzyme measurements (creatine phosphokinase, aldolase, glutamicoxaloacetic transaminase).
• Electromyography • Muscle biopsy.
Nursing care plan Help the child to develop self-help skills; to modify clothing for wheelchair wear, to fit over the contracted limbs; help the family to modify the environment to facilitate self help.
Emphasize on the importance to carry out physical therapy program.
Help the family to acquire the necessary equipment to promote mobility.
You can be the child's immediate doctor even before the professional comes to his/her aid.
The number of muscle fibers is established by the fourth or fifth month of fetal life and remains constant throughout life.
Difference in muscle size between individuals and differences in one of the separate muscle size between individuals and differences in one person at various times during a lifetime are the result of the ability of the separate muscle fibers to increase in size.
The increase in muscle fiber length that accompanies growth is also associated with an increase in the number of nuclei in the fibers.
This increase is most apparent during the adolescent growth spurt.
At this time the increase in secretion of growth hormone and adrenal androgens stimulates the growth of muscle fibers in both sexes, but the growth in boys is further stimulated by the secretion of testosterone.
At about 6 months of prenatal life, muscle mass constitutes approximately one sixth of the body weight; at birth, about one fourth, and at adolescence, one third.
The variability in size and strength of muscle is influenced by genetic constitution, nutrition, and exercise.
At all ages muscles increase in size with use and shrink with inactivity.
Consequently maintaining muscle tone to minimize the amount of atrophy in skeletal muscle through active or passive range or motion exercises is an important protective nursing function.
Peculiarity of musculoskeletal system in newborn At birth, the skeletal system contains larger amounts of cartilage than ossified bone, although the process of ossification is fairly rapid during the first year.
The nose, for example, is predominantly cartilage at birth and is frequently soft and not yet joined.
The sinuses are incompletely formed at birth.
Growth in the size of muscular tissue is caused by hypertrophy, rather than hyperplasia of cells.
Duchenne Muscular dystrophy Inherited disorder is characterized by gradual degeneration of muscle fibers.
1.
Manifestations of duchenne muscular dystrophy • Waddling gait • Marked lordosis.
• Frequent falls.
• Gower sign (the child turns onto side and abdomen, flexes knees to assume a kneeling position, then with knees, extended gradually pushes torso to an upright position by "walking" the hands up the legs).
• Enlarged muscles especially thighs and upper arms) • It is felt unusually firm or woody on palpation.
2.
Later signs • Profound muscular atrophy • Mental deficiency (common), usually mild.
• Complications (contracture deformities of hips, knees and ankles, diffuse strophy, obesity).
Paraclinic diagnostic procedures • Serum enzyme measurements (creatine phosphokinase, aldolase, glutamicoxaloacetic transaminase).
• Electromyography • Muscle biopsy.
Nursing care plan Help the child to develop self-help skills; to modify clothing for wheelchair wear, to fit over the contracted limbs; help the family to modify the environment to facilitate self help.
Emphasize on the importance to carry out physical therapy program.
Help the family to acquire the necessary equipment to promote mobility.
You can be the child's immediate doctor even before the professional comes to his/her aid.
