CHAPTER 8 Growth and Nutrition: Tanner Stages of Breast Development
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Questions and Answers

What percentage of older adult men in the United States were obese in 2017–18?

42.4%

Describe the Tanner 4 stage of male development.

Continued enlargement of the penis and sculpturing of the glans; increased pigmentation of scrotum.

What is acromegaly?

A rare disease of excessive growth and distorted proportions caused by hypersecretion of growth hormone and insulin-like growth factor after closure of the epiphyses.

What does growth hormone excess lead to?

<p>Slow skeletal growth and soft tissue enlargement.</p> Signup and view all the answers

What is the Tanner 1 stage of male development characterized by?

<p>Testes, scrotum, and penis are the same size and shape as in the young child.</p> Signup and view all the answers

What is the Tanner 5 stage of male development?

<p>Scrotum ample, penis reaching nearly to bottom of scrotum.</p> Signup and view all the answers

What is the growth pattern in acromegaly?

<p>Excessive growth and distorted proportions.</p> Signup and view all the answers

What is the most common cause of acromegaly?

<p>A benign pituitary adenoma or other rare tumor.</p> Signup and view all the answers

What is the purpose of pausing puberty using GnRH analogs in adolescents?

<p>To solidify gender identity, treat gender dysphoria, and promote mental well-being.</p> Signup and view all the answers

What happens if an adolescent stops taking GnRH analogs?

<p>Puberty will resume.</p> Signup and view all the answers

Describe Tanner stage 2 in females.

<p>Initial, scarcely pigmented straight hair, especially along medial border of the labia.</p> Signup and view all the answers

What is the recommended weight gain range during pregnancy for patients with a prepregnancy BMI of 19.8 to 26.0?

<p>11.5 to 16 kg (25 to 35 lb) over the entire pregnancy.</p> Signup and view all the answers

Why is it important to monitor the patient's weight throughout pregnancy using the BMI weight gain curve guidelines?

<p>To provide guidance in weight gain during pregnancy and improve reproductive outcomes.</p> Signup and view all the answers

What is the significance of Tanner stage 5 in females?

<p>Lateral spreading; type and triangle spread of adult hair to medial surface of thighs.</p> Signup and view all the answers

How can the weight gain during pregnancy be calculated?

<p>Calculate the weight gain by subtracting the patient's prepregnancy weight from their current weight.</p> Signup and view all the answers

What should patients with a prepregnancy BMI of 26.0 or higher aim for in terms of weight gain during pregnancy?

<p>7 to 11.5 kg (15 to 25 lb) over the entire pregnancy.</p> Signup and view all the answers

Explain Tanner 4 stage of breast development in females.

<p>Increasing fat deposits; areola forms a secondary elevation above that of the breast.</p> Signup and view all the answers

What is Tanner 5 stage of breast development in females?

<p>The areola is (usually) part of general breast contour and is strongly pigmented; nipple projects.</p> Signup and view all the answers

What could be a normal variant for delayed onset of puberty in males and females?

<p>Delayed onset of puberty and secondary sexual characteristic development later than average.</p> Signup and view all the answers

What may accompany delayed puberty onset?

<p>A lag of stature growth.</p> Signup and view all the answers

What is a possible cause of delayed puberty onset?

<p>Use of puberty blockers in transgender and gender-diverse youth.</p> Signup and view all the answers

In Tanner 2 stage, what change occurs in females' breast development?

<p>Budding stage; bud-shaped elevation of the areola; areola increased in diameter.</p> Signup and view all the answers

Describe a feature of Tanner 3 stage in females' breast development.

<p>Breast and areola enlarged; no contour separation.</p> Signup and view all the answers

What happens in approximately half of all girls at Tanner 4 stage?

<p>The areola forms a secondary elevation above that of the breast.</p> Signup and view all the answers

How do GnRH analogs work as puberty blockers?

<p>GnRH analogs work by suppressing the secretion of LH and FSH, which ultimately suppress the body’s release of sex hormones like testosterone and estrogen during puberty.</p> Signup and view all the answers

What are the effects of GnRH analogs on individuals identified as male at birth?

<p>In those identified as male at birth, GnRH analogs decrease the growth of facial and body hair, prevent voice deepening, and limit the growth of genitalia.</p> Signup and view all the answers

How do GnRH analogs impact individuals identified as female at birth?

<p>In those identified as female at birth, GnRH analogs stop breast development, widening of the hips, and delay or stop menstruation.</p> Signup and view all the answers

Do puberty blockers like GnRH analogs stop acne, body odor, or axillary and pubic hair development?

<p>No, puberty blockers do not stop acne, body odor, or axillary and pubic hair development.</p> Signup and view all the answers

What is the purpose of using GnRH analogs in adolescents?

<p>The purpose is to delay changes in both primary and secondary sex characteristics that can affect gender expression.</p> Signup and view all the answers

Can the use of GnRH analogs cause permanent changes in an adolescent’s body?

<p>No, the use of GnRH analogs does not cause permanent changes in an adolescent’s body.</p> Signup and view all the answers

What might the early development of sexual hair without signs of sexual maturation indicate?

<p>It may indicate premature pubarche.</p> Signup and view all the answers

When is further evaluation needed if no evidence of pubertal development is seen in a female?

<p>Further evaluation is needed if no evidence of pubertal development is seen in a female by 13 years of age.</p> Signup and view all the answers

What is the recommended weight gain range for underweight patients with a BMI of 29 during pregnancy?

<p>5 to 9.1 kg (11 to 20 lb)</p> Signup and view all the answers

List three complications obese patients may face during pregnancy.

<p>Gestational hypertension, preeclampsia, gestational diabetes</p> Signup and view all the answers

Why might pregnant adolescents younger than 16 years require higher weight gains during pregnancy?

<p>To achieve an optimal infant birth weight</p> Signup and view all the answers

What is the recommended weight gain range during the first trimester of pregnancy?

<p>1.4 to 2.7 kg (3 to 6 lb)</p> Signup and view all the answers

What is the recommended weekly weight gain range in the second and third trimesters of pregnancy?

<p>0.23 to 0.45 kg (0.5 to 1 lb) per week</p> Signup and view all the answers

What risk are patients who gain too little weight during pregnancy at?

<p>Risk for having a low-birth-weight infant</p> Signup and view all the answers

What risk are patients who gain too much weight during pregnancy at?

<p>Risk for having a high-birth-weight infant</p> Signup and view all the answers

What are the measurement procedures for calculating the BMI of older adults?

<p>Same as those used for other adults</p> Signup and view all the answers

Study Notes

Growth and Nutrition

Obesity in Older Adults

  • In 2017-18, 42.4% of older adult men and 43.3% of older adult women in the United States were obese.

Tanner Stages of Male Genital Development

  • Tanner Stage 1: Testes, scrotum, and penis are the same size and shape as in the young child.
  • Tanner Stage 2: Enlargement of scrotum and testes; skin of the scrotum becomes redder, thinner, and wrinkled.
  • Tanner Stage 3: Enlargement of the penis, especially in length; further enlargement of testes; descent of scrotum.
  • Tanner Stage 4: Continued enlargement of the penis and sculpturing of the glans; increased pigmentation of scrotum.
  • Tanner Stage 5 (adult stage): Scrotum ample, penis reaching nearly to bottom of scrotum.

Acromegaly

  • A rare disease of excessive growth and distorted proportions caused by hypersecretion of growth hormone and insulin-like growth factor after closure of the epiphyses.
  • Caused by a benign pituitary adenoma or other rare tumor, or familial syndromes (e.g., multiple endocrine neoplasia type 1 and McCune-Albright syndrome).
  • Growth hormone excess leads to slow skeletal growth and soft tissue enlargement.
  • Most common in middle-aged adults.

Puberty Blockers

  • GnRH (gonadotropin-releasing hormone) analogs, a synthetic form of the human body’s GnRH hormone.
  • Suppresses the release of LH and FSH, which suppresses the body’s release of sex hormones, including testosterone and estrogen, during puberty.
  • Delays changes in both the primary and secondary sex characteristics that can affect gender expression.
  • Does not cause permanent changes in an adolescent’s body.

Breast Development in Females

  • Tanner Stage 1: Only the nipple is raised above the level of the breast, as in the child.
  • Tanner Stage 2: Budding stage; bud-shaped elevation of the areola; areola increased in diameter and surrounding area slightly elevated.
  • Tanner Stage 3: Breast and areola enlarged; no contour separation.
  • Tanner Stage 4: Increasing fat deposits; areola forms a secondary elevation above that of the breast.
  • Tanner Stage 5 (adult stage): The areola is part of general breast contour and is strongly pigmented; nipple projects.

Pubic Hair Development in Females

  • Tanner Stage 1: No growth of pubic hair.
  • Tanner Stage 2: Initial, scarcely pigmented straight hair, especially along medial border of the labia.
  • Tanner Stage 3: Sparse, dark, visibly pigmented, curly pubic hair on labia.
  • Tanner Stage 4: Hair coarse and curly, abundant but less than adult.
  • Tanner Stage 5: Lateral spreading; type and triangle spread of adult hair to medial surface of thighs.
  • Tanner Stage 6: Further extension laterally, upward, or dispersed (occurs in only 10% of women).

Weight Gain During Pregnancy

  • Calculate the weight gain during pregnancy from the patient’s prepregnancy weight.
  • Monitor the patient’s weight throughout pregnancy using the BMI weight gain curve guidelines on the prenatal weight gain chart.
  • Guidelines for recommended weight gain during pregnancy are based on the patient’s prepregnancy BMI to improve reproductive outcomes.
  • Patients with a prepregnancy BMI of 19.8 to 26.0 should gain 11.5 to 16 kg (25 to 35 lb) over the entire pregnancy.

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Test your knowledge on the Tanner stages of breast development in females, as part of Chapter 8 on Growth and Nutrition. From Tanner 1 to Tanner 5, can you identify and understand the changes that occur during puberty?

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