Growth, Development, & Aging
Chapter 24
Learning Objectives
Lesson 24.1: Development
from Conception to Birth
1. Discuss the concept of development as a
biological process characterized by
continuous modification and change.
2. Discuss the major developmental changes
characteristic of the prenatal stage of life
from fertilization to birth.
3. Identify the three primary germ layers and
several derivatives in the adult body that
develop from each layer.
4. Discuss the three stages of labor that
characterize a normal vaginal birth, and the
occurrence of multiple births.
Human Development
Life is a biological process characterized
by continuous change and modification
Labeling different life stages simply
makes it easier to study development
Prenatal Period
Prenatal period begins at conception
and continues until birth
Science of fetal growth and
development called embryology
Human life starts as a single cell and
develops into a complex human
Fertilization to Implantation
Fertilization to implantation requires
about 10 days
Fertilization normally occurs in outer third of
oviduct (uterine or fallopian tube)
Fertilized ovum called a zygote; zygote is
genetically complete: All that is needed for
expression of hereditary traits is time and
nourishment
After 3 days of cell division, the zygote has
developed into a solid cell mass called a
morula
Fertilization
Lennart Nilsson, Albert Bonniers Forlag AB, Stockholm Sweden.
Fertilization and Implantation
Blastocyst Development
Continued cell divisions of the morula
produce a hollow ball of cells called a
blastocyst
Blastocyst implants in the uterine wall
about 10 days after fertilization
Blastocyst forms the amniotic cavity and
chorion of the placenta
Amniotic cavity becomes a fluid-filled,
protective sac
Chorion develops into the placenta, which
exchanges nutrients and waste products
between mother and fetus
Implantation and Early
Development
Prenatal Periods of Development
Length of pregnancy or gestation period
is about 39 weeks
Embryonic phase extends from third
week after fertilization to the end of
week 8 of gestation
Fetal phase extends from week 8 to
week 39 of gestation
The Placenta: Interface Between
Maternal and Fetal Circulation
From Kumar V, Abbas AK, Fausto N: Robbins and Cotran
pathologic basis of disease, ed 7, Philadelphia, 2005, Elsevier.
Formation of the Primary Germ Layers
Formation of the primary germ layers:
Appear in the developing embryo after
implantation of the blastocyst
Endoderm: Inside layer
Ectoderm: Outside layer
Mesoderm: Middle layer
All organ systems are formed and
functioning by month 4 of gestation
Stem cells: Unspecialized cells that
reproduce to form specific lines of
specialized cells
Human Embryos and Fetuses
Lennart Nilsson, Albert Bonniers Forlag AB, Stockholm, Sweden.
Histogenesis and Organogenesis
Formation of new organs (organogenesis) and
tissues (histogenesis) occurs from specific
development of the primary germ layers
Each primary germ layer gives rise to definite
structures such as the skin and muscles
Growth processes include cell differentiation,
multiplication, growth, and rearrangement
From 4 months of gestation until delivery, the
development of the fetus is mainly a matter
of growth
Critical Periods of Neonatal
Development
Birth or Parturition
(1 of 2)
Process of birth called parturition
At end of week 39 of gestation, the uterus
becomes “irritable”
Fetus takes head-down position against the
cervix
Muscular contractions begin, and labor is
initiated
Amniotic sac (“bag of waters”) ruptures
Cervix dilates
Fetus moves through vagina to exterior
Birth or Parturition
(2 of 2)
Stages of Labor
Stage one: Period from onset of uterine
contractions until dilation of the cervix
is complete
Stage two: Period from the time of
maximal cervical dilation until the baby
exits through the vagina
Stage three: Process of expulsion of the
placenta through the vagina
Clinicians sometimes refer to the
recovery period immediately following
delivery of the placenta as the fourth
stage of labor
Apgar Score and Cesarean
Section
Apgar score assesses general condition
of a newborn infant
Cesarean section (C-section): Surgical
delivery, usually through an incision in
the abdomen and uterine wall
Multiple Births
Two or more infants from the same
pregnancy
Identical siblings result from the splitting of
tissue from the same zygote, making them
genetically identical
Fraternal siblings develop from different ova
that are fertilized separately
Learning Objectives
Lesson 24.2: Conditions Associated with
Pregnancy and Development from Birth to
Death
5. Distinguish the differences between
monozygotic and dizygotic twins and
identify treatments that increase the
likelihood of multiple births.
6. Identify and describe the major conditions
associated with pregnancy.
7. List and discuss the major developmental
changes characteristic of the five postnatal
periods of life.
8. Discuss the effects of aging on the major
body organ systems.
Monozygotic and Dizygotic Twins
Monozygotic twins: Identical
Develop from the same fertilized egg
Have same genetic code
Dizygotic twins: Fraternal
Result from fertilization of two different ova
by two different spermatozoa
Requires production of more than one
mature ovum during a single menstrual
cycle
Conditions of Pregnancy
Conditions of Implantation
Ectopic pregnancy: Implantation outside the
uterus (e.g., tubal pregnancy)
Placenta previa: Growth of the placenta at
or near cervical opening, often resulting in
separation of the placenta from the uterine
wall
Abruptio placentae: Separation of a
normally placed placenta from the uterine
wall; causes fetal death within minutes, and
mother can hemorrhage
Preeclampsia
Toxemia of pregnancy:
Syndrome of pregnancy that includes
hypertension, proteinuria, and edema
May progress to eclampsia, a severe
toxemia that may result in death
Miscarriage and Birth Defects
Fetal death
Spontaneous abortion (miscarriage): Loss
before week 20 (or 500 g)
Stillbirth: Loss after 20 weeks
Congenital conditions: Developmental
problems present at birth
May be inherited (congenital abnormalities)
or acquired
Acquired conditions are caused by
teratogens (agents that disrupt normal
development)
Postpartum Conditions
Puerperal fever is
Caused by bacterial infection that may
progress to septicemia and death
Occurs in mothers after delivery
(postpartum)
Lactation and thus infant nutrition can
be disrupted by anemia, malnutrition,
and other factors
Mastitis: Inflammation or infection of the
breast
Breastfeeding Issues
Milk can be supplied by another nursing
mother or replaced by breast-milk
substitutes
Lactose intolerance results from an
infant’s inability to digest lactose
present in human or animal milk
Postnatal Period
Postnatal period begins at birth and
lasts until death
Divisions of postnatal period into
isolated timeframes can be misleading;
life is a continuous process; growth and
development are continuous
Obvious changes in physical
appearance of the body—in whole and
in proportion—occur between birth and
maturity
Divisions of Postnatal Period
Infancy
Childhood
Adolescence and adulthood
Older adulthood
Developmental Changes
in Body Proportions
Infancy
Infancy lasts from birth to about 18 months
First 4 weeks called neonatal period
Neonatology: Medical and nursing specialty
concerned with the diagnosis and treatment of
disorders of the newborn
Many cardiovascular changes occur at the time
of birth; fetus is totally dependent on mother,
whereas the newborn must immediately become
totally self-supporting (respiration and
circulation)
Respiratory changes at birth include a deep and
forceful first breath
Neonate
Courtesy Karen Turner.
Developmental Changes
From Birth to 18 Months
Doubling of birth weight by 4 months and
tripling by 1 year
Fifty percent increase in body length by
12 months
Development of normal spinal curvature
by 15 months
Ability to raise head by 3 months
Ability to crawl by 10 months
Ability to stand alone by 12 months
Ability to run by 18 months
Spinal Curvatures
From Hockenberry MJ, Wilson D: Wong’s essentials of Copyright Kevin Patton, Lion Den Inc,
pediatric nursing, ed 8, St Louis, 2009, Mosby Weldon Spring, MO.
Childhood
Extends from end of infancy to puberty:
13 years in girls and 15 in boys
Overall rate of growth remains rapid but
decelerates
Continuing development of motor and
coordination skills
Loss of deciduous or baby teeth and
eruption of permanent teeth
Adolescence
Average age range of adolescence is
from 13 to 19 years
Period of rapid growth resulting in
sexual maturity (adolescence)
Appearance of secondary sex
characteristics regulated by secretion of
sex hormones
Growth spurt typical of adolescence;
begins in girls at about 10 and in boys
at about 12
Growth in Height
Adulthood
Growth plates fully close in adult; other
structures, such as the sinuses, acquire
adult placement
Adulthood characterized by
maintenance of existing body tissues
Degeneration of body tissue begins in
adulthood
Older Adulthood
Degenerative changes characterize
older adulthood, or senescence
Every organ system of the body
undergoes degenerative changes
A variety of mechanisms of aging have been
described
The free-radical theory of aging states that
the number of oxygen free radicals
increases as one ages, thus increasing the
rate of cellular damage
Senescence culminates in death
Theories of Aging
Scientists have a wide range of theories
Free radicals increase the rate of cellular
damage over time and contribute to cellular
aging
Nutrition, injury, disease, and other
environmental facts affect aging process
Cellular changes due to “aging” viruses
found in all living cells
“Aging” genes cause preprogrammed aging
Diminished capacity of cells to reproduce
over time
Effects of Aging
Skeletal system
Aging causes changes in the texture,
calcification, and shape of bones
Bone spurs develop around joints
Bones become porous and fracture easily
Degenerative joint diseases, such as
osteoarthritis, are common
Biological Changes Associated
With Maturity and Aging
Effects of Aging:
Integumentary System
With age, skin “sags” and becomes thin,
dry, and wrinkled (or inelastic)
Pigmentation problems are common
Frequent thinning or loss of hair occurs
Effects of Aging:
Central Nervous System
Risk of dementia, or loss of memory,
with aging
Other degenerative conditions affecting
nervous system
Some risk of depression
Effects of Aging:
Special Senses
(1 of 2)
All sense organs show a gradual decline
in performance with age
Eye lenses become hard and cannot
accommodate for near vision; result is
farsightedness in many people by age
45 (presbyopia, or “old eye”)
Loss of transparency of lens or cornea is
common (cataract)
Effects of Aging:
Special Senses
(2 of 2)
Glaucoma (increase in pressure in eyeball)
is often the cause of blindness in older
adulthood
Loss of hair cells in inner ear produces
frequency deafness in many older people
Decreased transmission of sound waves
caused by loss of elasticity of eardrum and
fixing of the bony ear ossicles is common
in older adulthood
Some degree of hearing impairment is
universally present in the aged
Ability to smell and taste may be reduced;
only about 40% of the taste buds present
Effects of Aging:
Cardiovascular System
Degenerative heart and blood vessel
disease is among the most common and
serious effects of aging
Fat deposits in blood vessels
(atherosclerosis) decrease blood flow to
the heart and may cause complete
blockage of the coronary arteries
Hardening of arteries (arteriosclerosis)
may result in rupture of blood vessels,
especially in the brain (stroke)
Hypertension, or high blood pressure, is
common in older adulthood
Effects of Aging:
Respiratory System
Calcification of costal cartilages causes
rib cage to remain in expanded position,
resulting in barrel chest
Wasting of respiratory muscles
decreases respiratory efficiency
Respiratory membrane thickens;
movement of oxygen from alveoli to
blood is slowed
Effects of Aging:
Urinary System
Nephron units decrease in number by
50% between ages 30 and 75
Blood flow to kidney, and therefore
ability to form urine, decreases
Bladder problems, such as inability to
void completely, are caused by muscle
wasting in the bladder wall
Effects of Aging:
Reproductive System
Changes in the sexual response
Men: Erection is more difficult to achieve and
maintain; urgency for sex may decline
Women: Lubrication during intercourse may
decrease
Changes in fertility
Men: May continue to be fertile throughout
later adult years
Women: Experience menopause (cessation of
reproductive cycling) between the ages of 45
and 60
Menopause
Not a disease condition, but a natural
period of change
Decreased blood estrogen levels leads to
symptoms such as hot flashes, sleep
disturbances, and dryness in the vagina
Previously, estrogen was supplemented
through hormone replacement therapy
(HRT)
HRT can cause increased risk of some
cancers, stroke, and blood clotting
disorders
Questions?