PUBERTY
) Research number ( 26
Module: Reproductive
الفرقة :التانيه
بيانات خاصة بالكنترول بيانات خاصة بالطالب
187 الرقم التسلسلى فى الكشف
011 الدرجة 18192 الرقم االكاديمى فى الكشف
القسم المختص Tarek االيميل الجامعى للطالب
اسم عضو هيئة التدريس 180214@fmed.bu.edu.eg
االمضاء 01030670712 رقم الموبايل
تاريخ تسليم البحث:
9191-9102
Abstract :
Young people undegro many sorts of improvement, involving cognitive (the
advancement of thinking), psychosocial (the stages of puberty), and physical. This
complicated arrangement of physical moves is defined as adolescence, and these
changes may influence psychosocial characters. The most obvious changes among
adolescence are development in stature and advancement of sexual characteristics.
Similarly significant are changes in body composition; the accomplishment of
richness; and changes in most body frameworks, such as bone, with expanded
development and mineralization, brain improvement, and the cardiovascular
framework, with more prominent high-impact control, save, electrocardiographic
changes, and blood weight changes.
Aim of work :
Discuss, after describing puberty and adolescence, staging of puberty and
physiological changes that occur during this period and its effects on both male and
female.
Introduction:
True precocious puberty or Central Precocious Puberty (CPP) comes about from
premature reactivation of the gonadotropic axis. CPP (Central Precocious Puberty
)
is much more common in females than in males and is idiopathic in most of cases.
In males, premature adolescence is more likely to be connected to hypothalamic
injuries (40 %). Later thinks about have involved the inactivation of MKRN3
factor in “idiopathic” familial CPP, but such impairment doesn't underlie familial
transmitted CPP and is once in a while included in sporadic shapes. Premature
adolescence may have results for development and psychosocial improvement.
Reproductive module (Puberty)
-Puberty: The time at which the gonads, under the effect of
gonadotropin hormones, mature and are capable of reproduction.
-Adolescence: The transitional period of dramatic phenotypic, sexual, and
behavioral changes that shift the subject from childhood to adulthood.
-Onset of puberty (in average age): 1-in female: 8 years old
2-in male: 12 years old (1).
……. ……… ….… ……. ……… ….… ……. ……… ….… ……. ………
-Mechanism of one of puberty (not fully understand) :
1-At the period of prepuberty (I.e during childhood) :
a-The anterior pituitary secretes minimal amounts of gonadotropins hormones LH
and FSH.
b-SO, Gonads (testis or ovary )secrete very small amounts of sex hormone
(testosterone or estrogen ).
c-By -ve feedback control of testosterone and estrogen, The hypothalamus secrete
minimal amounts of Gonadotropins Releasing Hormones GnRH (due to its
hypersensitivity ).
2-At puberty (adolescence changes)
a-Decrease -ve feedback of gonadotropins on hypothalamus (its sensitivity regain
to normal)
b-Increase release of Gonadotropins Releasing Hormones GnRH in a pulsatile
manner .so, increase secretion of Gonadotropins Hormones LH and FSH and so on
increase secretion of sex or gonadal hormones.
c-The discharge of hypothalamic GnRH is additionally inhibited by pineal organ
hormone, melatonin; subsequently, the pineal organ also takes part in directing the
onset of adolescence.
d- Adrenarche, secretion of adrenal androgens, occurs at the same time of puberty
with no alter in the release of ACTH from the adrenal gland. (2).
The figure shows the mechanism of onset of puberty
(1).
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Factors affecting the onset of puberty:
1- Intrinsic (genetic): Hereditary variables appear to be major determinants of
pubertal onset.
2- Extrinsic (environmental):
a-Correlation between mother and daughter.
b-Body composition, Fat composition.
c-Exposure to light, Geographic location.
d-State of nutrition.
e-Marked obesity and heavy exercise delay puberty onset. (3).
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*Physiologic Changes Associated with Puberty:
A-In males( 1ry &2ry sexual changes):
1-Testes: Spermatogenesis and increase sex hormones.
2-Prostate and seminal Vesicle: increase growth and function.
3-Penis and scrotum increase in size.
4-Muscle mass increases.
5- Hair: pubic, facial, axillary, and body increase.
6-Vocal cords increase.
7-Libido increase.
B-In females(1ry &2ry sexual changes
1-Ovary: Oogenesis and increase sex hormones.
2-Uterus: Enlarge &menses.
3-External genitalia increase.
4-Breast increase.
5-Hair: pubic and axillary increase. (1,2,3,4)
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Tanner stages of sexual development (5,6).
Stage Age Changes in male Changes in
female
1- Stage 1 prepubertal No hair No hair
2-stage 2 8-11.5 years Appears pubic hair Appear pubic hair
Increase testis Breast bud , mound
3-stage 3 11.5 -13 years Sparse of pubic hair Sparse of pubic hair
Increase penis Increase breast
4-stage 4 13-15 years Penis, glans increase High areola
5-stage 5 >15 years Adult Adult
development Tanner arrange is relegated autonomously to genitalia,
pubic hair, and breast (eg, an individual can have Leather treater arrange
2 genitalia, Leather treater arrange 3 pubic hair). Most punctual
perceptible auxiliary sexual characteristic is breast bud improvement in
young ladies, testicular extension in boys
figure shows stages of tanner (5).
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Abnormal puberty
A-Precocious puberty: early development of secondary sex characteristics may be
true or pseudo.
1-True precocious puberty:
Definition: early development of secondary sex characteristics with
gametogenesis.
Causes:
(a) Constitutional.
(b) Pineal tumor.
(c) Tumer in Posterior hypothalamus.
2- Pseudo precocious puberty:
Definition: early development of secondary sex characteristics without
gametogenesis.
Causes:
(a) Adrenal disorder
(b) Gonadal disorder
B-Delayed puberty: delayed the function of ovary until 17 years.
Causes: panhypopituitarism . (1,2).
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Recommendations and Conclusion: treatment of male delayed
puberty, Administration of patients with pubertal delay depends on the
fundamental cause. The most differential analysis of postponed adolescence in
boys incorporates protected delay of development and adolescence (CDGP),
idiopathic hypogonadotropic hypogonadism, and hypogonadotropic
hypogonadism. Treatment of disconnected CDGP includes eager perception or
brief courses of low-dose sex steroid supplementation. More complex and included
administration is required in males with hypogonadism to realize both
improvement of sexual characteristics and to boost the potential for ripeness.
References :
(1) Medical Physiology for Undergraduate Students - book44-1.
(2) AK Jain Textbook of Physiology.
(3) Medical Physiology E-Book
(4) Human_physiology;_Stuart_Ira_Fox.
(5) First Aid for the USMLE Step 1 2020, Thirtieth edition-1.
(6) The Harriet Lane Handbook E-Book.
