1. Physical Measurements Compiled by: Dr.D.Hembram

2.  Anthropometry is the study of the human body measurements in terms of the dimensions of bone, muscle, adipose (fat) tissue.

3.  To study the growth in children & adolescent.  To assess nutritional disorder  In the study of dysmorphology  Helps in some therapeutic interventions.

4.  1.Weight  2.Recumbent length  3.Standing height  4.Crown rump length  5.Sitting height  6.Occipito frontal circumference (OFC)  7.Chest circumference (CC)  8.Mid Upper arm circumference (MUAC)  9.Upper segment (US)  10.Lower segment (LS)  11.Arm span  12.Sub cutaneous fat thickness

5.  Weighing scale for infants & children  Infantometer  Stadiometer  Measuring tape  Herpendens caliper

6.  Very very important parameter  It measures the total body mass  Very sensitive to changes in Body fluid,fat,muscle mass,skeletal & body organs.  Combined with height/length – gold standard for diagnosis of malnutrition.  Used for optimal drug therapy

7.  Baby weighing scale for infants (pan type & hand held spring type)

8. Digital display

9.  Always fix at zero before measurement

10.  Name: Sumit Das Age: 3 years Sex: Male Wt: 6 kgs -------------------------------------- ---  Name: Rina Dey Age: 8 years Sex: Female Wt: 39 kgs -------------------------------------- ----

11.  At birth: 3250 gms.  5 months: 6500 gms  12 months: 9750 gms  2 years: 13 kgs.  7 years: 22.750 kgs.  10 years: 32.500 kgs.

12.  Term AGA babies – regains birth weight by 7-10 days.  1-4 months – 30 gms /day  5-8 months – 20 gms/day  9-12 months – 10 gms/day  Thereafter upto 1 year – 400gms /month  1-2 years: 3 kgs/year  3-12 years: 2 kgs/year  13-18 years: 5-6 kgs/year

13.  Upto 1 year: (age in months+9)/2  1-6 years: (age in years x 2) + 8  7-12 years: (age in years x 7 – 5)/2

14.  CDC growth charts developed by: NCHS (National Center for Health Statistics)  IAP: Agarwal et al.

15.  Recumbent length: upto 2 years  Height: > 2 years

16.  Infantometer

17.  Stadiometer

18.  Landmarks: Top of the head to sole of foot. INFANTS: i) Knees should be pressed down gently – at least one leg ii) Head should be held gently in position- Frankfurt horizontal plane iii) Ankle at right angle to the leg

19.  The lower edge of the Lt. bony orbit and the upper margin of both the external opening of the auditory canal of the ear are in the same plane

21.  Position The patient should stand upright, with the back against the wall and the head erect (Frankfurt horizontal plane), facing forward, and looking straight ahead. The patient should be gently straightened upright; the heels placed together; buttocks and shoulders should be in contact with the wall or measuring device. The moveable headboard is lowered gently until it touches the top of the head. Appropriate clothing should be worn.

22.  Expected length/height up to 12 years of age (in cm): age in years x 6 + 77

23. At birth: 50 cms 6 months: 68 cms 1 year: 75 cms 2 years:85 cms 3 years: 95 cms 4 years: 100 cms Over next 8 years: 5.5 cms/ year

24.  Gain during 1 st year: 25 cms  Gain during 2 nd year: 10-12.5 cms  Gain during 3 rd year: 7.5-10 cms  Gain during (4-12) years: 5-7.5 cms/year  Gain during adolescence: Girls: 8 cms/yr Boys: 10 cms/yr

25.  Definition: Crown–rump length is the distance from the top of the head to the bottom of the buttock.  Landmarks: Measure from the top of the head to the posterior distal part of the thighs with legs extended at right angles at the hips

26.  It can give valuable information to define disproportionate growth, especially in patients with reduction defects of the limbs or contractures  At 1 year: 48 cms

27.  Definition Sitting height is the distance from the top of the head to the buttocks when a sitting position  Landmarks Measure from the top of the head to the bottom of the thighs (surface on which the patient is sitting) At 4 years: 60 cms.

28.  Boys: mean parental height+6.5 cms  Girls: mean parental height-6.5 cms TANNER’S FORMULA: Boys: 0.545H3+0.544P+14.84 Girls: 0.545H3+0.544P+10.09

29.  Definition: Maximum circumference of the head  Landmarks: The maximum head circumference (usually horizontal just above the eyebrow ridges), is measured from just above the glabella to the area near the top of the occipital bone (opisthocranion) Instruments: Tape-measure Position: The patient should look straight ahead

30.  Normal range of HC in the 1 st year(5 th – 95 th percentile) => [ length in cm/2 + 9.5] +2.5 cm [ length in cm/2 + 9.5] - 2.5 cm

31.  At birth: 35 cms  3 months: 40 cms  6 months: 44 cms  1 year: 47 cms  2 years: 49 cms  12 years: 52 cms 2-7 years: 0.5 cms/year 8-12 years: 1/3 rd cm/year

32.  Till 3 months : 2 cm/month  3 months – 1 year: 2 cm/3 months  1-3 years: 2 cm / 1 year  3-5 years: 2 cm/ 2 years

33.  Method: At the level of nipple line, preferably in mid respiration. Interpretation: At birth: HC 3cm > CC At 9 months:HC = CC > 9 months:CC > HC Detects malnutrition in the 1 st 5 years of life. If CC/HC<1 means child is malnourished.

34.  The circumference at the midpoint between acromion & olecrenon. Normally MUAC increases rapidly from birth to 1 year from about 11-16cm. Between 1-5 years – remains fairly constant at about 16-17 cms.

35.  Shakirs tape is a fiber glass tape with: green (>13.5cm),yellow(12.5-13.5cm) and red(<12.5cm) shading.

36.  Bangle test: with fiber glass ring of internal diameter of 4 cm.  Quack stick: it is a meter rod with two sets of marking. Height (cm)&MUAC (cm)

37.  US: vertex to mid point of symphysis pubis  LS: symphysis pubis to heels  At birth: US:LS=1.8  At 10-12 years: 1:1

38.  Distance between the tips of middle fingers of both arms outstretched at right angles.  Under 5 child: span 1-2 cm< than the length/height.  At 10-12 years: arm span = height

39.  Definition: Total length of foot  Landmarks: Usually the foot length is the longest axis of the foot. It is measured from an imaginary vertical line drawn from the posterior prominence of the heel, to the tip of the longest toe, on the plantar aspect of the foot (in some people, the first toe is the longest; in other people, the second toe is the longest)

40.  Subcataneous fat thickness is measured over the triceps or sub scapular region.  Tools:Herpenden’s caliper

41.  1-6 years of age: 10 mm or more.

42.  BMI= weight in kgs/(height in meter)2x100

43.  Weight for height: [wt of the child/wt corresponding to the ht of the child]x100 normal value> 90% Rao’s index: [ wt. in kgs /(ht. in cm)2]x100 normal range(up to 5 yrs): 0.15-0.16 Kanwati & Mc Laren index(3months-4 yrs) MUAC/OFC x 100 Normal ratio > 0.31

44. THANKS FOR PATIENCE