Maximal in first year, reaches 90-95% adult size by 4 years. Birth 32-35 cm (less than 30 cm microcephaly).

measure of brain growth. Maximal in first year, reaches 90-95% adult size by 4 years. Birth 32-35 cm (less than 30 cm microcephaly). First 3 months. 2 Cm per month (av. 39 cm) 4-6 monts: 1 cm per month (av. 42 cm) 6-12 months. 1/2 cm per month (av. 46-47 cm) 2nd year 2 cm [48-49 cm) 3rd year. 2 cm (50-51 cm) 4th year 2 cm (52-53 cm) Adult 53-56 cm Upto 13 months use formula 1/2 x length (cm) + 10cm +25cm (4) Surface area. It bears constant relation to nutritional factors affecting growth. Best calculated from nomograms involving average weight and height. Crude methods are Lowe's formula. Surface area (m2) -Simpler formula 1-5 kg m2 = (0.05xkg) + 0.056-10kg m2 - (0.04x kg) + 0.10 11-20kg m2 = (0.03x kg) + 0.2021-40 kg M2 = (0.02 x kg) + 0.40 (5) Upp to lower segment ratio: Upper segment measured from vertex to pubic symphisis. Important in assessment of growth distarbances - proportionate or disproportionate dwarfs. Ratio changes with age and height. Marginal difference between males and females. Ratio retarded for age in - hypothyroidism, achondroplasia and other short-limbed dwarfism, rickets with lower limb deformilities. Ratio advanced for age in - Short trunk dwartism, aquired spinal disease. with hyposis or scoliosis, e.g. tuberculosis, hypogonadism (Klinefelter's syndrome). Marfan's syndrome. (6) Chest circumference. Smaller than head circumference by 2-3 cm Cross-over of head and chest circumferences takes place in Indian children at about 2 years of age (about 1 year in white races. (7) Mid-upper arm circumference taken at midpoint of acromion and olecranon index of mainutrition constant at 1-5 years at 16-17 cms. Mild (9) Ossification centre apperances in infancy and childhood Birth. Distal famoral. proximal tibial, cuboid 3 wks. Head of humerus 2-4 mths. Hamate, capitate 4-6 mths: Head of femur 1 year. Distal radial 2 years. Distal tibia and fibula, capitellum of humerus. 3 years. Triquetral bone, treads of metacarpals and phalanges of hand 4 years. Lunate, navicular of foot,. greater trochanter of femur. 5-6 years. Scaphoid, trapezoid, trapezium.