Objectives
- Recognize the stages of sexual development and the range of onset of each
- Know that most boys achieve a genital sexual maturity rating (Tanner) of stage 4 prior to attainment of peak height velocity
- Understand factors that influence the timing of puberty
- Understand the relationship between the timing of onset of puberty and final adult height
- Understand the sequence of development of secondary sexual characteristics in boys and girls
- Understand the timing, duration and normal range of peak height velocity in male and female adolescents
- Understand the impact of relatively early or late puberty on final adult height
- Understand that an individual adolescent’s bone age (skeletal maturity) and chronological age may be disparate by as much as two years and still be within normal limits
- Know the average prepubertal height velocity (5-6cm/yr) and the accelerated rate (9-10cm/year) in the peak adolescent growth spurt and that completion of the pubertal growth spurt takes two to four years
- Know that girls’ heights will typically increase 6-8cm after menarche has occurred
- Recognize that physiologic leucorrhea commonly precedes menses by three to six months
- Know that a testicular volume of <4ml is prepubertal
Self-quiz:
- Describe Tanner staging.
- When is the normal onset of puberty for both males and females? What is the first sign for a male? Female?
- How does puberty progress in females? In males?
- Approximately how much later does a boy’s growth spurt start after a girl’s?
- How do you estimate a predicted target height?
- On average how long does it take to complete puberty? What impact does late or early puberty have on final adult height?
- How long before menses can physiologic leucorrhea occur?
- How much will girl’s height increase after menarche?
- What defines “precocious” puberty for girls? Boys?
- What work-up do you do to investigate precocious puberty?
- Describe how a bone age is evaluated. What is considered normal standard deviation?
Reviewed 11/2017
