Question

Describe the effects of puberty on the adolescent patient.

Answer 1

Puberty is the period during which growing boys or girls undergo the process of sexual maturation. Puberty involves a series of physical stages or steps that lead to the achievement of fertility and the development of the so-called secondary sex characteristics, the physical features associated with adult males and females (such as the growth of pubic hair). While puberty involves a series of biological or physical transformations, the process can also have an effect on the psychosocial and emotional development of the adolescent.

During puberty all body parts normally increase in size with the exception of the thymus, tonsils, and adenoids, which decrease in size. Normally, the linear growth of puberty accounts for 15 to 25% of an individual's adult height, while the growth in weight accounts for close to 50% of an "ideal" adult body weight.

The major contributors to the gain in weight are the lean, fat, and bone masses. The male and female increases in these components differ quantitatively and qualitatively. The most striking differences are in muscle and fat. In the pubertal male there is about a 7-fold increase in muscle mass compared to a 3- to 5-fold in the female. Peak muscle growth usually occurs within 6 to 12 months of the PHV( YEAR OF PEAK HIGH VELOCITY) year with the peak increase in strength coming 12 to 18 months after PHV. In the pubertal female there is a 4 to 10% increase in the percentage of total body weight as fat compared to a 5 to 7% decrease in the male.

Bone mass increases in parallel with muscle mass, and the epiphyses of the hands, wrist, and long bones progressively fuse during puberty. The hand and wrist epiphyses are usually closed in the female by age 17 years and in the male by 19 years. Once this fusion is complete, it is rare for an individual to grow more than another 3.75 cm in height.

The striking facial changes during puberty are the result of an increase in the length and width of the face, particularly the mandible, which usually peaks in growth within 6 months of PHV. Moreover, the nose and pharynx grow in length and the hyoid bone moves to a lower position than during childhood.

For the body-conscious teenager, the development of secondary sexual characteristics is an important and easily observed milestone in the pubertal process. For almost all males (~98%), the first physical evidence of beginning puberty is an enlargement of the testes and for about 80% of females the appearance of palpable breast tissue under the areola (breast budding). For the remainder, pubic hair is the first physical evidence of puberty. There is also a progressive growth of axillary hair in both sexes, and in the male the voice lowers and a beard begins with the mustache of puberty. There is about a 7-fold increase in the size of the male's testes, epididymis, and prostate and the female's uterus and ovaries. A substantial increase also occurs in the size of the areola and male genital organ in the male and the areola, breasts, labia, clitoris, vagina, and fallopian tubes in the female.

The uniformity of the sequence of gonad (G) and pubic hair (PH) development in the male and breast (B) and pubic hair in the female allows these components to be staged