. Diseases of children. frontal bones results. The faulty nutritionof bone cells is especially marked in the long bones—bowing andshortening them—and is the result of interference with endochondralossification which is most marked at the extremities of the long bones. The pathological changes are found only in endochondral ossifica-tion. Bone formation from the periosteum continues, and the shafts ACHONDROPLASIA 139 of tlie long |>()nes aie formed largely from this periosteal growth. Theepiphyses are more or less enlarged. The long bones fail to increase hilength owing to dystrophy of the e
. Diseases of children. frontal bones results. The faulty nutritionof bone cells is especially marked in the long bones—bowing andshortening them—and is the result of interference with endochondralossification which is most marked at the extremities of the long bones. The pathological changes are found only in endochondral ossifica-tion. Bone formation from the periosteum continues, and the shafts ACHONDROPLASIA 139 of tlie long |>()nes aie formed largely from this periosteal growth. Theepiphyses are more or less enlarged. The long bones fail to increase hilength owing to dystrophy of the epipliyseal cartilages during intra-uterine life; in some cases a fibrous ingrowth of the periosteum betweenthe epiphysis and the diaphysis is present and tends to check theincrease in length. The thyroid gland and all other organs are apparently chest is smaller than normal, and the ribs are badly formed. Thebones of the limbs, the ossa innominata, the ribs, and the basa occipitalare especially Fig. 20.—Achondroplasia in a child aged two years. Symptoms.—The infant may be stillborn or die in the first fewweeks of life. The short arms and legs, with the trunk much longer inproportion than the extremities, produce an unusual t\pe of dwarf,the ordinary height being from 40 to 48 inches. The upper arms andthe thighs are proportionately shorter than the forearms and legs. Thehead is large, with prominent forehead and saddle-shaped nose, whichconstitute a characteristic type of face. The features are large andmassive. The maximum circumference of the head is above the normal,and may suggest hydrocephalus, although hydrocephalus and chondro-dystrophy have nothing in common. The normal spinal curve in thelumbar region is much exaggerated, the scapulse are short. Theabdomen is large and prominent, the buttocks unnaturally thick andheavy, the genital organs are normal. 140 DISEASES OF THE NEWBORN During early child life the muscular development is usually po
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