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05 - Tests and Measurements > 05-01b: Developmental Reflexes and Righting Reflexes > Flashcards

05-01b: Developmental Reflexes and Righting Reflexes Flashcards

1
Q

Purpose of Tests and Measures

A
  • Provide objective data to determine degree of function and/or dysfunction
  • Focuses the POC on task-specific (pt goal-oriented) interventions and goals
  • Provides objective data that justifies need for PT
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2
Q

Integration

A

No longer automatic - primitive reflexes are integrated during development

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3
Q

Persistence

A

Lasting longer than the normally expected time of integration; can cause developmental delay, abnormal movements, and.or structural deformities

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4
Q

Reimergence

A

Had been integrated, now showing up again; Primitive reflexes can reimgerge after injury to brain

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5
Q

ATNR

A
  • Asymmetrical Tonic Neck Reflex
  • Stimulus: Head position turned to one side
  • Response: UE/LE on face side extended; UE/LE on scalp/skull side flexed; Spine curved with convexity to face side
  • Integration: Birth to 6 months
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6
Q

ATNR Persistence

A
  • Feeding
  • Visual tracking
  • Midline use of hands
  • Bilateral hand use
  • Rolling development of crawling
  • Can lead to skeletal deformities (scoliosis, hip subluxaton, hip dislocation)
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7
Q

STNR

A
  • Symmetrical Tonic Neck Reflex
  • Stimulus: Head positon, flexion or extension, baby is prone
  • Response: Head flexed —> UE flexed, LE extended; Head extended —> UE extended, LE flexed
    Integration: 6-8 months (onset 4-6 months)
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8
Q

STNR Persistence

A
  • Ability to prop on arms in prone
  • Attaining and maintaining hands/knees position
  • Crawing reciprocally
  • Sitting balance when looking around
  • Use of hands when looking at object in hands in sitting
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9
Q

TLR

A
  • Tonic Labyrinthine Reflex
  • Stimulus: position of labyrinth in inner ear is reflected in head position
  • Response: Supine - Body, extremities held in extension; Prone - Body, extremities held in flexion
    Integration: Birth to 6 months
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10
Q

TLR Persistence

A
  • Ability to initiate rolling
  • Ability to prop on elbows with extended hips when prone
  • Ability to flex trunk and hips to come from sitting to supine
  • Often causes full body extension, which interferes with balance in sitting or standing
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11
Q

Galant Reflex

A
  • Stimulus: touch skin along spine from shoulder to hip (almost tickle response)
  • Response: Lateral flexion of trunk on sode of stimulus
  • Integration: 30 weeks of gestation to 2 months
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12
Q

Galant Persistence

A
  • Development of sitting balance

- Can lead to scoliosis

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13
Q

Palmar Grasp Reflex

A
  • Stimulus: pressure in palm on ulnar side of hand
  • Response: flexion of fingers causing strong grip
  • Integration: 28 weeks of gestation to 4 months
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14
Q

Palmar Grasp Persistence

A
  • Ability to grasp and release objects voluntarily

- WB on open hand for propping, crawling, protective responses

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15
Q

Plantar Grasp Reflex

A
  • Stimulus: Pressure to base of toes
  • Response: Toe flexion
  • Integration: 28 weeks gestation to 9 months
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16
Q

Plantar Grasp Persistence

A
  • Ability to stand with feet flat on surface

- Balance reactions and WS in standing

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17
Q

Flexor Withdrawal Reflex

A
  • Stimulus: Noxious (pin-prick) to the sole of the foot. Test in supine
  • Response: Toes extend, ankle dorsiflex, LE flexes
  • Integration: 28 weeks gestation to 2 months
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18
Q

Rooting Reflex

A
  • Stimulus: Touch on cheek
  • Response: Turning of head to same side with mouth open
  • Integration: 28 weeks gestation to 3 months
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19
Q

Rooting Reflex Persistence

A
  • Oral-motor development
  • Development of midline control head
  • Optical righting, visual tracking and social interaction
20
Q

Moro Reflex

A
  • Stimulus: Head dropping into extension suddenly for a a few inches (about 30˚) and then re-support
  • Response: Arms abduct with fingers open, then cross trunk into adduction; Cry
  • Integration: 28 weeks of gestation to 5 months
21
Q

Moro Reflex Persistence

A
  • Balance reactions in sitting
  • Protective responses in sitting
  • Eye-hand coordination, visual tracking
22
Q

Startle Reflex

A
  • Stimulus: Loud, sudden noise
  • Response: Similar to Moro response, but elbows remain flexed and hands closed
  • Integration: 28 weeks of gestation to 5 months
23
Q

Startle Reflex Persistence

A
  • Sitting balance
  • Protective responses in sitting
  • Eye-hand coordination, visual tracking
  • Social interaction, attention
24
Q

Positive Support Reflex

A
  • Stimulus: Weight placed on balls of feet when upright
  • Response: stiffening of legs and trunk in LE extension
  • Integration: 35 weeks of gestation to 2 months
25
Q

Positive Support Reflex Persistence

A
  • Standing and walking
  • Balance reactions and WS in standing
  • PF contractures of ankles
26
Q

Stepping Reflex

A
  • Stimulus: Supported upright position with soles of feet on firm surface
  • Response: Reciprocal flexion/extension of legs
  • Integration: 38 weeks gestation to 2 months
27
Q

Stepping Reflex Persistence

A
  • Standing and walking
  • Balance reactions and WS in standing
  • Development of smooth, coordinated reciprocal movements of LE’s
28
Q

Equilibrium/balance reactions of postural reflexes

A
  • Highest level of responses that allow humans to function on 2 LEs and use hands to manipulate while standing and moving
  • Helps establish normal postural tone which allows for movement against gravity
  • Allows muscles to be in a state of “readiness”
29
Q

Neck Righting (General)

A
  • Stimulus: Child turns head
  • Response: Body will realign itself with head
  • Functional Implication (FI): Neck is first independent body part to rotate
  • Develops trunk control
30
Q

Neck Righting (Neonatal)

A

S: Head is turned
R: Body rotates as a whole toward side that is turned; differentiation of body segments developed only between head and trunk (non-segmental except head and trunk - shoulder and pelvis move with trunk)
FI: Prevents suffocation when infants in prone

Onset: 0-10 days
Integration: 4-6 months

31
Q

Neck Righting (4-6 months)

A

S: Head is turned
R: Body follows with rotation seen between pelvis and shoulders
FI: Segmented rolling

Onset: 4-6 months

32
Q

Head Righting (3-5 months)

A

Head always attempts to align itself to a vertical position to the floor, with mouth horizontal and face vertical - develops sequentially.
- Prone (3 mo), Supine (3 mo), Lateral (5 mo)

Onset: 3-5 months
FI: Neck muscles stimulated/developed from neck righting
- Prone: Neck extensors stimulated
- Supine: Neck flexors stimulated
- Lateral: Lateral flexion is developed
33
Q

Head Righting - Labyrinthine righting

A

Head rights itself in relation to gravity

FI: Important for development of head control

34
Q

Head Righting - Optical/Visual righting

A

Head rights in relation to visual horizontal
- Closing eyes can affect balance

FI: Important for development of head control

35
Q

Body Righting

A

When one body part is displaced in relation to the other body parts, child will initiate a series of rotational movements that will realign the body

FI: Rotational movement of body parts facilitates segmented rolling and leads to rotational components needed for moving in and out of position

Onset: 5-6 months

36
Q

Body-on-Head Righting

A
  • When supporting surface is moved, infant rights head toward the vertical
  • If trunk is rotated, head will have a tendency to follow
37
Q

Body-on-Body Righting

A
  • If pelvis is rotated, shoulders will tend to follow the pelvis
  • If shoulders (or upper trunk) are rotated, the pelvis follows
38
Q

Landau reaction

A

S: Child suspended in prone, supported under the lower chest (Superman position)
R: Child will right head (facilitated by labyrinthine and optical righting reactions); Symmetrical extension of the spine and hips will follow
FI: Activates total extension (facilitates toward standing); development of spinal and trunk extensors; Ability to sit without support

Onset: 6 months
Integration: 12-24 months

39
Q

UE Protective Reaction (Forward Protective)

A
  • When child is sitting and body falls forward, child’s shoulders will flex, arms extend and abduct (move away from body) and hands open
  • When hands contact surface, UE supports body on hands
  • Onset: 6-7 months
40
Q

UE Protective Reaction (Sideways Support)

A
  • When child is sitting and body falls to side, arm on that side abducts (moves away from body) and extends
  • When hands contact surface, UE supports on hands
  • Onset: 7-8 months
41
Q

UE Protective Reaction (Backwards Support)

A
  • When child is sitting and body falls backward, shoulder and arms extend and hands open
  • When hands contact surface, UE are supported on hands
  • Onset: 9-10 months
42
Q

UE Protective Reaction (Extension downward)

A
  • When body is suspended head-first toward surface, arms extend and abduct (move away from body) and hands open to contact surface
  • FI: protectiion of head
  • Onset: 7 months
43
Q

LE Protective Reaction

A
  • Positive support reactions

- Taking a step if upright

44
Q

Reflex Scoring (0-4+)

A 
0 = Absent
1+ = Tone change: slight, transient with NO movement of extremities
2+ = Visible movement of extremity
3+ = Exaggerated, full movement of extremities
4+ = Obligatory and sustained movement lasting for more than 30 seconds

Primitive Reflexes: 0 = normal
Age-appropriate: 2+ = normal

  • If a developmental reflex is present beyond its normal integration period, it is considered abnormal
  • Reflex score of 0 is normal for any reflex not present after its integration period
45
Q

Balance Reaction

A

When balance is lost, BR is automatic response to use arms to stabilize body.

05 - Tests and Measurements (21 decks)

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