lecture 1: part 2 new born and primitve reflexes Flashcards
1
Q
what are the 3 periods that gestation is divide into and how long is it
A
first trimester: weeks 1-12
second: weeks 13-26
third: weeks 27-40
2
Q
when during gestation development is all major body systems established
A
first trimester: weeks 1-12
3
Q
what happens during the second trimester (weeks 13-26
A
body proportion grow to newborn proportions
4
Q
what happens during the 3rd trimester: weeks 27-40
body weight ___
body length ___
body fat accumulates (helps w body ___)
@ ___ weeks the lungs are developed
A
body weight triples
body length doubles
body fat accumulates (helps w body temperature)
@ 36 weeks the lungs are developed
5
Q
at how many weeks do the lungs become developed
A
36 weeks
6
Q
when is a baby considered an embryo
A
first 8 weeks
7
Q
when is a baby considered a fetus
A
8weeks until birth (40 weeks full gestation)
8
Q
when is full gestation
A
40 weeks
9
Q
what are common detrimental environmental influences on the perinatal that could influence development
A
STORCH
tobacco
smoke
alcohol
caffeine
drugs
10
Q
what is STORCH
A
Syphillis
Toxoplasmosis
Other infections (HIV, Coxsackievirus, Varicella-Zoster Virus)
Rubella
CMV
Herpes
11
Q
what is teh typical development of a child dependent on (3 )
A
Nervous system maturation
Genetics
Environment
12
Q
what are the directional typical development
A
Cephalo-caudal (head to toe)
Proximal to distal
Gross motor to fine motor
13
Q
what are 3 things that a newborn needs to do
A
breathe , suck and swallow
14
Q
what is the apgar score
A
test performed by delivering medical team to assess the infant
15
Q
when is the apgar score delivered at
A
1 minute and 5 min and 10 minutes (if needed)
16
Q
the apgar score is based on a total score of what
A
1 to 10 ( the higher the score , the better the baby is doing after birth
17
Q
when is a new born , born
A
38-42 weeks (40 weeks is full term)
18
Q
when is an infant considered premature? extreme premature
A
< 37 weeks
<28 weeks
19
Q
what does a new born look like
A
head proportionately larger with short LEs
kyphotic, horizontal ribs
20
Q
what is the ROM differences for a newborn
A
excessive DF
30° flexion contracture at hips and knees
21
Q
what is a new born dominated by
A
flexion anf lack of antigravity mm control
22
Q
In PRONE , how is the newborns UE , LE and head
A
UE flexion, held to
body, hands fisted
LE flexion, highly
positioned pelvis
Head: turned to
one side
23
Q
In SUPINE , how is the newborns UE , LE and head
A
UE flexion
LE flexion,
abduction,
external rotation
Head: turned to
one side
-No anti-gravity neck flexion so
unable to hold in midline
24
Q
During a pull to sit in a new born how is the head , what is present thruough the C curve and at the hips
A
head lag
flexion throughout C curve
flexed at hips
25
Pertaining to a NEWBORN, how is the head and C curve during SITTING
head forward: no control and head bobbing
C curve with flexion - no antigravity extension
26
what colors do a NEWBORN see
black and white
27
pertaining to a NEWBORN , is it easiest to fixate on a moving object ___ and ____
laterally and vertically
28
newborns prefer strong ___ colors
contracts at 8-9 inches away
29
what’s are **primitive reflexes**
involuntary motions that aid in the development of certain skills
30
As the baby’s brain matures and goes through
typically development these primitive reflexes and
associated involuntary movements should be
replaced with ___ ones.
voluntary
31
As the child’s CNS matures, the involuntary movements become controlled motor responses. If this doesn’t happen, the child will struggle with both ____ and ___ skills.
motor and cognitive
32
A 2018 study by Gieyztor, et al. suggested that preschool children who retained the ___ and ____ reflexes had difficulty with motor skills
TLR and ATNR
33
The same study of 35 children concluded that children with an unintegrated ___ reflex showed poor posture, poor eye-hand coordination, and focusing difficulties. They also had difficulty sitting still at a desk, learning to swim, and playing ball games. Ditto for children who retained the plantar, palmer, and Galant reflexes.
ATNR
34
An unintegrated ATNR reflex could have
an adverse affect that may also lead to what?
poor eye
tracking
35
Asymmetrical tonic neck reflex (ATNR)
- weeks of gestation that it appears:
- integrates:
- stimulus
-response:
- weeks of gestation that it appears: 20
- integrates: 4-5 months
- stimulus: turning of head
-response: facial arm extends and abducts , opposite arm flexes and abducts
36
Rooting reflex
- weeks of gestation that it appears:
- integrates:
- stimulus
-response:
- weeks of gestation that it appears: 28 weeks
- integrates: 3 months
- stimulus: touch to perioral area of hungry infant
-response: turns head and lips toward stimulus
37
Suck-swallow
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
- weeks of gestation that it appears: 28-34 weeks
- integrates: 5 months
- stimulus: touch to lips and inside mouth for suckling and liquid for swallowing
-response: rhythm is excursions of jaw
38
**Palmar grasp**
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
- weeks of gestation that it appears: 28 weeks
- integrates: 4-7 months
- stimulus: pressure on palm of hand
-response: flexion of fingers
39
plantar grasp
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
- weeks of gestation that it appears: 28 weeks
- integrates: 9 months
- stimulus: supported standing on feet or pressure to sole fo the foot just distal to MT head
-response: flexion of toes
40
flexor withdrawal
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
-weeks of gestation that it appears: 28
- integrates:1-2 months
- stimulus: noxious stimulus to sole of foot
-response: flexion withdrawal of leg
41
crossed extension
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
-weeks of gestation that it appears: 28 weeks
- integrates: 1-2 months
- stimulus : noxious stimulus to sole of foot
-response: flexion of stimulated leg and then extension of opposite leg with adduction
42
**Galant (trunk incurvation)**
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
-weeks of gestation that it appears: 28 weeks
- integrates: 3 months
- stimulus: in prone , stroke paravetebral skin
-response: lateral curvature of trunk on stimulated side
43
Moro
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
-weeks of gestation that it appears: 28 weeks
- integrates: 3-5 months
- stimulus: head drop backwards ( stimulate for the startle reflex is loud noise with same response)
-response: abduction and extension of arms , splaying of fingers , may be followed by arm flexing and adduction
44
positive support
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
-weeks of gestation that it appears: 35 weeks
- integrates: 1-2 months
- stimulus: ball of feet in contact with firm surface
-response: legs extend to support weight
45
automatic walking/ reflex stepping
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
-weeks of gestation that it appears: 37 weeks
- integrates: 3-4 months
- stimulus : hold upright with feet on support
-response: high stepping movements with regular rhythm
46
Symmetrical tonic neck reflex (STNR)
-weeks of gestation that it appears:
- integrates:
- stimulus
-response:
-weeks of gestation that it appears: 4-6 months after full term delivery
- integrates: 8-12 months
- stimulus: flexion or extension of head
-response: with head flexion , arms flex and hip extend , with head extension arms extend and hips flex
47
during a positive support/ primary stnading reflex how long will the bay extend his legs before flexing his legs and collapsing into a sitting position
20-30 seconds
48
when does teh stepping/automatic walking reflex re appears at
10-15 months
49
when does the sucking reflex appear and integrate
appear around 28 weeks of gestation
integrated by 3 months
50
when does the moro reflex start to integrate by
3 month s
51
he palmar grasp reflex is a primitive, ____ response to a mechanical stimulus present in a newborn.
involuntary
52
what does the integration of the **palmar grasp** reflex signifies
cortical maturation and the development of voluntary motor milestones
53
a weak response to the **palmar grasps** before 6 months or even after 7 months can be possible injury to what
peripheral nerve (root, plexus , or SC)
54
persistence of the **palmar grasp reflex** beyond 7 months is usually present in children
with what ?
spastic cerebral palsy.
55
the palmar grasp reflex can also reappear in adulthood, indicating a ___ ___
affecting the ____ or ____ frontal cortex (e.g., ischemic or hemorrhagic
stroke)
cortical lesion
medial or lateral
56
when is the tonic labyrinthine reflex present and integrated by
present at birth and integrated by 6 months
57
Tonic Labyrinthine Reflex (TLR) , tone in prone and supine ?
Prone – infant with greater flexion tone
Supine – infant with greater extension tone
58
for the Tonic Labyrinthine Reflex (TLR) when the neck is extended what is increased ? what about when the neck is flexed ?
-Neck extended: Increased
extensor tone and extension
of all limbs.
Neck flexed: Increased
flexor tone and flexion of all
limbs
59
when is the **Tonic Labyrinthine Reflex (TLR)** best seen at
3 months
60
are Tonic Labyrinthine Reflex (TLR) and symmetrical tonic neck reflex the same
NOOOOO w tonic u are holding baby
61
if the Galant reflex does not integrate by 9 months what may result in a problem be with
inability to sit still
62
what is the big development at one month
reduced effects of physiologic flexion as extension develops
63
for **ONE** month **PRONE** there is less what and what does the head do
less UE flexion , hip flexion , more anterior pelvic tilt
Head: able to lift
head momentarily
More active neck extension
64
for ONE month supine there is less what and what does the head do
less UE flexion , some reaching , hands fisted
less LE flexion reciprocal symmetric kicking
head is turned to one side (no anti gravity flexion yet)
65
during a **ONE** month old **pull to sit** is more pronounced head lag due to what and what is the spine and hips in
due to loss for physiologic flexion
spine and hips in flexion
66
how is the head and curved spine in supported sitting for a ONE month old
head forward
curved spine: no anti gravity trunk end tension
67
What is a 2 month old baby characterized by
Decreased flexion dominance
Increased extension
Asymmetry: extension not balanced by
flexion
68
Describe what **2 month baby** in **PRONE** would look like (UE. LE, head) where do they weight bear?
Less UE flexion , more shoulder abduction
Less LE flexion , pelvis closer to surface
Head: able to lift head 45°
WB on elbows , elbows behind shoulders
69
In a **2 month old baby** in **SUPINE** what is increased and decreased? what reflect is present
increased shoulder ER
increased neck rotation
decreased hip flexion , abduction and ER
ATNR present with neck rotation (integrated at 4-6 months)
70
how is the head and spine during a **pull to sit** in a **2 month old baby**
Continued head lag
and flexion throughout
the spine
71
describe supported sitting in a 2 month old baby
head bob
flexion thru spine; no antigravity trunk extension
72
at 2 months do babies have anti gravity trunk extension
no
73
what reflex is integrated at 2 months
positive support/ primary standing
74
for a 2 month old baby in stnading do they accept weight thru their LE
NO
75
what is the typical emergence for a baby at 3 months
emergency of symmetry and balance of neck flexors and extensors
emergence of midline orientation
body awareness
76
how is the UE , LE and head for a 3 month baby in PRONE?
UE increased abduction
hip extension , abduction , ER , pelvis flat on surface , knee flexed , feet together
head is able to lift 90° - upper trunk extension
77
where do babies WB in PRONE as a 3 month old
on forearms - elbows in line with shoulders
78
when does the babies hands come together , resting in midline on chest with some reaching
3 months
79
how is the LE and head for a **3** month old baby in **SUPINE**
hip and knee flexion , abduction , still some ER , heels together
HEAD is in midline - chin tuck - neck flexor activities
80
at what age do babies begin to chin tuck
3 months
81
what is head righting ? and when is it the strongest
When suspended in a vertical position and tilted slowly side to side, the child will move their head to a vertical position
strongest at 3 months
82
describe what a pull to sit looks like for a 3 months old
asymmetric head lifting
neck flexors work inconsistently with extensors
83
describe what a sitting looks like for a 3 months old
Head in midline: shoulder elevation and upper cervical extension
Flexion throughout the spine: still not enough trunk extension
84
what is the standing position for a 3 month old
some weight on feet again
hip abducted
knees in stiff extension
toes curled (plantar reflex)
85
when is automatic walking integrated
at 3 months
86
what is the simple overview for a 4 months old
symmetry and balance good between flexors and extensors
good head control
87
describe how a baby is when PRONE at 4 months ( UE < LE < Head)
scapular adduction w trunk extension
hip extension and adduction , increased anterior pelvic tilt with lumbar extension
head and chest lifted
88
where does the baby WB in prone at 4 months
on forearms , elbows close to body
89
when may a baby accidentally roll over to their sides
4 mths
90
when does a bay start reaching above body in midline , hands to knees
4 months
91
how is a baby laying in **supine** at **4 months**
increased pelvic control , postieror pelvic tilt with hands to knees
head in midline
92
how is the babies pull to sit at 4 months of age
no head lag
assists to sit with upper chest and UE flexion , overflow to abs and LE
93
at what age does a baby not have anymore head lag when going from pull to sit
4 months
94
how is the head , hips and spine for a baby sitting at 4 months
head in midline
hips flexed
curved spine below point of upper trunk extension
95
how is the baby standing at 4 months
can be held by hands instead of chest
pelvis behind shoulders
les nay be flex or extend
96
when does a baby develope very beginnings of lateral weight shift and lateral righting reactions
of head and trunk
5 months
97
how is the baby positioned in PRONE at 5 months
____ arm WB
weight shift on ____ with reaching
hip ____ and ____
____ and ___ trunk lifted
extended arm WB
weight shift on forearms with reaching
hip extension and adduction
head and upper trunk lifted
98
what is “swimming” and when does it start
total spinal extension ,movement of UE and LE
start at 5 months
99
when a baby is PRONE reaching at 5 months how is the weight bearing side and reaching side of the LE positioned ? and what is developed
Weight bearing side: hip extension, adduction, IR
Reaching side: hip hike, hip flexion, abduction, external rotation
Development of lower extremity dissociation
100
when ,may a baby roll prone to supine
5 months
101
how is the baby reaching in SUPINE at 5 months
reaching w full shoulder flexion and adduction , elbow , wrist and finger extension - hands to feet
102
when does a baby have increased pelvic control , posteiror pelvic tilt with feet to hands and mouth
5 months
103
when does a baby do asymmetrical rolling to sidelying ?
5 months
UE and LE dissociation
104
how is the baby positioned in sidelying at 5 months
lateral flexion of head away from floor
elongation of WB side -
105
how is the babies LE positioned during SIDELYING at 5 months
bottom leg: extended and adducted
top leg: flexed and abducted
106
No head lag
Increased
abdominal
control, increased
LE flexion
Holds head in line
with body
Assists with upper
extremities
what month does this pull to sit describe
5 months
107
how is the baby sitting at 5 months
head in midline
flexion at hips , propping on arms or high guard position to stabilize
108
how is the baby standing at 5 months
may pull to stand with knee extension and PF
hips in abduction adn ER
hips almost in line w shoulder
lumbar lordosis
109
when dos the mature landau response occur
6 months
110
when do postural responses emerge
6 months
111
Good head control in all directions
Increased control of shoulder girdle
Mature Landau response
Prone equilibrium reactions, emerging
in supine
Postural responses emerge
this overview describes a baby at how many months
6
112
what is the landau response
in prone , horizontal suspension , head is above horizontal with trunk and extremity extension
examiner flexed the neck and hips so the feet go down
113
when does the landau reflex emerge and last till
3-5 months and last until 12 months
114
how is a 6 month old baby in PRONE and what matures
reaches foward w weight shift on extended arm
- shoulder girdle stability
- elbow, wrist and finger extension
less anterior tilts
“mature swimming”
115
how is the baby reaching in SUPINE at 6 months
bilaterally , transfers objects from one hand to another
head: chin tuck
116
how is the babies head in SUPINE at 6 months
in chin tuck
117
when can a bay pull to sit independently
6 months
118
how is the baby sitting at 6 months (spine , hips , what protective extension)
back straight
PPT , hips flexed, abducted and ER
UE used for reaching
anterior protective extension
119
where is **righting reactions** organized
in midbrain
120
what is the righting reaction
beings able to realign the head or trunk with each other w an outside stimulus
121
when is usually the first of the protective extensions to emerge and when
anterior protective extension around 6-9 months
122
what is the anterior protective extension
when the baby is in sitting and u push them foward their arms should extend in front to prevent from falling
123
what protective extension usually comes after anterior protective extension and when does it emerge
lateral protective extension and around 6-9 months
124
what is the lateral protective extension
when the baby is in sitting and u push their hips laterally and their arms should extend to prevent from falling
125
how is the baby stnading at 6 months old
able to stand holding fingers
full WB on feet
hips abducted
can bounce up and down with feet on floor
126
when is a baby able to stand by holding fingers
6 months
127
Variety of positions and
movements
Very active against gravity
Little time spent in supine
what age does this overview describe
7 months
128
how is the baby positioned in **PRONE** at **7 months**
quadruped - tummy off the floor
rocks in quadruped
belly crawl
129
when does a baby not line supine anymore and rolls out of it
7 months
130
when does a baby develope trunk rotation in sitting and assumes sitting from quadruped
7 months
131
how does a baby frequently play at 7 months
in sidelying
132
how is the baby stnading at 7 months
minimal support
pulls self to stand
133
what is upper extremity parachute and when does it emerge
baby is prone horizontal at the chest , you move child toward surface head first and the baby shoudl have symmetrical arm extension and abduction
‘
emerges at 6-7 months
134
when does a baby start to play in supported standing or kneeling
8 months
135
8 months PRONE :
what is the primary mode of locomotion and how does the baby transition from quadruped to sitting
hands and knees
uses lateral righting
136
Good trunk
extension
Decreased lower
extremity positional stability
Rotation-counter
balanced by sideward
protective extension or
equilibrium reactions
Sitting to quadruped
this deszcribes what age of sitting
8 months
137
how does a baby stand at 8 months
pulls to stand through kneeling , half kneeling
rotated trunk over LE
cruses sideways
stnading with one hand held
138
when can a bay stand with one hand held
8 months
139
when is crawling the primary means of locomotion
9 months
140
when is sitting the MOST functional versatile position
9 months
141
would we rather a baby side sit or w sit
side sit
142
what is the last protective extension to emerge and when does it emerge
postieor
9-11 months
143
what is anterior righting and when does it emerge
when the baby is sitting , phill them back on shoulder and the baby shoudl extend head and arms foward to recorder balance
around 9 months
144
how is the baby kneeling at 9 months
hip extension incomplete
may move to hal kneeling to play
145
how does a baby pull to stand at 9 months
uses UE
cruises around furniture
146
how is. a baby doing supported walking at 9 months
walks with 2 hand held
decreased LE abduction and ER
147
what is the 10 months overview
exploration and practice of motor skills
plays in and out games with containers
148
when is a bay able to long sit
10 months
149
how does a baby sit for stability at 10 onths
tailor sitting (hip flexion ,abduction and ER)
150
when does a baby start to lower self form standing and reaching for toy with one hand
10 months
151
what is the overview for 11 mon this
enjoys container play , carrying toys and BI manual activites
beginning of independent standing
152
at 11 months of sitting the baby demonstrated controlled trunk ____ and ____ hip control ; able to use kneeling and half kneeing more
rotation
increased
153
how is the baby standing at 11 months
stands alone - no UE
wide BOS and LE abduction
squatting
154
when does a bay attempt unsupported walking
at 11 months
155
how is the baby walking at 11 months
upper extermity fixing
steppage gait with ER
156
what is the overview at 12 moths
right reactions are integrated
equilibrium reactions present in all positions except standing
basic motor skills present
157
at 12 onths equilibrium reactions are present in all positions except what ?
stranding
158
how is the baby sitting at 12 months
rises from floor with legs - no long needs UE and able to weight shift and lift one leg
159
when may a bay use squatting to play
12 months
160
how is the baby unsupported walking at 12 months
trunk extension
scapular adduction
wide BOS
161
