Neuro Peds - 01 - Early Normal Reflexes Flashcards
describe Flexor Withdrawal Reflex
position: supine
test: noxious stimulus to sole of one foot
response: withdrawal of stimulated LE from stimulus
describe Crossed Extension Reflex
position: supine
test: hold one LE at the knee in extension; noxious stimulus to sole of the foot
response: flexion, adduction and then extension of contralateral LE
describe Galant Reflex
position: prone
test: stroke along paravertebral line about 1-2” away from spine, from shoulder to buttocks
response: trunk will curve concave to stimulus and remain as long as stimulus is presented
describe Placing Reflex
position: supported in vertical
test: move the child so dorsum of one foot brushes against table edge
response: child will flex the stimulated LE and place the foot on the table
* also UE placing reflex
describe Stepping Reflex
position: supported in vertical
test: stand child over table with feet touching the surface. incline child forward and gently move forward
response: alternating, rhythmical and coordinated stepping
describe Positive Supporting Reflex
position supported in vertical
test: allow firm contact of child’s feet with floor or table
response: bilateral LEs extend with contraction of flexors and extensors into weight bearing
describe Plantar Reflex
aka ________
Babinski Sign
position: supine
test: stroke lateral aspect of the sole of the child’s foot from the heel towards the toes.
response: toe extension
describe Plantar Grasp Reflex
position: supine
test: place firm pressure against the plantar surface of the child’s foot below the toes.
response: plantar flexion of all toes
* also Palmar Grasp Reflex
describe Moro Reflex
position: supine
test: quickly tip child backwards to allow a 30 degree head drop
repsonse: child should startle by quickly extending, abducting shoulders, extending and abducting fingers, crying. in 2-3 seconds, shoulders flex and adduct to bring UE back to chest
describe Suck/Swallow Reflex
position: supine
test: place a finger into the child’s mouth
response: rhythmical sucking and spontaneous swallow
describe
Asymmetrical Tonic Neck Reflex (ATNR)
postion: supine
test: turn child’s head slowly to one side and hold gently
repsonse: arm and leg extend on face side, arm and leg flex on skull side
describe
Symmetrical Tonic Neck Reflex (STNR)
position: supine over examiner’s knees or quadruped
test: passive or active neck extension and flexion
repsonse: neck extension produces UE extension and LE flexion, neck flexion causes UE flexion and LE extension
describe
Tonic Labyrinthine Reflex (TLR)
position: supine, prone
test: passively attempt to lift child’s head from surface
response: supine - extensor tone dominates in body; prone - flexor tone dominates in body
* Landau Reflex (vertical suspension)
describe Rooting Reflex
position: supine
test: stroke perioral skin at corners of the mouth toward cheek. stroke upper lip toward cheek. stroke lower lip toward cheek.
response: head turns toward stimulus; mouth opens and neck extends; mouth opens and neck flexes
describe Traction Reflex
position: supine
test: grasp child’s wrist and pull toward sitting position
response: flexion of shoulders, elbows, wrist, fingers
describe Labyrinthine Righting Reaction
position: supported in vertical in space
test: occlude child’s vision; tilt child anterior, posterior, lateral about 45 degrees
response: head orients immediately to vertical and is steady
describe Body on Head Righting Reaction (BOH)
position: prone
test: occlude child’s vision; observe
response: head orients to vertical and is steady
describe Neck on Body Righting Reaction (NOB)
position: supine
test: flex child’s head and rotate slowly to one side and hold
response: child will turn in direction of head turning, in order of shoulders, trunk, pelvis to side or prone
describe Body on Body Righting Reaction (BOB)
position: supine
test: flex one leg and rotate it across the pelvis to the opposite side
response: child will roll segmentally in order of trunk shoulders, head
describe Protective Extension Reaction
position: sitting with legs in front
test: quickly push child forward (or sideways or backwards) about 45 degrees
response: child will quickly throw extended UEs in front (or of displaced side or behind trunk) to break fall
describe Staggering Reaction
position: standing
test: push child in different directions to displace COG off BOS
response: child takes one or more steps in direction of displacement to correct posture
describe Visual Placing Reaction
position: supported in vertical
test: move child forward towards a tabletop or floor
response: leg flexion, then extension to place foot on top of table or floor
* also Visual Placing Reaction for UEs
describe Optical Righting Reaction
position: supported in vertical
test: tilt child anterior, posterior, lateral about 45 degrees
response: child orients head to vertical and is steady
describe Equilibrium Reactions - Prone/Supine
position: prone/supine on moveable surface
test: move child lateral to perimeter of base of support
response: child curves trunk (concave) toward displacement; head rotates toward upper side and UE/LE (upper side) may abduct
describe Equilibrium Reactions - Sitting
position: sitting on moveable surface
test: move child to perimeter of base of support
response: child curves trunk (concave) toward displacement; head rotates toward upper side and UE/LE (upper side) may abduct
describe Equilibrium Reactions - Kneeling/Standing
position: kneeling/standing on moveable surface
test: move child to perimeter of base of support
response: child curves trunk (concave) toward displacement; head rotates toward upper side; UE/LE (lower side) may extend, abduct; UE/LE (concave side) may extend, abduct
which 8 reflexes are at CNS Level = Spine?
flexor withdrawal crossed extension reflex galant reflex placing reflex stepping reflex positive supporting reflex plantar reflex plantar grasp reflex
which 5 reflexes are at CNS Level = Medulla?
moro reflex suck/swallow reflex ATNR STNR TLR
which 2 reflexes are at CNS Level = Pons?
rooting reflex
traction reflex
which 3 reactions are at CNS Level = Midbrain?
righting
- labyrinthine righting reaction
- BOH
- NOB
- BOB
protective
- protective extension reaction - forward
- protective extension reaction - sideways
- protective extension reaction - backwards
staggering reaction
which reactions are at CNS Level = Cortex?
visual placing reaction optical righting reaction equilibrium reaction - prone equilibrium reaction - supine, sitting equilibrium reaction - kneeling equilibrium reaction - standing
which 6 reflexes have a duration from Birth to 2 months?
flexor withdrawal crossed extension reflex galant reflex placing reflex stepping reflex positive supporting reflex
which 1 reflex has a duration from Birth to 3 months?
rooting reflex
which 2 reflexes have a duration from Birth to 5 months?
suck/swallow reflex
traction reflex
which 3 reflex/reactions have a duration from Birth to 6 months?
moro reflex
ATNR
TLR
which 2 reflexes have a duration from Birth to 9 months?
plantar reflex
plantar grasp reflex
which reaction has a duration from 10 months to adult?
protective extension reaction - backwards
which reaction has a duration from 12 months to adult?
equilibrium reaction - kneeling
which reaction has a duration from 15 months to adult?
equilibrium reaction - standing
which reaction has a duration from 18 months to adult?
staggering reaction
which reactions have a duration from 2 months to adult?
labyrinthine righting reaction
BOH
optical righting reaction
which reflex has a duration of 4 months to 12 months?
STNR
which reactions have a duration from 5 months to adult?
visual placing reaction
equilibrium reaction - prone
which reactions have a duration from 6 months to 5 years?
NOB
BOB
which reactions have a duration from 7 months to adult?
protective extension reaction - forward
protective extension reaction - sideways
which reactions have a duration from 8 months to adult?
equilibrium reaction - supine, sitting
