Pediatrics Flashcards
ATNR
Asymmetrical Tonic Neck Reflex Stimulus: rotation of head to one side Response: arm and leg on same side extend "fencing posture" Onset: birth Integrated: 4-6 months
Crossed extension reflex
Stimuli to ball of foot of extremity fixed in ext
tested in supine
Response: opposite LE flexes, then adducts and extends
Onset: 28 weeks’ gestation
Integrated: 1-2 months
Equilibrium reactions
Stimulus: displace the center of gravity by tilting/moving the support surface
Response: curvature of the trunk toward the upward side, protective extension on the downward side
Onset: 6 mo in prone, 7-8 mo in supine & sitting, 9-12 mo kneeling and standing 12-21 mo
Integration persists through development
Grasp
Stimulus: maintain pressure to palmar or plantar aspects
Response:maintain flexion of fingers or toes
Onset: palmar at birth, plantar and 28 weeks gestation
Integrated: palmar 4-6 months, plantar 9 mo
Landau’s Reflex
Stimulus: lift the child under the thorax in a prone position
Response: head, back and legs extend
Flex of the head eliminates extensor tone
Onset: 3 mo
Integrated 5-6 mo.
Moro Reflex
Stimulus: sudden change in position of the head in relation to the trunk
Response: ext and and of UE’s with hand opening and crying, followed by flex, add and arms across chest
Onset: 28 weeks’ gestation
Integrated 5-6 mo
Optical and Labyrinthine Righting Reflexes
Stimulus: tipping body in all directions, for alrythine occlude vision
Response: head orients to vertical position and mouth horizontal
Onset: birth-2 months
Integrated: persists
Positive Supporting Reaction
Stimulus: to the ball of the foot in upright standing
Response: rigid ext of LE’s, PF, INV and IR of hip, “clawing” toes
Onset: birth
Integrated: 6 mo
Protective Extension Reaction
Stimulus: displace the center of gravity outside the base of support
Response: arms or legs ext and and to support and protect the body against falling
“parachute reaction” -protective ext downward develops first
Onset: arms 4-6 mo, legs 6-9 mo
Integration persists
STNR
Symmetrical Tonic Neck Reflex
Stimulus: flex or ext of head
Response: with flex - flex of arms and ext legs
with ext - ext of arms and flex legs
Onset-4-6 months
Integrated: 8-12 months
*Strongly influences ability to assume quadruped and crawl
Tonic Labyrinthine reflex
stimulus: prone or supine
Response: with prone - increased flexor tone
with supine - increased extensor tone
Onset: birth
integrated: 6 months
Traction reflex
Stimulus: pulling on forearm from supine to sit
Response: grasp and total flexion of upper extremities and head will lag behind
onset: 28 weeks gestation
integrated: 2-5 months
What does APGAR scoring system measure?
Heart rate, respiration, muscle tone, color and reflex irritability
Scale 0-2
Measured at birth, 1, 5 10 and 15 min after birth
Score of >7 is normal
<4 requires immediate care
Upper Brachial Plexus injury
What are the function implications?
Erb’s Palsy
Occurs when C5 and C6 nerve roots are stretched during birth process
Arm sits in waiter tip position (sh add, IR)
Fxnal implications: child will not be able to used the involved side to hug a doll, drink from a cup or zip and coat
Lower Brachial Plexus injury
What are the functional implications?
Klumpke’s Paralysis
Occurs when C8 and T1 nerve roots are stretched during birth process
A claw hand appearance is common
Hand function is affected in this injury
