Pediatrics and Development

Question 1

APGAR Scores

Answer 1

A = appearance (skin color)
P = Pulse rate
G = Grimace (reflex irritability)
A = Activity
R = Respiration 

• scores calculated at once minute and five minutes following birth
• 7 to 10 = healthy
• 3 or below = immediate medical attention

Question 2

APGAR - Appearance

Answer 2

0 = Blue; pale
1 = Normal body color, but blue hands and feet
2 = Normal "pink" color

Question 3

APGAR - Pulse rate

Answer 3

0 = absent pulse
1 = below 100 bpm
2 = above 100 bpm

Question 4

APGAR - Grimace

Answer 4

0 = no response to stim
1 = minimal response to stim
2 = pulls away, sneezes or coughs

Question 5

APGAR - Activity

Answer 5

0 = no movement, floppy
1 = flexing of the arms and legs
2 = active movement

Question 6

APGAR - Respiration

Answer 6

0 = absent 
1 = slow, irregular
2 = vigorous cry

Question 7

Asymmetrical Tonic Neck Reflex (ATNR)

Answer 7

Stimulus: head position, turn to one side
Response: arm and leg on face side are extended, arm and leg on scalp side are flexed
Normal age of response: birth to 6 months

Question 8

Symmetrical Tonic Neck Reflex (STNR)

Answer 8

Stimulus: head position; flexion or extension
Response: when head is in flexion, arms are flexed and legs are extended; when head is in extension, arms are extended and legs are flexed
Normal age of response: 6 to 8 months

Question 9

Tonic Labyrinthine Reflex (TLR)

Answer 9

Stimulus: position of labyrinth in inner ear - reflected in head position
Response: in supine, body and extremities are held in extension; in prone, body and extremities are held in flexion
Normal age of response: birth to 6 months

Question 10

Galant Reflex

Answer 10

Stimulus: touch skin along spine from shoulder to hip
Response: lateral flexion of trunk to side of stimulus
Normal Age of response: 30 weeks of gestation to 2 months

Question 11

Palmar Grasp Reflex

Answer 11

Stimulus: pressure in palm of ulnar side of hand
Response: flexion of fingers causing strong grip
Normal Age of response: birth to 4 months

Question 12

Plantar Grasp Reflex

Answer 12

Stimulus: pressure to base of toes
Response: toe flexion
Normal Age of response: 28 weeks of gestation to 9 months

Question 13

Rooting reflex

Answer 13

Stimulus: touching on cheek
Response: turning head to the same side with mouth open
Normal age of response: 28 weeks of gestation to 3 months

Question 14

Moro Reflex

Answer 14

Stimulus: head dropping into extension suddenly for a few inches
Response: arms abduct with fingers open, then cross trunk into adduction; crying
Normal age of response: 29 weeks of gestation to 5 months

Question 15

Startle Reflex

Answer 15

Stimulus: loud, sudden noise
Response: similar to Moro response, but elbows remain flexed and hands closed
Normal age of response: 28 weeks of gestation to 5 months

Question 16

Positive Support Reflex

Answer 16

Stimulus: weight placed on balls of feet when upright
Response: stiffening of legs and trunk into extension
Normal age of response: 35 weeks of gestation to 2 months

Question 17

Walking (stepping) reflex

Answer 17

Stimulus: supported upright position with soles of feet on firm surface
Response: reciprocal flexion/extension of legs
Normal age of response: 38 weeks of gestation to 2 months