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MedSurg III > Primitive Reflexes > Flashcards

Primitive Reflexes Flashcards

1
Q

Influenced by the immature central nervous
system

A. Suppression
B. Motor Behavior
C. Maturation
D. Volitional control

A

B. Motor behavior

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2
Q

This means maturation

A

Suppression

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3
Q

Volitional control is acquired
usually by the
A. 4-5 months
B. 3-4 months
C. 6-8 months
D. 7-10 months

A

C. 6-8 months

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4
Q

Earliest markers of
abnormal neurologic maturatio

A

Obligatory or persistent primitive reflexes

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5
Q

More sophisticated postural responses emerge between____
months of age that are used and incorporated into volitional motor
behavior

A. 9-10 mos
B. 2-14 mos
C. 3-12 mos
D. 4-7 mos

A

B. 2-14 mos

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6
Q

Sophisticated postural responses are incorporated at birth (T/F)

A

F, not incorporated

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7
Q

Adaptive responses that develop during the neonatal period and
integrate over time as the brain matures

A

Primitive Reflexes

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8
Q

Reflexes are automatic movements that are controlled by the
______

A

Brainstem

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9
Q

Primitive reflexes require no conscious thought (cortical involvement) T/F

A

T

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10
Q

Primitive reflexes are present for survival & development in the early months of life T/F

A

T

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11
Q

Automatic reflexes are measured in terms of:

A

Timing
Strength
Symmetry

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12
Q

Indicate how the signals are sent from the brain to the spinal cord
and outward to individual muscles of the:

A

Face
Neck
Torso
Extremities

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13
Q

Primitive reflexes are NOT involved in postural control and movement T/F

A

F, involved

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14
Q

One of the most common tools used by physicians and therapists to assess the integrity of the ______ in infants and children

A

CNS

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15
Q

Causes of retained reflexes:

A

Caesarean section
Trauma
Exposure to toxins
Anesthetics
Medications

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16
Q

Other possible causes:

A

Decreased tummy time in infancy,
short period or lack of crawling,
walking early,
chronic ear infections,
head injuries

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17
Q

Reflexes should be integrated as the child’s motor development mature T/F

A

T

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18
Q

During normal development, these reflexes are slowly inhibited by
the _____ of the brain as the age progresses

A

frontal lobe

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19
Q

The motor responses arising from CNS are inhibited by _____
months of age as the brain matures and replaces them with
voluntary motor activities but certain neurological diseases can
relapse

A. 4-6 mos
B. 6-8 mos
C. 8-10 mos
D. 10-12 mos

A

A. 4-6 mos

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20
Q

The persistence of these reflexes beyond the usual ages of integration is suggestive of ___

A

ischemic brain injury

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21
Q

Cortical Reflex

A

Equilibrium reactions

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22
Q

Midbrain Reflex

A

Kinetic Labyrinthine
Body righting acting on head
Body righting acting on body
Protective extension
Parachute reflex

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23
Q

Brainstem Reflex

A

Tonic Neck Reflex - ATNR/STNR

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24
Q

Spinal Reflex

A

Flexor withdrawal
Extensor thrust
Palmar grasp
Plantar grasp
Sucking reflex
Rooting reflex
Walking/Stepping reflex

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25
Q

Classification depending upon purpose

A

Protective/Flexor reflexes
Antigravity/Extensor reflexes

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26
Q

Classification depending upon clinical basis (Superficial Reflex)

A

Mucus membrane
Cutaneous

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27
Q

Classification depending upon clinical basis (Deep Reflex)

A

Visceral reflexes
Pathologic reflexes

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28
Q

Moro/Startle Reflex (Stimulus)

A

Sudden neck extension

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29
Q

Moro/Startle Reflex (Response)

A

Arm extension abduction
followed by flexion adduction

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30
Q

Moro/Startle Reflex (Age of Suppression)
A. 2-5 months
B. 3-8 months
C. 4-6 months
D. 5-7 months

A

C. 4-6 months

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31
Q

Moro/Startle Reflex (Significance)

A

Gives an indication of muscle tone

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32
Q

Moro/Startle Reflex (If retained)

A

Sensitive/overreactive to sensory stimuli
Poor impulse control
Sensory overload
Anxiety and emotions
Social immaturity

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33
Q

Moro/Startle Reflex (signs of a retained moro reflex)

A

Motion sickness
Poor balance
Poor coordination
Easily distracted
Unable to adapt well to change
Mood swings

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34
Q

Rooting Reflex (Stimulus)

A

Stroking the corner of the
mouth upper or lower lip

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35
Q

Rooting Reflex (Response)

A

Moving tongue,
mouth and head towards stimulus

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36
Q

Rooting Reflex (Age of suppression)
A. 1 mo
B. 2 mos
C. 3 mos
D. 4 mos

A

D. 4 mos

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37
Q

Rooting Reflex (Signs of Retention)

A

Anterior Tongue Tie
Thumb sucking or oral hypersensitivity
Poor eating
Speech and articulation problem

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38
Q

Rooting Reflex (signs of retained reflex)

A

Difficulty c solid foods
Poor articulation
Thumb sucking

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39
Q

Positive supporting reflex (stimuli)

A

Tactile contact and weight bearing on
the sole

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40
Q

Positive supporting reflex (response)

A

Legs extend for partial support of
Body weight

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41
Q

Positive supporting reflex (suppression)
A. 4-9 months and replaced by
volitional standing
B. 3-7 months and replaced by
volitional standing
C. 10-12 months and replaced by
volitional standing
D. 2-5 months and replaced by
volitional standing

A

B. 3-7 months and replaced by
volitional standing

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42
Q

Positive supporting reflex (significance) - 1

A

Difficulty placing the heel on the ground for standing
Putting the heel down first in walking
Normal body weight transference in walking

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43
Q

Positive supporting reflex (significance) - 2

A

Difficulty getting up from or sitting down in a chair and walking down steps because it is not possible to move the joints in weight-bearing (leg-remains stiff in extension)

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44
Q

Positive supporting reflex (significance) - 3

A

Rigid leg will be able to carry the patient’s body weight (unable to contribute any balance

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45
Q

Asymmetric Tonic Neck Reflex (Stimulus)

A

Head turning or tilting to the side

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46
Q

Asymmetric Tonic Neck Reflex (Response)

A

Extremity extend on the chin/face side and flex on the occiput side

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47
Q

Asymmetric Tonic Neck Reflex (Suppression)
A. 6-7 mos
B. 7-8 mos
C. 9-10 mos
D. 10-11 mos

A

A. 6-7 mos

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48
Q

Asymmetric Tonic Neck Reflex (significance)

A

Assists with early eye hand regard
Vestibular stimulation

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49
Q

Asymmetric Tonic Neck Reflex (Persistence)

A

Impair ability to roll
Use hands smoothly together at midline
Poor visual regard for object held
Poor balance and/or fall when rotates his head

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50
Q

Symmetric Tonic Neck Reflex (Stimulus)

A

Neck flexion or neck extension

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51
Q

Symmetric Tonic Neck Reflex (Response)

A

Arms flex
Legs extend
Arms extend
Legs flex

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52
Q

Symmetric Tonic Neck Reflex (Suppression)
A. 5-8 months
B. 3-5 months
C. 6-7 months
D. 4-9 months

A

C. 6-7 months

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53
Q

Symmetric Tonic Neck Reflex (Significance)

A

Development of (B) patterns of body movement
Move up against gravity
Assume quadruped
Integrates as child begin to crawl

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54
Q

Symmetric Tonic Neck Reflex (if retained)

A

Interfere c advanced reciprocal creeping
Impair dissociation between 2 lower extremities
Transition between quadruped to sitting
Bunny hop vs true creeping in floor

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55
Q

Palmar grasp (stimulus)

A

Pressure or touch on the palm; stretch of finger flexors

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56
Q

Palmar grasp (response)

A

Flexion of fingers/toes

57
Q

Palmar grasp (suppression)
A. 2-3 months
B. 3-4 months
C. 4-5 months
D. 5-6 months

A

D. 5-6 months

58
Q

Palmar grasp (significance)

A

Create basic motor patten that lays foundation for voluntary ability

59
Q

Palmar grasp (if retained)

A

Stick tongue out while writing
Messy handwriting

60
Q

Plantar grasp (stimulus)

A

Pressure on the sole just distal to the metatarsal head

61
Q

Plantar grasp (response)

A

flexion of toes

62
Q

Plantar grasp (suppression)
A. plantar 12-18 mos
B. plantar 18-24 mos
C. plantar 24-36 mos
D. plantar 36-48 mos

A

A. plantar 12-18 mos

63
Q

Plantar grasp (significance)

A

Integrates at the same time that independent gait

64
Q

Plantar grasp (significance)
A negative or diminished reflex during
early infancy is often a sensitive
indicator of RIGIDITY (T/F)

A

F, SPASTICITY

65
Q

Automatic walking (stimulus)

A

Contact of sole in vertical titling the body forward and from side to side

66
Q

Automatic walking (response)

A

Alternating automatic steps with support

67
Q

Automatic walking (suppression)
A. 1-2 months
B. 3-4 months
C. 5-6 months
D. 7-8 moths

A

B. 3-4 months

68
Q

Automatic walking (Significance)

A

With daily practice of reflex, infants may walk alone at 10 months

69
Q

Automatic walking (Significance)

Premature infants walk in ______
Mature infants walk in

A

Toe-heel pattern
Heel-toe pattern

70
Q

Neck RIGHTING or body detortational (stimulus)

A

Neck rotation in supine

71
Q

Neck RIGHTING or body detortational (Response)

A

Sequential body rotation from shoulder to pelvis toward direction of face

72
Q

Neck RIGHTING or body detortational (emerge at)

A

4 mos and replaced by volitional rolling

73
Q

Neck RIGHTING or body detortational (Significance)

A

Enables child to roll from prone to supine
Supine to prone
Build muscle tone against gravity

74
Q

Neck RIGHTING or body detortational (Significance)

In neurologic cases e.g. cerebral palsy, righting reflexes are PRESENT T/F

75
Q

Head position in space strongest at 45 degrees from horizontal

A

Tonic Labyrinthine Reflex

76
Q

Tonic Labyrinthine Reflex (Stimulus)
Supine:______
Prone:____

A

Predominant extensor tone
Predominant flexor tone

77
Q

Tonic Labyrinthine Reflex (Suppression)
A. 4-6 mos
B. 6-8 mos
C. 8-10 mos
D. 11-12 mos

A

A. 4-6 mos

78
Q

Tonic Labyrinthine Reflex (Significance)

A

Learn to do neck and head control
Together c STNR, Landu etc help infant develop coordination
Proper head alignment and posture

79
Q

Placing reflex (stimulus)

A

Tactile contact on dorsum of foot or hand

80
Q

Placing reflex (Response)

A

Extremity flexion to put foot or arm over an obstacle

81
Q

Placing reflex (Suppression)

A. Before end of 1st month
B. After end of 1st month
C. After end of 1st yr
D. Before end of 1st yr

A

D. Before end of 1st yr

82
Q

Placing reflex (Significance)

A

Demonstrable in new born
Persistent failure to elicit at this stage -> neurologic abnormality

83
Q

Babinski’s reflex (stimulus)

A

Firm painful stroke along the lateral sole from heel to toe

84
Q

Babinski’s reflex (Response)

A

Flexion/Extension of big toe and sometimes fanning of other toes

85
Q

Babinski’s reflex (Suppression) - Present at birth suppressed by:
A. 8-9 months
B. 9-10 months
C. 10-11 months
D. 11-12 months

A

B. 9-10 months

86
Q

Babinski’s reflex ( Significance)

A

Presence of reflex later may indicate diseases

87
Q

This reflexes are needed for development of some activities

A

Physiologic Postural Reflex Response

88
Q

PPRR are present at birth and suppressed as the child developes T/F

A

F; absent at birth, emerge to be integrated during child development

89
Q

Types of PPRR

A

Head righting
Body, Head righting
Parachute reaction or protective extension
Equilibrium/Tilting reaction

90
Q

Head righting (stimulus)

A

Visual & vestibular
Align face/head vertical
mouth horizontal

91
Q

Head righting (emergence)
Prone:______
Supine:_____

A

2 mos
3-4 mos

92
Q

Head righting delays or absent in CNS would mean immaturity/damage T/F

93
Q

Body, head righting (stimulus)

A

Tactile proprioception vestibular

94
Q

Body, head righting (Reaction)

A

Align body parts in anatomic position relative to each other an gravity

95
Q

Body, head righting (emergence)
A. 1-2 mos
B. 2-3 mos
C. 3-4 mos
D. 4-6 mos

A

D. 4-6 mos

96
Q

Parachute rxn/protective extension (stimulus)

A

Displacement if center of gravity outside of supporting surface

97
Q

Parachute rxn/protective extension (response)

A

Extension-abduction of the extremity toward side of displacement to prevent falling

98
Q

Parachute rxn/protective extension (emergence)
A. 4-10 mos
B. 5-12 mos
C. 6-14 mos
D. 7-16 mos

A

B. 5-12 mos

99
Q

Parachute rxn/protective extension (Significance)

A

Absent/abnormal in CP pts
Asymmetric spastic hemiplegia

100
Q

Equilibrium or tilting rxn (stimulus)

A

Displacement of COG

101
Q

Equilibrium or tilting rxn (response)

A

Adjustment of tone
Posture of trunk to maintain balance

102
Q

Equilibrium or tilting rxn (emergence)
Sitting:____
Standing:_____

5-7 mos
6-8 mos
10-12 mos
12-14 mos

A

6-8 mos
12-14 mos

103
Q

Defines as babies born alive BEFORE 37 weeks of pregnancy are completed

A

Preterm (premature infant)

104
Q

Sub-categories of preterm birth (based
on gestational age)

<28 wks

A

Extremely preterm

105
Q

Sub-categories of preterm birth (based
on gestational age)

28-32 wks

A

very preterm

106
Q

Sub-categories of preterm birth (based
on gestational age)

32-37 wks

A

moderate to late preterm

107
Q

Risk factors of Premature infant

A

-Twins/triplets/other multiples
-<6 mos between pregnancies
-Assisted reproduction (in vitro fertilization)
- >1miscarriage/abortion
- previous premature birth
- preeclampsia (especially this)
- prelabor rupture of membrane
- medicines
- smoking
- alcohol
- low nutrition

108
Q

Ideal waiting time between pregnancies
A. 16-20
B. 17-22
C. 18-24
D. 19-25

mos

109
Q

Determine if PRETERM/TERM (Posture)

Relaxed attitude, limbs more extended,
body size is small, head appear larger in
proportion than body

110
Q

Determine if PRETERM/TERM (Posture)

More subcutaneous fat, rests in a more
flexed attitude

111
Q

Determine if PRETERM/TERM (SCROTUM/TESTES)

Well developed, pendulous, rugated
Testes down scrotal sac

112
Q

Determine if PRETERM/TERM (SCROTUM/TESTES)

Undeveloped, not pendulous, minimal
rugae
Testes may be in the inguinal canal or in
abdominal cavity

113
Q

Determine if PRETERM/TERM (CLITORIS/LABIA MAJORA)

Prominent, labia majora poorly developed and gaping

114
Q

Determine if PRETERM/TERM (CLITORIS/LABIA MAJORA

Fully developed labia majora, clitoris
not prominent

115
Q

Determine if PRETERM/TERM (SCARF SIGN)

Elbow may be brough across chest with
little or no resistance

116
Q

Determine if PRETERM/TERM (SCARF SIGN)

Resisting attempt to bring elbow past
midline

117
Q

Determine if PRETERM/TERM (EARS)

Cartilages poorly developed, easily fold

118
Q

Determine if PRETERM/TERM (EARS)

Ear cartilages well formed

119
Q

Determine if PRETERM/TERM (HAIR)

Firm hair, separate glands

120
Q

Determine if PRETERM/TERM (HAIR)

Lanugo over back and face

121
Q

Determine if PRETERM/TERM (RESPIRATORY)

Fully developed lungs

122
Q

Determine if PRETERM/TERM (RESPIRATORY)

Presence of distress, breathing complications

123
Q

Determine if PRETERM/TERM (BRAIN)

By 35th weeks baby’s brain still needs to
grow 50%

124
Q

Determine if PRETERM/TERM (BRAIN)

higher brain functioning

125
Q

Determine if PRETERM/TERM (BODY FAT)

Unable to regulate temperature through
body fat until 34th week

126
Q

Determine if PRETERM/TERM (BODY FAT)

Has enough fat and energy to regulate
body function

127
Q

Determine if PRETERM/TERM (FEEDING)

Weak suck/swallowing; not fully developed till 34th weeks

128
Q

Determine if PRETERM/TERM (FEEDING)

Able to suck, swallow leading to rapid
weight gain

129
Q

COMPLICATIONS OF PREMATURITY (Cardiac)

Patent Ductus Arteriosus
- if infant is ______wks, 98% it will close by the time of discharge

130
Q

COMPLICATIONS OF PREMATURITY (CNS)

A

Poor suck
Apneic episode - abnormal breathing
IV hemorrhage - prone to bleeding
Cognitive delays
Seizures

131
Q

COMPLICATIONS OF PREMATURITY (EYES)
_______interfere with the normal vascularization process due to abnormal vessel development and sometimes defects in vision such as _____.

Myopia and/or ______

A

Retinopathy of prematurity
Blindness
Strabismus

132
Q

COMPLICATIONS OF PREMATURITY (GI tract)

A

Feeding intolerance increasing risk of aspiration
Swallowing/sucking

133
Q

COMPLICATIONS OF PREMATURITY (Infection)

A

Sepsis
Meningitis
4x likelihood occuring 25% in very low birthweight infants (needs antibiotic)

134
Q

COMPLICATIONS OF PREMATURITY (Lungs)

A

Respiratory distress syndrome
Chronic lung disease
Surfactant production is inadequate to prevent alveolar collapse and
atelectasis causing respiratory distress syndrome (RDS)

*hindi makabuka so baby will develop repirtory disease syndrome

135
Q

COMPLICATIONS OF PREMATURITY (Metabolic Problems)

A

Hypoglycemia, hyperbilirubinemia
Kernicterus

136
Q

COMPLICATIONS OF PREMATURITY (Metabolic Problems)

Brain damage cause by hyperbilirubinemia

A

Kernicterus

137
Q

COMPLICATIONS OF PREMATURITY (Metabolic Problems)

Elevation in bilirubine in the blood d/t immature liver

A

Hyperbilirubinemia

*bilirubin is neurotoxic, if child develops jaundice, they can develop brain damage

138
Q

COMPLICATIONS OF PREMATURITY (Metabolic Problems)

Hyperbilirubinemia causes what type of CP

139
Q

COMPLICATIONS OF PREMATURITY (Metabolic Problems)

Hyperbilirubinemia and kernicterus occurs with serum bilirbin as low as _____

MedSurg III (1 decks)

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