Reflex Flashcards
What is a reflex?
involuntary movement reaction that is elicited by a form of sensory stimulus like sound, light, touch, or body position.
What are the most significant and retained primitive reflexes
symmetrical
asymmetrical tonic neck reflexes
the tonic labyrinthine reflex
the moro reflex
spinal galant reflex
What happens if asymmetrical tonic neck reflex doesn’t disappear
prevents child from achieving hand skills done on midline
Ex: handwriting
What happens if tonic labyrinthine reflex doesn’t disappear
affects balance and visual tracking
The ________causes children to be hypersensitive and have difficulty in concentrating.
moro reflex
this reflex produces a wriggle at the bottom of the spine which makes it very difficult for them to sit still for long.
Spinal galant
Factors that Affect Child’s Motor Development
- Rate of physical and neurological maturation
- Quality and variety of child’s movement experiences
- The conditions (environmental/genetic) that may affect motor efficiency
Role of Reflexes in Infant Development
- Protection and survival
- Nutrition
Lobe that is responsible for suppressing primitive reflex in adults
Frontal lobe
examples of conditions that may cause the primitive reflexes to reappear for adults
Neurological conditions like dementia, traumatic lesions and stroke
examples of conditions that may cause the primitive reflexes to reappear for older children and adults
cerebral palsy
If primitive reflexes remain beyond_____months of life they are termed aberrant and may result in immature patterns of behavior and despite the acquisition of later skills may cause immature systems to remain.
6-12 months
Reflex that should be inhibited when rolling over
Moro, startle, ATNR
Reflex that should be inhibited when in balance
ATNR, Moro, Startle, Tonic neck reflexes
Reflex that should be inhibited when standing alone
Plantar grasp
Babinki reflex
_______ must disappear to be able to rollover and to put
hands in midline to play and have normal eye-hand
coordination
ATNR
instinctive response to seek food
aka Search reflex, where the newborn turns its head toward the stimulus in search of nourishment
Rooting Reflex
The earliest form of “fight or flight” (reaction to stress)
moro reflex
Rotation of the head to one side
- Flexion of skull limbs, extension of the jaw limbs, “bow and arrow” or “ fencing” posture.
Asymmetrical Tonic Neck Reflex
Asymmetrical Tonic Neck Reflex Onset and Integrated
Onset: Birth
Integrated:4-6 months
When retained, the ATNR can result in the following manifestations:
- Homolateral movements when walking, marching skipping instead of cross-pattern movements
- Difficulty crossing the midline, can’t manipulate objects with both hands, poor ocular pursuit movements, fails to establish a preferred hand/eye/leg/ear dominant side
- Mixed laterality
- Poor handwriting and poor expression of ideas on paper
- Visual-perceptual difficulties
Persistence may impede head raising when prone or supine, inhibit reaching and grasping, sitting and walking
Symmetrical Tone Reflex
Noxious stimulus (pinprick) to sole of foot. Tested in supine or sitting position.
response: Toes extend, foot dorsiflexes, entire leg flexes uncontrollably.
Onset: 28 weeks gestation
Integrated: 1-2 months
Flexor Withdrawal
Noxious stimulus to ball of foot of extremity fixed in extension; tested in supine position
RESPONSE
Opposite lower extremity flexes, then adducts and extends. Onset: 28 weeks gestation
Integrated: 1-2 months
CROSSED EXTENSION
STIMULUS
Grasp forearm and pull up from supine into sitting position.
RESPONSE
Grasp and total flexion of the upper extremity Onset: 28 weeks gestation Integrated: 2-5 months
TRACTION
STIMULUS
Sudden change in position of head in relation to trunk; drop patient backward from sitting position
RESPONSE
Extension: abduction of upper extremities, hand opening, and crying followed by flexion, adduction of arms across chest.
Onset: 28 weeks gestation
Integrated: 5-6 months
MORO
STIMULUS
Sudden loud or harsh noise
RESPONSE
Sudden extension or abduction of arms, crying.
Onset: birth Integrated: persists
STARTLE
STIMULUS
Maintained pressure to palm of hand (palmar grasp) or to ball of foot under toes (plantar grasp)
RESPONSE
Maintained flexion of fingers or toes Onset: palmar: birth plantar: 28 weeks gestation
Integrated: palmar: 4-6 months plantar: 9 months
GRASP
STIMULUS
Rotation of the head to one side
RESPONSE
Flexion of skull limbs, extension of the jaw limbs, “bow and arrow” or “fencing” posture
Onset: birth Integrated: 4-6 months
ATNR
STIMULUS
Flexion or extension of the head
RESPONSE
With head flexion: flexion of arms, extension of legs
With head extension: extension of arms, flexion of legs
Onset: 4-6 months Integrated: 8-12 months
STNR
STIMULUS
Prone or supine position
RESPONSE
With prone position: increased flexor tone/ flexion of all limbs
With supine position: increased extensor tone/ extension of all limbs
Onset: birth
Integrated: 6 months
TONIC/BRAINSTEM REFLEX: SYMMETRICAL TONIC LABYRINTHINE (TLR OR STLR)
STIMULUS
Contact to ball of the foot in upright standing position
RESPONSE
Rigid extension (cocontraction) of the lower extremities Onset: birth Integrated: 6 months
TONIC/BRAINSTEM REFLEX: POSITIVE SUPPORTING
STIMULUS
Resisted voluntary movement in any part of the body
RESPONSE
Involuntary movement in a resting extremity Onset: birth – 3 months
Integrated: 8-9 years
TONIC/BRAINSTEM REFLEX: ASSOCIATED REACTIONS
MIDBRAIN/CORTICAL REFLEXES: Neck righting action on the body (NOB)
STIMULUS
Passively turn head to one side; tested in supine.
RESPONSE
Body rotates as a whole (log rolls) to align the body with the head
Onset: 4-6 months Integrated: 5 years
STIMULUS
Passively rotate upper or lower trunk segment; tested in supine
RESPONSE
Body segment not rotated follows to align the body with the head
Onset: 4-6 months Integrated: 5 years
MIDBRAIN/CORTICAL REFLEXES: Body righting acting on the body
(BOB)
MIDBRAIN/CORTICAL REFLEXES: Labyrinthine head righting (LR)
STIMULUS
Occlude vision; alter body position by tipping body in all directions
RESPONSE
Head orients to vertical position with mouth horizontal Onset: birth – 2 months
Integrated: persists
STIMULUS
Alter body positions by tipping body in all direction
RESPONSE
Head orients to vertical position with mouth horizontal Onset: birth – 2 months
Integrated: persists
MIDBRAIN/CORTICAL REFLEXES: Optical righting (OR)
MIDBRAIN/CORTICAL REFLEXES: Body righting acting on head (BOH)
STIMULUS
Place in prone or supine position
RESPONSE
Head orients to vertical position with mouth horizontal Onset: birth – 2 months
Integrated: 5 years
Protection and survival REFLEX
Moro reflex
ATNR
Parachute Reflex
STIMULUS
Displace center of gravity outside the base of support
RESPONSE
Arms or legs extend and abduct to support and to protect the body against falling Onset: arms: 4-6 months; legs: 6-9 months
Integrated: persists
MIDBRAIN/CORTICAL REFLEXES: PROTECTIVE EXTENSION
Nutrition REFLEXES
Rooting reflex
Sucking reflex
movements produced by small muscles
* usually involves the hands or fingers
Fine Motor Control
- movements produced by large muscles
- movements that move the body in space
- Gross Motor Control
Locomotion with the body in a prone position, trunk on the ground. The feet or arms exert a pushing motion and the arms engage in pulling.
- Crawling
Locomotion on hands and knees with the trunk
off the ground.
* first, one limb at a time then contralateral movement of opposite leg and arm
Creeping
Skip
a gait in which steps and hops alternate
* Skipping is the combination of a walk and a hop.
* you step on one foot and hop in place on the same foot, then you step on the other foot and hop in place.
gallop
you take a step with one foot bringing the other foot up behind it, then you shift your weight to the back foot.
* The foot that led then leads again and the moves are repeated.
Compensations for inadequate balance:
- Wide base of support
- Hyper-rotation of toes
- Larger lateral sway
- Hyper-flexion of knees
- Arms in high guard
- Shorter swing phase
- Longer double support phase
Compensations for inadequate strength:
- Flat foot contact
- Shorter swing phase
- Rigid arms
Phase 1 of Development
reflexes to rudimentary movements
Phases 2 of Development
fundamental skills
Phase 3 of Development
specific movement skills appear
fundamental skills become more refined
Phase 4 of Development
movements are specialized
Attempts to lift head in midline
Typical Age: 1 month
Age range: 1-2 months
Astasia
Abasia
Fencer’s posture
Typical Age: 2 months
Age range: 1-4 mo
Rolling supine to Side-lying non segmentally
Typical Age: 3 months
Age range: 2-4 months
Beginning midline head control
Typical Age: 3 months
Age range: 2-3 months
Hands to midline and POE head to 90 deg chin tuck
Typical Age: 4 months
Age range: 3-5 months