Reflexes

Question 1

What are Primitive reflexes?

Answer 1

Spinal reflexes- numbers that babies are born with

Question 2

Primitive reflexes: Galant Reflex

Answer 2

Stimulus- stroke spine in downward motion while infant lies on stomach

Response- infant will twitch their hips towards the touch in a dancing movement

Time- in utero (20 weeks) and disappears at 3-9 months

Significance: helps in birthing process, also encourages movement and develop ROM to prep for crawling and walking

Question 3

Primitive reflexes: Crawl reflex

Answer 3

Stimulus: prone position (skin to skin on mother) on the tummy

Response: Pull their legs under their body and kick them out in a crawling motion

Time: at birth, disappears by 12 weeks

Significance: This reflex will help a newborn crawl to the breast right after delivery when lying on their mother’s abdomen.

Question 4

Primitive reflexes: Rooting reflex

Answer 4

Stimulus: stroking or touching corner of mouth, or cheek/lips

Response: face turns towards the side- cheek towards breast side

Time: appears at birth and disappears by 12 weeks

Significance: feeding process of the baby

Question 5

Primitive reflexes: sucking reflex

Answer 5

Stimulus: introduce finger to mouth

Response: sucking action of the lips and jaw

Time: appears at birth and disappears around 3-4 months

Significance: breastfeeding

Question 6

Primitive reflexes: Moro (startle) reflex

Answer 6

Stimulus: position- supine and back of head supported above table. Drop the head backwards associated with a loud sound

Response: abduction and extension of the arms (as in embrace) often associated by a cry

Time: appears 9 weeks in utero- fully present at birth and disappears at 3-4 months

Significance: survival reflex, give extra info- if one limb responding- something wrong

Question 7

Primitive reflexes: babinski reflex

Answer 7

Stimulus: stroke lateral aspect of the foot from the heel to the base of the great toe

Response: fanning of all 5 toes, extension of hallux

Time: appears at birth, integrates at 1-2 years

Significance: shows CNS is in tact- positive sign commonly seen in babies <2 years of age

Question 8

Primitive reflexes: Flexor withdrawal

Answer 8

Stimulus: position- supine, head mid position, noxious stimuli to sole of the foot

Response: uncontrolled flexion response of the stimulated leg

Time: appears at birth- integrates at 1-2 months

Significance: upper protective response

Question 9

Primitive reflexes: Crossed extension

Answer 9

stimulus: position- supine, head mid position leg extended- noxious stimuli to the ball of the foot

Response: opposite lower extremity adducts and extends + foot goes into PF

Time: usually is only present until one month of age

Significance: to maintain BOS, enhance postural support during withdrawal of the affected limb from the painful stimulus.

Question 10

Primitive reflexes: Stepping reflex

Answer 10

Stimulus: support infant by holding around their thorax and place feet flat on a surface

Response: alternating steps forward are observed (hip/knee flexion, ankle DF)

Time: appears at birth, disappears by 6 months

Significance: babies brain understands the motions they’ll eventually need to walk

Question 11

Primitive reflexes: Grasp reflex

Answer 11

Stimulus: Press finger or other suitable object into palm from ulnar side

Response: fingers flex and grip the object

Time: appears at birth, disappears by 12 weeks

Significance: good indication of spasticity or prolonged retention of reflex- something going on neurologically

Question 12

What are tonic reflexes?

Answer 12

They are brainstem reflexes

Question 13

Tonic reflexes: Tonic labyrinthine reflex (TLR)

Answer 13

stimulus: change of orientation of the head in space; position head in relation to gravity while prone and supine

Response: prone- flexion of all limbs as they try to lift head supine- extension of all limbs as head is moved backwards

Time: appears at birth and disappears at 2-4 months

Significance: thought to help the infant with newfound challenge of gravity

Question 14

Primitive reflexes: Asymmetrical Tonic Neck Reflex (ATNR)

Answer 14

Stimulus: position- supine lying, head in mid position, arms and legs extended

Response: increase in extensor tone on face side and increase in flexor tone on the skull side

Time: appears at birth and disappears at 6 months

Significance: able to perform one sided movement that go together with proper hand eye coordination and if impaired= can’t horse ride and roll due to extension of the arm

Question 15

What are midbrain/cortical reactions?

Answer 15

Happen after 1 year, consist of righting reactions, equilibrium reactions + protective extension

Question 16

Primitive reflexes: Symmetrical Tonic Neck reflexes (STNR)

Answer 16

Stimulus: position= supine lying, head in mid position, arms and legs extended- flexion or extension of the head

Response: Flexion of the head= arms flex and legs extend, extension of the head= arms extend and legs flex

Time: emerges after ATNR (6-9 months) and disappears after 9-11 months

Significance: preps baby for crawling on all 4’s

Question 17

Righting reactions=

Answer 17

NOB, BOB, BOH, Labyrinthine head righting

Question 18

Neck on Body (NOB)

Answer 18

Stimulus: passive turning of the head to one side in supine

Response: log rolling towards the same side to align with head

Time: appears at 6 months and disappears at 5 years once they master skill

Significance: baby will logroll

Question 19

Body on Head (BOH)

Answer 19

Stimulus: positioning baby either supine or prone

Response: baby tends to arrange by keeping head vertical and mouth horizontal- will always maintain original alignment

Time: appears at 2 months and disappears at 5 years

Significance: develop posture and movement, important for head control in relation to body in all positions

Question 20

Body on Body (BOB)

Answer 20

Stimulus: passive turning of the trunk (upper/lower) to one side in supine lying position

Response: log rolling of the corresponding (upper/lower) segment towards the same side

Time: appears at 6 months, disappears at 5 years

Significance: keeps body oriented to ground- develop rotary components

Question 21

Labyrinthine Head Righting

Answer 21

Stimulus: Position baby in supine with your hands around thorax, tilt them 30 degrees into flexion/extension, side flexion, bringing them back to midline between positions- from 8 months face a blank wall to avoid visual cueing

Response: head should correct immediately back to upright position

Time: appears at birth and normally persists

Significance: head control as baby moves in space, allows child to lift head in prone or supine

Question 22

Equilibrium reactions=

Answer 22

tilting and postural fixation

Question 23

Tilting

Answer 23

Stimulus: alter the COG by shifting the surface by placing the baby in different positions

Response: extension and adduction of supporting extremity and flexion and abduction of other side

Time: prone (4-6 months), supine (6-8 months), sitting (6-8 months) quadripod (10-12 months) standing 12-21 months) and persists

Significance: to make postural adjustments, maintain stability under conditions of instability of supporting base

Question 24

Postural Fixation

Answer 24

Stimulus: alter the COG by slow force on the normal surface by placing the baby in different positions- pushing to one side

Response: extension and adduction of supporting extremity, flexion and abduction of other side

Time: same as tilting and doesn’t disappear

Significance: based on how the baby is maturing

Question 25

Protective extension=

Answer 25

Parachute reflex

Question 26

Parachute reflex

Answer 26

Stimulus: hold infant firmly with both hands around the trunk- rapidly top child towards floor

Response: swift flexion of shoulders and extension of elbow, wrist and fingers with slight shoulder ER

Time: appears at 9 months and normally persists

Significance: protect from injury during loss of balance- whole body response to instability