Reflexes

Question 1

Babinksi Reflex

Question 2

Asymmetrical Tonic Reflex (ATNR)

Answer 2

• Stimulus: rotation head to one side
• Response: flexion of skull limbs, ext of jaw limbs
• Onset: birth
• Integrated: 4-6 months
• Other: prolonged influence can result in scoliosis or hip subluxation if hypertonic. If reflex is severe, grasping of objects with extended arm is only possible if patient looks away from object to decrease influence

Question 3

Crossed Extension Reflex

Answer 3

• Stimulus: noxious stimulus to ball of foot of extremity fixed in extension; tested in supine
• Response: (1) opp LE flexes, then adducts/extends (2) pts w/ hemiplegia, lifting uninvolved leg during ambulation results in increased tone in involved leg
• Onset: 28 weeks
• Integrated: 1-2 months
• Other: coupled w/ positive supporting reflex may result in hyperextension of the knee

Question 4

Equillibrium Reactions

Answer 4

• Stimulis: displace COG by tilting/moving support surface (board or ball)
• Response: (1) curvature of trunk toward opposite side along with ext/abd of ipsilat extremities (2) protective ext on opp side (downward) (3) equilibrium rxns will be absent w/ marked spasticity
• Onset: Prone - 6 mo supine - 7-8 mo sitting - 7-8 mo kneeling - 9-12 mo standing - 12-21 mo
• Integrated: Persists

Question 5

Grasp Reflex

Answer 5

• Stimulis: maintain pressure to palmar or plantar surface
• Response: maintain flexion of fingers or toes
• Onset: Palmar - birth, Plantar - 28 weeks gestation
• Integrated: Palmar - 4-6 mo, Plantar - 9 mo.

Question 6

Landau’s Reflex

Answer 6

• Stimulis: lift the child under the thorax in prone
• Response: head/back/legs will extend. (head flexed extensor tone will disappear)
• Onset: 3 months
• Integrated: 2 years. Absent w/ strong flexor spasticity

Question 7

Moro Reflex

Answer 7

• Stimulus: sudden change in position of head in relation to the trunk
• Response: extension/abduction of UE w/ hand opening/crying followed by flexion, adduction and crossed arms across chest
• Onset: 28 weeks gestation
• Integrated: 5-6 months

Question 8

Optical and Labrinthine Righting Reflexes

Answer 8

• Stimulis: alter body position by tipping body in all directions. (vision occluded for labyrinthine)
• Response: head orients to vertical position and mouth horizontal
• Onset: birth-2 months
• Integrated: persists

Question 9

Positive Supprting Reaction

Answer 9

• Stimulis: contact to the ball of foot in upright stand
• Response: rigid extension (cocontraction) LE w/ plantar flexion and inversion toes “clawing” and hip IR
• Onset: Birth
• Integrated: 6 months
• Other: (1) CP - adductor spasm may occur. (2) hemiplegia - may produce hip ABD (3) ambulation will be disrupted by inability to DF or move LE

Question 10

Protective Extension Reaction

Answer 10

• Stimulis: displace COG outside BOS
• Response: extremity ext/abd to support/protect body against falling. (parachute develops first- ext downward) followed by forward, sideward, and backward protective extension
• Onset: arms - 4-6 months, legs - 6-9 months
• Integrated: Persists

Question 11

Rooting Reflex

Answer 11

• Stimulis: Side of face is stimulated w/ light touch
• Response: turns head toward stim & opens mouth
• Onset: present in premature infants
• Integrated: 3 months

Question 12

Symmetrical Tonic Reflex (STNR)

Answer 12

• Stimulis: flex or ext of head
• Response: (1) w/ head flexion - flexion of arms and extension of legs (2) w. head extension - ext of arms and flexion of legs
• Onset: 4-6 months
• Integrated: 8-12 months
• Other: can strongly influence ability to assume quadruped position and crawling

Question 13

Tonic Labrinthine Reflex

Answer 13

• Stimulis: prone or supine position
• Response: Prone: increased flex tone, Supine: increased ext tone
• Onset: Birth
• Integrated: 6 months
• Other: it may be impossible for the patient to turn side lying from the supine because extensor tone limits flexion of shoulder or hip on one side

Question 14

Traction Reflex

Answer 14

• Stimulis: grasp forearm and pull up from supine into sitting
• Response: grasp and total flex of UE w/ head lag
• Onset: 28 weeks
• Integrated: 2-5 months