Reflexes Flashcards
1
Q
Rooting
A
● Purpose - locate source of food ● Lightly stroke the corner of infants mouth, infant responds by turning face and tongue to side of stimulation and activates sucking
● Birth – 2 months
2
Q
Moro reflex
A
● Hold infant in semi-seated position ● Supports head in midline with one hand and one hand on the back ● Tip child to allow the head to drop back a few cm ● Sudden movement backward into space sets up a startle response ● You should see abduction and upward movement of the arms, extension of elbows and fingers ● Should be followed by adduction and flexion of UE’s ● Response of LE is toward flexion ● Asymmetrical/absent response = dysfunction
● Active at 2 months
● Inhibited 4-6 months
3
Q
Palmer grasp
A
● Insert finger into infants hand from ulnar side and press against palm to elicit grasp ● Response should be strong flexion of fingers
● Up to 2 months
● Inhibited with W/B
4
Q
Plantar grasp
A
● Supply pressure to sole of foot ● Infant responds with strong flexion of toes ● The flexion of stronger if foot is in DF
● 12 months
● Inhibited with W/B through
standing
5
Q
Primary standing reflex
A
● Infant suspended vertically with trunk supported under the arms ● Sole of feet brought to contact with hard surface ● Infants reflexive response is to bear some weight through feet ● Hips, knees, and trunk not fully extended
● Primary standing present – 2 months, gradually disappears ● However, some children may bear weight this way throughout the course of development until the positive supporting reaction develops
6
Q
Placing reaction
A
● Suspend infant vertically ● Dorsum of hand or foot contact the under edge of the examining table ● Dorsum of hand – wrist will extend, and the palm is placed on the table ● This reflex forms sensorimotor preparation for more active weight bearing during weight shifting in crawling and walking ● Dorsum of foot – flexion of hip and knee seen, lifting the foot above the table ● To extend the leg, put the sole of the foot on the table
● Birth – 2 months, gradually
inhibited
7
Q
Primary walking
A
● First few weeks of life – 2 months
● No reaction is seen by 3-4 months ● Support under arms and hold in
upright position, with trunk tipped
forward
8
Q
ATNR
A
● More pronounced in the arms ● Place child in supine with head toward you, rotate head to 90 and hold for 5 seconds, should bring on ATNR ● 0 – 2 months ● Integrated 4 – 6 months ● Integrated because development of symmetry typically seen at 4 months ● Bilateral control of flexors and extensors around the head and neck allow the head to stay in midline for a more mature movement
9
Q
STNR
A
● 4-6 months ● Integration 10 – 12 months ● Hold child in prone, and flex and extend the head ● Arms will flex and legs will extend on flexion ● Arms extend and legs flex with extension
10
Q
Landau
A
● Clinically relevant, it answers the question: How much extension does this child have? ● Reflects degree of head and trunk rightening, and spinal extension ● Present at birth ● Hold child in prone suspension with support under the trunk, between shoulder and pelvis ● Observe action of the head, back, and hips ● Response can be encouraged by gently raising or lowering the child ● Extension of the back and legs should be active and mobile and not stiffly hypotonic
● 6 months should be able to do a
full Landau
● Integration 12-24 months
11
Q
Equilibrium reaction in sitting
A
● Back extension is developed through long hours of play in prone ● W/B is developed though UE in prone ● Play in supine enhances flexion of shoulders, abdominals, and hips ● 7 months equilibrium reactions in sitting are beginning ● In sitting infant uses forward protective extension developed in prone ● Necessary because of the lack of midline stability and equilibrium at this developmental stage ● BOS is widened by abduction of legs and flexed ring posture ● Weight shifting begins with shifting from one buttock to the other while turning the head to orient visually to environment ● Infant becomes more erect with some rounding of lumbar spine ● When extension moves all the way down the back in prone position and abdominal and lateral trunk muscles become stronger, the infant can co-contract the trunk muscles and sit with pelvis in more stable, neutral position. Shoulders align over pelvis ● Lateral protective extension, initially used to push back to midline, later progressed to pulling back into midline using lateral flexion of trunk
12
Q
Righting and equilibrium reaction
A
● Stimulated by vestibular, proprioceptive, visual, and auditory input ● Full maturation 10 – 12 months ● No longer needed at 4 -5 years because higher level of cortical control emerges ● In a child with CNS dysfunction these reactions are often delayed ● Postural control against gravity develops with emergence of righting reaction ● Righting reaction restores relationship of head to trunk and brings it into proper alignment in space ● Stimulus of rotation of the head or thorax results in rolling over with rotation between the trunk and pelvis, develops 4 – 6 months ● Asymmetrical tactile stimulation to the touch receptors on the surface of the trunk results in trunk rotation, develops 6 – 8 months, marks emergence of rotation around the body axis, prerequisite to counterroatational body movement
13
Q
Protective responses: parachute reactions
A
● Elicited forward, sideways, backward, and downward ● Downward seen in the LE when the infant is quickly displaced in downward direction, developed at 4 months ● Forward stimulated by displacing infant quickly, head first, toward a flat surface, flexion of shoulder and elbow extension is seen ● Prior to 6 months, the infants Neuromotor system has not yet matured to allow active shoulder flexion with elbow extension ● Mature response of 8 month old includes wrist extension with fingers extended and abducted ● Sideway response develops at 6 months, at the time infant is learning to sit independently, elicited by sudden displacement in lateral direction in sitting, response is abduction with elbow, wrist, finger extension ● Backward last to develop, characterized by backward arm extension of arms, infant is quickly displaced backward, develops at 9 months
14
Q
Crawling
A
● Begin to use righting and equilibrium reactions while moving through space ● Stability around pelvic and shoulder girdles further developed ● Allowing arms and legs to move independently from the trunk and from one another
15
Q
Pull to stand
A
● Involves integration of vertical and rotational rightening ● Initially UE provide stability while LE align ● Balance reactions in the feet are established ● Visual perception and sensory and motor experience in the upright positions form the foundation for somatosensory awareness ● Midline stability and equilibrium reactions are enhanced by increased control of upper body and lateral weight shifting, this facilitates reciprocal movement of LE ● As child gains more control, they are able to motor plan movement in unfamiliar situations
