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Peds > Reflexes + postural reactions > Flashcards

Reflexes + postural reactions Flashcards

1
Q

What is a reflex

A

Automatic movement without conscious volition, usually initiated by sensory stimulation

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2
Q

Protective reflexes

A

Reflex with a purpose of protecting us from noxious stimuli (DTR, withdrawal, cross extension)

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3
Q

Components of a protective reflex

A

Stimulus
Predictable response
Limited modulation of response
Lifelong

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4
Q

Neonatal reflexes

A

Building blocks of movement
Provide 1st change in distribution of muscle tone
Adaptive utility
Can be used to determine gestational age in premature infants
Become less apparent over time

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5
Q

How can neonatal reflexes be used to determine gestational age in premature infants

A

Premies can have missing reflexes

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6
Q

How can neonatal reflexes be used to evaluate CNS health?

A

By knowing expected time frames of when they start to when they stop

Can evaluate if reflexes don’t go away when expected or come back

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7
Q

Similarities between protective reflexes and neonatal reflexes

A

Both have stimulus + response
Both have a protective/useful function

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8
Q

Differences between protective and neonatal reflexes

A

Neonatal reflexes become less pronounced over time
Neonatal reflexes get replaced by something more volitional + sophisticated

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9
Q

What are examples of neonatal reflexes

A

Rooting
Sucking
Stepping
Grasp
Startle (Morrow)
Galant

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10
Q

Attitudinal reflexes

A

Influence tone; opportunities for movement

Not protective in nature

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11
Q

Examples of attitudinal reflexes

A

ATNR (asymmetric tonic neck reflex(
STNR (symmetric tonic neck reflex)

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12
Q

Clinical relevance of neonatal reflexes

A

Failure of neonatal reflexes to appear at the appropriate age, or to assist beyond a certain age implies abnormal functioning of the nervous system

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13
Q

Stereotypical + obligatory neonatal reflexes

A

Abnormal at every age
Lack of variability in response to repeated stimulus (across multiple reflexes typically)

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14
Q

When are neonatal skills at their strongest?

A

At term (40 weeks)

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15
Q

How does strength of neonatal reflex change over time

A

Bell curve: weaker before 40 weeks, and weaker after 40 weeks

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16
Q

Relationship between strength of neonatal reflexes and postural reactions + volitional movement

A

Inverse
As the baby ages, neonatal reflexes decrease as postural reactions and volitional movements increase

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17
Q

Postural reactions

A

Motor skills that develop over first years of life and form basis for attainment of functional motor skills

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18
Q

Postural reactions vs reflexes

A

Postural reactions are learned, developed and last for a lifetime

Reflexes are born with and lost

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19
Q

Roll of postural reactions

A

Maintaining the body in an upright position in response to the position of the body

Last a lifetime to support movement + balance

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20
Q

What type of stimuli do postural reactions respond to in comparison to neonatal reflexes?

A

More global stimuli

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21
Q

Neonatal righting reactions

A

Neonatal neck righting
Body righting

Head/body follow each other while rolling

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22
Q

When do key head righting reactions happen?

A

Prone: 2-3 months
Side lying/lateral: 4 months
Supine: 5-6 months

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23
Q

Main goal of head righting reaction

A

Keep face vertical and mouth horizontal

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24
Q

3 options to keep yourself upright

A

Moving the base: move body weight (step or hop) to keep upright
Keeping center of gravity over base: (weight shifting, moving arms/legs with torsional twisting)
Widening BOS + lowering center of gravity (parachute reflex + widen stance)

25
Q

Equilibrium reactions

A

Keep you upright by incorporating rotation along the body axis with abduction of extremities

26
Q

When do equilibrium reactions occur? Why does this make sense?

A

Prone/supine: 5-6 mo
Sitting: 8 mo
Quad: 10 mo
Kneeling: 15 mo
Standing: 15-18 mo

Skills at these ages in these positions require rotation

27
Q

When do stepping reactions occur

A

15-18 months

28
Q

Protective extension reflexes

A

Forward parachute reflex
Lateral
Backward parachute reflex

29
Q

When do protective extension reflexes occur

A

Forward: 5-6 mo (prop sit; sagittal plane)
Lateral: 7-8 mo (frontal plane)
Backward: 9-10 mo (requires transverse plane to evaluate behind you)

30
Q

Cycle of improving balance

A

Lose balance
Balance improves
Movement + postural control increase

31
Q

Documentation of reflexes/reactions

A

+ present
- absent

32
Q

“integrating” neonatal reflexes

A

Influence is reduced

34
Q

Emerging postural reactions

A

developing

35
Q

What factors can affect if a reflex/reaction is present or absent

A

fatigue
physical/CNS stress
size/speed of displacement
positions

36
Q

Spontaneous stepping reflex

A

Child will take steps/weight bear through the legs while supported

When inclined forward, child makes alternating, rhythmical, and coordinated stepping movements

37
Q

Timeline for spontaneous stepping reflex

A

birth to 1-2 months

38
Q

Rooting reflex

A

Stroking corner of the mouth toward the cheek, upper lip, and lower lip

corner of mouth results in a directed head turning toward stimulated side
Upper lip results in mouth to open and head to tilt back
Lower lip causes mouth to open and head to tilt foward

Infant tries to suck fingerTi

39
Q

Timeline of rooting reflex

A

Birth to 3-4 months

40
Q

Sucking reflex

A

Place finger/nipple in infant’s mouth while on their back

Results in rhythmical sucking movements

41
Q

Timeline for sucking reflex

A

Birth to 3-4 months

42
Q

Palmar grasp reflex

A

Place index finger into hand of infant while on back from pinky finger side and gently press palmar surface

Infant’s fingers flex around index finger

43
Q

Timeline for grasp reflex

A

Birth to 3-4 months

44
Q

Galant reflex (Trunk incurvation)

A

Stroking back on one side of the spine results in lateral flexion toward stimulated side

45
Q

Timeline for Galant reflex

A

Birth to 11-12 months

46
Q

ATNR

A

Child on back; turn head to one side and hold this pos

Arm + leg on face side extend
Arm + leg on skull side flex

47
Q

Timeline for ATNR

A

1-2 months to 3-4 months

48
Q

STNR

A

Child laying face down being supported. Bend child’s head forward + backward

Forward: flexion of UE, extension of LE
Backward: extension of UE, flexion of LE

49
Q

Timeline of STNR

A

5-6 months

50
Q

What position is STNR helpful for and why does it make sense that it goes away at 6 months?

A

Quadruped: if it lasted longer, infant would not be able to look around/move in quadruped without collapsing

51
Q

Startle/Morrow reflex

A

Alerts caregiver that they need more support

Goes away around 4 mo

52
Q

Parachute protective extension reflex: Forward

A

Holding infant in upright position, plunge child downward towards flat surface

Child should extend their head, arms, and fingers outward to protect from falling. Weight into arms

53
Q

Timeline for forward parachute

A

5-6 months emerges and remains with child

54
Q

Sideways parachute reflex

A

Child sits with legs out, push child on shoulder to cause loss of balance

Child reaches out with arm on opp side of push force with extension of elbow, wrist, and fingers to catch from falling. Weight accepted through arm

55
Q

Timeline for sideways parachute reflex

A

Emerges at 7-8 months and remains

56
Q

Backward parachute reflex

A

Child sitting with legs out front, push child backwards to cause loss of balance

Results in extension of arms backwards to protect from falling. Weight accepted

57
Q

Timeline for backward parachute reflex

A

Emerges at 9-10 months and remains with child

58
Q

Two systems that contribute to righting

A

Optical righting: visual input
Labryinthine righting: vestibular input

** can also use proprioceptive + tactile input

Peds (11 decks)

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