S2L3: Reflexes Flashcards
Stimulus: Loud noise, sudden movement; may be elicited when testing Moro
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
B
Suppressed by 4-6 months
Stimuli: sudden change in position or dropping back of head with Arm extension-abduction followed by flexion-adduction
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
A
Effect:
- Non functional flexor pattern predominates
- Poor equilibrium reactions
- Muscle imbalances limiting the pt’s movement patterns
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
B
Treatment Strategies: Gradual introduction of the stimuli; child wears helmet to limit amount of stimulation particularly auditory stimuli
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
B
Effect
○ Extensor pattern predominates in the UE
○ Inability to develop protective reactions and sitting balance
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
A
Treatment Strategies
○ Train vertical head stability or head control
Weight bearing on UE - POE (prone on elbows) → POH (prone on hands)
Facilitate equilibrium and protective reactions
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
A
Suppressed by 5-6 months
○ Flexion of the fingers upon application of touch, pressure on the palm, or stretch to the finger flexors
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
C
Effect: Interferes with manipulative skills (transfer of objects, voluntary release)
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
C
Treatment: facilitate finger extension and inhibit flexion (place hard objects in the palm)
Weight bearing (palms down), (POE), (POH), Quadruped, sitting
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
C
Suppressed by 2-3 mos
○ Stroking on erector spinae or side of the spine, causes lateral flexion in the side that was stimulated
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
D
Effect: Interfere with development of trunk stability and sitting balance
○ Can lead to scoliosis
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
D
Treatment: Position body in midline, facilitate paraspinal muscle bilaterally
Stretch muscle on concave side
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
D
Suppressed by 1-2/3-4 mos.
Primitive spinal cord reflexes
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
E
Effect: Interferes with LE movement and reciprocation
○ Inability to crawl
○ Hypersensitivity to tactile input
○ Results in deformities or contractures
○ Inability to walk
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
E
Treatment: WB in standing position c joint compression through pelvis and hip
Facilitate hip abductors and inhibit hip adductors
Desensitization of soles (deep pressure)
Use shoes and various floor surface
A. Moro
B. Startle
C. Palmar grasp
D. Galant’s trunk incurvation
E. Crossed extension/Extensor thrust/Flexor withdrawal
E
Suppressed by 3-7 mos
○ Replaced by volitional standing
○ Leg extension upon tactile contract and WB on the sole
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
A
Effect: Inability to do reciprocal flexion and extension in lower limbs
Poor standing balance, no standing base
-> inability to walk
When feet are on the floor → genu recurvatum → reciprocal movement
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
A
Treatment: Break the total extension pattern
In supine hold the soles and move legs reciprocally
In standing, move the legs alternately, forward and back
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
A
Suppressed by 3-5 mos.
○ Stimulus is the same as positive supporting reflex but instead of extensor response on the LE, the pt will have a flexor response
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
B
Effect:
Flaccid patients
!! Child “sinks” astasia !!
Interferes with supporting responses in the LE
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
B
Treatment: Graded sensory input on soles
Weight bearing with joint compression
Facilitate co-contraction of muscles in the proximal joints
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
B
Suppressed by 6-7 mos
○ Extension of the extremities on the chin side, flexion on the occiput side
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
C
Effect: Prevents rolling from supine to prone
Interferes with crawling and creeping
■ Cant bear weight on the flexed side
Interferes with balance
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
C
Effect: Interferes with bilateral activities and midline play
Poor eye-hand coordination
Abnormal posturing during activities → scoliosis, hip subluxation or dislocation and contractures
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
C
Treatment: Activities with head in midline - neck extension
Bilateral symmetrical activities with head to side
Roll in barrel
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
C
Treatment: Quadruped - rock back and forth - reach forward
● Do activities in sidelying to prevent head rotation
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
C
Suppressed by 6 to 7 months
Limb movements are dependent on the position of the head
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
D
Neck flexion: arm flexion, leg extension
○ Neck extension: arm extension, leg flexion
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
D
Effect: Heel sitting → bunny hopping → hip and knee flexion contracture
○ No balance and protective reactions
Lack of trunk rotation
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
D
Treatment: POH → Quadruped (elbows extended) - rock back and forth (with neck extension/flexion)
Prone scooter board/gym ball - arms forward, feet off the floor
Balance while on hands and feet (knees extended)
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
D
Treatment: Isolated movement (e.g. reaching activities) and various positions
● Weight shifting and righting reactions
A. POSITIVE SUPPORTING REFLEX
B. NEGATIVE SUPPORTING REFLEX
C. ASYMMETRIC TONIC NECK REFLEX
D. SYMMETRIC TONIC NECK REFLEX
D
Effect: Trouble orienting, no head raising
Interferes with rolling to prone, rising from supine (assuming quadruped, sitting positions)
Interferes with reaching hand functions
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
B
Suppressed at 5 mos
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
C
Effect:
○ Interferes with segmental rolling
○ Can not dissociate the upper trunk from the pelvis
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
C
Treatment: Log rolling → segmental rolling (shoulder first, then the pelvis)
Counter rotation of trunk
● Bilateral limb movements – cross over midline
● Quadruped activities
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
C
integrated by 8-9 y/o
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
D
Effect: Isolated movement is difficult
○ General increase in muscle tension
○ Interferes with bilateral hand function
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
D
Treatment: Do Simple tasks – unilateral movement and movement in the cardinal plane
Do not apply excessive resistance
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
D
Suppressed by 12-18 mos
○ Flexion of the toes upon application of pressure on the sole just distal to the metatarsal head
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
E
Effect: Interferes with the ability to stand with feet flat on the surface, weight shifting and balance reactions
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
E
Treatment: ● Facilitate toe extension and inhibit toe flexion
● WB - joint compression in standing
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
E
Emerges at
■ 2 months in prone
■ 3 to 4 months in supine
○ Alignment of the face vertical and mouth horizontal
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
A
Effects when absent:
○ Inhibits development of balance and protective reactions
○ Interferes with visual processing and other sensory input
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
A
Treatment: Slow tilting activities
Balance activities in all developmental positions
Roll with head off the floor - rubber tire, bolster
Prone swings, POE, prone over ball, prone scooter
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
A
Emerges between 4 and 6 months
Alignment of body parts
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
B
Effects when absent: Makes segmental trunk movement difficult (trunk rotation)
Limits flexibility in all gross and fine motor skills
Leads to poor weight shifting
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
B
Treatment: (Same as neck righting)
Segmental rolling
Facilitate balance and protective reactions
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
B
Effects: Extension-abduction of the extremity toward the side of displacement to prevent falling
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
C
Effects when absent: Increases likelihood of injury
Makes child apprehensive about moving in space
Interferes with shoulder girdle stability and UE function
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
C
Treatment: Facilitate protective response – prone over bolster (POH) → over ball
Vestibular stimulation – falling to hands from kneeling
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
C
Emerge between 6 and 14 months
■ Sitting: 6-8 months
■ Standing: 12-14 months
○ Adjustments of tone and trunk posture to maintain balance
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
D
Effects when absent: Interferes with balance and flexibility
Makes child apprehensive about moving in space (gross motor)
Makes child unable to react fast enough to positional changes
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
D
Effects when absent: Affects emotional tone (labile)
Decreases attention span
Leads to poor postural basis for all fine motor tasks
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
D
Treatment: Facilitate trunk and head righting – start with slow tilting in all positions
Supine: rolling → side lying → sitting on a ball → platform swings (use any movable equipments) → standing
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
D
Emerges between 5 to 15 months
■ Sitting anterior: 5-7 months
■ Lateral: 6-8 months
■ Posterior: 7-8 months
■ Standing: 12-14 months
A. HEAD RIGHTING
B. BODY, & HEAD RIGHTING
C. PROTECTIVE EXTENSION (PROPPING)
D. EQUILIBRIUM (TILTING REACTION)
C
Treatment: sidelying to eliminate effect of gravity
Anti-gravity movement in supine (flexion activities)
Pull-to-sit – facilitate bilateral SCM
Supine activities - reach foot
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
B
Suppressed by 4 to 6 months
○ Increased extensor tone in supine
○ Anti-gravity movements are difficult in supine
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
B
Effect: Limited visual field
○ Contractures
- Abnormal vestibular input
○ Opisthotonic posture
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
B
Treatment: Do activities in sidelying to eliminate effect of gravity and influence of tone dominance
Anti-gravity movement in prone (extension activities)
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
A
Treatment: Prone scooted board activities - weight shifting, reaching forward
● POE → POH - facilitate neck and back extension by tapping (Rood’s sensory technique)
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
A
Effect:
- Limited visual field
○ Contractures
Abnormal vestibular input d/t difficulty orienting and seeing the surroundings
○ Interferes with development of head righting and gross motor skills (rolling, sitting, creeping)
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
A
Suppressed by 4 to 6 months
○ Increased flexor tone in prone
○ Antigravity movements are difficult in prone
A. TONIC LABYRINTHINE REFLEX (PRONE)
B. TONIC LABYRINTHINE REFLEX (SUPINE)
C. NECK RIGHTING REFLEX
D. ASSOCIATED REACTIONS
E. PLANTAR GRASP REFLEX
A
