Primitive Reflexes

What is an involuntary adaptive response to a stimulus?

reflex

What is a reflex that appears in infancy and stays through life?

reaction

What is a modification of a reflex by higher centers that doesn’t make it disappear but can reappear under stress?

integration

What is a posture or movement dominated by a reflex?

obligatory response

T/F. An obligatory response has a reflex response EVERY time stimuli is present.

True

What are 3 protective reflexes?

1. crossed extension

2. flexor withdrawal

3. galant

What are 2 precursors of righting reactions?

1. neonatal neck righting reflex (NOB)

2. neonatal body righting reflex (BOB)

What are 6 primitive reflexes?

1. neonatal positive supporting reflex

2. spontaneous stepping reflex

3. traction

4. palmar grasp

5. plantar grasp

6. moro

Many reflexes are precursors to higher level activities such as what?

reciprocal movement, standing, walking, grasping

What are 2 survival reflexes?

1. rooting

2. sucking-swallowing

What are 4 tonic reflexes?

1. tonic labyrinthine

2. ATNR

3. STNR

4. landau

What is the onset and integration for crossed extension reflex?

on: 28 weeks GA

integrate: 1-2mo

What is the stimulus and response of crossed extension reflex?

stim: supine with head in midline —> hold knee, extend LE —> noxious stimuli to sole of foot

resp: flex then add/ext CONTRALATERAL LE (kicking)

What happens if crossed extension reflex persists?

dominates posture, inhibits reciprocal kicking and gait

What is the onset and integration for flexor withdrawal reflex?

on: 28 week GA

integ: 1-2mo

What is the stimulus and response of flexor withdrawal reflex?

stim: supine —> noxious stimuli to foot/sole

resp: flex IPSILATERAL LE

What happens if flexor withdrawal persists?

can’t stand

What condition should flexor withdrawal and cross extension be checked?

spina bifida

What is the onset and integration for galant reflex?

on: 30-32 weeks GA

integ: 2 mo

What is the stimulus and response of galant reflex?

stim: prone —> stroke paravertebral line from shoulder to iliac crest

resp: lateral flex trunk towards stimulated side

What happens if galant reflex persists?

scoliosis, delayed symmetrical stabilization, delayed independent head movement

What is the onset and integration of neonatal positive support?

on: 32-35 week

integ: 1-2 mo

What is the stimulus and response of neonatal positive support?

stim: support upright —> feet firm contact with flat surface

resp: co-contract flex and ext for WB of LE (partially flex) — slight bend of legs

What happens if neonatal positive support persists?

can’t advance to more mature LE movement

What is onset and integration of spontaneous stepping reflex?

on: 37-38 weeks GA

integ: 2 mo

What is the stimulus and response of spontaneous stepping reflex?

stim: stand —> incline forward/lateral

resp: reciprocal flex/ext of LEs (strong DF, no balance)

What happens if spontaneous stepping reflex persists?

poor standing balance, weight shift

What is onset and integration of traction reflex?

on: 28 weeks GA

integ: 2-5 mo

What is the stimulus and response of traction reflex?

stim: supine —> hold forearms/wrists —> pull to sit

resp: flex UE

What happens if traction reflex persists?

can’t reach, grasp, manipulate

What is onset and integration of palmar grasp?

on: 28 weeks GA

integ: 4-6mo

What is the stimulus and response of palmar grasp>

stim: pressure to ulnar side palm

respo: grab onto

What happens if palmar grasp persists?

poor grasp/won’t let go

What is onset and integration of plantar grasp?

on: 28 weeks GA

integ: 9 mo

What is the stimulus and response of plantar grasp?

stim: press thumb to ball of foot

resp: curl toes

What happens if plantar grasp persists?

delay independent standing, gait

What is onset and integration of moro reflex?

on: 28 weeks GA

integ: 5-6mo

What is the stimulus and response of moro reflex?

stim: sit with UE to chest —> drop head back 30* —> catch

resp: extend UE (spread out) —> flex UE (hug)

What happens if moro reflex persists?

can’t use UE protective reactions

What is onset and integration of NOB?

on: 34 weeks GA

integ: 4-5mo

What is the stimulus and response of NOB?

stim: supine —> turn head to one side

resp: body rolls like a log

What happens if NOB persists?

prevents segmental rolling

What is onset and integration of BOB?

on: 34 weeks GA

integ: 4-5mo

What is the stimulus and response of BOB?

stim: supine —> bring leg across

resp: roll like a log

What happens if BOB persists?

prevent segmental rolling

What is onset and integration of rooting reflex?

on: 28 weeks GA

integ: 3 mo

What is the stimulus and response of rooting reflex?

stim: stroke corner of mouth

resp: head turn —> mouth open

What happens if rooting reflex persists?

interferes with mature feeding, oral-motor development, head righting, tracking, socialization

What is onset and integration of suck/swallow reflex?

on: 28 weeks GA

integ: 2-5mo

What is the stimulus and response of suck/swallow?

stim: supine —> finger/nipple in mouth

resp: rhythmic suck and swallow

What happens if suck/swallow persists?

can’t voluntarily feed

What is onset and integration of tonic labyrinthine?

on: birth

integ: 6mo

What is the stimulus and response of tonic labyrinthine?

stim: prone/supine —> move extremities

resp: supine = increase passive tone of extensors; prone = increase passive tone of flexors

What happens if tonic labyrinthine persists?

can’t life head, support on extended arms, roll, get to sit, head control

What is onset and integration of ATNR?

on: birth - 2mo

integ: 4-6 mo

What is the stimulus and response of ATNR?

stim: supine —> visual cue for head turn

resp: fencing position

What happens if ATNR persists?

limit symmetry, scoliosis, rolling, visual tracking across midline, unsupported sitting, feeding, motor coordination

What is onset and integration of STNR?

on: 4-6 mo

integ: 8-12mo

What is the stimulus and response of STNR?

stim: suspend prone —> bend head

resp: head extend = crawl position/quadruped; flex = opposite

What happens if STNR persists?

limits reciprocal creeping, reciprocal walking, transition from stand to floor

What is onset and integration of landau?

on: 3-4mo

integ: 12-24mo

What is the stimulus and response of landau?

stim: prone

resp: superman, hip extension

What happens if landau persists?

spasticity/rigidity can inhibit flexors