Primitive Reflexes, Righting Reactions, Equilibrium Reactions, and Protective Reactions

rooting reflex stimulus

stroking of skin at corner of mouth moving laterally towards cheek, upper, and lower lip

rooting reflex response

head turns towards stimulated side, mouth opens. lip usually deviates towards stimulus. with stimulation of upper lip, head extends, with stimulation of lower lip, jaw drops. infant tries to suck finger

rooting reflex persistence

may adversely effect control of oral motor musculature, feeding and speech

sucking reflex stimulus

finger or nipple placed in infant’s mouth

sucking reflex response

rhythmical suck

sucking reflex persistence

oral motor coordination problems in feeding and speech

nutritive sucking

draws milk out of nipple by creating negative suction in oral cavity

non nutritive sucking

initiation of GI cycle (stimulates GI completion), facilitates GI completion

moro reflex stimulus

with infant in supine, infant’s head is suddenly dropped into extension in relation to trunk (20-30 degrees)

moro reflex response

abduction/extension of arms with spreading of fingers

abduction/flexion of arms

moro reflex persistence

functionally interferes with movement, ability maintain focused attention, quiet state. could lead to shoulder girdle fixing to guard against startle

how is the startle reaction similar and different to the moro reflex?

similarity: response is same to moro reflex

difference: occurs in response to sound or light, is a reaction that habituates

palmar grasp reflex stimulus

pressure in palm of infant’s hand

palmar grasp reflex response

fingers flex around object in palm

palmar grasp reflex persistence

precludes/affects normal hand function (can’t use hand very well_

plantar grasp reflex stimulus

pressure against sole of foot just behiind toes or in between 1st and 2nd toer

plantar grasp reflex response

flexion of all toes

plantar grasp reflex persistence

can affect walking/gait and lead to poor balance issues

asymmetrical tonic neck reflex (ATNR) stimulus

rotation of infant’s head to one side (either physically turning head or by enticing infant to look to one side in supine)

asymmetrical tonic neck reflex (ATNR) response

upper and lower extremities on face side extend, upper and lower extremities on skull side flex (upper respond more than lower). response is greater when neck is in extension and stronger when infant volitionally turns head compared to when head is passively turned

asymmetrical tonic neck reflex (ATNR) persistence

trouble with hands to mouth, rolling, getting both hands to midline, and achieving an maintaining midline head position, creeping, crawling

when is the ATNR reflex the strongest?

month 2

tonic labyrinthine reflex (TLR) stimulus

prone positioning OR supine positioning

tonic labyrinthine reflex (TLR) response

in prone: increased flexor tone and positioning

in supine: increased extensor tone and positioning

tonic labyrinthine reflex (TLR) persistence

Trouble lifting head up when in prone, too much extension (arched) in supine;

increased extensor tone and positioning in supine, extensive flexor tone and positioning in prone, compromising infant’s ability to move against gravity

positive support reaction stimulus

combination of cutaneous and proprioceptive input to the ball of foot (sole touches flat surface and bears some weight)

positive support reaction response

contraction of lower extremity muscles to transform lower extremity into pillar that supports weight - primarily includes hip and knee extension. infant should come down on hee (quads and plantarflexors co contract

positive support reaction persistence

can limit walking

how can the positive support reaction be inhibited?

lifting under first metatarsal head

automatic stepping/walking stimulus

child is supported in vertical suspension with feet touching supporting surface and inclined forward

automatic stepping/walking response

alternating, rhythmical, reciprocal lower extremity movments

automatic stepping/walking persistence

prevents functional locomotion with balance and equilibrium reactions

flexor withdrawal stimulus

noxious stimulus, such as a pin prick, to sole of foot

flexor withdrawal response

withdrawal of stimulated leg from stimulus

flexor withdrawal persistence

impedes normal movement or gait

crossed extension stimulus

firm pressure applied to sole of foot while knee is mantained in extensionr

crossed extension response

flexion, adduction, and then extension of opposite lower extremity as if to push examiner away

crossed extension persistence

may impede normal lower extremity movement and contribute to scissoring

symmetrical tonic neck reflex (STNR) stimulus

neck flexion or extension while infant is in prone or quadriped

symmetrical tonic neck reflex (STNR) response

neck extension yields upper extremity extension and lower extremity flexion

neck flexion yields upper extremity flexion and lower extremity extension

symmetrical tonic neck reflex (STNR) persistence

impedes adequate four point position and normal creep on hands and knees

galant response stimulus

moving stimulus on skin along paravertebral line

galant response response

incurvatum with hip swing towards stimulus

galant response persistence

scoliosis, trouble with stabilizing midline

placing reaction stimulus: upper extremity

hold in vertical, press dorsum of hand against table edge

placing reaction response: upper extremity

extremity flexes to clear table edge then extends to bear weight on hand

placing reaction stimulus: lower extremity

hold in vertical and press dorsum of foot against table edge

placing reaction stimulus: lower extremity

extremity flexes to clear table edge, then extends to bear weight on plantar surface of foot

neonatal neck righting stimulus

supine, turn head

neonatal neck righting response

body follows, turning as a whole (log roll)

neck righting stimulus

supine, turn head

neck righting response

shoulders follow, then pelvis, with trunk rotationb

body righting stimulus

lift one leg and rotate pelvis while child is in supine

body righting response

child will roll to prone with pelvic rotation followed by shoulder girdle rotation followed by headla

labyrinthine righting stimulus

hold in vertical suspension and tip A-P and lateral

labyrinthine righting response

head orients to vertical

landau reaction stimulus

child is held in prone suspension

landau reaction response

extension- but the response is variable

protective extension forward stimulus

child is supported in vertical position in space and plunged down towards a table or other flat surface

protective extension forward response

the child will extend and abduct arms, fingers extend and spread as if to break a fall

protective extension sideways stimulus

child is displaced to one side in sitting

protective extension sideways response

child abducts arm with extension of elbow, wrist, and fingers on side toward displacement. weight taken on open palm and finger

backwards protective reaction stimulus

child is displaced backwards in sitting

backwards protective reaction response

child extends arm backwards, trunk rotation with reaction in one arm only may occur

staggering reaction stimulus

displacement of center of gravity in standing beyond a point which equilibrium reactions can successfully prevent a fall

staggering reaction response

child takes 1 or more steps forward or backward to prevent a fall or sidesteps or crosses 1 foot over the other to prevent a fall

primitive reflexes are present in ____ normal infants at certain ages

primitive reflexes are present in ALL normal infants at certain ages

There (is/is not) variability in the age range that exists during which each primitive reflex is normally present.

There is variability in the age range that exists during which each primitive reflex is normally present.

the emergence and fading of primitive reflexes are both _____

the emergence and fading of primitive reflexes are both GRADUAL

many primitive reflexes are present __where?__

many primitive reflexes are present in utero

most primitive reflexes have been integrated by __ to __ months of age

most primitive reflexes have been integrated by 4 to 6 months of age

True/false? many primitive reflexes can be elicited in normal older individuals with sufficient stress

True

the presence of primitive reflexes can be tested in terms of specifically defined ____ and _____

the presence of primitive reflexes can be tested in terms of specifically defined STIMULUS and RESPONSE

in what two manners can some reflexes be elicited?

passively or actively

primitive reflexes are never normally ________

primitive reflexes are never normally OBLIGATORY

primitive reflexes are often _innate or learned?_ behaviors under neural control but are influenced by environmental effects

primitive reflexes are often INNATE behaviors under neural control but are influenced by environmental effects

what two types of significance do primitive reflexes have?

functional and clinical significance

primitive reflexes can be observed functionally and in terms of the extent to which they come in _________.

primitive reflexes can be observed functionally and in terms of the extent to which they come in SPONTANEOUSLY.

Equilibrium reactions are described in terms of response to _____

Equilibrium reactions are described in terms of response to PERTURBATION

what positions can equilibrium reactions be observed in?

any positions- supine, prone, sitting, kneeling, standing

perturbations that elicit equilibrium reactions can be varied in what 5 things?

direction, speed, timing, mechanism, specifics of imposition

the 3 most commonly used directions during equilibrium reactions include?

medial/lateral, anterior/posterior, diagonal

In what 3 ways does the mechanism of imposition of perturbation vary in terms of?

location, self vs externally imposed, imposed on the person vs supporting surface

In order, what 5 steps do equilibrium reactions usually involve?

1. elongation of the weight-bearing side

2. flexion of the non-weight-bearing side

3. limb counterbalancing towards the non-weight-bearing side

4. rotation comes in last, followed by staggering or protective reactions

5. response travels from point of perturbation

righting reactions are automatic movements that serve to maintain and restore what 3 things?

1. vertical position of head in space

2. alignment of head and trunk

3. alignment of trunk and limbs

what is the purpose of equilibrium reactions?

maintain and regain balance during movement