Peds - Reflexes

imported from quizlet sanaah sonnier

20

Weeks of gestation at which ATNR appears?

4-5 mo

When does ATNR integrate after birth?

ATNR - stimulus

Turn the infant's head to one side while the infant is in supine

ATNR - response

Extension (and ABD) of the arm and leg on the side the child is looking at with flexion (and ABD) of the arm and leg on opposite side (i.e., when the infant looks to the L, the L UE + LE extends)

• Asymmetrical posture

• Poor bilateral coordination

• Difficulty with reading and motor milestones

If ATNR persists-

CNS depression or sensory-motor dysfunction

If ATNR is absent-

28

Weeks of gestation at which rooting appears?

3 mo

When does rooting integrate after birth?

Rooting - stimulus

Lightly stroke the cheek or corner of the mouth

Rooting - response

Infant turns head toward the stimulus and opens the mouth

Interferes with normal sucking

If rooting persists-

• CNS depression or sensory-motor dysfunction

• Inability to locate object for sucking

If rooting is absent-

28-34

Weeks of gestation at which suck-swallow appears?

5 mo

When does suck-swallow integrate after birth?

Suck-swallow - stimulus

Touch lips and inside mouth for sucking and liquid for swallowing

Suck-swallow - response

Rhythmic sucking followed by coordinated swallowing (tongue moves up and down, then swallow)

• Inhibits volitional sucking

• Abnormal tongue movement

• Delayed sound production

If suck-swallow persists-

• CNS depression or sensory-motor dysfunction

• Poor nourishment and decreased oral sensory input

If suck-swallow is absent-

28

Weeks of gestation at which palmar grasp appears?

4-7 mo

When does palmar grasp integrate after birth?

Palmar grasp - stimulus

Apply pressure to the palm of the hand (base of the fingers).

Palmar grasp - response

Flexion of fingers (resulting in a strong grasp of the object)

Difficulty releasing objects

If palmar grasp persists-

• CNS depression or sensory-motor dysfunction

• Nerve injury or muscle weakness

If palmar grasp is absent-

28

Weeks of gestation at which plantar grasp appears?

9 mo

When does plantar grasp integrate after birth?

Plantar grasp - stimulus

Infant is held upright & pressure is applied to sole of the foot just distal to metatarsal heads

Plantar grasp - response

Flexion of toes

• Difficulty with standing and walking

• Unstable base of support

If plantar grasp persists-

CNS depression or sensory-motor dysfunction

If plantar grasp is absent-

28

Weeks of gestation at which flexor withdrawal appears?

1-2 mo

When does flexor withdrawal integrate after birth?

Flexor withdrawal - stimulus

Noxious stimulus to sole of foot

Flexor withdrawal - response

Flexion withdrawal of leg

Prevents weight bearing and standing

If flexor withdrawal persists-

• CNS inadequacy

• Peripheral N injury or muscle weakness

If flexor withdrawal is absent-

True

T/F? Flexor withdrawal is a bilateral response, more common at LE than UE

28

Weeks of gestation at which crossed extension appears?

1-2 mo

When does crossed extension integrate after birth?

Crossed extension - stimulus

Noxious stimulus to sole of foot

Crossed extension - response

Flexion of stimulated leg and then extension of opposite leg with abduction

• Homologous creeping ("rabbit hopping")

• Difficulty with sitting, standing, floor transfers

If crossed extension persists-

• CNS depression or sensory-motor dysfunction

• N injury or muscle weakness

If crossed extension is absent-

28

Weeks of gestation at which galant (trunk incurvation) appears?

3 mo

When does galant (trunk incurvation) integrate after birth?

Galant - stimulus

In prone, stroke paravertebral skin

Galant - response

Lateral curvature of trunk on stimulated side

Delayed symmetrical trunk stabilization

If galant persists-

• Brain damage

• Persistent asymmetry (results in scoliosis)

Galant asymmetry indicates-

Crawling, prop sitting

Galant prepares babies for ______ and _________ (to then progress to sitting independently)

28

Weeks of gestation at which moro appears?

3-5 mo

When does moro integrate after birth?

Moro - stimulus

Head drop backward (stimulus for the startle reflex is loud noise with same response)

Moro - response

Adduction and extension of arms, splaying of fingers, may be followed by arm flexion and adduction

• Sensory-motor dysfunction

• Poor head control, sitting, extension patterns

If moro persists-

• CNS depression or sensory-motor dysfunction

• Decreased ability to break flexor patterns

If moro is absent-

35

Weeks of gestation at which positive support appears?

1-2 mo

When does positive support integrate after birth?

Positive support - stimulus

Weight placed through balls of feet while infant is supported upright

Positive support - response

Legs extend to support weight

Delayed development of stepping and pre-walking skills

If positive support persists-

• CNS depression or sensory-motor dysfunction

• Inability to develop stepping reflex

If positive support is absent-

37

Weeks of gestation at which automatic walking/stepping appears?

3-4 mo

When does automatic walking/stepping integrate after birth?

Automatic walking/stepping - stimulus

Supported upright with slight forward lean allowing alternating foot contact

Automatic walking/stepping - response

High stepping movements with regular rhythm

May indicate athetosis

If automatic walking/stepping persists-

May indicate spasticity

If automatic walking/stepping is absent-

4-6 mo after full-term delivery

Weeks of gestation at which STNR appears?

8-12 mo

When does STNR integrate after birth?

STNR - stimulus

Flexion or extension of the neck

STNR - response

With head flexion, UE flexes and LE extends; with head extension, UE extends and LE flexes

True

T/F? STNR prepares infants for crawling + looking at where they are going

UE flexes and LE extends

For STNR reflex, when the head is in flexion, what happens?

UE extends and LE flexes

For STNR reflex, when the head is in extension, what happens?

• Homologous creeping ("rabbit hopping")

• Difficulty with sitting, standing, floor transfers

If STNR persists-

• CNS depression

• N injury or muscle weakness

If STNR is absent-

12

Weeks of gestation at which tonic labyrinthine reflex appears?

3-4 mo

When does tonic labyrinthine reflex integrate after birth?

Tonic labyrinthine reflex - stimulus

Change in head position relative to gravity

Tonic labyrinthine reflex - response

With neck flexion, extremities flex to midline (in prone); with neck extension, extremities extend (in supine)

Flexor

With the tonic labyrinthine reflex, in PRONE (neck flexion) the global (flexor/extensor) tone increases

Extensor

With the tonic labyrinthine reflex, in SUPINE (neck extension) the global (flexor/extensor) tone increases

2-4 mo after full-term delivery

Weeks of gestation at which landau appears?

12-24 mo

When does landau integrate after birth?

Landau - stimulus

Infant is held in horizontal prone suspension

Landau - response

Global extension of the body (head lifts into extension, trunk extends, LE extends)

8-9 mo after full-term delivery

Weeks of gestation at which parachute reflex appears?

~1 year

When does parachute reflex integrate after birth?

Parachute reflex - stimulus

Infant is held upright and rapidly lowered toward a surface (head-first)

Parachute reflex - response

Protective extension of the arms forward

True

T/F? Parachute reflex can elicit with rotation as well

Increased

Infants that suck & DON'T swallow have (increased/decreased) aspiration risk

Babinski - stimulus

Stroke the lateral border of the sole of the foot from heel toward the toes, then medially

Babinski - response

Great toe dorsiflexes (extends) and other toes flare out

UMN lesion

(+) Babinski after infancy suggests-