Infant neurologic exam

Question 1

True or false; motor control of the extremities develops first followed by head and neck

Answer 1

false; vise versa

Question 2

How do you perform optical blink reflex on infant

Answer 2

Shine light in infant’s open eye

Observe quick closure of eyes and dorsal flexion of infant’s head

Question 3

What is the doll’s eye reflex, and what CN is it testing?

Answer 3

CN 8

Move head from side to side - eyes should move in direction of rotation at first then shift opposite way when stopped (example move head right - eyes go right - when stop eyes should go left)

Question 4

What CN is being tested when looking at the rooting reflex

Answer 4

CN V (same with sucking reflex)

Question 5

How do you asses for CN VII

Answer 5

Observe infant’s facial expression when crying

Question 6

What is Acoustic blink reflex

Answer 6

clap your hands close to infant’s head

should blink in response to sound - move eyes toward sound - freeze when high pitched sound made

Question 7

True or false; swallowing and gag reflex = CN IX, X

Answer 7

true

Question 8

How do you asses for CN XII

Answer 8

Pinch infant’s nose; mouth will open tip of tongue will rise in midline

Question 9

True or false; like adults ankle clonus upon deep tendon reflex is not common

Answer 9

false; clonus common in infants

Question 10

When is patellar reflex present? Achilles and brachioradialis?

Answer 10

Patellar at birth

Achilles and brachioradialis = 6 months

Question 11

What is the babinski sign? When is it retained until?

Answer 11

fanning of toes and dorsiflexion of big toe

16-24 months

Question 12

When is the plantar grasp present? Outside of pressing on palm what else stimulates it?

Answer 12

strongest 1-2 months; disappears by 3 months

sucking facilitates grasp

Question 13

How long is the plantar grasp present?

Answer 13

(Touch plantar surface of feet and toes curl)

strong up to 8 months

Question 14

What is the Moro? When does it go away?

Answer 14

“falling test”

diminishes strength by 3-4 months

Question 15

What is the placing reflex

Answer 15

Hold infant upright - touch dorsum of foot on edge of flat surface - infant lifts and places foot on surface

age of disappearance varies

Question 16

What is stepping reflex?

Answer 16

Hold infant upright place feet on surface - as you lean them forward watch as they try to walk forward

Question 17

What is the Galant reflex?

Answer 17

Stroke paraspinals shoulder to butt

trunk should curve toward side stroked

Question 18

What is perez reflex

Answer 18

stroke over spinous processes sacrum to Occ

infant extends head, knees to chest, urinates

Question 19

Asymmetric tonic neck (fencer)

When does it peak? Disappear?

Answer 19

supine, turn head to one side

ipsilateral extension and contralateral flexion of extremities

Peak 2-3 months

Disappear 6 months

Question 20

What is neck righting reflex? When does it appear?

Answer 20

Supine - turn head to side - infant rolls body to that side

appears ~ 3 months (after fencer disappears)

Question 21

What is landau?

Answer 21

Suspend prone

infant raises head and extends legs

diminishes by 18 months - disappears 3 years

Question 22

What is parachute reflex?

Answer 22

hold infant suspended - lower head first toward ground

should extend arms and legs to protect itself

reflex SHOULD NOT disappear

Question 23

When is myelinization of brain and nervous system completed?

Answer 23

During 1st year of life (brain growth continues until 12-15 years)