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Pediatric PT Exam 1 > Developmental Concepts: Reflexes > Flashcards

Developmental Concepts: Reflexes Flashcards

1
Q

What are the 5 components of reflexes?

A
  1. Time of appropriate/integration if appropriate
  2. Testing position
  3. Stimulus
  4. Normal response (certain ages norm vs. abn)
  5. Abnormal response
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2
Q

Flexor withdrawal:

What is the testing position?

A

Supine

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3
Q

Flexor withdrawal:

How do you test it?

A

Noxious stimuli to the sole of the foot

Squeeze ball to foot with firm pressure

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4
Q

Flexor withdrawal: What is the response?

A

Uncontrolled FLEXION of the leg, usually with ER, ABDUCTION

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5
Q

Flexor withdrawal: Withdrawal?

What would be a red flag?

A

Usually see full reflex the first time you stimulate

Red flag if every time stimulus is given, full reflex occurs (obligatory)

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6
Q

Flexor withdrawal: What is abnormal?

A

Absence, asymmetry, persistence

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7
Q

Flexor withdrawal: Asymmetry represents some sort of _____ is there

A

damage

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8
Q

Flexor withdrawal: Reflex should be there at _____ weeks

A

28

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9
Q

Stepping: What ages do you see this?

A

37 weeks GA to 2 months post

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10
Q

Stepping: How do you test?

A

Holding child support in upright position
Place weight on feet and tilt child forward
Stimulus in DF position in standing

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11
Q

Stepping: What is the response?

A

Will see stepping pattern even though baby cannot walk yet

Rhythmical stepping - NOT GRAVITY DEPENDENT

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12
Q

Stepping: What is abnormal?

A

Absent
Asymmetrical — should be symmetrical in both legs
Persistence

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13
Q

Positive supporting: what is the time frame that you see this reflex?

A

32 weeks GA to 1-2 months

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14
Q

Positive supporting: How do you test?

A

Support child upright

Firm contact of feet on surface

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15
Q

Positive supporting: Is adduction abnormal?

A

YES

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16
Q

Positive supporting: Is flexion at hip and knees abnormal?

A

No, extension is abnormal

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17
Q

Positive supporting: What is the response?

A

Co-contraction in LEs, slight flexion of hips and knees

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18
Q

Positive supporting: Where do you have a limitation?

A

In full extension

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19
Q

Positive supporting: What would be an excessive response?

A

Leaning back into extension

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20
Q

Positive supporting: what are abnormal responses?

A

Absent, asymmetrical, EXCESSIVE response

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21
Q

Palmar/plantar grasp: What is the position?

A

Supine, head midline

or other reflexes play in [ATNR]

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22
Q

Palmar/plantar grasp: How do you test?

A

Pressure in palm/ball of foot

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23
Q

Palmar/plantar grasp: What is the response?

A

Flexion of digits, grasp of hand

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24
Q

Palmar/plantar grasp: What would be an abn response?

A

Indwelling thumb —> thumb tucks into palm, or sticks out through fingers

Thumb (obligatory) flexion = abnormal

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25
Q

Palmar/plantar grasp: What are abnormal responses?

What can we work on?

A

Asymmetry, absent, persistence

Work on desensitization

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26
Q

Moro: what is the testing position?

A

Semi recline, supported sit —> PT hands along back, drop hands

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27
Q

Moro: Procedure?

A

Drop head into 20-30 deg extension —> stimulation of spine into extension

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28
Q

Moro: What is the response?

A

Abduction and extension of UEs
Then adduction and flexion of UEs
Then crying

Look at shoulder girdle also

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29
Q

Moro: What are abnormal responses:

A

Absent
Asymmetry
Persistent

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30
Q

Describe what an upper plexus injury (Erbs Plexus) is

A

1 arm comes out into abduction/extension, the other arm stays in flexion, but hand opens

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31
Q

Describe what a distal plexus injury is

A

Arm comes out, but hand is closed

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32
Q

Moro: Without _____ _____, Moro will persist

A

Head control

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33
Q

ATNR: When is this reflex present?

A

Emerges birth-2 months
Integrated 4-6 months
(Max at 2 months)

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34
Q

ATNR: What is the testing position?

A

Supine, head in midline

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35
Q

ATNR: What is the procedure?

A

Head rotation

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36
Q

ATNR: What is the response?

A

Extension on face side, flexion on skull side

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37
Q

ATNR: Normal development: ________ ATNR, move into it and able to flex arm to bring object to mouth

A

Attitudinal

Excessive if through out the whole body

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38
Q

ATNR: What are abn response?

A

Absent, obligatory, persistent

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39
Q

ATNR: At 2 months, should be _____ on both sides

A

Symmetrical

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40
Q

ATNR: If rolling kids, don’t turn head because ATNR will impact ability to promote rolling so keep head in _____

A

Midline

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41
Q

STNR: Crawling with symmetrical movements, child will “_____ ____” through quadruped

A

Bunny hop

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42
Q

STNR: When does the reflex occur?

A

Emerges at 4-6 months, integrated at 10-12 months

43
Q

STNR: Position for testing?

A

Ventral suspension or QP

44
Q

STNR: Procedure for testing

A

Raise and lower head in QP

Arms do what heads does, legs are opposite

45
Q

STNR: If you have head extension, what happens at the arms and legs?

A

Extension of arms, flexion of legs

46
Q

STNR: If you have head flexion, what happens at the arms and legs?

A

Flexion of the arms, extension at the legs

47
Q

STNR: What are abnormal responses?

A

Persistence, obligatory

48
Q

Tonic Labyrinthine: When does this reflex occur?

A

Birth to 6 months

49
Q

Tonic Labyrinthine: What is the testing position?

A

Supine/prone (head midline)

50
Q

Tonic Labyrinthine: In supine, you have more ____

A

Extension

51
Q

Tonic Labyrinthine: What does pistatonic mean?

A

If head and feet on ground and rest of body is up in supine position (very extended)

52
Q

Tonic Labyrinthine: In prone, you are more ____

A

Flexed

53
Q

Tonic Labyrinthine: In prone position as a fetus, it is abnormal to move into extreme _____

A

Extension

54
Q

Tonic Labyrinthine: Position in _____

A

Space

55
Q

Tonic Labyrinthine: Extension/flexion (normally only a bias toward the ______

A

Reponse

56
Q

Tonic Labyrinthine: What is abnormal ?

A

Persistence

Excessive response

57
Q

Tonic Labyrinthine: If strong, what position should you work in?

A

Sidelying

58
Q

Tonic Labyrinthine: How do you test in prone? What is your command?

A

Do an airplane

If sea-saw … abnormal

59
Q

Tonic Labyrinthine: How do yo test in supine?

A

Do a sit up

How long can they hold it?

60
Q

Associated reactions: At what age should the child be able to inhibit the response?

A

8 years old

61
Q

Associated reactions: What is the testing position?

A

Any position

Looking at effortful task for the child

62
Q

Associated reactions: Effort during activity —> should be able to ______ _____ of it at specific age

A

Break out

63
Q

Associated reactions: _____ and _____ contraction of other parts of body

A

Tonic and sustained

64
Q

Associated reactions: What is abnormal?

A

Asymmetric
Absent
Persist/excessive

65
Q

Neck Righting: What is the testing position?

A

Supine, arms at side

66
Q

Neck Righting: How do you test it?

A

Head rotation to shoulder

67
Q

Neck Righting: Rolling as one unit (log) - early on, okay… later on should see _______

A

Separation

68
Q

Neck Righting: What are abn responses?

A

Asymmetric, Obligatory, Persistence, Absent

69
Q

Modification of Primitive Reflexes:

Suppression of primitive reflexes as child gains _______ control

A

Volitional

70
Q

Modification of Primitive Reflexes: If ATNR/STNR comes back, need to work in ____

A

Midline

71
Q

Modification of Primitive Reflexes: Emergence of ______ responses

A

Mature

72
Q

Modification of Primitive Reflexes: In case of neurological damage, we see _______ of primitive reflexes

A

Reappearance

73
Q

Labyrinthine/optical righting: When does each occur?

A

Lab: 32 weeks
Optical: 1-2 months

74
Q

Labyrinthine/optical righting: _____ ___: tells where body is in space

A

Inner ear

75
Q

Labyrinthine/optical righting: Drive from lab system to pick up ____ and look (lab righting) and then reinforce to keep ____ up

A

Head

Head

76
Q

Labyrinthine/optical righting: Both persist for _____

A

Life

77
Q

Labyrinthine/optical righting: Testing positions

A

Supine
Prone
Supported upright

78
Q

Labyrinthine/optical righting: Position of head?

A

Head vertical, mouth horizontal (oriented to ground)

79
Q

Labyrinthine/optical righting: Abn response?

A

Absence

Slow/weak

80
Q

Placing: Proprioceptive/Tactile and Visual: When do these reflexes show up?

A

Proprioceptive: 35 weeks GA/birth to 2 months

T and V: 3-4/5 months for life

81
Q

Placing: Proprioceptive/Tacile and Visual: Reach before _____

A

Touch

82
Q

Placing: Proprioceptive/Tacile and Visual: What is the order of how these progress?

A

P > T > V

83
Q

Placing: Proprioceptive/Tacile and Visual: What is the testing position?

A

Supported vertical

84
Q

Placing: Proprioceptive/Tacile and Visual: How do we test?

A

Stimulate dorsum or hand/foot

85
Q

Placing: Proprioceptive/Tacile and Visual: What is the response?

A

Lifts extremity, places on surface, and weight bears

86
Q

Placing: Proprioceptive/Tacile and Visual: What are abn responses?

A

Asymmetric, absent, B/L response (should only occur on stimulated side_)

87
Q

Protective Extension: Emerging times of:
Forward:
Sideways:
Backward:

A

Forward: Emerges at 6-7 months
Sideways: Emerges at 7-8 months
Backwards: 9-10 months

88
Q

Protective Extension: Testing position?

A

Ventral suspension/sitting/sitting

89
Q

Protective Extension: Fast movement through space ______ surface

A

Toward

90
Q

Protective Extension: ____ and _____ of UEs with Weight bearing

A

Extension and abduction

91
Q

Protective Extension: Abn responses?

A

Asymm

Absent

92
Q

Staggering: protective extension of ____

A

LEs

93
Q

Staggering: When does this reflex emerge?

A

15-18 months, remains for life

94
Q

Staggering: Standing, walking at ____ months

A

12

95
Q

Staggering: How to test?

A

Shift weight so center of gravity is displaced off BOS

96
Q

Staggering: Protective movement of ____ to restore ____

A

LEs

Balance

97
Q

Staggering: Use to see ankle ___

A

DF

98
Q

Staggering: Abn responses:

A

Asymm
Absent
Weak

99
Q

Tilting/Equilibrium Reactions: How do you test?

A

Tilt thru space (if done quickly, will stimulate protective extension)

100
Q

Tilting/Equilibrium Reactions: Trunk concavity, extremity _____ on uphill side, protective reaction on _____ side

A

Abduction

Downhill

101
Q

Tilting/Equilibrium Reactions: Abn responses

A

Asymm
Absent
Slow/weak

102
Q

Tilting/Equilibrium Reactions: If you want to test equilibrium reactions, how do you test?

A

Slower

Smaller

103
Q

Tilting/Equilibrium Reactions: If you wanted to test protection, how would you test?

A

Faster, larger

104
Q 
Emergence of tilting/equil responses: 
PRONE
SUPINE
SITTING
QP
KNEELING
STANDING
A 
PRONE: 6 mos
SUPINE: 7-8 mos
SITTING: 7-8 mos
QP: 9-12 mos
KNEELING: 15 mos
STANDING: 12-21 mos

Pediatric PT Exam 1 (14 decks)

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