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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
Palmar/plantar grasp: What are abnormal responses? What can we work on?
Asymmetry, absent, persistence Work on desensitization
26
Moro: what is the testing position?
Semi recline, supported sit —> PT hands along back, drop hands
27
Moro: Procedure?
Drop head into 20-30 deg extension —> stimulation of spine into extension
28
Moro: What is the response?
Abduction and extension of UEs Then adduction and flexion of UEs Then crying Look at shoulder girdle also
29
Moro: What are abnormal responses:
Absent Asymmetry Persistent
30
Describe what an upper plexus injury (Erbs Plexus) is
1 arm comes out into abduction/extension, the other arm stays in flexion, but hand opens
31
Describe what a distal plexus injury is
Arm comes out, but hand is closed
32
Moro: Without _____ _____, Moro will persist
Head control
33
ATNR: When is this reflex present?
Emerges birth-2 months Integrated 4-6 months (Max at 2 months)
34
ATNR: What is the testing position?
Supine, head in midline
35
ATNR: What is the procedure?
Head rotation
36
ATNR: What is the response?
Extension on face side, flexion on skull side
37
ATNR: Normal development: ________ ATNR, move into it and able to flex arm to bring object to mouth
Attitudinal Excessive if through out the whole body
38
ATNR: What are abn response?
Absent, obligatory, persistent
39
ATNR: At 2 months, should be _____ on both sides
Symmetrical
40
ATNR: If rolling kids, don’t turn head because ATNR will impact ability to promote rolling so keep head in _____
Midline
41
STNR: Crawling with symmetrical movements, child will “_____ ____” through quadruped
Bunny hop
42
STNR: When does the reflex occur?
Emerges at 4-6 months, integrated at 10-12 months
43
STNR: Position for testing?
Ventral suspension or QP
44
STNR: Procedure for testing
Raise and lower head in QP | Arms do what heads does, legs are opposite
45
STNR: If you have head extension, what happens at the arms and legs?
Extension of arms, flexion of legs
46
STNR: If you have head flexion, what happens at the arms and legs?
Flexion of the arms, extension at the legs
47
STNR: What are abnormal responses?
Persistence, obligatory
48
Tonic Labyrinthine: When does this reflex occur?
Birth to 6 months
49
Tonic Labyrinthine: What is the testing position?
Supine/prone (head midline)
50
Tonic Labyrinthine: In supine, you have more ____
Extension
51
Tonic Labyrinthine: What does pistatonic mean?
If head and feet on ground and rest of body is up in supine position (very extended)
52
Tonic Labyrinthine: In prone, you are more ____
Flexed
53
Tonic Labyrinthine: In prone position as a fetus, it is abnormal to move into extreme _____
Extension
54
Tonic Labyrinthine: Position in _____
Space
55
Tonic Labyrinthine: Extension/flexion (normally only a bias toward the ______
Reponse
56
Tonic Labyrinthine: What is abnormal ?
Persistence | Excessive response
57
Tonic Labyrinthine: If strong, what position should you work in?
Sidelying
58
Tonic Labyrinthine: How do you test in prone? What is your command?
Do an airplane If sea-saw ... abnormal
59
Tonic Labyrinthine: How do yo test in supine?
Do a sit up How long can they hold it?
60
Associated reactions: At what age should the child be able to inhibit the response?
8 years old
61
Associated reactions: What is the testing position?
Any position | Looking at effortful task for the child
62
Associated reactions: Effort during activity —> should be able to ______ _____ of it at specific age
Break out
63
Associated reactions: _____ and _____ contraction of other parts of body
Tonic and sustained
64
Associated reactions: What is abnormal?
Asymmetric Absent Persist/excessive
65
Neck Righting: What is the testing position?
Supine, arms at side
66
Neck Righting: How do you test it?
Head rotation to shoulder
67
Neck Righting: Rolling as one unit (log) - early on, okay... later on should see _______
Separation
68
Neck Righting: What are abn responses?
Asymmetric, Obligatory, Persistence, Absent
69
Modification of Primitive Reflexes: | Suppression of primitive reflexes as child gains _______ control
Volitional
70
Modification of Primitive Reflexes: If ATNR/STNR comes back, need to work in ____
Midline
71
Modification of Primitive Reflexes: Emergence of ______ responses
Mature
72
Modification of Primitive Reflexes: In case of neurological damage, we see _______ of primitive reflexes
Reappearance
73
Labyrinthine/optical righting: When does each occur?
Lab: 32 weeks Optical: 1-2 months
74
Labyrinthine/optical righting: _____ ___: tells where body is in space
Inner ear
75
Labyrinthine/optical righting: Drive from lab system to pick up ____ and look (lab righting) and then reinforce to keep ____ up
Head Head
76
Labyrinthine/optical righting: Both persist for _____
Life
77
Labyrinthine/optical righting: Testing positions
Supine Prone Supported upright
78
Labyrinthine/optical righting: Position of head?
Head vertical, mouth horizontal (oriented to ground)
79
Labyrinthine/optical righting: Abn response?
Absence | Slow/weak
80
Placing: Proprioceptive/Tactile and Visual: When do these reflexes show up?
Proprioceptive: 35 weeks GA/birth to 2 months | T and V: 3-4/5 months for life
81
Placing: Proprioceptive/Tacile and Visual: Reach before _____
Touch
82
Placing: Proprioceptive/Tacile and Visual: What is the order of how these progress?
P > T > V
83
Placing: Proprioceptive/Tacile and Visual: What is the testing position?
Supported vertical
84
Placing: Proprioceptive/Tacile and Visual: How do we test?
Stimulate dorsum or hand/foot
85
Placing: Proprioceptive/Tacile and Visual: What is the response?
Lifts extremity, places on surface, and weight bears
86
Placing: Proprioceptive/Tacile and Visual: What are abn responses?
Asymmetric, absent, B/L response (should only occur on stimulated side_)
87
Protective Extension: Emerging times of: Forward: Sideways: Backward:
Forward: Emerges at 6-7 months Sideways: Emerges at 7-8 months Backwards: 9-10 months
88
Protective Extension: Testing position?
Ventral suspension/sitting/sitting
89
Protective Extension: Fast movement through space ______ surface
Toward
90
Protective Extension: ____ and _____ of UEs with Weight bearing
Extension and abduction
91
Protective Extension: Abn responses?
Asymm | Absent
92
Staggering: protective extension of ____
LEs
93
Staggering: When does this reflex emerge?
15-18 months, remains for life
94
Staggering: Standing, walking at ____ months
12
95
Staggering: How to test?
Shift weight so center of gravity is displaced off BOS
96
Staggering: Protective movement of ____ to restore ____
LEs | Balance
97
Staggering: Use to see ankle ___
DF
98
Staggering: Abn responses:
Asymm Absent Weak
99
Tilting/Equilibrium Reactions: How do you test?
Tilt thru space (if done quickly, will stimulate protective extension)
100
Tilting/Equilibrium Reactions: Trunk concavity, extremity _____ on uphill side, protective reaction on _____ side
Abduction | Downhill
101
Tilting/Equilibrium Reactions: Abn responses
Asymm Absent Slow/weak
102
Tilting/Equilibrium Reactions: If you want to test equilibrium reactions, how do you test?
Slower | Smaller
103
Tilting/Equilibrium Reactions: If you wanted to test protection, how would you test?
Faster, larger
104
``` Emergence of tilting/equil responses: PRONE SUPINE SITTING QP KNEELING STANDING ```
``` 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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