Pedia 3B - Applied Neurology - Primative Reflexes Flashcards Preview

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Flashcards in Pedia 3B - Applied Neurology - Primative Reflexes Deck (100):
0

Reflex: Plantar
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Plantar
Onset (AOG): 11w
Fully Developed:
Duration/disappears: 7-9m
Elicitation: Stimulate Metatarsal arch of foot
Normal: Ball of foot drops and "grasps" w/feet; ready to cruise

1

Reflex: Palmar Grasp
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Palmar Grasp
Onset (AOG): 28w
Fully Developed: 32w
Duration/disappears: 2-3m
Elicitation: Dr finger in baby's palm
Normal: thumb locks onto finger tightly

2

Reflex: Rooting
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Rooting
Onset (AOG): 32w
Fully Developed: 36w
Duration/disappears: Less prominent after 1m
Elicitation: Stroke cheek
Normal: Infant turns toward stimulus and makes sucking motions

3

Reflex: Moro
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Moro
Onset (AOG): 28-32w
Fully Developed: 37w
Duration/disappears: 5-6m
Elicitation: Sudden drop of head (rel. to trunk
Normal: Abduction+Ext of arms+Legs flexed --> Abduction and flexion, flexed fists and flexed flegs

4

Reflex: Tonic Neck
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Tonic Neck
Onset (AOG): 35w
Fully Developed: 1m
Duration/disappears: 6-7m
Elicitation: Head of a relaxed child, laying on back, is rotated to side
Normal: "Fencer stance"
Arm faced extends straight away from body w/hand partially open
Arm on far side - flexed and fist clenched

5

Reflex: Placing/Stepping
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Placing/Stepping
Onset (AOG): 37w
Fully Developed:
Duration/disappears: 4-5m; pt can creep/crawl
Elicitation: Stimulate dorsum of foot against table edge
Normal: Stepping/walking movement

6

Reflex: Parachute
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Parachute
Onset (AOG): 4-9 (7-8?)
Fully Developed: 10-11
Duration/disappears: Masked by voluntary (Remains?)
Elicitation: Hold child upright and rotate body forward by hips (as if falling fwd)
Normal: Arms ext as if to break fall

7

Reflex: Landau
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Landau
Onset (AOG): 9-10m
Fully Developed:
Duration/disappears: Masked by voluntary action
Elicitation: Hold in horizontal/prone position
Normal: Superman pose
Ext neck,head,arms
Flex lower extremities

9

Reflex: Righting
Onset (AOG):
Fully Developed:
Duration/disappears:
Elicitation:
Normal

Reflex: Righting
Onset (AOG): 4-8m
Fully Developed:
Duration/disappears: Masked by voluntary
Elicitation: Supine, turn head to one side (sequential manner)
Normal: Rotates shoulder, trunk then pelvis

10

Developmental Milestones: Gross
Runs

24m

11

Developmental Milestones: Gross
Walks upstairs w/assistance

18m

12

Developmental Milestones: Gross
Walks w/1 hand held

12m

13

Developmental Milestones: Gross
Pulls to stand

9m

14

Developmental Milestones: Gross
Sits momentarily

6m

15

Developmental Milestones: Gross
Supports weight on forearms

3m

16

Developmental Milestones: Fine Motor
Opens hands spontaneously

3m

17

Developmental Milestones: Fine Motor
Transfers objects

6m

18

Developmental Milestones: Fine Motor
Pincer grasp

9m

19

Developmental Milestones: Fine Motor
Releases object on command

12m

20

Developmental Milestones: Fine Motor
Feeds from a spoon

18m

21

Developmental Milestones: Fine Motor
Builds a tower of 6 blocks

24m

22

Developmental Milestones: Social skills
Smiles appropriately

3m

23

Developmental Milestones: Social skills
Social smile

2m

24

Developmental Milestones: Social skills
Shows likes/dislikes

6m

25

Developmental Milestones: Social skills
Plays peek-a-boo & pat-a-cake

9m

26

Developmental Milestones: Social skills
Comes when called

12m

27

Developmental Milestones: Social skills
Mimics actions of others

18m

28

Developmental Milestones: Social skills
Plays with others

24m

29

Developmental Milestones: Language
Coos/Laughs

3m

30

Developmental Milestones: Language
Babbles

6m

31

Developmental Milestones: Language
Imitates sounds

9m

32

Developmental Milestones: Language
1-2 meaningful words

12m

33

Developmental Milestones: Language
At least 6 words

18

34

Developmental Milestones: Language
2-3 word sentences

24m

35

Head circumference growth in PRETERM

1st week: 0.5cm
2nd week: 0.5cm
3rd week: 0.75cm
4th week+: 1cm/week until 40th

36

Head circumference growth in TERM

34-35 @Birth
44cm @6m
47cm @1y

37

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Depth- Elevated disc (Phyiologic Cup Obliterated)

Papilledema
Papillitis

38

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Depth- Shallow

Optic Atrophy

39

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Edge: Blurred

Papilledema
Papillitis

40

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Edge: Very sharp

Optic Atrophy

41

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Vessels - Engorged

Papilledema
Papillitis

42

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Vessels - Narrow/Few

Optic Atrophy

43

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Color - No Venous pulse

Papilledema
Papillitis

44

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Color - Hyperemic

Papilledema
Papillitis

45

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Color - Hemorrhages

Papilledema
Papillitis

46

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Vision - Good (or enlarged blind spot)

Papilledema

47

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Vision - Poor (or loss of central)

Papillitis

48

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:
Vision - Reduced

Optic Atrophy

49

Visual acuity in an infant

20/150

50

Visual acuity reaches adult level of 20/20 at

6m

51

Dazzle Reflex:
Definition:
Present:
Note:

Involuntary avoidance response to a light shined in eyes
Present in 28week old PRE-mature infants
By 32w, eyes remain closed until light is removed

52

Blink Reflex:
Definition:
Present:
Note:

Fxn'l vision
Close when object moves to eye
(-) in newborn
(+) 3-4m (ALL by 1y/o, otherwise likely blind)

53

Turn eyes to sound by

7-8w

54

Turn head to sound by

3-4m

55

Weber
Defective ear =
Better ear =

Defective ear = Conductive HL
Better ear = Sensorineural HL

56

Rinne
- should be (AC vs BC)
- Bone > Air
- Air > Bone


- AC > BC
- - Normal or
- - Sensorineural HL

- AC < BC = Conductive HL

57

Muscle stretch:
Jaw Jerk

CN V

58

Muscle stretch:
Biceps

C5-6
(Also in Brachio-radialis)

59

Muscle stretch:
Triceps

C6-8

60

Muscle stretch:
Brachio-radialis

C5-6
(Also in Biceps)

61

Muscle stretch:
Patellar:

L2-L4

62

Muscle stretch:
Ankle

S1-2

63

Muscle stretch:
Asking patient to contract a muscle you are not testing

Jendrassik Maneuver

64

Superficial Reflexes: How/What
Umbilical migration test (Beevor's)

Stroke quadrants of abdomen towards umbilicus --> Umbilicus moves towards orgin of stimulus

Tests for injury between T10-T12

65

Superficial Reflexes: How/What
Cremasteric Reflex

L1-L2
Stroke inner thigh towards testicle --> ipislateral testicle moves upward

66

Superficial Reflexes: How/What
Anal pucker

S4-5
Pricking the skin around anus --> Quick twitch-like constriction of sphincter

67

Superficial Reflexes: How/What
Ext Toe Sign -

Pyramidal tract function
- Normal up to 2 years old ("up to 2 1/2")

68

Superficial Reflexes: How/What
Chaddock

Extensor toe sign - lateral side of foot

69

Superficial Reflexes: How/What
Schaeffer

Ext toe sign - Squeeze hard on achillies

70

Superficial Reflexes: How/What
Oppenheim

Ext toe sign - Squeeze calf muscles

71

Superficial Reflexes: How/What
Bing

Ext toe sign - multiple light pinpricks on dorso-lateral surface of foot

72

Abnormal movements:
Incessant, random, moderately quick movements

"Milkmaids"

Chorea

73

Abnormal movements:
Slow, writhing movements of fingers or extremities

Athetosis

74

Abnormal movements:
Prolonged, strong contraction + relaxation of agonists and antagonists

Dystonia

75

Abnormal movements:
Quick, stereotyped movements of face, tongue or extremities

Tics

76

Abnormal movements:
Hand turns to palm outward as arms are raised over head

Pronator sign

77

Abnormal movements:
Child should maintain flexed legs at right angles at knee

Barre sign

78

Reflex: Plantar
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Plantar
Onset (AOG): 11
Fully Dev:
Duration/Disappears: 7-9m

79

Reflex: Palmar
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Palmar
Onset (AOG): 28w
Fully Dev: 32w
Duration/Disappears: 2-3m

80

Reflex: Rooting
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Rooting
Onset (AOG): 32w
Fully Dev: 36w
Duration/Disappears: Less prominent after 1m

81

Reflex: Moro
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Moro
Onset (AOG): 28-32w
Fully Dev: 37w
Duration/Disappears: 5-6m (?)

82

Reflex: Tonic Neck
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Tonic neck
Onset (AOG): 35
Fully Dev: 1m
Duration/Disappears: 6-7m

83

Reflex: Placing/Stepping
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: 37w
Onset (AOG):
Fully Dev:
Duration/Disappears: 4-5m; Pt can creep and crawl

84

Reflex: Parachute
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Parachute
Onset (AOG): 7-8m
Fully Dev: 10-11m
Duration/Disappears: Persists throughout life

85

Reflex: Landau "Superman"
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Landau "Superman"
Onset (AOG): 9-10m
Fully Dev:
Duration/Disappears: Covered up by voluntary

86

Reflex: Parachute
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Parachute
Onset (AOG): 4-9m
Fully Dev:
Duration/Disappears: Covered up by voluntary

87

Reflex: Righting
Onset (AOG):
Fully Dev:
Duration/Disappears:

Reflex: Righting
Onset (AOG): 4-8m
Fully Dev:
Duration/Disappears: Covered up by voluntary

88

Sensory Examination: Level of Involvement
Back of head

C2

89

Sensory Examination: Level of Involvement
Shoulders

C4

90

Sensory Examination: Level of Involvement
Thumbs

C6

91

Sensory Examination: Level of Involvement
Nipple line

T4

92

Sensory Examination: Level of Involvement
Umbilicus

T10

93

Sensory Examination: Level of Involvement
Inguinal sign

L1

94

Sensory Examination: Level of Involvement
Big toe

L5

95

Sensory Examination: Level of Involvement
Small toe

S1

96

Sensory Examination: Level of Involvement
Posterior thigh

S2

97

Meningeal signs:
(+) Resistanceto flexion
(-) Resistance to extension
Inflammation in dura

Nuchal rigidity/catch
(Protective reflex prevents stretching/lengthening)

98

Meningeal signs:
Bent-knee
Straight-knee-leg raising test
Neck bends to prevent stretching

Kernig

99

Meningeal signs:
ADduction and flexion of legs as you attempt to flex the kneck --> ?

Brudzinski

--> knees go up to prevent stretching

100

Scarf sign tests

If elbow passes midline --> HYPO-tonia