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פידס > Reflexes 0-12 Months > Flashcards

Reflexes 0-12 Months Flashcards

(49 cards)

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1
Q

Principle

REFLEX BEFORE CORTICAL CONTROL

earliest response

matured response

A

earliest response:

  1. ATNR
  2. MORO

matured response:
1. moves limbs, independent of head

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2
Q

Principle

TOTAL BODY MOVEMENT BEFORE ISOLATED MOVEMENT (DISSOCIATION)

earliest response

matured response

A

earliest: random
UE swiping
prone kicking both legs (random)

matured response: isolated
grasp
prone flexing/extending knee

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3
Q

Principle

PROXIMAL CONTROL BEFORE DISTAL CONTROL

earliest response

matured response

A

earliest:
- shoulder and hip stability

matured:
- elbow-wrist-hand-knee-ankle

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4
Q

Principle

CEPHALIC BEFORE CAUDAL CONTROL

earliest response

matured response

A

earliest response:
-shoulders control and stability

matured:
- hip control and stability

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5
Q

Cephalocaudal Direction First Quarter

A

head control in all positions

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6
Q

Cephalocaudal Direction Second Quarter

A

arms and upper trunk control (shoulder girdle)

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7
Q

Cephalocaudal Direction Third Quarter

A

lower trunk and pelvic control (hips)

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8
Q

Cephalocaudal Direction Fourth Quarter

A

mobility and control of the lower legs and upright postural control (standing)

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9
Q

Cephalocaudal Direction After Fourth Quarter

A

antigravity control

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10
Q

Principle

MEDIAL CONTROL BEFORE LATERAL CONTROL

earliest response

matured response

A

earliest:
3 ULNAR fingers dominate first grasp

matured:
thumb and index finger dominate grasp

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11
Q

Principle

EXTENSOR ANTIGRAVITY CONTROL BEFORE FLEXOR ANTIGRAVITY CONTROL

earliest response

matured response

A

earliest:
lift head in prone at 4 months , antigravity extensor

matured:
lift head in supine at 5 months, antigravity flexor

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12
Q

Principle

WEIGHT BEARING ON FLEXED EXTREMITIES BEFORE EXTENDED EXTREMITIES

earliest response

matured response

A

earliest:
prone on elbow

matured:
prone on extended arms

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13
Q

Principle

GROSS MOTOR DEVELOPMENT BEFORE FINE MOTOR DEVELOPMENT

earliest response

matured response

A

earliest:
jump

matured:
handwrite

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14
Q

Grasp Patterns

RAKING

A

emerges at 6 MONTHS

thumbs against curled index finger

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15
Q

Grasp Patterns

PINCER GRASP

A

emerges 8-12 MONTHS

pad of thumb and pad of index finger

note: WHICH IS IT??
pad to pad is more refined than tip to tip
pad to pad is nails together?
tip to tip is the palmar aspect of fingers together?

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16
Q

Developing hand preference before 12 months:

A

developing hand before 12 months indicates motor impairment in the opposite extremity

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17
Q

When does hand preference start?

A

NOT begin to develop until age 2 years

establish somewhere between 3 and 4

should see swatting, reaching, grabbing with both hands in infants

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18
Q

What reflexes are present at birth?

A
  • Moro
  • Suck
  • Root
  • Palmar
  • Plantar
  • ATNR
  • Babinski
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19
Q

What reflexes are not present at birth but emerge during infancy?

A
  • STNR
  • Landau
  • Parachute
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20
Q

When does Moro start?

Study These Flashcards
A

Startle reflex

Start: week 28-32 gestation
well established by week 37

infant is born with this normal reflex

Integrates: 4-5 months diminishes with head control

poor neck stability may retain startle response longer

21
Q

What does a baby do in Moro reflex?

Study These Flashcards
A
  • Startled look
  • wide abduction and extension of UEs, Palms Up, Baby will freeze for a moment in that position:

followed by adduction and flexion of UEs and relocation of limbs

-usually cries

22
Q

What stimulates Moro reflex?

6

Study These Flashcards
A

this is done in the hopes of grabbing onto something to prevent a fall

Reflex activated when STARTLED

  1. loud noise
  2. change in light
  3. change in body position
  4. feeling like falling backwards
  5. their own cry will startle them
  6. head suddenly tips backwards. neck hyperextension

startling can wake up a sleeping infant

ELICIT: LOWER HEAD RAPIDLY BELOW THE LEVEL OF THE SPINE

23
Q

What is the purpose of the Moro reflex?

Study These Flashcards
A

grab onto something to prevent a fall

24
Q

When does Moro reflex integrate?

Study These Flashcards
A

Startle reflex

START: week 28-32 gestation
well established by week 37
infant is born with this normal reflex

INTEGRATES: 4-5 MONTHS, DIMINISHES WITH HEAD CONTROL

Poor neck stability may retain startle longer if persists:

  • throws infant off balance in upright positions sitting, standing, walking
  • excess extensor tone development
  • associated with CP
25
Why may a moro reflex persist? what happens? (3)
Poor neck stability may retain startle longer if persists: 1. Throws infant off balance in upright positions sitting, standing, walking 2. EXCESS EXTENSOR TONE DEVELOPMENT 3. associated with CP
26
What does it mean if Moro absent on ONE SIDE? (3)
1. fractured clavicle or humerus 2. brachial plexus injury 3. hemiplegia
27
What does COMPLETE BILATERAL ABSENCE of Moro mean?
damage to the BRAIN or SPINAL CORD
28
Elicit Moro relfex
elicit by lowering head rapidly below the level of the spine
29
Rooting Reflex what is it? what is its purpose? what if it persists? what if it is absent?
tactile stimulation to cheek head rotates and mouth opens food finding: prepares baby to suck, helps baby find bottle or breast persistence can interfere with volitional sucking absence seen in neuro impaired infants
30
Purpose of rooting reflex
food finding: prepares baby to suck, helps baby find bottle or breast
31
When is Rooting absent?
absence seen in neuro impaired infants
32
What does persistence of rooting cause?
persistence can interfere with volitional sucking
33
Sucking Reflex - when does it start - purpose - when may it be absent - how to elicit - how to test strong suck - what does sucking action promote - when does it integrate - what if it persists
does not begin until 32nd week of gestation not fully developed until **36 WEEKS** PURPOSE: *develop oral musculature* PREMATURE BABIES MAY HAVE A WEAK/ IMMATURE SUCK ELICIT: stimulate the roof of the mouth TEST: determine strong suck: if you can remove the bottle easily PROMOTES: sucking action promotes FLEXION INTEGRATES: 2-5 months PERSISTENCE: may inhibit voluntary sucking
34
Purpose of sucking reflex
develop oral musculature
35
Persistence of sucking reflex
may inhibit voluntary sucking
36
When does sucking reflex integrate
2-5 months
37
How do you determine if an infant has a strong suck?
if you can remove the bottle easily
38
What action does sucking promote?
FLEXION
39
PALMAR Grasp Reflex: when elicited what is it what if response is diminished, asymmetric, no response? when integrated?
ELICITED *28 WEEKS* ---response diminished with prematurity **stimulate palm and fingers flex strongly CANNOT VOLITIONALLY RELEASE DIMINISHED: premature ASYMMETRIC: brachial plexus injury, humeral fracture NO RESPONSE: severe neurological deficit INTEGRATED: when voluntary grasp develops (6 months able to grasp voluntarily toy and release it)
40
PLANTAR Grasp Reflex: when does it begin what is it when does it integrate
BEGINS at 28 weeks gestation apply firm pressure to the base of the toes and toes flex/curl, toe curling may be seen when standing INTEGRATES: around the time child walks (distal fixing: use a distal point and contract to assist proximally, such as an open mouth: put out tongue for new motor skill, walking with hands tightly grasped to support proximally)
41
BABINSKI when is it normal/abnormal, how to stimulate response
NORMAL: until age 2 yrs * *disappear as child ages and as the nervous system becomes more myelinated - -may disappear as early as *12 MONTHS* **sign of UMN LESION after age 2 YEARS ie CP) STIMULATE: stimulate from heel along lateral edge across ball of foot RESPONSE: thumb toe DF, toes fan out
42
Step or walk reflex: onset what is it/response when is integration
ONSET: 37 weeks of gestation Elicit: support infant upright with feet touching a hard surface. Incline the infant forward and gently move the infant forward to accompany any stepping. Response: alternating, rhythmical, and coordinated steps. May see walking on toes or scissors. INTEGRATION: 2 months
43
ATNR when is it seen what is it what may be indication of atypical development persistent neck reflexes 12-24 months...
Present 2 weeks until 4 months Turn head and see posturing: Skull side flexion, face side extension considerable resistance to moving the infant out of ATNR may be indication of atypical development --persistent neck reflexes 12-24 months: suggests limited motor control, association with a decreased possibility of independent walking
44
persistent neck reflexes 12-24 months ie ATNR -what it means -why this is a problem
suggests limited motor control association with a decreased possibility of independent walking
45
Neck Righting on the Body onset testing position/procedure response: integeration
ONSET: 34 weeks of gestation Testing position: Infant supine, head midline Procedure: turn infants head to one side Response: infants entire body turn in the direction of the head -->Accidental rolling INTEGRATION: 4-6 months
46
Body Righting on the Body
Rotate the infants hips and log rolling occurs to realign the body
47
LANDAU REFLEX onset testing position procedure response integration
ONSET: 3-4 months Testing position: infant prone supported in air by therapist places hands under chest and stomach Procedure: wait for a reaction Absent Response: head and hips remain below horizontal absent response ? Response: Extends head above horizontal and extends trunk. Butt and head below the horizontal. Complete response: Extends head above horizontal then extends trunk and symmetrical raises hips and legs into full extension-complete response SUPERMAN INTEGRATION: 12-24 months ****need extension, wont see in low tone baby
48
STNR
4th -7th month Flex neck--> arms flex and legs extend Extend neck--> arms extend and legs flex online: ONSET - 4-6 months INTEGRATION - 8 - 12 months TESTING POSITION - child in quadruped position on the floor PROCEDURE - passively flex the head forward and then extend it backwards RESPONSE forward head flexion will produce flexion of the upper extremities and extension of the lower extremities; extension of the head will produce extension of the upper extremities and flexion of the lower extremities FUNCTIONAL SIGNIFICANCE - necessary to achieve quadruped crawling ****hemiparesis, head down when walk, need to flex LE to walk, stiff and get hip hiking/circumduction
49
Parachute
LAST POSTURAL REFLEX TO DEVELOP Appears ~6/9 months baby turned face down to mat: arms extend as if baby is trying to catch himself REMAINS THROUGHOUT LIFE!!! (before developing this reflex the baby will bring his arms back to plane of body away from mat)

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