Flashcards
Topic 4: primitive reflexes
Cards in this deck (49)
- 1dynamic systems view of neonatal neuromotor patterns• Neonates have preferred patterns of movement, highly predictable
• Reflexes intimately associated with movement in the 1st 3 months
• Reflexes are non-obligatory
Reflexes can be altered by: child hunger, upset, tired, behaviour state, weight of limbs, task environment - 2Traditional maturationist view of neonatal neuromotor patternsStereotyped, obligatory response to sensory stimuli. Stimuli => response (always)
- 3Identify and describe the typical neonatal neuromotor behaviours in proneProne: able to lift the head and turn it from side to side. Flexion is noted in the upper and lower limbs. Poor trunk control.
Primitive reflexes: tonic labyrinthine reflex - 4identify and describe the typical neonatal neuromotor behaviours in supineSupine: head is typically turned to the side, Reciprocal kicking is noted (jerky movements). Extensor tone dominates. Poor trunk control.
Primitive reflexes- asymmetric tonic neck reflex, tonic labyrinthine reflex - 5function of primitive reflexes• Assist in survival
• Link sensory and motor
• Develop rudimentary movement patterns of grasping, postural control, walking, antigravity
However persistence can impede development/function - 6when are primitive reflexes tested?• At birth my medical staff
• Each maternal and child health nurse check
• Diagnostic purposes
OT as part of neuromotor assessment - 7primitive reflexes helps us to understand:• Normal infant development- their integration fits into the sequence of typical development and allows for voluntary control
• Neuromotor assessment
-observe and ID reflexes that have not been integrated or re-emerge
Know they can be sign of CNS depression
Diagnosis
• Interventions in therapy
-e.g. postural supports
-Know what positions/stimulus may provoke the response - 8grasping reflexespalmar grasp
plantar grasp - 9palmar grasp-onset- birth-2 months
-integrate: 4-9/11 months with hand use
-procedure- pressure into the palm
-response- fingers flex around
-Significance- immature grasp. Cant utilise volitional reach and grasp until integrated. Persistence indicates NS damage. - 10plantar grasp-onset- prenatal
-integrate- 9mth-when standing
Procedure- firm pressure below toes
-response- plantar flexion of toes
-significance- immature attempt to maintain stability. Should disappear in standing. - 11oral motor reflexesrooting
sucking - 12rootingOnset- prenatal
Integration- 3 months
Stimulus- stroke on infants cheek/corner of mouth
Response- turn towards stimulus. If stroke lower lip-mouth opens (purpose is to find the nipple)
Significance- survival. Rarely absent when infant is not full. Absence may indicate CNS depression. - 13suckingOnset- prenatal
Integration- 2-5 months
Stimulus- downward pressure of tongue
Response- rhythmical sucking movement
Significance- survival. Rarely absent when infant is not full. Absence may indicate CNS depression. - 14gravity dependent reflexestonic labyrinthine reflex
labyrinthine righting reaction - 15tonic labyrinthine reflex (prone)Onset- prenatal
Integration- 6 months
Testing position 1: prone
Procedure: observe tone and posture in prone
Response: flexor tone dominates. Child doesn't life head (can turn to side) - 16tonic labyrinthine reflex (supine)Onset- prenatal
Integration- 6 months
Procedure: observe tone and posture in supine. In pull-to-sit, note presence of extensor tone
Response: extensor tone dominates, in pull to sit see head lag. Will not flex, only extension. - 17labyrinthine righting reactionOnset- birth- 2 months
Integration- persists
Stimulus- position of head or body in space
Position: ventral suspension, prone, vertical, pull-to-sit
Procedure- tilt body in all directions
Response- head orients to align to gravity- antigravity response
Significance- mediates development antigravity behaviours and learning to change positions - 18tactile based reflexesbabinksy reflex
- 19babinksy reflexPresent: 2-3 months, up to 12 months
Position- supine
Procedure- pressure on lateral side of the volar aspect of the foot
Response- dorsiflexion big toe and fanning of toes
Significant: persistence suggest NS damage - 20postural control and mobility reflexestraction reflex
moro reflex
galants response
neonatal neck righting
asymmetric tonic neck reflex
placing reflex - 21traction reflexOnset- prenatal
Integration- 2-5 months
Position- supine
Procedure- grasp wrists and pull towards sitting
Response- flexion of shoulders, elbows, wrists and fingers
Significant- persistence inhibits voluntary use of arms - 22moro reflexOnset- prenatal
Integrated- 4-6 months
Procedure- support head and shoulders; allow head to drop back
Response: abduction U/L extension elbows, wrist, fingers, then adduction of arms at shoulders and flexion at elbows
Significance- total absence indicates neurologic abnormality - 23gallants responseOnset- prenatal
Integration- end 3rd month
Position- ventral suspension
Procedure- stroke on one side of the vertebrae
Response- trunk curves with shortening on the stimulated side. Body moves towards the stimulus.
Significance- may be useful in early evaluation of children with spina bifida. Determine trunk muscles innervation. - 24neonatal neck rightingOnset- prenatal
Integration- 4-6 months
Position- supine
Procedure- lift and turns child's head to side
Response- child's body follows like a log
Significance- persists in presence of spasticity. Will prohibit mature rolling. - 25asymmetric tonic neck reflexOnset- birth-2 months
Integration- 4-6 months
Position- supine
Procedure- turn head in one direction
Response- arm and leg to which the face is turned will extend. Arm and leg of the opposite side will flex.
Significance- link hand and eye coordination. If it persists, CNS damage, prevents symmetrical behaviours, hand to mouth. - 26placing reflexOnset- birth
Integration- end of 3rd month
Position- vertical suspension
Procedure- brush dorsum hand/foot against tabletop
Response- limb lifts in flexion followed by extension/placing
Significance- seen in CNS damage - 27movement patterns of the lower limbs reflexesflexor withdrawal
crossed extension
positive support
spontaneous stepping - 28flexor withdrawalOnset- prenatal
Integration- end of 3rd month
Position- supine
Procedure- apply noxious stimuli to sole of foot
Response- total withdrawal, flexion of total leg
Significance- total withdrawal is integrated, localised jerk remains - 29crossed extensionOnset- prenatal
Integration- end of 3rd month
Position- supine
Procedure- hold one leg straight, apply firm pressure to sole of foot
Response- flexion, adduction, then extension of opposite leg
Significance- represents spinal cord neural networks that will lay the foundation for reciprocal pattern of locomotion - 30positive supportOnset- prenatal
Integration- end of 3rd month
Position- vertical suspension
Procedure- allow feet to contact support surface, flexed hip/knee
Response- limb support minimal body weight; hips and knees partial flexion.
Significance- indicates normal muscle tone. Persistence associated with high muscle tone e.g. CP, must be integrated to permit true weight bearing - 31spontaneous steppingOnset- birth
Integration- end of 3rd month
Position- hold upright in vertical suspension
Procedure- touch feet to the support surface; lean slightly forward
Response- alternating stepping movement
Significance- must be integrated to permit true walking. May persist in CP. - 32—asymmetrical tonic neck reflex
- 33—babinsky reflex
- 34—crossed extension
- 35—gallants response
- 36—labyrinthine righting reaction
- 37—flexor withdrawal
- 38—neonatal neck righting
- 39—palmar grasp
- 40—moro reflex
- 41—plantar grasp
- 42—placing reflex
- 43—sucking reflex
- 44—rooting reflex
- 45—positive support
- 46—spontaneous stepping
- 47—tonic labyrinthine reflex (supine)
- 48—tonic labyrinthine reflex (prone)
- 49—traction reflex
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- OTHY200 Flashcards on Topic 4: primitive reflexes , created by Bonnie McDonald on 09/03/2019.
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- Bonnie McDonald
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