NEURO - Primitive Reflexes

What primitive reflex is stimulated by a noxious stimulus (pinprick) to the sole of the foot? a. flexor withdrawal b. crossed extension c. startle d. positive support

A In the flexor withdrawal reflex the toes extend, foot dorsiflexes, and the entire lower extremity flexes uncontrollably. Onset of the reflex is 35 weeks of gestation and it is integrated at 2 months.

Which age would persistence of the Galant reflex be considered normal? a. 1 month b. 4 months c. 7 months d. 10 months

A The Galant reflex is considered to be normal from 30 weeks of gestation to 2 months. As a result, an infant that is 1 month old would likely exhibit the reflex.

Match the following reflex with the appropriate response: palmar grasp reflex

flexion of the fingers causing a strong grip

which of the following stimuli is associated with the ATNR? - touch on cheek - loud, sudden noise - pressure to base of toes - head position, turning to one side

head position, turning to one side

which area would be most impacted by a failure to integrate the startle reflex? - proper spine development - volitional apprehension - protective responses in sitting - oral-motor development

protective responses in sitting

Match the following reflex with the appropriate response: Positive support reflex

stiffening of the legs and trunk into extension

Which reflex is stimulated by touching the skin along the spine from the shoulder to the hip? a. Galant b. Moro c. rooting d. startle

A The Galant reflex is stimulated by touching the skin along the spine from the shoulder to the hip. The response is lateral flexion of the trunk on the side of the stimulus. Failure of this reflex to integrate may interfere with development of sitting balance and may lead to scoliosis.

Which primitive reflex would be elicited when a two-month-old infant turns their head to one side causing the arms and legs on the face side to extend and the arms and legs on the opposite side to flex? a. ATNR b. Galant c. positive support d. TLR

A The asymmetrical tonic neck reflex is stimulated when the head is turned to one side. The response is a fencing posture (arm and leg on face side are extended, arm and leg on scalp side are flexed). The normal age of the reflex is from birth to 6 months.

Which of the following primitive reflexes is normally fully integrated by three months of age? a. rooting b. STNR c. plantar grasp d. Moro

A The rooting reflex is stimulated with touch to the cheek. The response is the infant turning their head to the same side. The normal age of the response is from 28 weeks of gestation to three months.

At what ages is the symmetrical tonic neck reflex considered normal? a. 0-2months b. 3-6moths c. 6-8months d. 8-12months

C Failure of the symmetrical tonic neck reflex to integrate interferes with the ability to prop on arms in prone, crawl reciprocally, and interact with handheld toys in sitting.

Which primitive reflex is stimulated by flexion and extension of the head? a. ATNR b. Galant c. STNR d. TLR

C In the symmetrical tonic neck reflex, when the head is in flexion, the arms are flexed and the legs are extended. When the head is in extension, the arms are extended and the legs are flexed.

Which primitive reflex is depicted in the image? a. Moro b. rooting c. palmar grasp d. plantar grasp

C The palmar grasp reflex is stimulated by maintained pressure to the palm of the hand. The normal age of the response is from birth to 4 months.

Which primitive reflex is stimulated simply by positioning in prone or supine? a. startle b. positive support c. TLR d. associated reactions reflex

C The tonic labyrinthine reflex promotes increased flexor tone when positioned in prone and increased extensor tone when positioned in supine. Onset is at birth and integration is at 6 months.

Which reflex is stimulated by supported upright positioning with the soles of the feet on a firm surface? a. positive support b. stepping c. plantar grasp d. Galant

B Failure of the stepping reflex to integrate may interfere with standing, walking, balance reactions in standing, and development of smooth, coordinated reciprocal movements of the lower extremities.

Which age is most consistent with the typical integration of the asymmetrical tonic neck reflex? a. 3 months b. 6 months c. 9 months d. 12 months

B The asymmetrical tonic neck reflex is normally present at birth and integrates at 6 months. Persistence of this reflex can affect feeding, visual tracking, bilateral use of hands, and rolling.

Startle Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: loud, sudden noise Response: similar to Moro response, but elbows remain flexed and hands closed Normal age of response: 28 wks. gestation - 5 months Interferes with: sitting balance, protective responses in sitting, eye-hand coordination, visual tracking, social interaction, attention

Which of the following developmental reflexes persists throughout the lifespan? a. plantar grasp b. STNR c. ATNR d. protective extension

D Protective extension reactions emerge within the first year of life and persist throughout the lifespan to aid in maintaining balance and minimizing injury due to a fall. This is considered to be a postural developmental reflex that works at the level of the cortex in the brain

Which primitive reflex is stimulated by a sudden change in position of the head in relation to the trunk? a. grasp b. STNR c. positive support d. Moro

D The Moro reflex is stimulated by a sudden change in head position in relation to the trunk. Response includes extension and abduction of the upper extremities, hand opening and crying followed by flexion, adduction of arms across chest. Onset of the reflex is 28 weeks gestation and it is integrated at 5 months.

Stroking an infant's mouth and cheek stimulates which reflex? a. sucking b. Moro c. Landau d. rooting

D The rooting reflex appears at 28 weeks gestation and is integrated at 3-4 months.

Which of the following pediatric reflexes does not typically integrate at two months? a. positive support reflex b. stepping reflex c. gallant reflex d. plantar grasp

D Typical integration of the plantar grasp reflex occurs at nine months. Failure to integrate may interfere with the ability to stand with feet flat, balance reactions, and weight shifting in standing.

T or F: the normal age of response of the palmar grasp reflex begins during gestation

FALSE 0-4 months

T or F: the positive support reflex exists throughout an initial's lifetime

FALSE 35 wks-2 months

T or F: a possible negative effect resulting from failure to integrate the rooting reflex is impaired protective responses

FALSE impaired oral-motor development

the depicted image shows the normal response of which reflex? - ATNR - Galant - STNR - TLR

Galant

Sequence the following primitive reflexes in order from the earliest to the latest age of integration: TLR Galant Reflex STNR Palmar Grasp Reflex

Galant (30wks-2months) Palmar Grasp (0-4months) TLR (0-6months) STNR (6-8months)

Match the following reflex with the appropriate response: Moro reflex

arms abduct, then cross into adduction

Moro Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: head dropping into extension suddenly Response: arms abduct with fingers open, then cross trunk into adduction and cry Normal age of response: 28 wks. gestation - 5 months Interferes with: balance reactions in sitting, protective responses in sitting, eye-hand coordination and visual tracking

Symmetrical Tonic Neck Reflex (STNR): Stimulus Response Normal age of response Interferes with

Stimulus: head flexion or extension Response: when head is in flexion, arms are flexed and legs are extended; when head is in extension, arms are extended and legs are flexed Normal age of response: 6-8 months Interferes with: ability to prop on arms in prone, attaining and maintaining hands-and-knees position, crawling reciprocally, sitting balance when looking around, use of hands when looking at objects in hands in sitting position

Asymmetrical Tonic Neck Reflex (ATNR): Stimulus Response Normal age of response Interferes with

Stimulus: head rotated to one side Response: arm and leg on face side are extended, arm and leg on scalp side are flexed, spine curved with convexity toward face side Normal age of response: 0-6 months Interferes with: feeding, visual tracking, midline use of hands, bilateral hand use, rolling, development of crawling, can lead to skeletal deformities (scoliosis, hip subluxation, hip dislocation)

Tonic Labyrinthine Reflex (TLR): Stimulus Response Normal age of response Interferes with

Stimulus: position of labyrinth in inner ear - reflexed in head position Response: supine - body and extremities are held in extension; prone- body and extremities are held in flexion Normal age of response: 0-6 months Interferes with: initiate rolling, ability to prop on elbows with extended hips while in prone, ability to flex trunk and hips to come into sitting position from supine, often causes full body extension, which interferes with balance in sitting or standing

Palmar Grasp Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: pressure in palm on ulnar side of hand Response: flexion of fingers causing strop grip Normal age of response: 0-4 months Interferes with: ability to grasp and release objects voluntarily, weight bearing on open hand for propping, crawling, protective responses

Plantar Grasp Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: pressure to base of toes Response: toe flexion Normal age of response: 28 wks. gestation - 9 months Interferes with: ability to stand with feet flat on surface, balance reactions and weight shifting in standing

Walking (stepping) Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: supported upright position with soles of feet on firm surface Response: reciprocal flexion/extension of legs Normal age of response: 38 wks. gestation - 2 months Interferes with: standing/walking, balance reactions and weight shifting in standing, development of smooth, coordinated reciprocal movements of LEs

Rooting Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: touch on cheek Response: turning head to same side with mouth open Normal age of response: 28 wks. gestation - 3 months Interferes with: oral-motor development, development of midline control of head, optical righting, visual tracking, and social interaction

Galant Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: touch to skin along spine from shoulder to hip Response: lateral flexion of trunk TO SIDE OF STIMULUS (convex side to side of stimulus) Normal age of response: 30 wks. gestation - 2 months Interferes with: development of sitting balance, can lead to scoliosis

Positive Support Reflex: Stimulus Response Normal age of response Interferes with

Stimulus: weight placed on balls of feet when upright Response: stiffening of legs and trunk into extension Normal age of response: 35 wks. gestation - 2 months Interferes with: standing/walking, balance reactions and weight shift in standing, can lead to contractures of ankles into PF

T or F: the normal response of the startle reflex is similar to the Moro reflex, but the elbows remain flexed and the hands closed

TRUE

Match the following reflex with the appropriate response: rooting reflex

turning the head toward the stimulus with the mouth open