Infant Reflexes- Righting Reactions

Front 1

What is the starting position of labyrinthine head righting reaction?

Back 1

Hold infant under axilla with head and body vertical. Blindfold should be used to eliminate optical righting reactions.

Front 2

How to elicit labryrinthine head righting reaction?

Back 2

Tilt infant to the sides or forward or backward and observe head position.

Front 3

Correct response of Lab head righting reaction?

Back 3

Infant should move head into position perpendicular with the ground. Positive response may be inhibited if child trusts examiner.

Front 4

Why is lab head righting reaction important?

Back 4

Allows infant to place head in optimal position for safety and breathing (when in prone). Head righting reactions must be established in order to roll over, get on hands and knees, sit-up and to stand.

Front 5

Problems with child development of lab head is delayed or persistent?

Back 5

Normal locomotion and developmental pathways are not achieved. Safety is also a concern when infant is prone due to inability of infant to clear airway.

Front 6

Starting position of optical righting reaction?

Back 6

First observe child in prone, sitting and standing. Look for head control.

Front 7

How to elicit optical righting reactions?

Back 7

Change environment. Pull patient from supine to sitting and observe head control.

Front 8

Correct response of optical righting reactions?

Back 8

Head is maintained in upright position corresponding to body position.

Front 9

Negative response of optical righting reactions?

Back 9

Head lags behind in movement with change in body position.

Front 10

Importance of optical righting reactions?

Back 10

Same as labyrinthine head righting reactions. Also utilizes visual coordination. Can also compensate for deficiency in labyrinthine head righting reaction. Assists with pull to sit->child sees mom’s outstretched hands that acts as a signal to the child that he is going to be picked up and child may start to lift head.

Front 11

What happens to child’s development if optical righting reactions doesn’t “disappear” or does not appear?

Back 11

Same as labyrinthine head righting reaction. Righting reactions will be severely inhibited if there is abnormal muscle tone present and primitive reflexes persist.

Front 12

Starting position of body righting acting on the head (BOH)?

Back 12

Place infant prone on table and observe head position.

Front 13

How to elicit BOH?

Back 13

Contact of body on table surface should elicit response.

Front 14

Correct response of BOH?

Back 14

When contact is made, infant should lift head away from surface. Can’t be separated from Labyrinthine Righting Reaction due to effect of gravity pulling on the head.

Front 15

Negative response of BOH?

Back 15

No movement of head when body comes in contact with surface.

Front 16

Importance of BOH?

Back 16

Allows infant to right its head in the prone position due to the lack of labyrinthine righting reaction in infants; allows infant to turn head in prone to insure open airway.

Front 17

Developmental issues if reflex doesn't disappear or does not appear?

Back 17

Lack of development of head control resulting in lack of equilibrium reactions.

Front 18

Starting position of neck righting reaction acting on the body (NOB)?

Back 18

Place child in supine

Front 19

How to elicit the NOB?

Back 19

Turn the head to either side and observe movement of the trunk.

Front 20

Correct response of the NOB?

Back 20

In the immature form, the trunk will follow the head in a manner similar to log rolling. In the mature form, the shoulders and thorax will follow the head and then the trunk or pelvis will follow in a rotational or segmental pattern toward the side to which the head is turned (segmental rolling).

Front 21

Negative response of the NOB?

Back 21

No response or response unequal from side to side.

Front 22

Importance of NOB?

Back 22

Allows infant to roll from supine to sidelying.

Front 23

Result if NOB is delayed or persistant?

Back 23

Infant will not be able to dissociate his body from his head in order to move one without the other. He will lack all trunk rotation patterns necessary for rolling from prone to supine, attaining sitting, standing and all upright activities requiring rotational components.

Front 24

Starting position of the BOB? Body righting reaction acting on the body

Back 24

Place child in supine.

Front 25

How to elicit the BOB?

Back 25

Flex one leg towards the chest and rotate it across the body.

Front 26

Correct response of the BOB?

Back 26

You should see rotational movement with the pelvis moving first followed by the thorax.

Front 27

Negative response of the BOB?

Back 27

Child rolls as a bound unit or “log” as in neonatal.

Front 28

Importance of the BOB?

Back 28

Acts in changing sequence of movement in attaining the erect position from supine lying.

Front 29

Result if BOB is delayed or persistent?

Back 29

Infant will not learn to sit up or walk.

Front 30

Starting position of the landau reaction?

Back 30

Child is held in horizontal suspension with hand between the nipple line and the umbilicus..

Front 31

What does the LANDAU reaction do?

Back 31

(Combination of Labyrinthine Head Righting Reaction, Body on Head Righting Reaction, & Optical Righting Reaction)

Front 32

Correct response of landau reaction?

Back 32

Coincides with the development of the pivot prone position. Child exhibits an extension response throughout the body. Shoulders are extended and scapulae are retracted and elbows are either flexed or extended and forearms are pronated. Once this position is attained, passive flexion of the head should result in trunk and LE flexion as well. When hand is removed from head, note the return to extension.

Front 33

Negative response of landau reaction?

Back 33

No extension present.

Front 34

Importance of landau reaction?

Back 34

Helps break up the flexion posture at birth and assists the child in extending his head when prone (Labyrinthine Head Righting Reaction). Also helps child support himself on forearms. The extension of the LEs is valuable in preparation for standing and seems to underlie the infant’s ability to weight bear fully. Due to promoting extension in prone, it helps to integrate the tonic labyrinthine reflex to pave the way for sitting and standing.

Front 35

Result if landau reaction is delayed or persistent?

Back 35

Absence may be associated with motor weakness, motor neuron disease and/or mental retardation. An absence or delay may result in a delay in the acquisition of the pivot prone position, sitting and standing.

Front 36

Starting position of the positive supporting reactions-LE

Back 36

Support the child with your hands under the arms and around the chest holding him in the vertical position.

Front 37

How to elicit the positive supporting reactions? LE

Back 37

Allow the soles of the feet to make firm contact with a flat surface. Observe response.

Front 38

Correct response of positive supporting reactions? LE

Back 38

When feet touch the supporting surface, there is a stretch of the intrinsic muscles of the feet resulting in synergistic reinforcement of all flexor muscles of the LE and synergistic reinforcement of all extensor resulting in simultaneous contraction of both the flexors and extensors enabling the extremity to form a supporting pillar. Child bears more weight than with neonatal positive supporting reaction.

Front 39

Negative response of positive supporting reactions? LE

Back 39

No weight bearing.

Front 40

Importance of response of positive supporting reactions? LE

Back 40

Allows infant to weight bear when placed in an upright position with the feet in contact with the floor.

Front 41

Result if LE positive supporting reaction is delayed or persistent?

Back 41

NWB infants won’t be able to stand independently or subsequently walk. An exaggerated reaction can also limit this ability. If the child learns to adapt to the exaggerated reaction, he won’t have a normal gait.