The nurse is conducting reflex testing on infants at a well-child ...

[jc611]

The nurse is conducting reflex testing on infants at a well-child clinic. Which reflex finding should be reported as abnormal and considered as a possible sign of cerebral palsy?
 
  a. Tonic neck reflex at 5 months of age
  b. Absent Moro reflex at 8 months of age
  c. Moro reflex at 3 months of age
  d. Extensor reflex at 7 months of age

Question 2

Which clinical manifestations in an infant would be suggestive of spinal muscular atrophy (Werdnig-Hoffmann disease)?
 
  a. Hyperactive deep tendon reflexes
  b. Hypertonicity
  c. Lying in the frog position
  d. Motor deficits on one side of body

[iceage]

Answer to Question 1

ANS: D
Establishing a diagnosis of cerebral palsy (CP) may be confirmed with the persistence of primitive reflexes: (1) either the asymmetric tonic neck reflex or persistent Moro reflex (beyond 4 months of age) and (2) the crossed extensor reflex. The tonic neck reflex normally disappears between 4 and 6 months of age. The crossed extensor reflex, which normally disappears by 4 months, is elicited by applying a noxious stimulus to the sole of one foot with the knee extended. Normally, the contralateral foot responds with extensor, abduction, and then adduction movements. The possibility of CP is suggested if these reflexes occur after 4 months.

Answer to Question 2

ANS: C
The infant lies in the frog position with the legs externally rotated, abducted, and flexed at knees. The deep tendon reflexes are absent. The child has hypotonia and inactivity as the most prominent features. The motor deficits are bilateral.

[jc611]

Thanks for the timely response, appreciate it

[xiaomengxian]

Excellent