Reflexes

an action or movement that is made automatically without thinking as a reaction to a stimulus

1. REFLEXES

2. “An action that is performed without conscious thought as a response to a stimuli”

3. INTRODUCTION

4. DEPENDING UPON INBORN OR ACQUIRED Unconditioned/ inborn reflex Conditioned /Acquired reflex CLASSIFICATION OF REFLEXES DEPENDING UPON SITUATION OF THE CENTER Cerebellar reflex Cortical reflex Midbrain reflex Bulbar / Medullary Reflex Spinal Reflex

5. CLASSIFICATION OF REFLEXES

6. Depending upon clinical basis 4 . Pathological reflex

7. Helps the pediatrician to identify whether the child is developing normally or not. Tells about what abnormalities the child may be having if all reflexes are not proper SIGNIFICANCE OF REFLEXES

8. Knowledge of development of motor skills – helps to identify whether development is going on at a proper rate or not.

9. GENERAL BODY REFLEXES OF BABY MORO REFLEX / STARTLE REFLEX PALMAR/GRASP REFLEX WALKING / STEPPING REFLEX LIMB PLACEMENT REFLEX LIMB PLACEMENT REFLEX ASYMMETRIC TONIC NECK REFLEX BABINSKI’S REFLEX BABKIN REFLEX PARACHUTE REFLEX LANDAU REFLEX

10. GENERAL BODY REFLEXES OF BABY WITHDRAWAL REFLEX TRUNK INCURVATION TENDON REFLEX BABINSKI’S REFLEX PARACHUTE REFLEX PLANTER GRASP REFLEX

11. FACIAL REFLEX NASAL REFLEX BLINK REFLEX DOLL’S EYE REFLEX AUDITORY ORIENTING REFLEX

12. ORAL REFLEXES ROOTING REFLEX SUCKING REFLEX GAG REFLEX SWALLOWING REFLEX CRY REFLEX

13. GENERAL BODY REFLEXS MORO REFLEX / STARTLE REFLEX Begins at 28 weeks of gestation Initiated by any sudden movement of the neck Elicited by – pulling the baby halfway to sitting position from supine and suddenly let the head fall back

14. It Consist of rapid abduction and extension of arms with the opening of hands, tensing of the back muscles, flexion of the legs and crying Within moments, the arms come together again

15. CLINICAL SIGNIFICANCE Its nature gives an indication of muscle tone Failure of the arms to move freely or the hands to open fully indicates hypotonia . It fades rapidly and is not normally elicited after 6 months of age.

16. PALMAR/GRASP REFLEX Begin at 32 weeks of gestation. Most effective way– slide the stimulating object, such as a finger or pencil, across the palm from the lateral border Disappears at 3-4 months

17. Light touch of the palm produces reflex flexion of the finger. Replaced by voluntary grasp at 45 months

18. Clinical significance Exceptionally strong grasp reflex– spastic form of cerebral palsy and kernicterus. May be asymmetrical in hemiplegic and in case of cerebral damage. Persistence beyond 3 to 4 months indicate spastic form of palsy.

19. PLANTER / GRASP REFLEX Placing object or finger beneath the toes causes curling of toes around the object Present at 32 weeks of gestation Disappears at 9 to 12 months

20. CLINICAL SIGNIFICANCE This reflex referred to as the “readiness tester” Integrates at the same time that independent gait first becomes possible

21. WALKING / STEPPING REFLEX When sole of foot is pressed against the couch, baby tries to walk Legs prance up and down as if baby is walking or dancing.

22. Present at birth. Disappearing at 2 to four months With daily practice of reflex, infant may walk alone at 10 months.

23. CLINICAL SIGNIFICANCE Premature infants will tend to walk in a toe-heel fashion while more mature infants will walk in a heel-toe patterns

24. LIMB PLACEMENT REFLEX When the front of the leg below the knee or the arm below the elbow is brought into contact with the edge of a table, child lift the limbs over the edge Present at birth, fades away rapidly in early months of life.

25. CLINICAL SIGNIFICANCE Reflex is readily demonstrable in the newborn and persistent failure to elicit it at this stage, is thought to indicate neurological abnormality.

26. WITHDRAWAL REFLEX This is the reflex that allows the baby to “hold hands until it disappears at about 6 months. Withdrawal reflex:  A pin prick to the sole of baby's foot will result in knee and foot flexion . Present at birth, persists throughout life .

27. CLINICAL SIGNIFICANCE Absence of this is seen in neurologically impaired infants.

28. ASYMMETRIC TONIC NECK REFLEX Asymmetric tonic neck reflex, or ATNR, is  one of the primitive reflexes that babies experience as part of brain development . ... ATNR presents as consistent, one-sided movements of the body that go together with proper hand-eye harmonization. The reflex happens when a newborn turns their head but you may not notice them .

29. CLINICAL SIGNIFICANCE The reflex fades rapidly and is not normally seen after 6 months of age. Persistence is the most frequently observed abnormality of the infantile reflexes in infant with neurological lesions. Greatly disrupts development.

30. SYMMETRIC TONIC NECK REFLEX When your baby's head moves forward (their chin toward their chest), their legs straighten and their arms bend.

31. CLINICAL SIGNIFICANCE Not normally easily seen at elicited in normal infants. May be seen in an exaggerated form in many children with cerebral palsy

32. BABINSKI’S REFLEX Babinski reflex is  one of the normal reflexes in infants . Reflexes are responses that occur when the body receives a certain stimulus.

33. The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot. The other toes fan out.

34. BABKIN REFLEX Deep pressure applied simultaneously to the palm of both hands while the infant is in supine position. Stimulus is followed by flexion or forward bowing of the head, opening of the mouth and closing of the eyes. Fades rapidly and normally cannot be elicited after 4 months of age. A neonatal reflex in which infants open their mouths and twist their heads in response to pressure on their palms . 

35. Clinical significance Reflex can be demonstrated in the newborn, thus showing a hand-mouth neurological link, even at that early stage

36. PARACHUTE REFLEX Reflex appears at about 6-9 months and persists thereafter. Elicited by holding the child in ventral suspension and suddenly lowering him in the couch Arms extended as a defensive reaction.

37. Clinical significance Absent or abnormal in children with cerebral palsy. Would be asymmetrical in spastic hemiplegic .

38. LANDAU REFLEX Seen in horizontal suspension with the head, legs and spine extended. If the head is flexed, hip knees and elbows also flex. Appears at approximately 3 months, disappears at 12-24 months.

39. Clinical significance Absence of reflex occurs in hypotonia , hypertonia or mental abnormality.

40. TRUNK INCURVATION REFLEX Stroking one side of spinal column while baby is on his abdomen causes crawling motion with legs, lifting head from surface Present in utero , seen at approximately 3 rd or 4 th day Persist for 2-3 months.

41. GALLANT’S REFLEX Firm sharp stimulation along side of the spine with the fingernails or a pin produces contraction of the underlying muscles and curving of the back. Response is easily seen when the infants is held upright and the trunk movement is unrestricted. Best seen in the neonatal period and thereafter gradually fades.

42. TENDON REFLEX Simple monosynaptic reflexes, which are elicited by a sudden stretch of a muscle tendon. Occurs when the tendon is tapped. Present throughout the life.

43. Clinical significance Useful diagnostically for Detection of upper motor neuron lesions (exaggerated response) Myopathic conditions (depressed or absent response) Localization of the segmental lesions of the cord.

44. TONIC LABYRINTHINE REFLEX With this  reflex , tilting the head back while lying on the back causes the back to stiffen and even arch backwards, the legs to straighten, stiffen, and push together, the toes to point, the arms to bend at the elbows and wrists, and the hands to become fisted or the fingers to curl.

45. FACIAL REFLEX

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