Newborn reflexes

Sucking reflex
- When the roof of the baby's mouth is touched, the baby will start to suck. This reflex
doesn't start until about the 32nd week of pregnancy and is not fully developed until about
36 weeks. 
- Persist throughout infancy
- infants with poor or absent suck reflex usually have moderate or significant perinatal
hypoxic ischemic encephalopathy (lack of oxygen around the time of birth).
Rooting reflex
- This reflex starts when the corner of the baby's mouth is stroked or touched. The baby will
turn their head and open their mouth to follow and root in the direction of the stroking.
This helps the baby find the breast or bottle to start feeding. This reflex lasts about 4
months.
- Retention of the rooting reflex beyond four months may result in difficulty with solid foods,
poor articulation, and thumb sucking.
Moro reflex or startle reflex
- usually occurs when a baby is startled by a loud sound or movement. In response to the
sound, the baby throws back their head, extends out their arms and legs, cries, then pulls
the arms and legs back in.
- Disappears after 4 months
- If a child experiences a retained Moro reflex beyond 4 months, he may become over
sensitive and over-reactive to sensory stimulus resulting in poor impulse control, sensory
overload, anxiety and emotions, and social immaturity.
-
Palmar grasp reflex
- Stroking the palm of a baby's hand causes the baby to close their fingers in a grasp. The
grasp reflex lasts until the baby is about 5 to 6 months old.
- A palmar reflex that isn't integrated by 6 months of age may signal that your baby's central
nervous system (CNS) hasn't taken enough control for the reflex to become a voluntary
movement. It may also indicate spastic cerebral palsy or other damage to your baby's CNS.
Plantar reflex

- Similar to the palmar grasp reflex, an object placed just beneath the toes causes them to
curl around it.
- Disappears after 8 months.
- abnormal response of plantar reflex reliably indicates metabolic or structural abnormality
in the corticospinal system upstream from the segmental reflex.

Tonic neck reflex

 - When a baby is lying on its back turns its head to the right side, for example, the left side of
the body shows a flexing of the left arm and the left leg.
- Disappears after 4 months.
- If tonic reflex is absent your child can't track a horizontally passing object past the nose
without stopping at the midline. This will affect their reading, spelling, and writing abilities
later in life. The child might also experience: Poor balance control when they move the head
from side to side.
Stepping reflex
- Hold the baby upright so that the feet touch a flat surface.
- The legs then move up and down as if the baby were walking.
- Disappears after 2 months.
Babinski reflex
- Sole of the foot is stroked; the big toe rises and the other toes fan out.
- After age 1, the infant exhibits a negative Babinski, toes curl downward
- Positive Babinski after age 1 indicates brain damage.
Neck righting reflex
- Head turn to side where body is rotated
- Appear around 6 months and persist through life
Landau reflex
- Suspend horizontally against trunk and neck flexed, leg will flex and be drawn up to the
trunk.
- Emerges 3 months after birth and It is fully integrated by one year. If the landau reflex
persists beyond this point, children may experience short-term memory problems, poor
motor development, and low muscle tone.

Parachute reflex
- It is elicited by positioning the infant prone in mid-air, head first. The response of the infant
is to extend the arms and spread the fingers to protect the head.
- Appears around 8 months and persist through life
- The absence of parachute reflex may indicate an underlying neurological condition.

reflexes that last into adulthood

 Blinking reflex: blinking the eyes when they are touched or when a sudden bright light
appears

 Cough reflex: coughing when the airway is stimulated

 Gag reflex: gagging when the throat or back of the mouth is stimulated
  Sneeze reflex: sneezing when the nasal passages are irritated

 Yawn reflex: yawning when the body needs more oxygen

Adult reflexes
BICEPS REFLEX
- The biceps reflex is elicited by placing your thumb on the biceps tendon and striking your
thumb with the reflex hammer and observing the arm movement. Repeat and compare with
the other arm.
- The biceps and brachioradialis reflexes are mediated by the C5 and C6 nerve roots.

TRICEPS REFLEX
- The triceps reflex is measured by striking the triceps tendon directly with the hammer
while holding the patient's arm with your other hand. Repeat and compare to the other
arm.
- mediated by the C6 and C7 nerve roots, predominantly by C7.

SUPERNATOR (BRACHIODIALIS) REFLEX

- The brachioradialis reflex is observed by striking the brachioradialis tendon directly with
the hammer when the patient's arm is resting. Strike the tendon roughly 3 inches above the
wrist. Note the reflex supination. Repeat and compare to the other arm.
- mediated by the C6 and C7 nerve roots, predominantly by C7.

ABDOMINAL
- Elicit reflex by lightly but briskly stroking each side of the abdomen above and below the
umbilicus
- Use key, wooden end of cotton applicator, tongue blade twisted and split longitudinally
- Above the umbilicus (T8, T9, T10)
- Below the umbilicus (T10, T11, T12)
- Note contraction of the abdominal muscle and deviation of umbilicus towards the stimulus
- Obesity may mask an abdominal reflex

KNEE (PATELLAR) REFLEX

- With the lower leg hanging freely off the edge of the bench, the knee jerk is tested by
striking the quadriceps tendon directly with the reflex hammer. Repeat and compare to the
other leg.
- The knee jerk reflex is mediated by the L3 and L4 nerve roots, mainly L4.
Insult to the cerebellum may lead to pendular reflexes. Pendular reflexes are not brisk but
involve less damping of the limb movement than is usually observed when a deep tendon
reflex is elicited. Patients with cerebellar injury may have a knee jerk that swings forwards
and backwards several times. A normal or brisk knee jerk would have little more than one
 swing forward and one back. Pendular reflexes are best observed when the patient's lower
legs are allowed to hang and swing freelly off the end of an examining table.

ANKLE REFLEX
- The ankle reflex is elicited by holding the relaxed foot with one hand and striking the
Achilles tendon with the hammer and noting plantar flexion. Compare to the other foot.
- The ankle jerk reflex is mediated by the S1 nerve root.

PLANTAR RESPONSE
- The plantar reflex (Babinski) is tested by coarsely running a key or the end of the reflex
hammer up the lateral aspect of the foot from heel to big toe. The normal reflex is toe
flexion. If the toes extend and separate, this is an abnormal finding called a positive
Babinski's sign.
- A positive Babinski's sign is indicative of an upper motor neuron lesion affecting the lower
extremity in question.