PRIMITIVE REFLEXES, SPAN AND

PATHOLOGICAL REFLEXES

PRESENTED BY:
SAIRA REHMAN
ROLL # 01
CONTENTS:

•Introduction
• reflex arc
•Primitive reflexes
•Types of reflexes
•Conclusion
 INTRODUCTION:
• A reflex is an involuntary or automatic action
that your body does in response to something
without even having to think about it.
• Neonatal reflexes ___ inborn reflexes present
at birth and occur in a predictable fashion.
• Normally developing newborn should respond
to certain stimuli with these reflexes.
 REFLEX ARC:
• Anatomical pathway for reflex is called a
reflex arc.
• It has 5 components:
1. Receptor
2. Afferent nerve
3. Centre
4. Efferent nerve
5. Effector organ
 PRIMITIVE REFLEXS:
• Are reflex actions originating in the CNS
that are exhibited by normal infants in
response to particular stimuli.
• Suppressed by development of frontal
lobe as a child start developing.
 TYPES OF REFLEXES:
GENERA
FACIAL ORAL
L BODY
Moro
Nasal Rooting Palmar
Plantar
Blink Sucking Stepping
Limb placement
Swallowing ATNR
Doll’s eye
STNR
Gag Babinski
Auditory Babkin
orienting cry Parachute
refkex Landau
Gallant’s
Tonic
labyrinthine
 FACIAL REFLEXES:
NASAL REFLEX:
• Stimulation of the face or nasal cavity with
water or local irritant produces apnea in
neonates.
• Breathing stops in expiration with laryngeal
closure in infants __ bradycardia and
lowering of cardiac output.
• Blood flow to skin, splanchnic areas, muscles
and kidney decreases.
• Blood flow to heart and brain remain
protected.
 BLINK REFLEX:
• A bright light suddenly shone into the eyes, a puff of air on sensitive
cornea or a sudden loud noise will produce immediate blinking of
the eyes.
• PURPOSE: to protect the eyes from foreign bodies and bright light
• May be associated tensing of the neck muscles, turning of the head
away from stimulus, frowning and crying.
• Reflexes are easily seen in the neonates and continue to be present
throughout life.
 DOLL’S EYE REFLEX:
• When the infant’s head
is slowly turned the
eyes will remain
stationary.
• Disappears within a
week or two of birth.
• Failure of this reflex to
appear indicate a
cerebral lesion.
 AUDITORY ORIENTING REFLEX:
• A sudden loud and unpleasant noise:
May produce a blink reflex
Infant may remain still and show increased alertness.
• Quieter sounds usually cause reflex eye and head
turning to the side of the sound, as if to locate it.
• Seen first at about 4 months of age
• Thereafter head turning towards sound stimuli occurs
and the accuracy of localization increases rapidly by
9-10 months.
 ORAL REFLEXES:
• ROOTING REFLEX:
• This reflex begins when the corner of
the baby's mouth is stroked or touched.
• The baby will turn his/her head and
open his/her mouth to follow and
"root" in the direction of the stroking.
• This helps the baby to begin feeding.
• Onset __ 28 weeks of gestation
• Disappears __ 3-4 months.
 SUCKING REFLEX:
• Rooting helps the baby become ready to
suck. When the roof of the baby's mouth
is touched, the baby will begin to suck.
• This reflex does not begin until about the
32nd week of pregnancy and is not fully
developed until about 36 weeks and
disappears around 12 months.
• Premature babies may have a weak or
immature sucking ability because of this
 GAG RFELEX:
• Seen in 19 weeks of IU life
• Reflex contraction of the back of
the throat.
• Evoked by touching the roof of the
mouth, the back of the tongue and
the area around the tonsils
 CRY RFELEX:
• Non conditioned reflex which
accounts for its lack of its
individual character.
• Sporadic in nature.
• Start as early as 21-29 weeks of
IU life.
 GENERAL BODY REFLEXES:
• MORO REFLEX:
• Begins at 28 weeks of gestation and lasts
about 5-6 months.
• Initiated by any sudden movement of the
neck.
• Elicited by: pulling the baby half way to
sitting position from supine and suddenly
let the head fall back.
• Consists of rapid abduction and extension
of arms with the opening of hands, tensing
of the back muscles, flexion of the legs and
crying. Then within moments the arms
comes together again.
 PALMAR REFLEX:

• Begins at 32 weeks of gestation

• Light touch of the palm produces reflex
flexion of the fingers.
• Most effective way __ slide the stimulating
object such as the finger or pencil, across
the palm from the lateral border.
• Disappears at 3-4 months.
• Replaced by voluntary grasp at 45 months.
 PLANATR REFLEX:
• Placing object or finger beneath toes
causes curling of toes around the
object.
• Present at 32 weeks of gestation.
• Disappears at 9-12 months.
• This reflex is referred to as “readiness
tester”.
• Integrates at the same time that
independent gait first becomes possible
 STEPPING REFLEX:
• When sole of foot is pressed
against couch, baby tries to walk.
• Legs prance up and down as if
baby is walking or dancing.
• Present at birth, disappears at
app. 2-4 months.
• With daily practice of reflex,
infants may walk alone at 10
months.
 LIMB PLACEMENT REFLEX:
• When front of leg below the knee
or arm below the elbow is brought
into contact with the edge of a
table, child lifts the limbs over the
edge.
• Present at birth, fades rapidly at
early months of life.
 WITHDRAWAL REFLEX:
• Protective reflex
• Stimulus: a pin prick or sharp
painful stimulus to sole of foot.
• Response: flexion or withdrawal
of stimulated leg.
• Present at birth, persists
throughout life.
 ASYMMETRIC TONIC NECK REFLEX:
• Also known as fencing posture.
• Most evident at 2-3 months of age.
• Disappears around 4 months.
• When the child's head is turned to the side,
the arm on that side will straighten and the
opposite arm will bend.
• The reflex fades rapidly and is not seen after
6 months of age.
• Most frequently observed abnormality in
infants and greatly disrupts development.
 SYMMETRICAL TONIC NECK REFLEX:
• Extension of the head causes
extension of forelimbs and flexion
of hindlimbs.
• Evident between 2-3 months of
age.
• Not normally easily seen or elicited
in normal infants.
• May be seen in an exaggerated
form in many children with CP.
 BABINSKI’S REFLEX:
• Stimulus consists of a firm painful stroke
along the lateral border of the sole from
heel to toe.
• Response consists of movement (flexion or
extension) of big toe and sometimes
movement (fanning) of other toes.
• Present at birth, disappears at app. 9-10
months.
• Presence of reflex later may indicate
disease.
 BABKIN REFLEX:
• Deep pressure applied simultaneously
to the palms 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, closing of the eyes.
• Fades rapidly and normally not elicited
after 4 months of age.
 PARACHUTE REFLEX:
• Reflex appears at about 6-9 months and
persists thereafter.
• Elicited by holding the child in vertical
suspension and suddenly lowering him
to the couch.
• Arms extend as a defensive mechanism.
• Absent or abnormal in children with CP.
 LANDAU REFLEX:
• Seen in horizontal suspension, with the head, leg and
spine extended.
• If the head is flexed, hip, knees and elbow also flex.
• Appears at app. 3 months, disappears at 12-24 months.
• Absence of reflex occur in hypotonia, hypertonia and
mental abnormality.
 GALLANT’S REFLEX:
• Firm sharp stimulation along sides of the spine with a
fingernail or a pin produces contraction of the underlying
muscles and curving of the back.
• Response is easily seen when the infant is held upright and
the trunk movement is unrestricted.
• Best seen In neonatal period and thereafter gradually fades.
 TONIC LABYRINTHINE REFLEX:
• Labyrinths: most important organs concerned with
development of anti-gravity postures and balance.
• Movement of the head in any dimension stimulates the
labyrinths, and produces appropriate responses.
• Arms and legs extend when the head moves backward and
will curl in when the head moves forward.
• Emerges in utero until approximately 4 months postnatally.
 Conclusion:
• Helps a paedodontist to identify whether the
child is developing normally or not.
• Tells about what abnormalities the child may be
having if all reflexes are not normal.
• Knowledge of development of motor skills __
helps to identify whether development is going
on at a proper rate or not.
THANK
YOU