Primitive reflex

Question 1

Primitive reflexes

Answer 1

1. Rooting reflex
   • Present at birth –> stimulate lip –> tongue moves to stimulus –> finger slides away –> head follows it
   • Only easily elicited when baby is hungry
2. Sucking reflex
3. Eye- Response to rotation
   • when bb is propped up & spinned around 2-3 times –> eyeballs move in the direction of rotation –> Stopped spinning, eyes move in the opposite direction. Good to detect extra-ocular eye movement palsy
4. Grasp reflex
   • At palm and sole
   • 36 weeks –> 3 months
   • Abnormal –> CP
5. Moro Reflex
   • 28 weeks –> 3 months
   • Abnormal –> Hypertonus / Hypotonia / paralysis (eg Erbs)
   • DDx - Startle reflex: Flexion of elbow forwards, grasping of fingers (Elicited by sudden loud noise / sternal tap)
   • Elicited by sudden movement of cervical spine (sudden extension of neck)
   • • Abduction extension of arms - hands open, fingers curve
   • • Adduction of arms (Embrace) - accompanied by crying, extension of trunk & movement of LLs
6. Asymmetrical Tonic Neck Reflex
   • 1 month –> 3 months
   • Abnormal –> CP
7. Walking reflex
   • 40 weeks –> 2 months
   • Abnormal in CP / paralysis of LLs
   • Test - place bb on the table with sole pressed against the surface – repeated flexion / extension of LLs
8. Placing reflex
   • 4th day –> 7 months
   • Significance = walking reflex
   • Text : Place the baby at the side of table with shin/ dorsum against the table edge –> leg raised & step onto table
9. Galant reflex
   • Day 5 –> 7 months
   • Abnormal in Hemisyndromes
10. Anal reflex
    • S3, S4
    • Present since birth - reflects sacral cord integrity
11. Cremasteric reflex
    • L1, L2
    • Present since day 10 - reflects sacral cord integrity
12. Abdominal reflex
    • T7 to T12
    • Present since 7 days old
    • Absence may not mean spinal cord abnormal
    • Only +ve –> Intact thoracic spinal cord
13. Righting reflex
    • test: sole press on hard surface –> extension of leg and trunk
14. Crossed extension reflex
    • Test: Extension of 1 leg –> flexion of the opposite leg, followed adduction and then extension
15. Parachute reflex
    • Present from 6 - 9 months
    • test: ventral suspension of baby –> sudden lowering of bb towards the couch –> arms extended - Abnormal in CP
    c.f. Propping reflex - child sits –> tilted to one side / back –> arms extend in appropriate manner to protect child from falling
16. Landau reflex
    • Present since 3 months, after 1 year - difficult to elicit
    • Test: Ventral suspension of bb –> extension of head, UL and LL. Depressed head –> flexion of hip, knew and elbow
    • Absent in
17. MR
18. CP
19. Hypotonia