Primitive Reflexes - MT Flashcards
*Placing
Perform: Hold infant under arms and touch the dorsum of the infant’s foot to the examination table.
Normal: Infant should flex knee and bring foot up onto surface (stimulus on top of foot); disappears 6 mo
Occurs: 0-6 weeks
Abnormal: paresis, hip abnormalities.
*Stepping/Walking
Perform: Hold infant under arms and touches the soles of the infant’s feet onto the table.
Normal: Infant flexes both knees followed by extension of the knees in a mock walk.
Occurs: 0-6 weeks
Abnormal: paresis, hip abnormalities.
*Gallant/Trunk Incurvation
Perform: hold infant in a prone position supported securely under abdomen. examiner strokes one side of para vertebral muscles from occiput to base of sacrum bilaterally
Normal: infant should extend and laterally flex head and trunk to the side of stimulus
Occurs: 0-8 weeks
Abnormal: lower motor neuron lesion if it is still persists past 6 months it may indicate a pathology.
*Note: to help correct, while they sleep or wake up, stimulate the abnormal side.
Moro/Startle Reflex
Perform: hold infant supine and abruptly changes head position of infant 1-2cm.
Normal: initially the infant should symmetrically extend and fully abduct the arms bilaterally concomitant with extension if the trunk and flexion of the knees and hips, then followed by an embrace response.
Occurs: 0-4 months
Abnormal: hemi paresis of upper or lower extremity is asymmetrical response is produced. brachial plexus injury, spinal cord injury.
Rooting reflex
Perform: firmly strokes above the ramus at the mandible towards the mouth bilaterally
Normal: infant moves towards side of stimulus
Occurs: 0-4 months while awake. 0-7 months while asleep
Abnormal: CN V or CN VII lesion or general CNS disorder
NOTE: baby might not do the reflex if he recently ate.
NOTE: if atlas is out on the RT, then baby can rotate to the RT easily but harder on the left. Baby will have a hard time turning to the left for feeding on right breast.
Sucking Reflex
Perform: insert clean finger in infant mouth and lightly stroke the hard pallet
Normal: infant starts to suckle
Occurs: 0-4 months
Abnormal: General CNS disorder
Check: Hard palate shape and TMJ function
Shallow: Baby spits up
High: gas
Asymmetrical: Sphenoid
Vertical Suspension
Perform: supports the upright infant around the torso. Then raises t he infant suddenly upwards
Normal: the infant should bilaterally flex his hips and knees
Occurs: 0-6 months
Abnormal: hip joint abnormalities or spastic paraplegia
pick baby up, then raise him up quickly. the baby’s legs should do like a canonball
Palmar Grasp Reflex
Perform: places finger on the infant’s palm/ball of foot
Normal: infant grasps examiner’s finger
Occurs: 0-6 months
Abnormal: cerebral dysfunction. persistent fist/clenched toes. presentation during walking hours after 2 months of age may suggest CN5 disorder like CP
Blink/Dazzle Reflex
Perform: shine pen light into infant’s eyes
Normal: infant blinks
Occurs: 0-1 year
Abnormal: blindness or decreased visual acuity
Acoustic Blink Reflex
Perform: make a loud noise away from infant’s visual gaze
Normal: infant should blink eyes
Occurs: 0-gradually disappears
Abnormal: decreased or total hearing loss. facial paralysis
Asymmetrical tonic neck reflex
Perform:
Normal: infant takes on a fencing type posture. the infant should extend the upper and lower extremity on the side of head rotation and flex the upper and lower extremity on the contralateral side.
Occurs: 2 weeks - 6 months
Abnormal: a persistent ATNR is abnormal and may indicate ipsilateral hemi paresis or CNS damage.
Landau
Perform: hold baby under belly the back arches
Normal: neck extends and back arches while extremities extend. when the head is passively flexed the child will flex hips and torso
Occurs: 2 weeks - 2 years
Abnormal: present after 2 years may indicate poor motor development.
Note: important for cervical curve. trying to see if they attempt to lift head early. at 2 years they should look up.
Neck righting
Perform: infant face up, examiner rotates the infant’s head to one side.
Normal: infant should rotate trunk to the side of head rotation
Occurs: 0-10 months
Abnormal: cerebral damage
*you turn the baby’s head and the body should try to rotate that direction.
parachute reflex
Perform: with infant suspended in prone position, examiner quickly changes head positioning of infant mimicking a fall.
Normal: infant should extend arms down as to brace the fall
Occurs: 6 months - 1 year
Abnormal: assess upper extremity function and asymmetry may indicate paresis
Note: 1 year the child should immedately try to protect themselves from fall. 6 months the child should make an attempt to.
babinski reflex
Perform: stroke plantar surface of the foot from the heel towards the toes but not across the ball of the foot
gentle on lateral aspect of foot.
Normal: extension and fanning of the toes with flexor response of the first toe.
Occurs: 0-1 year
Abnormal: possible cns dysfunction
