PRIMITIVE AND TONIC
REFLEX
These reflex are normaly
present during infancy and
become integrated by the CNS
at an early stage.
These reflex are not g...
Patients who exhibit these reflexes
typically present with extensive
brain damage and either UMN sign.
Reflexes important ...
A reflex scouring key from is:• 0+ve
absent.
• 1+ve
tone
change, slight,
transient with no movement of
the extremities.
• ...
• 3+ve
exaggerated, full
movement of extremities.
• 4+ve
obligatory and sustained
movement raising for more than 30
sec.
Primitive/spinal reflexes
•
•
•
•

Name- Flexor withdrawal
Onset-2-3wks gestation
Integrated- 1-2months
Stimulus- noxious ...
Name- cross extension
Onset-28 wks gestation
Integrated- 1-2months
Stimulus- noxious
stimulus to ball of foot of
lower ext...
Name- Traction
Onset-28wks of
gestation
Integrated- 2-5 months
Stimulus- Grasp
forearm and pull up
from supine into sittin...
Name- Moro
Onset- 28 wks of gestation
Integrated- 5-6 months
Stimulus- head drag method
used. Baby held in supine
with sup...
Name- Startle
Onset- birth
Integrated- persist
Stimulus- sudden loud or
harsh noise.
Response- sudden
extension or abducti...
NameGrasp(planter/palmer)
Onset- palmer birth
Integrated- palmer 4-6
months
planter 9 months
Stimulus- Maintain pressure
t...
Name- STNR
OnsetIntegrated- 4-6 month
Stimulus- Flexion or extension
of head.
Response - With head flex
, flexion of upper...
Name- symetrical tonic baby
ri TLR or STLR
Onset- birth
Integrated- 6 month
Stimulus- Prone or supine
position
Response- W...
Name- Positive supporting
Onset- birth
Integrated- 6 month
Stimulus- contact to the ball of the feet
in upright standing p...
Name - Associated reactions
Onset - birth/ 3months
Integrated - 8-9 yrs
Stimulus - Resisted voluntary
movement in any part...
Name – Asymmetrical tonic neck(ATNR)
Onset - birth
Integrated – 4-6 months
Stimulus – Rotation of the head on one
side.
Re...
Name – Neck righting action of the
body(NOB)
Onset – 4-6 months
Integrated – 5 years
Stimulus – Passively turn head to one...
Name – Body righting acting on
head(BOH)
Onset – birth-2 months
Integrated – 5 years
Stimulus – Place in prone or supine
p...
Name – Protective extension(PE)
Onset – arms, 4-6 months; legs , 6-9
months.
Integrated – persists
Stimulus – Displace cen...
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Primitive and tonic reflex

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Primitive and tonic reflex

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Primitive and tonic reflex

  1. 1. PRIMITIVE AND TONIC REFLEX
  2. 2. These reflex are normaly present during infancy and become integrated by the CNS at an early stage. These reflex are not generally present in adults .
  3. 3. Patients who exhibit these reflexes typically present with extensive brain damage and either UMN sign. Reflexes important to examine in the patients suspected of abnormal reflex activity include flexor withdrawal
  4. 4. A reflex scouring key from is:• 0+ve absent. • 1+ve tone change, slight, transient with no movement of the extremities. • 2+ve visible movements of extremities.
  5. 5. • 3+ve exaggerated, full movement of extremities. • 4+ve obligatory and sustained movement raising for more than 30 sec.
  6. 6. Primitive/spinal reflexes • • • • Name- Flexor withdrawal Onset-2-3wks gestation Integrated- 1-2months Stimulus- noxious stimulus(pin prick) to sole of foot. • Response-Toes extended, foot DF, entire lower extremity flexes.
  7. 7. Name- cross extension Onset-28 wks gestation Integrated- 1-2months Stimulus- noxious stimulus to ball of foot of lower extremity fixed in extension. Response- opposite lower extremity flexes then adduction and extends.
  8. 8. Name- Traction Onset-28wks of gestation Integrated- 2-5 months Stimulus- Grasp forearm and pull up from supine into sitting position. Response-grasps and total flexion of upper extremity.
  9. 9. Name- Moro Onset- 28 wks of gestation Integrated- 5-6 months Stimulus- head drag method used. Baby held in supine with supported behind the chest and head then head is allowed to drop 10degree Response- elbow extended shoulder abducted , upper limb- hand opening and crying followed by flexion , adduction of arms across chest.
  10. 10. Name- Startle Onset- birth Integrated- persist Stimulus- sudden loud or harsh noise. Response- sudden extension or abduction of upper extremity , crying.
  11. 11. NameGrasp(planter/palmer) Onset- palmer birth Integrated- palmer 4-6 months planter 9 months Stimulus- Maintain pressure to palm of hand(palmer grasp) or to ball of foot under toes (planter grasp). Response- Maintain flexion of fingers of hands or toes.
  12. 12. Name- STNR OnsetIntegrated- 4-6 month Stimulus- Flexion or extension of head. Response - With head flex , flexion of upper extremity , extension of lower extremity - with head extension , extension of upper extremity and flexion of lower extremity
  13. 13. Name- symetrical tonic baby ri TLR or STLR Onset- birth Integrated- 6 month Stimulus- Prone or supine position Response- With prone it increases flexor tone/Flexion of all limbs with supine and increase extensor tone / extension of all limbs
  14. 14. Name- Positive supporting Onset- birth Integrated- 6 month Stimulus- contact to the ball of the feet in upright standing position. Response- Rigid extension , coactions of the lower extremity.
  15. 15. Name - Associated reactions Onset - birth/ 3months Integrated - 8-9 yrs Stimulus - Resisted voluntary movement in any part of body. Response - Involuntary movements in a resting extremity.
  16. 16. Name – Asymmetrical tonic neck(ATNR) Onset - birth Integrated – 4-6 months Stimulus – Rotation of the head on one side. Response – Flexion of skull limbs extension of the jaw limbs “bow and arrow ” or “fencing” posture.
  17. 17. Name – Neck righting action of the body(NOB) Onset – 4-6 months Integrated – 5 years Stimulus – Passively turn head to one side, tested in supine Response – Body rotates as a whole to align the body with the head.
  18. 18. Name – Body righting acting on head(BOH) Onset – birth-2 months Integrated – 5 years Stimulus – Place in prone or supine position. Response – Head orients to vertical position with mouth horizontal.
  19. 19. Name – Protective extension(PE) Onset – arms, 4-6 months; legs , 6-9 months. Integrated – persists Stimulus – Displace center of gravity outside the base of support Response – Arms or legs extend and abduct to support and to protect the body against falling
  20. 20. THANK Uuuuu………
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