NNR

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NNR

  1. 1. NEONATAL REFLEXES Dr. Balbirsingh J.L.N.Hospital Research centre, Bhilai Steel Plant
  2. 2. INTRODUCTION Actions in response to specific stimuli that are present in newborn infants. These are unconditioned reflexes and not learned or developed through experience. Normally developing neonates or infants are expected to respond to specific stimuli with a specific, predictable behaviour or action.
  3. 3. MORO’S REFLEXEELICITED BY :PLACING THE BABY IN SEMI UPRIGHT POSITION ↓SUDDEN DROPING OF HEAD IN RELATION TO TRUNK AND CATCHING THE FALLING HEADDISAPPEARS AT 3 TO 6 MTHS
  4. 4. RESPONSE OPENING OF HAND EXTENSION AND ABDUTION OF UPPER EXTRIMITIES ANTERIOR FLEXION OF UPPER EXTRIMITIES AUDIBLE CRY
  5. 5. ABNORMALITIES:DEPRESSED OR ABSENT  GENERALISED DEPRESSION OF CNSASYMMETRICAL RESPONSE  FRACTURE CLAVICLE  ERB PALSY  HEMIPARESISEXAGERGERATED RESPONSE  KERNECTERUS
  6. 6. STARTLE REFLEX It is variant of Moro’s Reflex. Ellicited by: sudden loud noise or by tapping the sternum Response is like Moro’s reflex but elbow remain flexed and hands closed
  7. 7. PALMER GRASP Elicited By: Placing finger or object in open palm of each hand Response: Infant grasp the object and with attempted removal grip reinforced
  8. 8.  Appears at 28 weeks of gestation and disappears at 2-3 months of life Persistence beyond 6mths: Athetoid CP
  9. 9. TONIC NECK REFLEXASYMMETRIC TONIC NECK REFLEX Elicited By: Passive rotation of head in supine position Response: Extension of upper limb of same side and flexion of upper limb of opposite side
  10. 10.  Appears at birth and disappear at 3 months Persistence > 3 months: Spastic CP Importance: Prevents body from rolling
  11. 11. TONIC NECK REFLEXSYMMETRIC TONIC NECK REFLEX  Elicited By: Passive extension of head in prone position  Response: Extension of both UL & flexion of both LL
  12. 12.  Appears in 3 mths and disappear in 6mths Persistence > 6mths : CPImportance: When baby learn to turn to prone position chocking over bed may asphyxiate him so if baby lift his chin by extension of neck both upper limbs extend automatically and chocking avoided.
  13. 13. GALANT REFLEX Elicited By: Holding the child in ventral suspension or placed in prone position and running finger down in paravertebral area on one side Response: Swinging of pelvis towards stimulated side
  14. 14.  Appears at birth disappear by 1 year Used for mapping sensory level of trunk
  15. 15. PEREZ REFLEX Elicited By: Holding the child in prone position and pressure applied upword along spine. Response: Flexion of arms and legs with extension of neck and cry Appear at birth and disappear at 6 weeks
  16. 16. TRACTION RESPONSE Grasp the baby at his wrist and finger and pull to sit Response: Certain degree of head control is demonstrated and head is brought forward actively
  17. 17. ADDUCTION RESPONSE Elicited by: holding leg of baby in extension and sole of foot is rubbed Response: the other leg first withdraw and then extend with fanning of toes and bring toward the side of stimulation (as to push the noxious stimulus)
  18. 18. ROOTING REFLEX (SEARCH REFLEX) Elicited By: Touching the corner of mouth lightly with finger Response: Bottom lip is lowered on same side and tongue moves towards the point of stimulation as finger slides away head turns to find it.
  19. 19. Appear 28 week & disappear 4-7 mthsImportance:  Absence at birth and persistence beyond 7 months indicate developmental delay  Helps the baby for finding the breast
  20. 20. SUCKING REFLEX Elicited By: Introducing finger into babies mouth Response: Baby starts sucking vigorously Appear at 28 week disappear at 4-7 months Absence sucking at birth indicate sickness, persistence beyond 7 mths developmental delay
  21. 21. LANDAU REFLEX Elicited By: Holding the child in ventral suspension Response: Extension of head, spine and legs
  22. 22.  Appear at 3 months disappear at 9 months Absence beyond 3 mths indicate motor weakness, mental sub normality & CP
  23. 23. PARACHUTE REFLEX Elicited By: Holding the child in ventral suspension and suddenly brought down the baby towards ground from height Response: Extension of both UL in attempt to avoid injury
  24. 24.  Appears at 6-9 months persists life long. Absent in CP and hemiplegia of affected limb
  25. 25. PLACING REFLEX Elicited by: Bringing the anterior aspect of tibia against edge of table Response: Lifts leg on the table Appear at birth and disapper at 6 weeks.
  26. 26. WALKING REFLEX Elicited by: holding the baby upright over the table so that sole of foot presses against the table Response: Reciprocal flexion and extension of leg simulating walking Appears at birth and disappear at 6 week
  27. 27. PALMOMENTAL REFLEX Elicited by: Pressing the palm Response: Opening of mouth Appear at birth and disappear at 3 year
  28. 28. CONCLUSIONKnowledge of neonatal reflexes is important for  Understanding the human development as a whole.  Application for over all assessment of baby  Recognition of possible neurodevelopemental damage in prenatal and perinatal period.  Establishment of the prognosis for future  Predicting the Childs future potential
  29. 29. THANKS

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