1.
PRIMITIVE AND TONIC
REFLEX

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.
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.
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.
• 3+ve
exaggerated, full
movement of extremities.
• 4+ve
obligatory and sustained
movement raising for more than 30
sec.

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.
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.
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.
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.
Name- Startle
Onset- birth
Integrated- persist
Stimulus- sudden loud or
harsh noise.
Response- sudden
extension or abduction of
upper extremity , crying.

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.
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.
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.
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.
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.
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.
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.
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.
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.
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