OB/Peds Practical - Primitive Reflexes

Moro Reflex - procedure

infant supine, hold head in hands. Sudden/controlled head/shoulder drop of 2-3 cm.

Moro reflex - normal

Phase 1: shoulder abduction, elbow/finger extension, trunk/neck extension.

Phase 2: shoulder adduction, elbow flexion (infant ‘embraces’).

ATNR - Procedure

o   infant supine, rotate head 90 degrees to one side, hold briefly, and return.

ATNR - normal

face side UE/LE extension with hand opening, occiput side UE/LE flexion w/ head near mouth.

Asymmetrical Tonic Neck Reflex - abnormal

exaggerated ‘fencer’ posture

Spinal Galant Reflex - Procedure

o   prone, stroke paraspinal line from scapula à iliac crest (avoid midline)

Spinal Galant Reflex - normal

brief ipsilateral trunk lateral flexion/hip hike toward stimulus – organized/symmetrical

Spinal Galant Reflex - abnormal

sustained arching to light touch

Palmar grasp reflex - procedure

supine, head midline. Apply firm & even pressure on palm ulnar side or finger transversely in palm.

Palmar grasp reflex - normal

quick finger flexion/adduction, thumb flexion. Strong grasp can resist light traction

Palmar grasp reflex - abnormal

persistent fisting past 2-3 months, lack of hand opening

Sucking Reflex - procedure

finger/nipple/pacifier gently against infant’s palate or into mouth to stimulate sucking.

Sucking Reflex - normal

rhythmic, coordinated sucking pattern coordinated with swallowing & breathing.

Sucking Reflex - abnormal

Asymmetrical sucking, choking, fatigue

Rooting Reflex - procedure

Infant supported supine, NOT post-feed. Stroke from check à corner of mouth.

Rooting Reflex - normal

turn head to stimulus, open mouth, stick tongue out.

Rooting Reflex - abnormal

does not progress to effective latch/suck.

Vertical suspension - procedure

hold infant upright under axillae and raise baby in air

Vertical suspension - normal

bilateral hip and knee flexion (infant ‘scrunch).

Vertical suspension - abnormal

no scrunch

Parachute reflex - procedure

hold infant prone, support pelvis. Move infant toward firm surface, smooth descent.

Parachute reflex - normal

bilateral shoulder flexion/abduction, elbow/wrist extension, hand open toward surface.

Parachute reflex - abnormal

absent/weak after 8-9 months, asymmetry, exaggerated startle with no reach

Babinski/Plantar Reflex - procedure

supine/sit with foot relaxed. Stroke lateral sole à heel à little toe à ball of foot (J).

Babinski/Plantar Reflex - normal

1^st toe dorsiflexion and fanning of lesser toes.

Babinski/Plantar Reflex - abnormal

persistent extensor/fanning response after 24 months, absent/reduced response.