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PHYSIOLOGY OF NEWBORN :

NEUROMUSCULAR SYSTEM
REFLEX

ELICITING THE
REFLEX
Touch infants
lips,cheeks or
corner of mouth
with nipple

CHARACTERISTICS COMMENTS

Swallowing reflex

Feed infant
swallowing usually
follows sucking
and obtaining fluids

Grasp, palmer,
planter reflex

Place finger in
palm of hand. Place
fingers at base of
toes
Hold infant
vertically allowing
one foot to touch
table surface

Swallowing is usually
coordinated with
sucking and occurs
without gagging,
coughing or vomiting
Infants fingers curl
around examiners
fingers ,toes curve
downward
Infant stimulates
alternating flexion and
extension of feet.
Term infant walk on
soles of their feet.
Preterm infants walk
on flair toes
Newborn makes
crawling movements
with arms and legs
Reflex jerk is present
even with newborn
relaxed .nonselective
overall reaction may
occur.
Newborn forces
tongue outward

Sucking reflex &


Rooting reflex

Stepping or
walking reflex

Crawling

Place newborn on
abdomen

Deep tendon reflex

Use fingers elicit


patellar or knee
jerk reflex newborn
must be relaxed

Extrusion reflex

Touch or depress
tip of tongue

Glabellar reflex

Tap over
foreheadbridge of
nose or maxilla of
newborn whose
eyes are open

Infants turn head


towards stimukus
opens mouth takes
hold and sucks

Newborn blinks for 4


or 5 taps

Poor respone indicates


prematurity or neurologic
defect response.
Disappears after 3-4
months but persists upto 1
year
Weak response indicates
prematurity or
neurological defect
Palmer reflex lessend by
3-4months.plantar by 8
months
Response is normally
present 3 - 4 weeks

Response should
disappear at 6 weeks

Reflex disaapears at 4
months
Continuous blinking with
repeated taps indicate
extrainframidal disorder

Tonic neck reflex

Moro reflex

Startle reflex

Trunk incurvation
reflex

Magnet reflex

Crossed extension

Babinski reflex

With infant falling


as asleep or
sleeping turn
quickly to one side
Holdf infant in
sitting position
allow head and
trunk to fall
backward to an
angle of 30 degree
Perform sharp hand
.clap best elicited if
newborn is 2436hrs old
Place infant prone
on flat surface
down about 4-5cm
to lateral to supine
first onne side and
then down on other
side
Place infant in
supine position
partially flex both
lower extremities
and apply
pressureon soles of
feet
Infant should be
supine extend one
leg press knee
downward
stimulate bottom of
foot observe
opposite legs

Infant facing left side


arm & leg on that side
extends opposite arm
and leg reflex
Symmetric abduction
and extension of arms
are seen. Fingers fan
out.

Complete response
disappears by 3-4
months . incomplete
response until 3 0r 4 years
Response absent by 6
months or present
response indicates brain
damage

Arms abduct with


flexion or elbows
,hands stay clenched

Response should
disappear by 4 months

Trunk is flexed and


pelvis swings towards
stimulated side

Disappears by 4th week

Both lower limbs


must extend against
examiners pressure

Absence indicates spinal


cord damage or
malformation

Opposite leg reflexes


adducts and then
extend

Absence indicates spinal


cord lesion. Wsuggest
peripheral nerve damage

One sole beginning


at heel stroke
upward along
lateral aspect of
sole then move
finger across ball of
foot

All toes hyperextend


with dorsiflexion of
big toes recorded as
positive sign

Disappears after 1 year