CEREBLLAR DYSFUNCTION

Question 1

The _________, located inferiorly,
which is phylogenetically the oldest portion of the
cerebellum and is much the same in all animals (hence
archicerebellum) .

It is separated from the main mass of
the cerebellum, or corpus cerebelli, by the__________

Answer 1

flocculonodular lobe

posterolateral fissure.

Question 2

The anterior lobe, or paleocerebellum, which

is the portion rostral to the_____

Answer 2

primary fissure

Question 3

The ____________,
consisting of the middle divisions of the vermis and
their large lateral extensions

Answer 3

posterior lobe, or neocerebellum

Question 4

The
flocculonodular lobe receives special proprioceptive
impulses from the_________i and is therefore
also referred to as the vestibulocerebellum;

Answer 4

vestibular nucle

Question 5

The anterior vermis
and part of the posterior vermis are referred to as
the _________ since projections to these parts
derive to a large extent from the proprioceptors of
muscles and tendons in the limbs and are conveyed to
the cerebellum in the dorsal spinocerebellar tract (from
the lower limbs) and the ventral spinocerebellar tract
(upper limbs) .

Answer 5

spinocerebellum,

Question 6

The main influence of the spinocerebellum

appears to be on______ and _____

Answer 6

posture and muscle tone

Question 7

The neocerebellum derives its afferent fibers indirectly from the cerebral cortex via the pontine nuclei and brachium pontis, hence the designation ________

Answer 7

pontocerebellum.

Question 8

Lesions of the nodulus and flocculus

have been associated with a disturbance of ______

Answer 8

equilibrium

and frequently with nystagmus

Question 9

The ________, which receives both peripheral and central projections (from motor cortex), influences postural tone and also individual movements of the ipsilateral limbs.

The lateral zone is concerned mainly with _______ but is also involved
in other functions.

Answer 9

intermediate
zone

coordination
of movements of the ipsilateral limbs

Question 10

The projections from Purkinje cells are ______ whereas those from the nuclei are excitatory on other parts of the motor nervous system.

Answer 10

inhibitory

Question 11

The deep cerebellar nuclei, in turn, project to the
cerebral cortex and certain brainstem nuclei via two
main pathways:

fibers from the dentate, emboliform,
and globose nuclei form the _______
enter the upper pontine tegmentum as the brachium
conjunctivum, decussate at the level of the inferior colliculus, and ascend to the __________ of the
thalamus and, to a lesser extent, to the intralaminar
thalamic nuclei

Some of the ascending fibers,
soon after their decussation, synapse in the _____
but most of them traverse this nucleus without terminating, and pass on to the thalamus

Answer 11

superior cerebellar peduncle,

ventrolateral nucleus

red nucleus,

Question 12

A
small group of fibers of the superior cerebellar peduncle,
following their decussation, descend in the ventromedial
tegmentum of the brainstem via the central
tegmental fasciculus and terminate in the reticulotegmental
and paramedian reticular nuclei of the pons and
inferior olivary nuclei of the medulla.

Answer 12

Guillain-Mollaret triangle

Question 13

The _________sends fibers to the vestibular

nuclei of both sides and, to a lesser extent, to other nuclei of the reticular formation of the pons and medulla

Answer 13

fastigial nucleus

Question 14

The _______ project via the restiform body (inferior cerebellar
peduncle) to the contralateral cerebellar cortex and corresponding
parts of the deep cerebellar nuclei.

Answer 14

inferior olivary

nuclei

Question 15

The
dentate nucleus receives information from the premotor
and supplementary motor cortices via the pontocerebellar system and helps to initiate _________

Answer 15

volitional movements

Question 16

The _______ also receives
cerebrocortical projections via the pontocerebellar system;
in addition, it receives spinocerebellar projections
via the intermediate zone of the cerebellar cortex

Answer 16

interpositus nucleus

Question 17

Also, the _________ appears to be
responsible for making volitional oscillations (alternating
movements) .

Answer 17

prepositus nucleus

Question 18

The _________controls antigravity and
other muscle synergies in standing and walking; ablation
of this nucleus greatly impairs these motor activities

Answer 18

fastigial nucleus

Question 19

The cerebellar cortex is configured as a stereotyped

________containing______types of neurons

Answer 19

three-layered structure

five

Question 20

The outermost “molecular” layer of the cerebellum
contains two types of inhibitory neurons, the _____
and the ________

Answer 20

stellate cells

basket cells

Question 21

The _______ constitute
the main output of the cerebellum, which is directed at
the deep cerebellar and vestibular nuclei

Purkinje cells are likewise entirely inhibitory and utilize
the neurotransmitter _______

Answer 21

Purkinje cell axons

gamma-aminobutyric acid (GABA)

Question 22

The innermost “granular” layer contains an enormous
number of densely packed ______ and a few larger
________

Answer 22

granule cells

Golgi interneurons

Question 23

The predominant afferent input to the cerebellum is
via the_________which are the axons of the ___________ and the projections from pontine, vestibular,
and reticular nuclei

Answer 23

mossy fibers,

spinocerebellar
tracts

Question 24

Mossy fibers ramify in
the granule layer and excite Golgi and granule neurons
through special synapses termed ________

Answer 24

cerebellar glomeruli.

Question 25

The other main afferent input is via the_______
which originate in the inferior olivary nuclei (olives) and
communicate somatosensory, visual, and cerebral cortical
signals

Answer 25

climbing fibers,

Question 26

The climbing fibers have specific excitatory

effects on Purkinje cells that result in prolonged ________

Answer 26

“complex spike” depolarizations

Question 27

Four of the five cell types of the cerebellar cortex

(Purkinje, stellate, basket, Golgi) are ________

Answer 27

inhibitory

Question 28

Afferent fibers
to the cerebellum are of three types, two of which have
been mentioned above: (1) ________, which are the
main afferent input to the cerebellum, utilize aspartate.
(2) _______, which are the axons of cells in the
inferior olivary nucleus and project to the Purkinje cells of
the opposite cerebellar hemisphere.

3) _______, which project through the superior cerebellar peduncle and terminate on
the Purkinje and granule cells in all parts of the cerebellar
cortex.

Answer 28

Mossy fibers

Climbing fibers

Aminergic fibers

Question 29

The__________ elaborate the excitatory
transmitter glutamate.

All the inhibitory cerebellar cortical
neurons appear to utilize ______

Answer 29

granule cell axons

GABA.

Question 30

the fragmentation of a smooth movement into

a series of irregular, jerky components

Answer 30

decomposition

Question 31

with cerebellar lesions, there is a _________ between the commanded act and the onset of movement

Answer 31

prolongation of the interval

Question 32

Extensive lesions of one cerebellar hemisphere,
especially of the ________, cause mild hypotonia,
postural abnormalities, ataxia, and a mild weakness
of the ipsilateral arm and leg perceived by the patient

Answer 32

anterior lobe

Question 33

Lesions
involving the superior cerebellar peduncle or the dentate
nucleus cause the most severe and enduring cerebellar
symptoms, which manifest mostly as ________

Answer 33

ataxia in the

ipsilateral limbs.

Question 34

Damage in the _______ causes
vestibulocerebellar symptoms-namely, dizziness, vertigo,
vomiting, and nystagmus-in varying proportions

Answer 34

inferior cerebellum

Question 35

With
cerebellar disease, the _________ of the movement
are not checked in the normal manner.

Answer 35

velocity and force

Question 36

This side-toside movement of the finger as it approaches its mark tends to assume a rhythmic quality; it has traditionally
been referred to as i___________

Answer 36

intention tremor, or ataxic tremor

Question 37

Holmes called it rubral tremor, and although the
______ may be the site of the lesion, the nucleus itself
is not necessarily involved in this type of tremor.

Instead, it is a result of interruption of the fibers of the superior cerebellar peduncle, which traverse the nucleus, for which reason it may be more properly called _______

Answer 37

red nucleus

“cerebellar outflow
tremor.”

Question 38

Smooth pursuit
movements are slower than normal and require that the
patient make small _________ in an attempt
to keep the moving target near the fovea

Answer 38

“catch-up” saccades

Question 39

nystagmus
caused by cerebellar disease depends on lesions of
the _______

Answer 39

vestibulocerebellum

Question 40

disequilibrium
syndrome, with normal movements of the limbs,
corresponds more closely with lesions of the ________than with those of the flocculus and nodulus

Answer 40

anterior

vermis

Question 41

acute cerebellar lesions and hypotonia

are associated with a depression of _________

Answer 41

fusimotor efferent

and spindle afferent activity

Question 42

after strongly flexing one arm against a
resistance that is suddenly released, the patient may be
unable to check the flexion movement, to the point where
the arm may strike the face

Answer 42

Holmes’ rebound phenomenon,

Question 43

________i.e., brief (50- to 100-ms),
random contractions of muscles or groups of musclesare,
in some disease processes, combined with cerebellar
ataxia

Answer 43

Myoclonic movements-

Question 44

Cognitive changes show a wide range of subtle _________ in patients with disease apparently limited to the cerebellum

Answer 44

alterations of

memory and cognition, language function, and behavior

Question 45

Th e ataxia of severe sensory neuropathy and o f posterior column or posterior spinal root disease (sensory
ataxia) simulates cerebellar ataxia; presumably this is a
result of involvement of the _______

_________ and _______
are prime examples of this type of disorder

Answer 45

large peripheral spinocerebellar
afferent fibers

Tabes dorsalis and sensory ganglionopathy

Question 46

A cerebellar type of tremor
reaches an extreme form in the large-fiber polyneuropathy
related to antibodies against _________
but the features are closer to an enhanced action
tremor,

Answer 46

myelin-associated glycoprotein