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Neuromuscular III: Cerebellar Dysfunction > Cerebellum > Flashcards

Flashcards in Cerebellum Deck (29)
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1

Functions

Initiation and control of voluntary movement
Timing of movement/muscle actions
Moment-to-moment error correction
Compensating or cerebral cortex lesion
Motor learning and adaptive adjustments

2

SCA damage:

Dysmetria of ipsilateral UE movement
Unsteadiness w/ walking
Dysarthric speech
Nystagmus

3

PICA damage:

Vertigo
Unsteadiness
Walking ataxia
Nystagmus

4

AICA damage:

Dysmetria
Vestibular signs
Facial sensory loss

*gait usually okay*

5

Biggest predictor of recovery:

Amount of cerebellar nuclei involvement

6

Function of cerebellar nuclei:

Relay station for information

7

Medial zone - comprised of:

Mid-line structures
Vermis
Fastigial nuclei

8

Medial zone - functions:

Postural control and muscle tone
Upright stance
Locomotion
Gaze and other eye movements

9

Vermis - function:

Postural control ==> central cerebellar problems

10

What are central cerebellar problems?

Initiation/timing
Using feedback to help with accuracy
NOT strength

11

Intermediate zone - comprised of:

Intermediate hemispheres
Globose
Emboliform nuclei

12

Intermediate zone - functions:

Controlling coordination of agonist-antagonist muscle pairs during walking and voluntary limb movements (for accuracy of movement)

13

Lateral zone - comprised of:

2 broad lateral hemispheres
Output structures
Dentate nuclei

14

Lateral zone - functions:

Control of complex, multi-joint, voluntary limb movements (esp for vision)
Planning of complex movement
Assessment of movement errors

15

Will damage to the lateral zone see improvement back to baseline?

No

16

Lateral zone - deficits:

Strength 2/2 communication with cortex but because of lack of timing and planning - strength can improve

17

Flocculonodular lobe - function:

Control of eye movement (VOR - vestib)
Balance

18

Vestibulocerebellum...

Flocculonodular lobe

19

Spinocerebellum...

Medial and intermediate zones

20

Cerebrocerebellum...

Lateral zone

21

Damage to vestibulocerebellum...

Balance deficits:
Increase postural sway
Oscillations of head and trunk
Unsteady gait

Nystagmus

22

Will vestib problems w/ damage to vestibulocerebellum respond to vestib tx'ment?

Will NOT respond to maneuvers bc are CENTRAL problem, not BPPV or UVH

Need VOR interventions

23

Damage to spinocerebellum...

Loss of "updating" afferent information (difficulty adapting)
Inappropriate amplitude of muscle force (poor recruitment)
Inappropriate timing of muscle onsets
Abnormalities of balance w/ absence or decreased preparatory postural adjustments
Difficulty jumping/hopping

24

Challenges with damage to spinocerebellum...

RAMs/coordination tasks
Complex motor activities

25

Damage to cerebrocerebellum...

Movement incoordination
Problems w/ movement preparation
Delays w/ movement initiation
Difficulty w/ timing movements
Terminal tremors
Impaired temporal coordination of multi-joint movements and spatial coordination

26

What modifies function of the cerebellum and cerebellar circuitry?

Experience - increase in # of effective preferred synaptic paths

27

Signs of cerebellar dysfunction:

Dysmetria
Dyssynergia
Dysdiadochokinesia
Decomposition
Lack of check
Cerebellar tremor (action)
Postural tremor
Kinetic tremor (intention)
Imbalance
Hypotonia
Ataxia
Oculomotor deficits (saccades slowed and dysmetric, impaired or absent VOR, nystagmus at ER vertical/lateral gaze)
Ataxic dysarthria
Impaired motor learning

28

Muscle tone with cerebellar damage...

Hypotonic

29

Why is tone the way it is?

Decreased excitatory drive to vestibulospinal and reticulospinal pathways
Decreased extensor tone to hold body upright against gravity