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cerebellum Flashcards

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1
Q

where does the cerebellum lie?

A

in the posterior cranial fossa

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2
Q

what can be seen on the cerebellum surface from above?

A

narrow medio-lateral gyri

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3
Q

what is the vermis?

A

the part that lies in the midline

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4
Q

what separates the anterior and posterior lobes of the vermis?

A

primary fissure

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5
Q

what is the flocculus?

A

small 3rd lobe, part of flocculo-nodular lobe

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6
Q

what is the nodulus?

A

(not part of the vermis) part of the roof of the 4th ventricle. Ventral surface of the cerebellum

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7
Q

what are the main arteries supplying the cerebellum?

A
  • Superior cerebellar artery
  • Anterior inferior cerebellar artery
  • Posterior inferior cerebellar artery
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8
Q

what is the most common site of an infarct in the posterior circulation?

A

posterior inferior cerebellar artery

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9
Q

what are the 3 layers in the cerebellar cortex? what are each made of?

A

outer molecular layer - pale w mostly axons and only a few cells

middle layer - single row of Purkinje cells

inner layer (granule layer) - thick and vast no of granule cells

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10
Q

what are the cerebellar peduncle and what are the inputs and outputs to them?

A
  • Superior cerebellar peduncle: output fibres only
  • Middle cerebellar peduncle (biggest): input fibers from (contralateral) cerebral cortex and cranial nerves
  • Inferior cerebellar peduncle: input fibres from the spinal cord
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11
Q

does the cortex work contralaterally or ipsilaterally?

A

contralaterally

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12
Q

does the cerebellum work contralaterally or ipsilaterally?

A

ipsilaterally

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13
Q

where is the dorsal spinocerebellar tract found?

A

lateral funiculus

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14
Q

describe the pathway of the dorsal spinocerebellar tract?

A
  • receives proprioceptive afferents (muscle spindles and Golgi tendon organs)
  • enter dorsal horn and synapse at its base
  • travels ipsilaterally to the ipsilateral cerebellum
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15
Q

what is the most ventral lamina found in the dorsal horn?

A

lamina 7

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16
Q

is the dorsal spinocerebellar tract ipsilateral or contralateral?

A

ipsilateral

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17
Q

is the ventral spinocerebellar tract ipsilateral or contralateral?

A

contralateral

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18
Q

describe the pathway of the ventral spinocerebellar tract

A
  • Contralateral in the spinal cord but then recrosses in the brain stem to en dup on the same side it entered the cord  info from body is passed to same side cerebellum
  • VSCT also has cell bodies in lamina 7 but its contralateral to the afferents
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19
Q

what info does the ventral spinocerebellar tract carry?

A

info about the state of reflexes in the spinal cord

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20
Q

what do all inputs and outputs to the cerebellar cortex go through?

A

deep cerebellar nuclei

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21
Q

where are the deep cerebellar nuclei found?

A

in the white matter below the cortex

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22
Q

what are the deep cerebellar nuclei from medial to lateral?

A

o Fastigial
o Globose
o Emboliform
o Dentate

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23
Q

what deep cerebellar nuclei are the hemispheres connected to?

A

dentate nuclei

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24
Q

what deep cerebellar nuclei is the anterior lobe connected to?

A

globose and emboliform (interposed) nuclei

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25
what deep cerebellar nuclei is the vermis connected to?
fastigial
26
what deep cerebellar nuclei is the flocculo-nodular lobe connected to?
lateral vestibular nuclei of the pons
27
what is the role of the cerebellum in movement?
* Doesn’t initiate movement * Modulates and refines motor cortex commands using feedback from proprioceptors and other sensory organs --> produces smooth and accurate movements
28
what does cerebellar damage cause?
overall clumsiness, abnormal fatigue and movement instability o Extraocular eye movements are particularly affected
29
why is partial recovery of function possible after cerebellar damage?
neuronal plasticity in the cortex
30
what does damage to the deep cerebellar nuclei cause?
persistent disability
31
what are the 3 functional zones in the cerebellum?
1 - vestibulocerebellum 2 - spinocerebellum 3 - cerebrocerebellum
32
what is the vestibulocerebellum?
flocculonodular lobe connected to lateral vestibular nucleus (in pons)
33
what is the spinocerebellum?
anterior lobe + vermis connected to fastigial, globose and emboliform nuclei
34
what is the cerebrocerebellum?
posterior lobe (cerebellar hemisphere) connected to dentate nucleus
35
what is the function of the vestibulocerebellum?
- coordinates head and eye movements to ensure stability of gaze - controls balance of the head on the body - controls balance of the body on the ground
36
what information does the vestibular nuclei receive?
o Info about head movement from vestibular apparatus and neck muscles o Info from extra-ocular eye muscles
37
where are the vestibular nuclei found?
pons and medulla
38
what do motor commands to the neck and eye muscles travel via?
medial longitudinal fasciculus and medial vestibulospinal tract
39
what do motor commands to the legs travel via?
lateral vestibulospinal tract
40
where are motor programs from the vestibular nuclei stored?
flocculo-nodular lobe cortex
41
what is the function of the spinocerebellum?
* Controls locomotion and limb coordination | * Sends motor commands down the reticulospinal tracts to co-ordinate postural and locomotor movements
42
what is the function of the cerebrocerebellum?
Co-ordinates movements initiated by the motor cortex. Includes speech, voluntary movements of hands and arms, and hand-eye co-ordination
43
what are the parts of the neocerebellum?
* Cortex: cerebellar hemispheres * Deep Nuclei: dentate * Input: From cerebral cortex via middle cerebral peduncle * Output: To motor (VL) thalamus via superior cerebral penduncle
44
what are flocculonodular syndromes characterised by?
poor balance and disordered eye movements
45
what are common symptoms of flocculonodular syndromes?
1. Little control of axial muscles 2. Wide-based ‘ataxic’ gait, reeling and swaying 3. Tendency to fall to side of lesion 4. Nystagmus 5. Severe cases cannot sit or stand without falling
46
who is flocculonodular syndromes most commonly seen in?
in young children with medulloblastoma in 4th ventricle
47
what is the most common malignant CNS tumour in kids?
medulloblastoma
48
where do medulloblastomas originate?
wall of the 4th ventricle
49
what type of tumour is a medulloblastoma?
A type of primitive neuroectodermal tumour – NOT a glioma
50
what damage is anterior lobe syndrome related to?
damage to the spinocerebellum
51
what is anterior lobe syndrome characterised by?
incoordination of the limbs
52
what are the main symptoms of anterior lobe syndrome?
* Ataxia: ataxic gait (overlaps with flocculonodular syndrome) * Hypotonia: generalised muscle weakness and fatigue, * Reflexes may be depressed or pendular (upper motor neurone lesions)
53
who is anterior lobe syndrome seen in?
seen in alcoholics bc of malnutrition and lack of B vitamins
54
what are symptoms of neocerebellar syndrome?
- loss of hand-eye coordination - dysmetria - dysdiadochokinesis - intention tremors - Loss of good speech articulation (slurred speech) due to loss of co-ordination of muscles involved in speech production. • Loss of cognitive eye movement • Deficits in selective attention& perception due to ‘eye movement programs” failure
55
define dysmetria
inaccurate reaching with intention tremor
56
define dysdiadochokinesis
irregular performance of rapid alternating hand movements
57
what is the classic test for anterior lobe cerebellar dysfunction?
The finger-to-nose and heel-to-knee tests
58
what are the most common causes of neocerebellar syndrome?
Stroke Tumor Trauma Degenerative diseases
59
what are the 5 major groups of signs of cerebellar stroke?
1) headache, vertigo, nausea, vomiting 2) eye movement problems 3) dysarthria and dysphagia 4) ataxia 5) arm weakness and incoordination
60
how do headaches present in cerebellar stroke?
- sudden and severe onset | - headaches are intense, persistent and debilitating
61
how does vertigo present in cerebellar stroke?
presents as dizziness/spinning surroundings and leads to nausea and vomiting
62
what eye movement problems can occur in cerebellar stroke?
* Symptoms typically affect on eye + contribute to vertigo * Rapid/slow movement of the eye * Nystagmus – tremor of the eyeball * Ptosis – drooping eyelids * Constricted pupils
63
what is dysarthria?
motor disorder of speech weakening the muscles of the mouth, face and respiratory system - leads to slurred, slow, monotonous and hoarse speech
64
why does dysphagia occur in cerebellar stroke?
bc of incoordination or weakening of throat or oesophageal muscles
65
define ataxia
loss of balance and coordination while walking (as if they’re drunk) Feet set widely apart and patients wobble/lean to one side
66
how does arm weakness and incoordination present in cerebellar stroke?
* Clumsiness, incoordination and weakness usually in one arm | * Can’t do certain actions bc of trembling hands and arms
67
what is the primary test for stroke?
get patient to raise both arms to see if one’s dramatically lower than the other bc of trembling, weakness and incoordination
68
what are the common symptoms between alcohol intoxication and cerebellar damage?
slurred speech. ataxia, diplopia (double vision), incoordination, intention tremor etc.
69
why do alcohol intoxication and cerebellar damage share symptoms?
bc cerebellum has GABA-ergic interneurons which are sensitive to alcohol effects
70
where are most of the DCST cell bodies found?
lamina 7

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