Lecture 13: Cerebellum and Brainstem Deep Structures Flashcards Preview

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Flashcards in Lecture 13: Cerebellum and Brainstem Deep Structures Deck (65):
1

What are the 4 main functions of the cerebellum?

1. Acts as a "comparator" that compensates for error in movement by comparing intention with performance.
2. Involved with the coordination of somatic motor activity, the regulation of muscle tone, and mechanisms that influence and maintain equilibrium.
3. Contributes to non motor functions such as cognition, emotion, and affective processing.
4. Plays a role in sequencing incoming sensory patterns and detecting temporal changes in the sequence of sensory events.

2

What does the vermis and paravermian part of the cerebellum control?

Axial Musculature (neck and trunk muscles)

3

What do the lateral hemispheres of the cerebellum control?

Limbs (arms and legs)

4

What does the flocculonodular lobe of the brain do?

It is heavily involved in maintaining balance.

5

What are the pathways for the superior cerebellar peduncle ?

AFFERENT: Anterior Spinocerebellar Tract, Acoustic and Optic Information
EFFERENT: Dentarubrothalamic Tract, Dentatothalamic Tract

6

What are the pathways for the middle cerebral peduncle?

AFFERENT: Pontocerebral Tract
EFFERENT: none

7

What are the pathways for the inferior cerebellar peduncle?

AFFERENT: Vestibulocerebral Tract, Olivocerebellar Tract, Posterior Spinocerebellar Tract
EFFERENT: Cerebellovestibular Tract, Cerebelloolivary Tract

8

What type of cells are in the outer molecular layer of the cerebellar gray matter?

Basket and Stellate Cells

9

What type of cells are in the middle layer of the cerebellar gray matter?

Purkinje Cells

10

What type of cells are in the granule layer of the cerebellar gray matter?

Golgi and Granule Cells

11

What are the only output neurons of the cerebellar cortex?

Purkinje Cells

12

Where does the only direct input to the Purkinje Cells from outside the cerebellum come from?

climbing fibers that have their origin in the olivary nuclei

13

What cells have an inhibitory effect on Purkinje Cells?

Stellate and Basket Cells

14

What are the three functional divisions of the cerebellum?

1. Vestibulocerebellum
2. Spinocerebellum
3. Cerebrocerebellum

15

What are the components of the vestibulocerebellum?

Vestibular nuclei, flocculonodular lobe, inferior portion of the paravermis, fastigial nuclei

16

What are the components of the spinocerebellum?

Anterior lobe, vermis, superior paravermis

17

What are the components of the cerebrocerebellum?

lateral portions of the posterior lobes

18

What is the function of the vestibulocerebellum?

Coordinate eye, head, neck movements and maintains balance.

19

What is the function of the spinocerebellum?

Coordinate trunk and proximal limb movements.

20

What is the function of the cerebrocerebellum?

1. coordinate fine motor planning of limbs
2. anticipate sensory consequences of the movements
3. cognitive memory of motor movements

**Note that the RIGHT cerebellar hemisphere controls the RIGHT body, arm, and leg.

21

What are some of the clinical signs of cerebellar disease?

1. Unstable gait and stance with a tendency to fall. Bored based gait ("sailor's gait", reeling and drunken)
2. Movements are generally jerky and gunsmith and are accompanied by an intentional tremor.
3. Ataxia (dis-coordination): trunk and/or extremities.
4. Dysmetria of movement: goal-directed movement can over or undershoot the target.
5. Eye Movement Disorders: nystagmus saccadic and smooth pursuit dysmetria
6. Speech Disorders: ataxic dysarthria with scanning speech, difficulty to maintain speech rhythm, intention, and correct articulation.

22

Superior Colliculus

MIDBRAIN
Fuctions in the control of reflex movements that orient the eyes, head and neck in response to visual, auditory, and somatic stimuli

23

Periaquaductal Gray Matter

MIDBRAIN
Functions in the processing of autonomic and limbic activities, as well as modulation of nociception.

24

Aqueduct

MIDBRAIN
Passageway connecting the third and fourth ventricles.

25

Nucleus of Edinger-Westphal

MIDBRAIN
Parasympathetic innervation of the eye to constrict the iris and to the ciliary muscle to alter lens shape for accommodation.

26

CNIII nuclei and nerve

MIDBRAIN
Motor control of eye muscles

27

Spinothalamic tract

MIDBRAIN
Fiber pathways to the thalamus for pain/temp form the periphery.

28

Medial Lemniscus

MIDBRAIN
Sensory pathway for proprioception connecting the nucleus gracilis and cognates with the thalamus

29

Medial Geniculate

MIDBRAIN
thalamic relay nuclei for auditory information.

30

Lateral Geniculate

MIDBRAIN
thalamic relay nuclei for visual information.

31

Cerebral Peduncle

MIDBRAIN
Fiber bundles of the corticospinal tract connecting the cerebral cortex to the brainstem.

32

Optic Tract

MIDBRAIN
Optic fibers from optic chiasm to the lateral geniculate.

33

Substantia Nigra

MIDBRAIN
one of several nuclei involved in smooth muscle control
**Degenerates in Parkinson's Disease.

34

Red Nucleus

MIDBRAIN
Relay between the cerebellum to the thalamus.

35

Medial Longitudinal Fasciculus

MIDBRAIN
Fiber pathway between the vestibular nuclei and the CN nuclei III, IV, VI to coordinate head/eye movements.

36

Superior Cerebellar Peduncle

PONS
Fiber pathway to and from the cerebellum.

37

Middle Cerebellar Peduncle

PONS
Fiber pathway to and from the cerebellum.

38

Mesencephalic, Main Sensory Nucleus, Motor Nucleus of CNV

PONS
three nuclear components of the trigeminal nerve nuclei

39

CNV

PONS
Motor and sensory fibers of CNV

40

Pontine Nuclei

PONS
collection of neurons in the pons that receives input from the neocortex and sends crossing fibers through the middle and cerebrellar peduncle.

41

Locus coeruleus

PONS
a nonadrenergic brainstem nucleus involved in mood and the sleep/wake cycle.

42

Raphe nucleus pontis

PONS
one of several serotonin nuclei involved in mood and the sleep/wake cycle

43

Corticospinal Tract

PONS
motor fibers from the neocortex to spinal interneurons and lower motor neurons.

44

Inferior and Medial Vestibular Nuclei

UPPER MEDULLA
Nuclei of the vestibular system that regulates balance

45

Nucleus and Tractus Solitarius

UPPER MEDULLA
Sensory nucleus from taste (CNVII), glands, and chemo/baroreceptors (CNIX and CNX)

46

Dorsal Motor Nucleus Vagus (CNX)

UPPER MEDULLA
Parasympathetic motor nucleus to the lungs and gut.

47

Spinal Nucleus and Tract of CNV

UPPER MEDULLA
nuclear and tract components of CNV that extends down into the upper cervical spinal cord

48

Inferior Olivary Nucleus

UPPER MEDULLA
origin of the climbing fibers to the cerebellar parking cells

49

Pyramid

UPPER MEDULLA
name given to the corticospinal tract fibers in the medulla

50

Reticular Formation

UPPER MEDULLA
a network of neurons and axons that reside in the brain stem tegmenjtum involved in arousal, respiration and heart control

51

Nucleus of CNIX (in the lower medulla)

LOWER MEDULLA
Glossopharyngeal nucleus with motor control over tongue and pharyngeal muscles with taste

52

Weber's Syndrome

REGION: midbrain (base)

ARTERIAL SUPPLY: tip of basilar artery and/or branches of the PCA.

STRUCTURES INVOLVED: CNIII fasicles and Cerebral Peduncle

CLINICAL SIGNS/SYMPTOMS: Ipsilateral 3rd nerve paresis and contralateral hemiparesis.

53

Claude's Syndrome

REGION: midbrain (tegmentum)

ARTERIAL SUPPLY: tip pf the basilar artery and/or branches of the PCA

STRUCTURES INVOLVED: CNIII fasicles, red nucleus, superior cerebellar peduncle.

CLINICAL SIGNS/SMPTOMS: Ipsilateral 3rd nerve paresis, Contralateral tremor, Contralateral ataxia.

54

Benedikt's Syndrome

REGION: midbrain (base and tegmentum)

ARTERIAL SUPPLY: tip of the basil artery and/or branches of the PCA.

STRUCTURES INVOLVED: CNIII fasicles, red nucleus, superior cerebellar peduncle, substantia nigra

CLINICAL SIGNS/SYMPTOMS: Ipsilateral 3rd nerve paresis, Contralateral hemiparesis, Contralateral tremor, Contralateral ataxia.

55

Millard-Gubler Syndrome

REGION: medial pons (base and tegmentum)

ARTERIAL SUPPLY: Paramedian branches of the basilar artery.

STRUCTURES INVOLVED: Corticospinal and Corticobulbar Tracts, CNVII fascicles.

CLINICAL SIGNS/SYMPTOMS: Contralateral hemiparesis, Ipsialteral LMN facial paresis.

56

Foville's Syndrome

REGION: medial pons (base and tegmentum)

ARTERIAL SUPPLY: Paramedian branches of the basilar artery.

STRUCTURES INVOLVED: Corticospinal and Corticobulbar Tracts, CNVII fascicles, PPRF and/or CNVI.

CLINICAL SIGNS AND SYMPTOMS: Contralateral hemiparesis, Ipsialteral LMN facial paresis, Ipsialteral gaze paresis.

57

Gaze disorders

lesion in the medial longitudinal fasciculus

58

loss of discriminative touch, vibration, and conscious proprioception on the contralateral side of the body

lesion in the medial lemniscus

59

contralateral hemiparesis

lesion in the corticospinal tract

60

Medial Medullary Syndrome

REGION: Medial Medulla

ARTERIAL SUPPLY: Vertebral arteries, Paramed. Branches

STRUCTURES INVOLVED: Corticospinal Tract, Medial Lemniscus, CNXII

CLINICAL SIGNS/SYMPTOMS: Contralateral arm/leg weakness, Contralateral decrease in position/vibration, Ipsilateral tongue weakness

61

Wallenberg's Syndrome (lateral medullary syndrome)

REGION: Lateral Medulla

ARTERIAL SUPPLY: Vertebral arteries or PICA

STRUCTURES INVOLVED: Vestibular nuclei, Inferior Cerebellar Peduncle, CNV and Tract, Spinothalamic Tract, Sympathetic fibers, Nucleus Ambiguous, Nucleus Solitarius

CLINICAL SIGNS/SYMPTOMS: Ipsialteral ataxia, vertigo, nausea, Ipsilateral decrease in face pain sensation, Contralateral decrease in body pain sensation, Ipsilateral Horner's dysphagia.

62

Loss of pain and temp from ipsilateral side of the face

lesion in the spinal trigeminal nucleus and tract

63

dysarthria and dysphagia

lesion to the nucleus ambiguous

64

loss of pain and them to the contralateral side of the body

lesion to the spinothalamic tract

65

gait ataxia on the ipsilateral side of the body

lesion to the spinocerebellar tract