Cerebellar Disorders Flashcards

1
Q

What is the nickname for the cerebellum? What % is it of total brain volume? What are the non motor functions of the cerebellum?

A

“Little Brain”
10
Non motor not well understood but is responsible for shifting attention from one sensory or thought domain to another

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2
Q

What information does the cerebellum modulate?

A
tone
smoothness
accuracy
coordination
postural control
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3
Q

How is the cerebellum involved in motor learning?

A

It memorizes the small movements that are integrated into a complex activity (driving a stick)
It is active during the acquisition phase of learning
active during cognitive and emotional processes

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4
Q

What supplies blood to the cerebellum?

A

The PICA - posterior inferior cerebellar artery
AICA- Anterior inferior cerebellar artery
SCA- Superior cerebellar artery

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5
Q

What is the only output from the cerebellar cortex?

A

Out put comes from the purkinje cells to deep cerebellar nuclei and vestibular nuclei

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6
Q

T/F the hemispheres of the cerebellum ALWAYS control ipsilateral learned/skilled movement and motor planning

A

True!

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7
Q

Name the nuclei of the cerebellum

A

Fastigial nucleus- most medial
Globose nuclues + emboliform nucelus = nucleus interpositus
Dentate nucleus - lateral and largest

(most of the output from the cerebellum comes from the nuclei)

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8
Q

Which peduncles of the cerebellum modulate afferent info, efferent info?

A

Inferior and Middle cerebellar peduncles - modulate afferent

Superior - efferent information to the brainstem and thalamus

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9
Q

What do the archicerebellum, paleocerebellum and neocerebellum correspond to and what is their main source of input?

A

Archi -vestibulocerebellum = input from semicircular canals, retinal projections- influences eye movement
Paleo = spinocerebellum = input from the spinal cord - limb movement, muscle tone
Neo = cerebrocerebellum = input from the frontal association area for skilled movement

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10
Q

What are the most common pathologies that can affect the cerebellum?

A
Strokes of the cerebellum and brainstem
Spinocerebellar ataxia - 30 types- ped pop
Fredrichs ataxia
Tumors Trauma
metabolic disease
vitamin deficiency
multiple systems atrophy
TBI
MS
Acute alcoholism - ototoxic
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11
Q

What is archicerebellar syndrome?

A

lesions result in inability to coordinate head and eye movement, postural sway and impaired equilibrium.
Limbs are ok
Affects vestibular input and postural ton

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12
Q

What is paleocerebellar syndrome?

A

hypotonia and disruption of rhythmic patterns associate with walking
loss of precision
wide BOS, incoordination

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13
Q

What is neocerebellar syndrome?

A

The most common type of cerebellar disease

Results in intention tremor, hypotonia, asthenia, asynergia, ataxia

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14
Q

What are long-loop reflex responses?

A

Balance responses- are modifiable according to what the body needs immediately
if lesioned there is difficulty with adaptation - like standing on a moving bus
However, these individuals rarely fall because they have intersegmental movement and strength with good stepping strategies

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15
Q

What are the clinical signs of cerebellar involvement?

A
dysmetria
dysdiadochokinesia
hypotonia
interlimb dyscoordination
movement decomposition
asthenia -  general weakness
intention tremor
dysarthria
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16
Q

What are the classic signs of ataxic gait?

A

Uneven step length
irregular BOS
dyscoordinated
feet lifted to high

17
Q

What does ICARS stand for? What is it used for?

A

International Cooperative Ataxia Rating Scale

looks at posture and gait disturbances, kinetic functions, speech disorders, oculomotor disorders

18
Q

What determines the prognosis of a cerebellar disorder?

A

the type of lesion - static, progressive, multiple
extent of lesion - deep nuclei, multiple areas
support systems- premorbid/cormorbidities

19
Q

What are the goals of rehab for cerebellar disorders?

A

safe bed mobility and transfers
dynamic and static stability in sitting
dynamic and static in standing
ambulation

20
Q

What interventions can improve stability in this population?

A

Balance activities
balance master
foam, ball, mat activities
dynamic balance

21
Q

What are practical interventions for ambulation with cerebellar disorders?

A

instruct on how to use visual info to control walking
instruct how to use AD to widen BOS
move fewer joints and slow gait down
improve endurance training

22
Q

What other interventions could be used with this population?

A

Aquatic therapy
treadmill training
strengthening - tband, weights, pnf, manual
weighting

23
Q

Bottom line: intervention for individuals with cerebellar disorders should focus on’;

A

observation of intact and impaired abilities
improve abilities/ remediate depending on prognosis
use compensation strategies in all areas
prevent injury./ deconditioning
eventually prevent falls