Cerebellum

Question 1

Functions

Answer 1

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

Question 2

SCA damage:

Answer 2

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

Question 3

PICA damage:

Answer 3

Vertigo
Unsteadiness
Walking ataxia
Nystagmus

Question 4

AICA damage:

Answer 4

Dysmetria
Vestibular signs
Facial sensory loss

gait usually okay

Question 5

Biggest predictor of recovery:

Answer 5

Amount of cerebellar nuclei involvement

Question 6

Function of cerebellar nuclei:

Answer 6

Relay station for information

Question 7

Medial zone - comprised of:

Answer 7

Mid-line structures
Vermis
Fastigial nuclei

Question 8

Medial zone - functions:

Answer 8

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

Question 9

Vermis - function:

Answer 9

Postural control ==> central cerebellar problems

Question 10

What are central cerebellar problems?

Answer 10

Initiation/timing
Using feedback to help with accuracy
NOT strength

Question 11

Intermediate zone - comprised of:

Answer 11

Intermediate hemispheres
Globose
Emboliform nuclei

Question 12

Intermediate zone - functions:

Answer 12

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

Question 13

Lateral zone - comprised of:

Answer 13

2 broad lateral hemispheres
Output structures
Dentate nuclei

Question 14

Lateral zone - functions:

Answer 14

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

Question 15

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

Answer 15

No

Question 16

Lateral zone - deficits:

Answer 16

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

Question 17

Flocculonodular lobe - function:

Answer 17

Control of eye movement (VOR - vestib)

Balance

Question 18

Vestibulocerebellum…

Answer 18

Flocculonodular lobe

Question 19

Spinocerebellum…

Answer 19

Medial and intermediate zones

Question 20

Cerebrocerebellum…

Answer 20

Lateral zone

Question 21

Damage to vestibulocerebellum…

Answer 21

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

Nystagmus

Question 22

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

Answer 22

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

Need VOR interventions

Question 23

Damage to spinocerebellum…

Answer 23

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

Question 24

Challenges with damage to spinocerebellum…

Answer 24

RAMs/coordination tasks

Complex motor activities

Question 25

Damage to cerebrocerebellum…

Answer 25

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

Question 26

What modifies function of the cerebellum and cerebellar circuitry?

Answer 26

Experience - increase in # of effective preferred synaptic paths

Question 27

Signs of cerebellar dysfunction:

Answer 27

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

Question 28

Muscle tone with cerebellar damage…

Answer 28

Hypotonic

Question 29

Why is tone the way it is?

Answer 29

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