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Neuro Anatomy > Cerebellum > Flashcards

Cerebellum Flashcards

1
Q

Superior cerebellar peduncles

A

Connects to rostrum pons

Contains mostly efferent fibers

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2
Q

Middle cerebellar peduncles

A

Connects to pons

Contains mostly afferent fibers from cerebral cortex

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3
Q

Inferior cerebellar peduncles

A

Connects to caudal pons/rostrum medulla

Coattails mostly afferent fibers for BS and SC

Contains efferent to vestibular nuclei and RF in brainstem

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4
Q

Cerebellum function

A

Detects movement that deviates from the intended cortical command

Contributes to motor planning

Smoothly coordinates ongoing movements and posture by comparing the intended movement w/ actual movement

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5
Q

Cerebellum receives sensor input from

A

SC cerebellar tracts

  • muscle spindles
  • GTOs
  • joint and cutaneous receptors
  • vestibular apparatus

Integrates this sensory info and adjusts movement as necessary

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6
Q

Cerebellum - three main functions

A

Synergy of movement
Maintenance of upright posture
Maintenance of tone (during muscle contraction)

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7
Q

Other cerebellum functions

A

Speech articulation
Respiratory movement
Motor learning
Possibly higher order cognitive processes

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8
Q

Lateral cerebellar hemispheres

A

Motor planning for extreme ties

Lateral corticospinal tract

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9
Q

Intermediate cerebellar hemisphere (B/n lat and vermis)

A

Distal limb coordination

Lateral corticospinal tract, rubrospinal tract

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10
Q

Vermis and flocculonodular lobe

A

Proximal limb and trunk coordination — anterior corticospinal tract, reticulospinal tract, vestibulospinal tract, tectospinal tract

Balance and vestibulo-ocular reflexes — medial longitudinal fascicles

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11
Q

Cerebellar lesions result in

A

Ataxia — uncoordinated movements

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12
Q

Input to cerebellar cortex

A 
Mossy fibers (excitatory)
Climbing fibers (excitatory)

Synapse directly or indirectly onto purkinje cells
-input to cerebellar cortex also have collateral fibers that synapse on deep cerebellar nuclie

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13
Q

Output from cerebellar cortex

A

Purkinje fibers (inhibitory)

Project to the deep cerebellar nuclei and/or vestibular nuclei (excitatory)

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14
Q

On/off center for cerebellar output

A

Deep cerebellar nuclei

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15
Q

Deep cerebellar nuclei - lateral to medial

A

Don’t eat greasy foods

Debate
Emboliform
Global economic
Fastigial

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16
Q

Denate cerebellar nucleus

A

Deep

Input from lateral hemisphere

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17
Q

Emboliform cerebellar nuclei

A

Deep

Input from intermediate hemisphere

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18
Q

Globase cerebellar nuclei

A

Deep

Input from intermediate hemisphere

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19
Q

Fastigial cerebellar nuclei

A

Deep

Input from vermis

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20
Q

Vestibular nuclei

A

Function in some ways like deep cerebellar nuclei

Input form inferior vermis and flocculonodular lobe

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21
Q

Why do cerebellar lesions cause ipilateral deficits?

A

Pathways from cerebellum that influence the lateral motor systems and periphery are double crossed

22
Q

Lesions of the vermis don’t cause unilateral deficits because

A

Medial motor systems influence bilateral proximal trunk musculature

23
Q

Cerebellar input

A

From virtually all areas of cerebral cortex
Many sensory modalities
BS nuclei
SC

Vestibular nuclie, RF nuclei, inferior Oliver’s nucleus

24
Q

Corticopontine fibers

A

Fibers traveling from the cerebral cortex to the cerebellum

Synapse in pons, then are called pronto cerebellar fibers

25
Q

Spinocerebellar pathways

A

Unconscious proprioception of limb movements

  • dorsal spinocerebellar tract (LE)
  • cuneocerebllar tract (UE)

Unconscious information regarding activity of spinal interneurons as well as spinal reflex circuit

  • ventral spinocerebellar tract (LE)
  • rostrum spinocerebellar tract (UE)
26
Q

Each cerebellar hemisphere receives inform from

A

Ipsilateral limbs

Inputs either don’t cross or are double crossed

27
Q

Cerebellar somatotopy

A

Add picture here later

28
Q

Cerebellar lesions

A
  1. Ataxia
  2. Midline lesions
  3. Lesion lateral to vermis
29
Q

Cerebellar lesion- ataxia

A

Ipsilateral to side of lesion

Disordered contractions of agonist and antagonist muscles and lack of normal coordination between movements at different joints

Movements have irregular, wavering course that consists of continuous overshooting and over correcting

30
Q

Cerebellar lesion- midline lesions

A

Unsteady gait and eye movement abnormalities

31
Q

Cerebellar lesion- lesions lateral to vermis

A

Limb ataxia

32
Q

Three classic signs of cerebellar damage

A

Ataxia
Nystagmus
(Intention) tremor (with movement)

33
Q

Cerebellar damage also involves

A

Dysrhythmia (abnormal timing)
Dysdiadochokinesia (ab rapid alternating movement)
Dysmetria (ab distance trajectory)

34
Q

Other possible S/S of cerebellar damage

A 
Vertigo
N/V
Unsteadiness
Slurred speech 
HA -side of lesion
35
Q

Abnormalities in other systems can confound the cerebellar exam

A

UMN - slow, clumsy movement of extreme tiers

LMN- weakness, test requiring little strength can be helpful

Basal ganglia - slow clumsy momvements and or gait unsteadiness

Sensory ataxia - severe loss of position sense (dorsal column/sensory nerves)- should improve w/ visual feedback

36
Q

Truncal ataxia

A

Lesion of vermis

Wide based, unsteady, drunk like gait

Severe cases: may also have problems sitting up w/out support

Bilateral disorder affects medial motor systems - fall or sway toward side of lesion

37
Q

Appendicular ataxia

A

Lesion of intermediate or lateral cerebellum

Uncoordinated movement of extreme ties

Intention tremor - irregular oscillating movements in multiple planes through trajectory when attempting to move limb toward a target

38
Q

Lesion of vermis and both cerebellar hemisphere

A

Exhibit truncal and appendicular ataxia

39
Q

Ipsilateral localization of ataxia

A

Lesion of cerebellar hemispheres cause ipsilateral ataxia of extremeties

40
Q

False localization of ataxia

A

Can be caused by lesion outside cerebellar cortex that involve cerebellar input or output pathways

41
Q

Testing for appendicular ataxia

A

Finger- nose- finger test
-watch for dysmetria and dysrhythmia

Rapid hand movements, foot patting, precision finger tap, rapid alternating movements, overshoot

42
Q

Testing for truncal ataxia

A 
Tandem gait (heal-to-toe-gait) 
-pt will tend to fall/sway to side of lesion if it extends slightly into cerebellar hemisphere

Romberg test
-note increased sway or fall

43
Q

Vasculature

A

Add picture here

44
Q

S/s of cerebellar artery infarcts

A 
Limb ataxia
Unsteady gait
Nystagmus
Vertigo
N/V
HA
45
Q

SCA and PICA infarct - cerebellum

A

Most common

46
Q

SCA infarct cerebellum

A

Ipsilateral ataxia w/ little/no BS signs

Mostly involves cerebellum itself and usually spares the lateral BS

47
Q

PICA infarct cerebellum

A

Ipsilateral ataxia w/ nystagmus, vertigo, N/V

Involves inf cerebellar peduncle and vestibular nuclei

Also can see signs of lateral medullary (Wallenberg) sysndrome

48
Q

AICA infarct - cerebellum

A

Supplies internal auditory artery

Unilateral hearing loss

49
Q

What can mimic S/S of cerebellar infarcts?

A

Infarcts to lateral pons or medulla because of cerebellar peduncles and vestibular nuclei involvement

50
Q

What happens if the cerebellum swells?

A

Can cause hydrocephalus because of compression of the fourth ventricle, as well as compression of vital brainstem structures, and subsequent herniation

Neuro Anatomy (22 decks)

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