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Neuro Exam 3 > Cerebellum > Flashcards

Cerebellum Flashcards

1
Q

Receives lots of _ input but does not discriminate/interpret this input

A
  • Sensory
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2
Q
  • Lesions do or do not result in lasting motor paralysis?
A
  • Do not
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3
Q
  • Where does the cerebellum send projections?
A
  • Reticular formation
  • Motor cortices
  • Thalamus
  • Vestibulospinal nuclei
  • Superior colliculus
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4
Q
A
  1. Vermis
  2. Anterior lobe
  3. Posterior lobe
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5
Q
A
  • Superior
  • Middle
  • Inferior cerebellar peduncles
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6
Q
A
  1. Nodulus
  2. Posterolateral Fissure
  3. Anterior Lobe
  4. Posterior Lobe
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7
Q
  • Identify the deep cerebellar nuclei ***
A
  1. Dentate nucleus
  2. Emboliform nucleus
  3. Globose nucleus
  4. Fastigial
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8
Q
  • Organization of gray matter within the cerebellum
    • What cell types are located in each layer
A
  • Molecular layer
    • Basket and stellate
  • Purkinje Layers
    • Purkinje Cell bodies
  • Granular layer (G,G,G)
    • Granule cells and Golgi Cells
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9
Q
  • Purkinje Cells
A
  • Output from cerebellar cortex
  • Inhibit cerebellar and vestibular nuclei
  • NTX: GABA
  • Many dendrites
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10
Q
  • Granule Cells
A
  • ONLY EXCITATORY CELL IN CEREBELLUM (releases Glutamate)
  • Smallest
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11
Q
  • Stellate Cells
A
  • Axons synapse w/ and inhibit Purkinje Cells
  • Star shaped dendrites
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12
Q
  • Golgi Cells
A
  • Inhibitory (release GABA)
  • Largely scattered w/ short axons
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13
Q
  • Basket Cells
A
  • Axons synapse with Purkinje cells and inhibit them (just like Stellate cells)
  • NTX: GABA
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14
Q

What are the two types of afferent fibers in the gray matter of the cerebellum?

A
  • Climbing fibers
  • Mossy fibers
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15
Q
  • Climbing fibers
A
  • From inferior olive in medulla
  • Excite Purkinje Cells
  • Info on movement errors-cerebellum
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16
Q
  • Mossy fibers
A
  • From spinal cord, reticular formation, vestibular system, pontine nuclei
  • Synapse with Granulocytes
  • Info on arousal, somatosensory, eq, motor info
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17
Q
  • What are the functional divisions of the cerebellum?
A
  • Vestibulocerebellum
  • Spinocerebellum
  • Pontocerebellum
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18
Q
  • Vestibulocerebellum (aka flocculonodular lobe)
    • Functions
A
  • Influence eye movements and postrual muscles of head and body
  • Neck and trunk movements
19
Q
  • Spinocerebellum/Paleocerebellum
    • Functions
A
  • Receives somatosensory info, internal feedback from interneurons and somatosensory cortex
  • Control ongoing movement in brainstem descending tracts
  • Axial and lower extremity movements
  • Gait and station
20
Q
  • Pontocerebellum
    • Input from?
    • Functions?
A
  • Input from
    • Cerebral cortex via pontine nuclei
  • Function
    • Coordination of voluntary movements
    • Planning of movements
    • Timing of movements
  • Precise coordinated movements of extremities
  • Mainly upper extremity
21
Q
  • Afferent Fiber pathways entering the cerebellum via the vestibular system are what types of afferent fibers?
  • What are their names?
A
  • Mossy fibers
  • Vestibular nuclei
  • CN VIII
22
Q
  • Afferent fibers entering the cerebellum via the spinal cord are what type of afferent fibers?
  • What are their names?
A
  • Mossy
  • Anterior spinocerebellar tract
  • Posterior spinocerebellar tract
  • Cuneocerebellar tract
23
Q
  • Afferent fibers entering the cerebellum from the cerebral cortex are what type of afferent fibers?
  • What are their names?
A
  • Both mossy and climbing
  • Mossy
    • Cortico-pontocerebellar
    • Cortico-reticulocerebellar
  • Climbing
    • Cortico-olivocerebellar
24
Q
  • What two afferent fiber pathways convey unconscious proprioception info about limb movement?
  • Which one does upper extremity?
  • Which one does lower extermity?
A
  • Posterior spinocerebellar tract-lower limb
  • Cuneocerebellar tract-upper limb
25
Q
  • Describe the posterior spinocerebellar tract
A
  • 1st order neurons enter DRG and ascend in fasciculus gracilis
  • Synapse in 2nd order neurons in Nucleus of Clark (C8-L2)
  • 2nd order neurons ascend in posterior spinocerebellar tract/dorsolateral funiculus
  • Enter cerebellum via inferior cerebellar peduncle
26
Q
  • Describe the cuneocerebellar tract
A
  • 1st order neurons enter DRG and ascend in fasciculus cuneatus
  • Synapse in accessory (external or lateral) cuneate nucleus in lower medulla
  • 2nd order neurons ascend to cerebellum
  • Enter via inferior cerebellar nucleus
27
Q
  • Function of superior cerebellar peduncle?
A
  • Efferent route from
    • Globose
    • Emboliform
    • Dentate muclei
  • Afferent fibers from
    • Ventral (anterior) spinocerebellar tract
28
Q
  • Function of the middle cerebellar peduncle?
A
  • Afferent fibers from pontine nuclei-cortex
29
Q
  • Function of the inferior cerebellar peduncle?
A
  • Primary afferent fibers from spinal cord

One efferent tract (that she didn’t discuss)

30
Q
  • The cerebrocerebellar pathway sends projections to the _ nucleus which then conveys information to the red nucleus and the thalamus
  • The spinocerebellum pathway sends projections to the _ and _ nuclei as well as the _ nucleus which then send projections to the red nucleus/thalamus and reticular formation
  • The vestibulocerebellum pathway sends projections to the _ nucleus
A
  • Dentate
  • Globose/Emboliform (Paravermal part-red nucleus/thalamus) and Fastigal (vermal part-reticular formation)
  • Vestibular
31
Q
  • Unilateral cerebellar lesions affect the _ side
  • What are some common symptoms of a cerebellar lesion?
A
  • Ipsilateral
  • Ataxia
    • Wide based gait
    • Fall towards side of lesion
32
Q
  • Lesions of the Vestibulocerebellum
    • ​What is lost?
    • What are symptoms?
A
  • Connections between vestibular system and flocculonodular lobe are lost
  • Symptoms
    • Nystagmus
    • Truncal ataxia-can’t maintain sitting and standing balance
    • Truncal instability (tibtubation)- can’t do the sobriety test walk
33
Q
  • Lesions of the spinocerebellar division?
    • ​What is lost?
    • What are symptoms?
A
  • Connections between cutaneous and proprioceptive information coming from spinal cord to vermis and paravermal regions
  • Symptoms
    • Gait and truncal ataxia-wide base, staggering base
34
Q
  • Midline Ataxia
    • ​Caused by?
    • Symptoms?
A
  • Vestibulocerebellar and spinocerebellar diseases causing ataxic syndromes
  • Symptoms
    • Truncal instability
      • Titubation
      • Gait ataxia
    • Equilibratory (gait) ataxis
      • Gait ataxia
        • Wide based irregular steps with lateral veering
35
Q

Lesions of cerebrocerebellum

Symptoms

A
  • Dysarthria-poor speech articulation
  • Ataxic gait-fall towards side of lesion
  • Decomposition of movements
36
Q
  • Limb ataxia manifestations
A
  • Dysdiadochokinesia
  • Dysmetria
  • Action tremor
37
Q
  • Dysdiadochokinesia
A
  • Inability to rapidly alternate hand movements
    (Patty cake motion)
38
Q
  • Dysmetria
A
  • Inability to accurately move an intended distance
  • (Finger to nose or heel to shin)
39
Q
  • Action tremor
A
  • Shaking of limb during voluntary movement
40
Q
  • When a physician asks the patient to say the following phrases, what cranial nerves/areas of the brain are being tested:
    • La la la
    • Kah kah kah
    • La pah kah
A
  • La-Hypoglossal (CN XII)
  • Pa- Glossopharyngeal (IX) and Vagus (X)
  • La pah kah (Cerebellum)
41
Q
  • Appendicular ataxia
A
  • Dysfunction of cerebellar hemispheres
    • Ataxia of extremities
    • Ataxia of speech (scanning dysarthria)
  • Symptoms
    • Hypotonia
    • Decomp of movement
    • Dysmetria
    • Dysdiadochokinesia
42
Q
  • Cerebellar ataxia versus sensory ataxia
A
  • Cerebellar
      • Romberg (swaying when feet together and eyes closed)
    • Can’t stand with feet together (w/ eyes closed or open)
    • Normal vibratory sense, proprioception and ankle reflexes
  • Sensory ataxia
    • Can stand with feet together with eyes open
      • Romberg
    • Abnormal vibratory sense, proprioception and ankle reflexes
43
Q
  • Clinical testing of vestibulocerebellum and spinocerebellum
A
  • Station
  • Walking Gait
  • Tandem Gait
44
Q
  • Clinical testing of cerebrocerebellum
A
  • Rapid alternating movements
  • Finger to nose
  • Toe to finger
  • Heel to shin
  • Rebound and check reflex
  • Speech

Neuro Exam 3 (14 decks)

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