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cerebellum Flashcards

1
Q

where does the cerebellum lie?

A

in the posterior cranial fossa

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2
Q

what can be seen on the cerebellum surface from above?

A

narrow medio-lateral gyri

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3
Q

what is the vermis?

A

the part that lies in the midline

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4
Q

what separates the anterior and posterior lobes of the vermis?

A

primary fissure

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5
Q

what is the flocculus?

A

small 3rd lobe, part of flocculo-nodular lobe

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6
Q

what is the nodulus?

A

(not part of the vermis) part of the roof of the 4th ventricle. Ventral surface of the cerebellum

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7
Q

what are the main arteries supplying the cerebellum?

A
  • Superior cerebellar artery
  • Anterior inferior cerebellar artery
  • Posterior inferior cerebellar artery
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8
Q

what is the most common site of an infarct in the posterior circulation?

A

posterior inferior cerebellar artery

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9
Q

what are the 3 layers in the cerebellar cortex? what are each made of?

A

outer molecular layer - pale w mostly axons and only a few cells

middle layer - single row of Purkinje cells

inner layer (granule layer) - thick and vast no of granule cells

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10
Q

what are the cerebellar peduncle and what are the inputs and outputs to them?

A
  • Superior cerebellar peduncle: output fibres only
  • Middle cerebellar peduncle (biggest): input fibers from (contralateral) cerebral cortex and cranial nerves
  • Inferior cerebellar peduncle: input fibres from the spinal cord
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11
Q

does the cortex work contralaterally or ipsilaterally?

A

contralaterally

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12
Q

does the cerebellum work contralaterally or ipsilaterally?

A

ipsilaterally

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13
Q

where is the dorsal spinocerebellar tract found?

A

lateral funiculus

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14
Q

describe the pathway of the dorsal spinocerebellar tract?

A
  • receives proprioceptive afferents (muscle spindles and Golgi tendon organs)
  • enter dorsal horn and synapse at its base
  • travels ipsilaterally to the ipsilateral cerebellum
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15
Q

what is the most ventral lamina found in the dorsal horn?

A

lamina 7

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16
Q

is the dorsal spinocerebellar tract ipsilateral or contralateral?

A

ipsilateral

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17
Q

is the ventral spinocerebellar tract ipsilateral or contralateral?

A

contralateral

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18
Q

describe the pathway of the ventral spinocerebellar tract

A
  • Contralateral in the spinal cord but then recrosses in the brain stem to en dup on the same side it entered the cord  info from body is passed to same side cerebellum
  • VSCT also has cell bodies in lamina 7 but its contralateral to the afferents
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19
Q

what info does the ventral spinocerebellar tract carry?

A

info about the state of reflexes in the spinal cord

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20
Q

what do all inputs and outputs to the cerebellar cortex go through?

A

deep cerebellar nuclei

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21
Q

where are the deep cerebellar nuclei found?

A

in the white matter below the cortex

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22
Q

what are the deep cerebellar nuclei from medial to lateral?

A

o Fastigial
o Globose
o Emboliform
o Dentate

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23
Q

what deep cerebellar nuclei are the hemispheres connected to?

A

dentate nuclei

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24
Q

what deep cerebellar nuclei is the anterior lobe connected to?

A

globose and emboliform (interposed) nuclei

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25
Q

what deep cerebellar nuclei is the vermis connected to?

A

fastigial

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26
Q

what deep cerebellar nuclei is the flocculo-nodular lobe connected to?

A

lateral vestibular nuclei of the pons

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27
Q

what is the role of the cerebellum in movement?

A
  • Doesn’t initiate movement
  • Modulates and refines motor cortex commands using feedback from proprioceptors and other sensory organs –> produces smooth and accurate movements
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28
Q

what does cerebellar damage cause?

A

overall clumsiness, abnormal fatigue and movement instability
o Extraocular eye movements are particularly affected

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29
Q

why is partial recovery of function possible after cerebellar damage?

A

neuronal plasticity in the cortex

30
Q

what does damage to the deep cerebellar nuclei cause?

A

persistent disability

31
Q

what are the 3 functional zones in the cerebellum?

A

1 - vestibulocerebellum
2 - spinocerebellum
3 - cerebrocerebellum

32
Q

what is the vestibulocerebellum?

A

flocculonodular lobe connected to lateral vestibular nucleus (in pons)

33
Q

what is the spinocerebellum?

A

anterior lobe + vermis connected to fastigial, globose and emboliform nuclei

34
Q

what is the cerebrocerebellum?

A

posterior lobe (cerebellar hemisphere) connected to dentate nucleus

35
Q

what is the function of the vestibulocerebellum?

A
  • coordinates head and eye movements to ensure stability of gaze
  • controls balance of the head on the body
  • controls balance of the body on the ground
36
Q

what information does the vestibular nuclei receive?

A

o Info about head movement from vestibular apparatus and neck muscles
o Info from extra-ocular eye muscles

37
Q

where are the vestibular nuclei found?

A

pons and medulla

38
Q

what do motor commands to the neck and eye muscles travel via?

A

medial longitudinal fasciculus and medial vestibulospinal tract

39
Q

what do motor commands to the legs travel via?

A

lateral vestibulospinal tract

40
Q

where are motor programs from the vestibular nuclei stored?

A

flocculo-nodular lobe cortex

41
Q

what is the function of the spinocerebellum?

A
  • Controls locomotion and limb coordination

* Sends motor commands down the reticulospinal tracts to co-ordinate postural and locomotor movements

42
Q

what is the function of the cerebrocerebellum?

A

Co-ordinates movements initiated by the motor cortex. Includes speech, voluntary movements of hands and arms, and hand-eye co-ordination

43
Q

what are the parts of the neocerebellum?

A
  • Cortex: cerebellar hemispheres
  • Deep Nuclei: dentate
  • Input: From cerebral cortex via middle cerebral peduncle
  • Output: To motor (VL) thalamus via superior cerebral penduncle
44
Q

what are flocculonodular syndromes characterised by?

A

poor balance and disordered eye movements

45
Q

what are common symptoms of flocculonodular syndromes?

A
  1. Little control of axial muscles
  2. Wide-based ‘ataxic’ gait, reeling and swaying
  3. Tendency to fall to side of lesion
  4. Nystagmus
  5. Severe cases cannot sit or stand without falling
46
Q

who is flocculonodular syndromes most commonly seen in?

A

in young children with medulloblastoma in 4th ventricle

47
Q

what is the most common malignant CNS tumour in kids?

A

medulloblastoma

48
Q

where do medulloblastomas originate?

A

wall of the 4th ventricle

49
Q

what type of tumour is a medulloblastoma?

A

A type of primitive neuroectodermal tumour – NOT a glioma

50
Q

what damage is anterior lobe syndrome related to?

A

damage to the spinocerebellum

51
Q

what is anterior lobe syndrome characterised by?

A

incoordination of the limbs

52
Q

what are the main symptoms of anterior lobe syndrome?

A
  • Ataxia: ataxic gait (overlaps with flocculonodular syndrome)
  • Hypotonia: generalised muscle weakness and fatigue,
  • Reflexes may be depressed or pendular (upper motor neurone lesions)
53
Q

who is anterior lobe syndrome seen in?

A

seen in alcoholics bc of malnutrition and lack of B vitamins

54
Q

what are symptoms of neocerebellar syndrome?

A
  • loss of hand-eye coordination
  • dysmetria
  • dysdiadochokinesis
  • intention tremors
  • Loss of good speech articulation (slurred speech) due to loss of co-ordination of muscles involved in speech production.
    • Loss of cognitive eye movement
    • Deficits in selective attention& perception due to ‘eye movement programs” failure
55
Q

define dysmetria

A

inaccurate reaching with intention tremor

56
Q

define dysdiadochokinesis

A

irregular performance of rapid alternating hand movements

57
Q

what is the classic test for anterior lobe cerebellar dysfunction?

A

The finger-to-nose and heel-to-knee tests

58
Q

what are the most common causes of neocerebellar syndrome?

A

Stroke
Tumor
Trauma
Degenerative diseases

59
Q

what are the 5 major groups of signs of cerebellar stroke?

A

1) headache, vertigo, nausea, vomiting
2) eye movement problems
3) dysarthria and dysphagia
4) ataxia
5) arm weakness and incoordination

60
Q

how do headaches present in cerebellar stroke?

A
  • sudden and severe onset

- headaches are intense, persistent and debilitating

61
Q

how does vertigo present in cerebellar stroke?

A

presents as dizziness/spinning surroundings and leads to nausea and vomiting

62
Q

what eye movement problems can occur in cerebellar stroke?

A
  • Symptoms typically affect on eye + contribute to vertigo
  • Rapid/slow movement of the eye
  • Nystagmus – tremor of the eyeball
  • Ptosis – drooping eyelids
  • Constricted pupils
63
Q

what is dysarthria?

A

motor disorder of speech weakening the muscles of the mouth, face and respiratory system
- leads to slurred, slow, monotonous and hoarse speech

64
Q

why does dysphagia occur in cerebellar stroke?

A

bc of incoordination or weakening of throat or oesophageal muscles

65
Q

define ataxia

A

loss of balance and coordination while walking (as if they’re drunk)

Feet set widely apart and patients wobble/lean to one side

66
Q

how does arm weakness and incoordination present in cerebellar stroke?

A
  • Clumsiness, incoordination and weakness usually in one arm

* Can’t do certain actions bc of trembling hands and arms

67
Q

what is the primary test for stroke?

A

get patient to raise both arms to see if one’s dramatically lower than the other bc of trembling, weakness and incoordination

68
Q

what are the common symptoms between alcohol intoxication and cerebellar damage?

A

slurred speech. ataxia, diplopia (double vision), incoordination, intention tremor etc.

69
Q

why do alcohol intoxication and cerebellar damage share symptoms?

A

bc cerebellum has GABA-ergic interneurons which are sensitive to alcohol effects

70
Q

where are most of the DCST cell bodies found?

A

lamina 7

b2 (5 decks)

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