Cerebellum Lecture 9 Flashcards by Charlene Enriquez

What is the general function of the cerebellum

Coordinated movements (corrective feedforward/backwards roles)

Motor learning/cognitive motor role

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____ in the brainstem play primary central role in maintaining equilibrium

Vestibular nuclei

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Where is the cerebellum located

Posterior fossa of the skull

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What attaches at the POSTERIOR brainstem of the cerebellum

Cerebellar peduncles

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What are cerebellar peduncles

Incoming and outgoing axons arranged in bundles of white matter

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What forms the “roof” of fourth ventricle

Cerebellar peduncles

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What is the tentorium cerebelli

Dural “roof” that separates cerebellum and occipital lobe

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What is the fourth ventricle

CSF cavity located posterior to pons

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What is the cerebral aqueduct

CSF pathway/conduit that “connects” the third and fourth ventricles

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What is the vermis

Midline region of cerebellum

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Where is the intermediate hemispheres (paravermis) in the cerebellar hemisphere

Medial portion of hemispheres

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Where is the flocculonodular lobe

Horizontal lobe located in the anterior region of cerebellum

“Oldest” part if the cerebellum

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What are the 3 pairs of nuclei located within the cerebellum

Fastigial nuclei
Interposed nuclei
Dentate nuclei

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What is fastigial nuclei

Associated with VERMIS pathways

Most midline

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What is the interposed nuclei

Associated w/ PARAVERMIS pathways

Two nuclei form interposed nuclei
- emboliform nuclei
- globose nuclei

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What is the dentate nuclei

Associated with lateral hemispheres pathways

Most lateral

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What branches off the PICA

Vertebral artery

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What branches off the AICA

Branch of the inferior portion of basilar artery

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What branches off from the superior cerebellar artery (SCA)

Branch of the superior portion of BASILAR ARTERY

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What are the motor functions of cerebellum

Balance and vestibulo-ocular control
Trunk/proximal limb coordination
Distal limb coordination/fine motor movements
Coordination of motor planning for complex movement

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What is the motor functions of flocculonodular lobe

Balance and vestibule-ocular control
Control eye movements
- smooth pursuits, saccades, VOR

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What is the pathway/connections INPUT for flocculonodular lobe

Vestibular nerve (CN 8)
Vestibular nuclei

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What is the pathway/connections OUTPUT for flocculonodular lobe

Vestibular nuclei in brainstem
- some vestibular nuclei project “UPWARDS” to control eye movements via medial longitudinal fasciculus (MLF)

some vestibular nuclei project “DOWNWARD” in vestibulospinal tracts for BALANCE/EQUILIBRIUM

What are smooth pursuits

Maintain base on moving target

slow, smooth eye movement used to follow a moving target

LIKE AN ANT

What are saccades

Rapidly move eye to new target “Rapidly move or quickly shift the eye from one target to another” LIKE A GRASSHOPER

What is function of vermis

Trunk and proximal limb coordination

What is the pathway/connections INPUT for vermis

1. Spinocerebellar tracts (unconscious proprioception) from trunk/proximal limb 2. Vestibular nuclei and visual info

What is the deep cerebellar nuclei for vermis

Fastigial nuclei

What is the pathway/connections OUTPUT for vermis

1. The info travels to vestibular nuclei and down the MEDIAL MOTOR TRACTS in the spinal cord 2. The medial motor tracts responsible for TRUNK/PROXIMAL MUSCLES

What is the function of paravermis / intermediate hemispheres

Distal limb coordination

What is the pathway/connections INPUT for paravermis

1. Spinocerebellar tracts (unconscious proprioception) from limbs - not visible on diagrams 2. Motor cortex via pontine nuclei

What is the deep cerebellar nuclei for paravermis

Interposed nuclei

What is the pathways/connections OUTPUT for paravermis

1. RED NUCLEUS to influence distal extremities via rubrospinal tract 2. Also send fibers to THALAMUS and MOTOR CORTEX to influence distal extremities via lateral motor tracts of spinal that control DISTAL LIMB MOVEMENT

What is the function of lateral hemispheres

Coordination of motor planning for complex movement/learning

What is the pathways/connections INPUT for the lateral hemisphere

Motor association cortex via pontine

What is the deep cerebellar nuclei of the lateral hemispheres

Dentate nuclei

What is the pathways/connections OUTPUT for the lateral hemispheres

1. Thalamus/cortex - info allows planning/learning complex movement in motor and somatosensory cortices 2. ALSO RED NUCLEUS - influences lateral motor tracts to assist in motor learning

What is cerebellar ataxic gait

Wide BOS, arms out

What is ataxic gait

Clumsy movements with wide BOS May see arms out to maintain balance Difficulty when asked to walk in a straight line Veering to one side Uncoordinated movement

What is a unilateral lesion of cerebellum

Function motor loss will be ISPILATERAL to the cerebellum lesion

What is a bilateral lesion of cerebellum

Bilateral functional motor loss

What are the motor impairments for cerebellar lesion

1. Hypotonia 2. Disequilibrium 3. Dyssynergia

What is hypotonia

Poor muscle tone Floppy rag doll, loose appearance Patient looks DRUNK

What is dyssnergia

Loss of coordinated activity

What is rebound

Type of dyssnergia Overshooting and correcting

What is dysarthria

Uncoordinated speech Slurring Slowing speech Scanning of speech - random or inappropriate variations of volume

What is dystaxia (ataxia)

Lack of coordination in the movement of learned voluntary movement Subtypes: Gait ataxia Trunk ataxia

What are the clinical oberservations of dystaxia

Trunk stability in sitting Standing posture Gait ADLS

What is dysmetria

Past point Overshooting Inability to stop muscular movement at desired point in space

What are the clinical exam procedures for dysmetria

1. Finger to nose test 2. Heel to shin test 3. Point to point test

(T/F) one of the symptoms of dyssynergia are intention tremors

True

What is dysdiadochokinesia

Inability to perform rapid alternating or repetitive movement, disruption of the timing of the movement INITIATING AND STOPPING

What are the clinical exam procedures for dysdiadochokinesia

Ask patient to perform rapid alternating movement (RAM) Rapid supination/pronation

What is nystagmus

“Ocular dysmetria” or spontaneous eye movement Rhythmic oscillations of the eyeballs

What are the clinical exam procedures for rebound

“Arm pull” test “Arms extended” test