Lecture 13: Cerebellum Flashcards

1
Q

What is the largest part of the hindbrain?

A

The cerebellum

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2
Q

What sits in the Posterior Cranial Fossa?

A

The Cerebellum

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3
Q

Where in the skull does the cerebellum sit?

A

In the posterior cranial fossa

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4
Q

What part of the dura does surrounds the dura mater?

A

The tentorium cerebelli

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5
Q

What sits under the tentorium cerebelli?

A

The cerebellum

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6
Q

What forms 2/3 walls of the fourth ventricle?

A

The cerebellum

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7
Q

What is the fourth ventricle surrounded by?

A

CSF

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8
Q

How does the CSF get to the cerebellum?

A

Through the median and lateral aperatures

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9
Q

What is the Cisterna Magna?

A

The big CSF cistern that allows CSF to reach the subarachnoid space

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10
Q

How does the cerebellum connect to the Brainstem?

A

Via the three peduncles

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11
Q

What percent of brain volume and neurons is the cerebellum?

A

10% of total brain volume; >50% of neurons

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12
Q

What is the overall purpose of the cerebellum?

A

It is the overall consultant on rapid movement - keeps the stride steady and balanced

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13
Q

Where does the cerebellum provide input to?

A

The Thalamus and the Cortex

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14
Q

What kind of input does the cerebellum receive?

A

Afferent input from all muscles and joints

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15
Q

Why does the cerebellum receive afferent input from all muscles and joints?

A

Because it needs to know where muscles and joints are in space before performing a function

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16
Q

What does the cerebellum consult on?

A

Rapid and ongoing movements to tweak motor skills

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17
Q

Where does the efferent information coming from the cerebellum need to go before reaching the cortex?

A

The thalamus

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18
Q

What does Cerebellum mean?

A

Little brain

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19
Q

What is the cerebellum considered part of the motor system?

A

Because if the cerebellum is damaged movement is still possible but the patient has deficits

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20
Q

What deficits may a patients have if the cerebellum is damaged?

A
  • Gait imbalance, poor postural control
  • Poor coordination of voluntary movements ex. Slurred speech or tremor when moving
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21
Q

Why are there deficits when the cerebellum is damaged?

A

Because the cerebellum, basal ganglia and motor systems are disinhibiting to all for motor movement

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22
Q

What happens to people with cerebellar damage when performing intentional motor movements?

A

They have a tremor

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23
Q

Why do people with cerebellar damage have a tremor when performing intentional motor movements?

A

Because the cerebellum is no longer inhibiting extraneous motor movement

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24
Q

What are the functions of the cerebellum?

A
  • Controls equilibrium/balance
  • Controls posture and muscle tone
  • Coordinates smooth and purposeful movement
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25
Q

How does the cerebellum control equilibrium and balance?

A

By using the vestibular pathway using information from the inner ear to control core musculature to balance

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26
Q

Is the cerebellum involved in sensory processing?

A

Yes, the cerebellum is a huge sensory processor

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27
Q

What is meant by the cerebellum is the great comparator?

A

It compares cortical command with muscle and joint positioning and tone

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28
Q

Through what tracts does the cerebellum compare muscle joint positioning and tone?

A

The ipsilateral spinocerebellar tracts (and cuneocerebellar tracts)

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29
Q

What are the spinocerebellar tracts and cuneocerebellar tracts?

A

Sensory afferents from all the muscles, joints and tendons from one side of the body that go to the ipsilateral side of the cerebellum

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30
Q

After receiving ipsilateral information from the spinocerebellar tracts what does the cerebellum do?

A

Sends information through the thalamus to and advises the cortex on how much, how many, and how fast

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31
Q

What happens after the cerebellum advises the cortex on a movement?

A

The motor cortex sends the revised command down the corticospinal tract

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32
Q

What are the three steps in the cerebellum being a comparator?

A
  1. Receives muscle and joint positioning from spinocerebellar tracts
  2. Advises the cortex on how much, how many and how fast
  3. Motor cortex sends the revised command down the corticospinal tract
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33
Q

How many afferent tracts does the cerebellum receive?

A

Two afferent tracts

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34
Q

What are the two afferent tracts that the cerebellum receives?

A

The Corticopontocerebellar tract and the spinocerebellar tracts (ipsilateral)

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35
Q

What are the corticopontocerebellar tracts?

A

Axon tracts from the premotor and supplementary motor cortex that connects to the cerebellum

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36
Q

What is the pathway of the Corticopontocerebellar tracts?

A
  1. Premotor cortex/supplementary motor cortex to the pons
  2. Pons through the middle cerebellar peduncle to the cerebellum
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37
Q

Which cerebellar peduncle doe the corticopontocerebellar tract travel through?

A

The Middle Cerebellar Peduncle (MCP)

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38
Q

What tract travels through the middle cerebellar peduncle?

A

The Corticopontocerebellar tract

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39
Q

Where does the Corticopontocerebellar tract synapse?

A

At the pons and cerebellum

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40
Q

What is the pathway of the Spinocerebellar tracts?

A

They go from the upper and lower limbs (muscle spindles and tendon organs) to the cerebellum through the inferior cerebellar peduncle (ICP)

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41
Q

What is the neuron pathway of the spincerebellar tracts?

A
  1. From muscle, joints and tendons they synapse at the spinal cord (at the dorsal nucleus of Clarke)
  2. From the spinal cord through the inferior cerebellar peduncle to the cerebellum
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42
Q

Where does the spinocerebellar tract synapse?

A

At the spinal cord (dorsal nucleus of Clarke) and cerebellum

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43
Q

Which pathway travels through the inferior cerebellar peduncle (ICP)?

A

The spinocerebellar tracts

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44
Q

Which peduncle does the spinocerebellar tract travel through?

A

The inferior cerebellar peduncle (ICP)

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45
Q

Which pathway travels through the middle and inferior cerebellar peduncles?

A

Middle Cerebellar Peduncle - Corticopontocerebellar tract
Inferior Cerebellar Peduncle - Spinocerebellar Tracts

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46
Q

What are the two dorsal spinocerebellar tracts?

A
  • Spinocerebellar tract (lower limbs)
  • Cuneocerebellar tract (upper limbs)
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47
Q

What do the spinocerebellar tracts sense?

A

Muscle spindles, tendons and tendon organs

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48
Q

What are the largest peripheral nerves?

A

The dorsal spinocerebellar tracts and cuneocerebellar tracts

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49
Q

What happens as a result of the spinocerebellar and cuneocerebellar axons being large?

A

They are the most myelinates and as a result they are faster than motor axons so they can adjust for sensory axons to advise motor axons

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50
Q

What synapses at the Dorsal Nucleus of Clarke?

A

The spinocerebellar and cuneocerebellar tracts

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51
Q

What happens when an individual is thinking about a movement?

A

The premotor and supplementary motor cortices send afferents down to the basal ganglia and cerebellum

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52
Q

What happens after the premotor and supplementary motor cortex sends afferents down to the basal ganglia and cerebellum?

A

The cerebellum processes this information and sends information back to the upper motor cortex to tell which muscles to contract or not to contract

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53
Q

Why is the middle cerebellar peduncle so big?

A

Because there are tons of afferent motor fibers from from the motor cortex to the cerebellum

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54
Q

What kind of afferents does the cerebellum receive?

A

Motor and sensory afferents

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55
Q

What do the motor afferents that the cerebellum receives refer to?

A

Information from the motor planning areas

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56
Q

What kind of sensory afferents does the cerebellum receive?

A

Afferent information from joints and muscle spindles

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57
Q

What side would a lesion to the cerebellum cause deficits?

A

Ipsilaterally

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58
Q

When advising the cortex, which side does the cerebellum project to?

A

It projects contralaterally

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59
Q

Why is a lesion to the cerebellum contralateral?

A
  1. The cerebellum receives cortical information from the contralateral side of the cortex
  2. The cerebellum sends information back to the contralateral side of the cortex
  3. The crotex then projects to muscles on the contralateral side
    This means that there is a double crossover
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60
Q

What is the other name for the Lateral Corticospinal Tract?

A

Pyramidal Tract

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61
Q

What happens in the cerebellum once a movement is evoked?

A

The cerebellum continues to compare the movement that it tried to tell the muscle to do and corrects for errors

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62
Q

Where does the Corticospinal tract synapse and cross over?

A

It crosses over at the medulla and synapses at the spinal cord

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63
Q

How is the cerebellum continuously involved in ongoing movements?

A

The cerebellum compares the intended movement with actual movement and corrects for errors as the movement evolves in real time

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64
Q

What are five cerebellar disorders?

A

Ataxia
Dysmetria
Dysdiadochokinesia
Forces ‘intentional tremor’
Vertigo

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65
Q

What is Ataxia?

A

Lack of coordination of muscle movements

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66
Q

What can Ataxia look like?

A

Awkwardness of posture and gait

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67
Q

What does Awkwardness of posture and gait usually mean for the cerebellum?

A

There is a lesion to the midline cerebellum

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68
Q

What is an ipsilateral cerebellar sign?

A

When there is a tendency to fall to the same side as a lesion

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69
Q

What are two types of Ataxia?

A

Dysmetria
Dysdiadochokinesia

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70
Q

What is Dysmetria?

A

Overshooting a goal in reaching for a target

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71
Q

What is Dysdiadochokinesia?

A

Inability to perform rapid alternating movements

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72
Q

What is is called when overshooting a goal in reaching for a target?

A

Dysmetria

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73
Q

What is it called when a person in unable to perform rapid alternating movements?

A

Dysdiadochokinesia

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74
Q

What is a Forced Intentional tremor?

A

When an individual has a tremor when attempting to perform purposeful movements

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75
Q

What usually causes resting tremors?

A

Basal Ganglia lesions

76
Q

What is the foliage of the cerebellum?

A

The folds of the cerebellum

77
Q

What are the spaces between folia called?

A

Fissures

78
Q

What do Primary Fissures in the cerebellum do?

A

Divides the cerebellum into lobes

79
Q

What is the Vermis?

A

The midline of the cerebellum

80
Q

What is the midlines of the cerebellum called?

A

The Vermis

81
Q

How many blood vessels supply the cerebellum?

A

Three

82
Q

What are the blood vessels that supply the cerebellum?

A
  1. Superior cerebellar artery
  2. Anterior Inferior Cerebellar Artery (AICA)
  3. Posterior Inferior Cerebellar Artery (PICA)
83
Q

How many peduncles does the cerebellum have?

A

Three

84
Q

How many lobes does the cerebellum have?

A

Three

85
Q

How many deep nuclei does the cerebellum have?

A

Three

86
Q

How many layers of cells does the cerebellum have?

A

Three

87
Q

How many functional divisions does the cerebellum have?

A

Three

88
Q

What are the three cerebellar peduncles?

A
  • Superior cerebellar peduncle
  • Middle cerebellar peduncle
  • Inferior cerebellar peduncle
89
Q

What are the afferent and efferent classifications of the cerebellar peduncles?

A
  • Superior cerebellar peduncle (mostly efferent)
  • Middle cerebellar peduncle (afferent)
  • Inferior cerebellar peduncle (afferent)
90
Q

What does the Inferior Cerebellar Peduncle do?

A

Carries information from the spinal cord and medulla going to the cerebellum - spinocerebellar tracts

91
Q

What does the Middles Cerebellar Peduncle do?

A

Carries information from the motor cortex for motor planning from the through the pontine nuclei to the cerebellum

92
Q

What does the superior cerebellar peduncle do?

A

Carries information from the cerebellum going to the midbrain, thalamus and ultimately the frontal lobe

93
Q

What is the Dentatothalamocortical tract?

A

The tract that carries information from the cerebellum to the motor cortex to tell it which UMNs to activate and inhibit

94
Q

What is the pathway of the Dentatothalamocortical tract?

A

Cerebellum through superior cerebellar peduncle to midbrain and thalamus to the primary motor cortex

95
Q

What are the three lobes of the cerebellum?

A
  1. Anterior Lobe
  2. Posterior Lobe (includes tonsil)
  3. Flocculonodular Lobe
96
Q

What happens if there is swelling or space-filling lesions in the brain?

A

It can cause the cerebellar tonsil to herniate and this is where the nucleus of the solitary tract and cardiorespiratory centers are and they get damaged

97
Q

Describe the cerebellar homunculus?

A
  • The midline structures are in the middle of the cerebellum
  • The shoulder and hip are lateral
  • Farther lateral are the distal limbs
  • The distal part of the cerebellum is associated with fingers, toes, legs and arms
  • Middle part is core and truncal stability
98
Q

What are the sizes of the anterior and posterior lobe of the cerebellum?

A

There is a smaller anterior lobe and a larger posterior lobe

99
Q

What is the Vermis made of?

A

The Anterior lobe, posterior lobe and the nodule

100
Q

What is the Flocculonodular lobe made of?

A

The Flocculus and Nodule

101
Q

What are the afferent tracts to the cerebellum?

A
  • Corticopontocerebellar tracts
  • Spinocerebellar tracts
  • Vestibulocerebellar tracts
102
Q

Through what does the cerebellum project to the motor areas?

A

Via the deep cerebellar nuclei (GABA)

103
Q

What is found deep in the cerebellum?

A

Deep cerebellar nuclei

104
Q

What are the inputs to the cerebellum classifed as?

A

Climbing fibers or mossy fibers

105
Q

What are Climbing fibers?

A

Any afferent fibers involving the olive

106
Q

What kind of fibers are Dorsal cerebellar and cuneocerebellar tracts (mossy/climbing)?

A

They are mossy fibers

107
Q

What are the three important afferents to the cerebellar cortex?

A
  • Corticopontocerebellar tracts
  • Dorsal Spinocerebellar and cuneocerebellar tracts
  • Vestibulocerebellar tracts
108
Q

What are the vestibulocerebellar tracts?

A

Tracts that sense when the head move in space and allows for truncal stability via the cerebellum

109
Q

What neurotransmitter do the three afferent pathways to the cerebellum release?

A

Glutamate. Meaning that the cerebellum receives glutamatergic afferents

110
Q

What kind of afferents does the cerebellum receive (neurotransmitter)?

A

Glutamatergic afferents

111
Q

What kind of neuron is the output neuron from the cerebellum?

A

The Purkinje neuron

112
Q

What happens if there is enough glutamate from the afferents to activate an output purkinje neuron in the cerebellum?

A

The output neuron from the cerebellum (purkinje neuron) will send GABA (an inhibitory neurotransmitter) to the deep cerebellar nuclei

113
Q

What causes the cerebellum Purkinje neuron to release GABA onto the deep cerebellar nuclei?

A

The release of glutamate from afferent fibers onto the cerebellum

114
Q

What does the GABA released onto the deep cerebellar nuclei do?

A

Inhibits the three deep cerebellar nuclei

115
Q

When there is no GABA being released onto the deep cerebellar nuclei by the Purkinje neurons what do the deep cerebellar nuclei do?

A

They fire GABA onto the thalamus

116
Q

What happens when the Purkinje neurons fire GABA onto the deep cerebellar nuclei?

A

They inhibit the deep cerebellar nuclei from firing GABA onto the thalamus

117
Q

What happens when GABA is released onto the thalamus?

A

It inhibits movement

118
Q

What are the steps starting from afferent fibers releasing glutamate onto cerebellum neurons?

A
  1. Afferent fibres release glutamate onto cerebellar neurons
  2. This cause Purkinje cells to be activated and release GABA onto the deep cerebellar nuclei
  3. The deep cerebellar nuclei then stop releasing GABA onto the thalamus
  4. This disinhibits the thalamus allowing it to fire to the cortex allow for movement
119
Q

How is the thalamus disinhibited?

A

The deep cerebellar nuclei stop releasing GABA onto the thalamus because Purkinje fibers are releasing GABA onto the deep cerebellar nuclei because they are activated by glutamate released from afferent fibers

120
Q

What are the three layers of the cerebellar cortex from outside to inside?

A
  • Molecular Layer
  • Purkinje cell Layer
  • Granule cell Layer
121
Q

What do the afferents release on the cerebellum?

A

Glutamate

122
Q

What do the Purkinje cells release onto the Deep Cerebellar Nuclei?

A

GABA

123
Q

What do deep cerebellar nuclei release onto the thalamus?

A

GABA

124
Q

Describe Purkinje cells?

A

They have a large dendritic arbour and unmyelinated cytoplasmic processes that reach into the molecule cell layer

125
Q

Where do Purkinje cell axons go?

A

They transverse the granule cell layer and reach the molecular cell layer and sends axon tracts down to the deep cerebellar nuclei

126
Q

How many dendrites and axons do Purkinje cells have?

A

They have many dendrites but one axon

127
Q

What acts on Purkinje cell neurons to tell them whether to fire or not onto deep cerebellar nuclei?

A

Afferents from the granule cell layer

128
Q

What happens if Purkinje neurons are activated by glutamate?

A

They release GABA onto deep cerebellar nuclei

129
Q

What is the outer cell layer in the cerebellum?

A

Molecular cell layer

130
Q

What is the middle cell layer in the cerebellum?

A

Purkinje cell layer

131
Q

What is the inner cell layer in the cerebellum?

A

The granule cell layer

132
Q

What cells do all the afferent pathways to the cerebellum act on?

A

Granule cells

133
Q

What kind of fibres synapse on granule cells?

A

Mossy fibers

134
Q

What do mossy fibers synapse on?

A

Granule cells

135
Q

What pathways do the mossy fibers come from?

A
  • Dorsal spinocerebellar and cuneocerebellar tracts
  • Vestibular cerebellar tracts
  • Pontocerebellar tracts
136
Q

What do the mossy fibres release onto granule cells?

A

Glutamate

137
Q

Where do granule cells project?

A

They protect through the granule cell layer into the molecular layer where purkinje dendrites are

138
Q

What do Granule cells synapse on?

A

Purkinje cells (parallel fibers)

139
Q

What synapses onto Purkinje cells?

A

Granule cells and climbing fibers

140
Q

What is the pathway of climbing fibers?

A

They climb pass the granule cells and synapse directly onto purkinje cells

141
Q

What do climbing fibers release onto purkinje cells?

A

Glutamate

142
Q

Where do climbing fibers come from?

A

They come from the olive

143
Q

What activate purkinje cells?

A

Climbing fibers and granule cells activated by mossy fibers releasing glutamate on them

144
Q

Where do Purkinje cells project to?

A

Deep cerebellar nuclei

145
Q

What do purkinje cells release?

A

GABA onto deep cerebellar nuclei to prevent them from releasing GABA onto the thalamus

146
Q

Through which peduncle do olivocerebellar fibers (climbing fibers) enter the cerebellum?

A

Through the Inferior Cerebellar Peduncle

147
Q

What is the pathway of Olivocerebellar fibers?

A

Inferior olive - cross midline - enter cerebellum through inferior cerebellar peduncle - synapse directly onto molecule layer (purkinje cell dendrite)

148
Q

Are mossy fibers excitatory or inhibitory?

A

They are excitatory

149
Q

What are the three mossy fiber tracts?

A
  • Spinocerebellar + Cuneocerebellar
  • Corticopontocerebellar
  • Vestibularcerebellar
150
Q

What is the pathway of mossy fibers?

A

Synapse onto granule cell layer - Granule cell axons project to molecular layer - They synapse onto Purkinje cells dendrites - Project to deep cerebellar nuclei

151
Q

What are the efferent axons of the cerebellum?

A

The deep cerebellar nuclei

152
Q

What do Purkinje cells do for the deep cerebellar nuclei?

A

They fine-tune impulses of the deep cerebellar nuclei

153
Q

What happens with the mossy and climbing fibers during rest?

A

They act directly onto the deep cerebellar nuclei and release glutamate on them to allow them to continue release GABA onto the thalamus to inhibit activation

154
Q

Why do Purkinje cells only fine tune the deep cerebellar nuclei?

A

Because the deep cerebellar nuclei already receive excitatory inputs from the mossy and climbing fibers

155
Q

What are the three deep cerebellar nuclei?

A
  • Fastigial nucleus
  • Interposed nucleus
  • Dentate nucleus
156
Q

Where is the Fastigial nucleus in the cerebellum?

A

In the vermis

157
Q

What is the Fastigial nucleus important for?

A

Balance and posture

158
Q

Which cerebellar nucleus is important for balance and posture?

A

The Fastigial Nucleus

159
Q

What is the Interposed Nucleus composed of?

A

The Globose Nucleus and the Emboliform nucleus

160
Q

What do the Globose and Emboliform nucleus make?

A

The Interposed nucelus

161
Q

Where is the interposed nucleus found?

A

In the Paravermal zone

162
Q

What does the interposed nucleus control?

A

The trunk, shoulder, hips and proximal limb muscles

163
Q

Where is the dentate nucleus located?

A

In the Lateral zone

164
Q

What does the Dentate nucleus control?

A

Distal limb muscles

165
Q

What area is each cerebellar nucleus located?

A

Fastigial nucleus - Vermis
Interposed nucleus - Paravermal zone
Dentate nucleus - Lateral zone

166
Q

What nucleus controls the trunk, shoulder hips and proximal limb muscles?

A

Interposed

167
Q

What nucleus controls the distal limb muscles?

A

Dentate nucleus

168
Q

Which tracts does the Fastigial Nucleus give input to?

A

The vestibulospinal and Reticulospinal

169
Q

Which tracts do the Interpositus nucleus give input to?

A
  • Corticospinal tract
  • Corticobulbar tract
  • Rubrospinal tract
170
Q

Where does the dentate nucleus give input to?

A
  • VA/VL thalamus to Motor, Premotor and supplementary motor cortex?
171
Q

What control does the Fastigial Nucleus have?

A
  • Modulate balance and truncal stability
  • Muscle tone
172
Q

What control does the Interpositus Nucleus have?

A
  • Execution of movement
  • Modulate movement
173
Q

What control does the Dentate Nucleus have?

A
  • Motor planning
  • Evaluation of sensory information
174
Q

What nuclei is in the Flocculonodular lobe?

A

The Vestibular nuclei

175
Q

What area of the cerebellum is the Vestibular Nuclei?

A

The Flocculonodular lobe

176
Q

What is the big motor planning area in the cerebellum?

A

The lateral zone

177
Q

What coordinates eye and head movements in the cerebellum?

A

The focculonodula lobe in connection with the vestibular nuclei

178
Q

What do the Fastigial nucleus and Interposed nucleus do together?

A
  • Maintain axial balance
  • Maintain muscle tone and synergy of collaborating muscles
179
Q

What does the dentate nucleus mainly do?

A
  • Motor planning
  • Evaluation of sensory info
  • Ensure smooth sequence of muscle contractions and precision of force, direction and extent of voluntary upper movements
180
Q

What does the Vestibular nuclei mainly do?

A
  • Coordinated muscles of balance equilibrium
  • Coordinates head and eye movements
181
Q

What is the Dentatothalamocortical tract?

A

The projection pathway from the thalamus to the motor planning areas of the cortex

182
Q

What is the projection pathway from the thalamus to the motor planning areas of the cortex?

A

The Dentatothalamocortical tract

183
Q

What are the major cerebellar efferent pathways?

A

The Dentatothalamocortical tract and the Vestibulospinal Tract

184
Q

What peduncle does the Dentatothalamocortical tract pass through?

A

The Superior Cerebellar peduncle

185
Q

What are the three functional divisions of the Cerebellum?

A

Flocculonodular lobe - controls equilibrium/balance
Vermal/Paravermal zone - controls posture and muscle tone
Lateral Zone - Coordinates smooth purposeful movements

186
Q

How does the Vestibulocerebellar tract work?

A
  1. Projects to granule neurons b/c they are mossy fibers
  2. Granule neurons synapse onto purkinje neuron dendrites
  3. They synapse of the Fastigial nuclei which project to the vestibular nuclei in the brainstem
  4. Vestibular nucleus send axons to excite arm/leg extensors for balance and axial core muscles