S2_L3: Cerebellum Flashcards
The following statements are true about the cerebellum, EXCEPT:
A. Also known as “small brain”
B. Largest structure in the posterior cranial fossa
C. Attached to the inferior aspect of the brainstem by three white matter peduncles
D. Develops from rhombic lip
E. None of the above
C. Attached to the inferior aspect of the brainstem by three white matter peduncles
NOTE: It is attached on the dorsal aspect.
TRUE OR FALSE: The cerebellum is concerned primarily, but not exclusively with motor function. It is for refinement of movement.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
The primary roles of the cerebellum are the following:
- Smooth (1)_______ of movements
- Control of (2)______ & ______
- Regulation of (3)_____
- Coordination
- Posture ; Gait
- Muscular tone
What are the 3 fissures of the cerebellum?
1.Primary fissure
2. Horizontal fissure
3. Posterolateral fissure/Uvulonodular fissure
This is located in the midline of the cerebellum. It commences at the anterior cerebellar notch and curves 180º to the posterior cerebellar notch.
Vermis
The vermis is named for its _______ appearance.
wormlike
Match the following cerebellar lobe to its corresponding description.
- Most superior lobe
- Known as the “inferior lobe of the cerebellum”
- Known as the “middle lobe of the cerebellum”
- Has connections to the vestibular nuclei
A. Anterior lobe
B. Posterior lobe
C. Flocculonodular lobe
- A
- C
- B
- C
Match the following - to its -.
- Largest lobe
- Known as the “superior lobe of the cerebellum”
- Most inferior and anterior lobe
A. Anterior lobe
B. Posterior lobe
C. Flocculonodular lobe
- B
- A
- C
The following statements are true about the cerebellar fissures, EXCEPT:
A. The primary fissure is the deepest fissure
B. The uvulonodular fissure separates the cerebellum into anterior and posterior lobes
C. The horizontal fissure divides the cerebellum into halves
D. All of the above
E. None of the above
B. The uvulonodular fissure separates the cerebellum into anterior and posterior lobes
NOTE: It separates posterior lobe from the flocculonodular lobe
TRUE OR FALSE: Thew cerebellum is responsible for modulation of an individual’s emotional state.
True
This fissure arcs around the cerebellum along its posterior margins and lateral margins to the point of the posterolateral fissure
Horizontal fissure
_____ are connected to the nodulus by thin pedicles
Flocculus
This is the most inferior portion of the cerebellar vermis
Nodulus
Cerebellar tonsils are
mass lesions of the cerebellum or brain swelling that will severely increase the (1)_______ , causing the tonsils to herniate through the (2)_______
- intracranial pressure
- foramen magnum
How many cerebellar peduncles are there?
3
The 3 cerebellar peduncles forms the (1)_______ of the (2)_______
- floor
- fourth ventricle
TRUE OR FALSE: The arbor vitae, Latin for “tree of life”, is the cerebellar white matter. The outer layer of the cerebellum consists of ridge called folia.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
The superior peduncle, also known as (1)______ , decussates in the midbrain at the level of the (2)_______
- brachium conjunctivum
- inferior colliculi
TRUE OR FALSE: Superior peduncles mainly carry inputs to the cerebellum. Middle and inferior peduncles mainly carries output from the cerebellum.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
B. Both statements are false
This is also known as the restiform body
Inferior peduncle
This is also known as brachium pontis
Middle cerebellar peduncle
The following are true about the deep nuclei of the cerebellum.
A. Also called “Floor Nuclei”
B. Are efferent fibers of the cerebellar cortex
C. Consist of the axons of the Purkinje cells
D. All of the above
E. None of the above
A. Also called “Floor Nuclei”
NOTE: It is also called Roof Nuclei
Enumerate the deep nuclei of the cerebellum from lateral to medial.
- Dentate nucleus
- Emboliform nucleus
- Globose nucleus
4 .Fastigial nucleus
_______ is the largest of the deep cerebellar nuclei
Dentate nucleus
The Globose and Emboliform nuclei combined is called as the
interposed nuclei
Determine the functional classification of the following phylogenetic classification.
Paleocerebellum
A. Vestibulocerebellum
B. Spinocerebellum
C. Cerebrocerebellum
B. Spinocerebellum
Determine the functional classification of the following phylogenetic classification.
Archicerebellum
A. Vestibulocerebellum
B. Spinocerebellum
C. Cerebrocerebellum
A. Vestibulocerebellum
Determine the functional classification of the following phylogenetic classification.
Neocerebellum
A. Vestibulocerebellum
B. Spinocerebellum
C. Cerebrocerebellum
Cerebrocerebellum
Match the anatomical structure with its corresponding nuclei.
- Cerebellar hemispheres
- Flocculonodular lobe
- Anterior lobe
- Posterior lobe
- Vermis
A. Fastigial nuclei
B. Interposed nuclei
C. Dentate nuclei
- C
- A
- B
- C
- B
Match the anatomical structure with its corresponding phylogenetic classification.
- Cerebellar hemispheres
- Flocculonodular lobe
- Anterior lobe
- Posterior lobe
- Vermis
A. Paleocerebellum
B. Neocerebellum
C. Archicerebellum
- B
- C
- A
- B
- A
Match the anatomical structure with its corresponding function.
- Coordination and tone
- Balance
- Posture
- Equilibrium
- Eye movement
A. Flocculonodular lobe
B. Vermis/ Anterior lobe
C. Posterior lobe/
Cerebellar hemispheres
- C
- A
- B
- A
- A
Determine which anatomical structure is affected with the following impairment.
- vestibulo–ocular reflexes
- truncal ataxia
- dysdiadochokinesia
- dysarthria
- dysmetria
A. Flocculonodular lobe
B. Vermis/ Anterior lobe
C. Posterior lobe/
Cerebellar hemispheres
- A
- B
- C
- C
- C
Determine which anatomical structure is affected with the following impairment.
- kinetic tremors
- nystagmus
- titubation
- hypotonia
A. Flocculonodular lobe
B. Vermis/ Anterior lobe
C. Posterior lobe/
Cerebellar hemispheres
- B/C
- A
- B
- C
This lobe receives inputs from the vestibular system, and sends outputs back to the vestibular nuclei.
Flocculonodular lobe
You have a patient with nystagmus, what phylogenetic classification is affected?
Archicerebellum
You have a patient with hypertonicity, what functional classification is affected?
None
You have a patient with postural instability, what anatomical structure is affected?
Vermis or anterior lobe
You have a patient with difficulty reaching the pen, usually overestimates distance, what nucleus is affected?
Dentate nucleus
NOTE: Hypermetria is a coordination problem
Determine the condition.
Rhythmic oscillations of the head: side-to-side, forward-and-backward, and rotatory movements of the head
A. Dyssynergia
B. Dysdiadochokinesia
C. Titubation
C. Titubation
Determine the Cerebellar Pathology
Movement performed in a sequence of component parts rather than as a single, smooth activity
A. Dyssynergia
B. Dysdiadochokinesia
C. Asthenia
A. Dyssynergia
Determine the Cerebellar Pathology
Impaired ability to perform rapid alternating movements
A. Dysarthria
B. Dysdiadochokinesia
C. Asthenia
B. Dysdiadochokinesia
Determine the Cerebellar Pathology.
Loss of ability to associate muscles together for complex movements
A. Asthenia
B. Asynergia
C. Delayed reaction time
B. Asynergia
Determine the Cerebellar Pathology.
Increased time required to initiate voluntary movement
A. Asthenia
B. Dysmetria
C. Delayed reaction time
C. Delayed reaction time
Determine the Cerebellar Pathology.
Involuntary oscillatory movement resulting from alternating contractions of the opposing muscle groups
A. Rebound phenomenon
B. Tremors
C. Dysdiadochokinesia
B. Tremors
Determine the Cerebellar Pathology.
Generalized muscle weakness
A. Asthenia
B. Hypotonia
C. Titubation
A. Asthenia
Determine the Cerebellar Pathology.
Inability to halt forceful movements after resistive stimulus removed
A. Dyssynergia
B. Dysdiadochokinesia
C. Rebound phenomenon
C. Rebound phenomenon
A pt presents with a disorder of the motor component of speech articulation.
What cerebellar pathology is seen?
Dysarthria
A pt presents with a broad base of support, postural instability, and an ataxic pattern
What cerebellar pathology is seen?
Gait disorders
A pt presents with rhythmic, quick, oscillatory, back-and-forth movement of the eyes
What cerebellar pathology is seen?
Nystagmus
TRUE OR FALSE: Dysarthria and dysphagia go hand in hand.
True
_____ is the inability to judge the distance or range of a movement
Dysmetria
This cerebellar pathology manifests with decrease in muscle tone
Hypotonia
(1)_____ is the overestimation of distance or range needed to accomplish a movement, (2)______ is the underestimation of distance or range needed to accomplish a movement
- Hypermetria
- Hypometria
This kind of tremors are evident during back-and-forth oscillatory movements while the patient remains in a standing position and also seen during up-and-down oscillatory movement of the limb when held against gravity
Static (Postural) Tremor
This kind of tremor is absent or diminished at rest and usually occurs during a limb’s voluntary motion and increases when the limb is near its intended goal or speed is increased
Kinetic (Intention) Tremor
TRUE OR FALSE:Postural tremors is more common in persons with cerebellar dysfunction
False
Enumerate the possible cerebellar signs using the mnemonic “DDANISH”
Dysdiadochokinesia, Dysmetria, Ataxia, Nystagmus, Intention Tremor, Speech, and Hypotonia
Enumerate the possible cerebellar signs using the mnemonic “VANISH DDT”
Vertigo, Ataxia, Nystagmus, Intention Tremor, Staccato speech, Hypotonia, Dysmetria, Dysdiadochokinesia, and Titubation
TRUE OR FALSE: A cerebellar stroke affects both motor and sensory functions. It is a contralateral affectation.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
NOTE: Cerebrum has contralateral affectation, while cerebellum has ipsilateral affectation
When there is (+) nystagmus, what must be noted about it?
- Direction of nystagmus
- Direction of gaze
TRUE OR FALSE: Slurred staccato speech is characteristic of cerebellar disease
True
SCENARIO: Pt told to stand still w/ arms outstretched and heels together. Pt is also told to close their eyes while, examiner observes pt’s posture.
What test is being done?
TRUE OR FALSE: Romberg’s Test is a test for cerebellar disease
False
NOTE: Test for proprioception rather than cerebellar disease
TRUE OR FALSE: All other tendons that can be assessed (DTR) can be used to test for hypotonia
True
Determine the coordination test using the description below.
Arm abducted or flexed. Switch arm abducted or flexed and arm with finger touching the nose.
Finger-to-nose Test
Determine the coordination test using the description below.
Pt is told to do elbow flexion up to 90 degrees, the examiner will add resistance on pt’s wrist.
The examiner will release pressure on the wrist suddenly, and pt must retain its original position.
Holmes Rebound Phenomenon
Determine the coordination test using the description below.
Pt is told to walk forward and backward in a straight line. The dynamic posture and movement coordination is assessed and analyzed by the examiner.
Test
Determine the coordination test using the description below.
The patient will be in a supine position and is instructed to slide the heel of one foot on the shin of the contralateral lower extremity.
Heel on shin Test
Determine which tests are used for the following manifestations. You may choose 2 or more answer.
- Alternate nose-to-finger
- Finger-to-nose
- Foot tapping
A. Dysdiadochokinesia
B. Dysmetria
C. Kinetic Tremor
D. Dysarthria
E. Hypotonia
- A/C
- A
- E
Determine which tests are used for the following manifestations.
- Pronation/Supination
- PATA and PATAKA Test
- Lower Extremity Motor Coordination
A. Dysdiadochokinesia
B. Dysmetria
C. Kinetic Tremor
D. Dysarthria
E. Hypotonia
- A
- D
- E
Determine which tests are used for the following manifestations.
- Knee jerk
- Finger-to-therapist’s finger
- Drawing a circle or figure eight
A. Dysdiadochokinesia
B. Dysmetria
C. Kinetic Tremor
D. Dysarthria
E. Hypotonia
- E
- C
- B
Determine which tests are used for the following manifestations.
- Holmes Rebound Phenomenon
- Pointing and past pointing
- Gait assessment
A. Dysdiadochokinesia
B. Dysmetria
C. Kinetic Tremor
D. Dysarthria
E. Hypotonia
- E
- B
- E
Determine which tests are used for the following manifestations.
- Knee flexion
- Finger-to-finger
- Walking, alter speed or direction
A. Dysdiadochokinesia
B. Dysmetria
C. Kinetic Tremor
D. Dysarthria
E. Hypotonia
- A
- C
- A
Determine which tests are used for the following manifestations.
- Deep tendon reflexes
- Toe-to-therapist’s finger
- Heel on shin
A. Dysdiadochokinesia
B. Dysmetria
C. Kinetic Tremor
D. Dysarthria
E. Hypotonia
- E
- C
- B
Determine the coordination test using the description below.
The patient alternately touches the tip of their nose and the tip of the therapist’s finger with the index finger. The position of the therapist’s finger may be altered during testing to observe ability to change distance, direction, and force of movement.
Alternate nose-to-finger Test
Determine the coordination test using the description below.
With knees positioned at 90 degrees and heels at the target board, pt is told to touch distal/proximal points in the board in a certain amount of time.
Lower Extremity Motor Coordination Test
Determine the coordination test using the description below.
Pt is told to recite “PATAKA/PATA” in a certain amount of time as many times as they could.
Test
What are the 3 factors that affect balance?
- Vision
- Proprioception
- Vestibular system
What are the 3 afferent fibers of the cerebellum?
- Corticopontocerebellar
- Cerebro-olivocerebellar
- Cerebroreticulocerebellar
Determine the afferent fiber being described.
- Only tract which becomes climbing fibers
- For control of voluntary movements
- Decussates at transverse fibers of the pons
- Connects the premotor areas to the contralateral cerebellar hemisphere
- Decussate to reach the fibers of the opposite Raphe nucleus
A. Corticopontocerebellar
B. Cerebro-olivocerebellar
C. Cerebroreticulocerebellar
- B
- C
- A
- A
- B
The Cerebroreticulocerebellar is also known as __________
corticoreticulocerebellar pathway
Corticopontocerebellar and Cerebro-olivocerebellar fibers arise from neurons in which lobes of the cerebral cortex?
All (frontal, parietal, temporal, and occipital)
The Cerebroreticulocerebellar and Corticopontocerebellar tract ends in cerebellum as wat fibers?
mossy fibers
In which peduncle do the fibers of the Corticopontocerebellar pathway passes through?
A. superior cerebellar peduncle
B. middle cerebellar peduncle
C. inferior cerebellar peduncle
D. Either A or B
E. Either B or C
B. middle cerebellar peduncle
In which peduncle do the fibers of the Cerebro-olivocerebellar pathway passes through?
A. superior cerebellar peduncle
B. middle cerebellar peduncle
C. inferior cerebellar peduncle
D. Either A or B
E. Either B or C
C. inferior cerebellar peduncle
In which peduncle do the fibers of the Cerebroreticulocerebellar pathway passes through?
A. superior cerebellar peduncle
B. middle cerebellar peduncle
C. inferior cerebellar peduncle
D. Either A or B
E. Either B or C
E. Either B or C
Cerebroreticulocerebellar fibers arise from neurons in which lobes of the cerebral cortex?
frontal & parietal lobes (sensorimotor areas)
What is the function of the 3 afferent fibers of the cerebellum?
control of voluntary movement
Where is the destination of the Cerebroreticulocerebellar tract?
Reticular formation to cerebellar cortex
Where is the destination of the Cerebroreticulocerebellar tract?
Where is the destination of the Cerebro-olivocerebellar tract?
Inferior olivary nuclei and climbing fibers to cerebellar cortex
Where is the destination of the Corticopontocerebellar tract?
Pontine nuclei and mossy fibers to cerebellar cortex
What are the 2 efferent fibers of the cerebellum?
- Globose-Emboliform Rubral Pathway
- Fastigial Vestibular Pathway
Determine which pathway is being described.
Motor activity on ipsilateral side
A. Globose-Emboliform Rubral Pathway
B. Fastigial Vestibular Pathway
A. Globose-Emboliform Rubral Pathway
Determine which pathway is being described.
axons travel through the inferior cerebellar peduncle
A. Globose-Emboliform Rubral Pathway
B. Fastigial Vestibular Pathway
B. Fastigial Vestibular Pathway
Determine which pathway is being described.
Balance and good control of extensor muscles to maintain posture
A. Globose-Emboliform Rubral Pathway
B. Fastigial Vestibular Pathway
B. Fastigial Vestibular Pathway
Determine which pathway is being described.
ravel through the superior cerebellar peduncle then decussate in the decussation of the superior cerebellar peduncles
A. Globose-Emboliform Rubral Pathway
B. Fastigial Vestibular Pathway
A. Globose-Emboliform Rubral Pathway
Determine which pathway is being described.
this pathway cross twice, once in the decussation of a cerebellar peduncle and another close to its origin
A. Globose-Emboliform Rubral Pathway
B. Fastigial Vestibular Pathway
A. Globose-Emboliform Rubral Pathway
Determine which pathway is being described.
Uncrossed tract
A. Globose-Emboliform Rubral Pathway
B. Fastigial Vestibular Pathway
B. Fastigial Vestibular Pathway
Determine which pathway is being described.
For flexors, influences ipsilateral motor activity
A. Globose-Emboliform Rubral Pathway
B. Fastigial Vestibular Pathway
A. Globose-Emboliform Rubral Pathway