T9.6: Movement Disorders - Cerebellum

Question 1

Which of the following is true of the Cerebellar pathways?

A. Dorsal Spinocerebellar pathways enters the superior cerebellar peduncle
B. The Ventral Spinocerebellar pathway doesn’t decussate
C. Cuneocerebellar relays proprioception for the lower limbs
D. Deep Cerebellar Nuclei are analogous to Cerebral Basal Ganglia

RFA

Answer 1

Ans. D.

A. Would be correct if said inferior peduncle

B. Ventral Spinocerebellar pathway actually decussates twice so while it effects the ipsilateral side but it does decussate.

C. Cuneocerebellar pathway is for the upper limbs both the Ventral and Dorsal Spinocerebellar pathways are for the lower limbs.

Question 2

A scientist is doing an experiment on a rats seeing what would happen when the the fibers that originate from the Granule Cells are damaged . Which fibers is the scientist damaging?

A. Mossy Fibers
B. Parallel Fibers
C. Climbing Fibers
D. Ragged Red Fibers

RFA

Answer 2

Ans. B Parallel fibers- are axons of Granule cells that bifurcate in the molecular layer( the most distal from the deep cerebellar nuclei) they excite Purkinje cells and Local Inhibitory interneurons in the molecular layer.

A. Mossy Fibers origin from the CN S input on the Granule cells in the Granule layer

C. Climbing fibers origin from the Inferior Olivary nucleus ascend directly on the synapse of Purkinje Cells.

D. Ragged Red Fibers is associated with MERRF a mitochondrial disease

Question 3

A woman brings her 2 year old son to the doctor. She tells the physician that her son frequently gets sick. She notes her son also learned to walk later than than her friends children. On examination the doctor notices small dilated vessels in the child’s eyes. What is the cause of the child’s condition?

A. Vitamin Deficiency 
B. Lesion of the Posterior Lobe
C. X linked Recessive disorder
D.  Damage to to the vertebral Artery system 
E. Compromised Chromosome 
F.  Lesion to the Vestibulocerebellum 

RFA

Answer 3

ANS. E- The child has Louis-Bar Syndrome which is an autosomal recessive disorder noted for widespread degeneration of cerebellar Purkinje cells and compromised immune function( chromosome 11)

The syndrome is associated with delayed motor development as well as small dilated blood vessels on the skin and eyes.

A. Vitamin Deficiency would be lack of B1(Thiamine) resulting in Spinocerebellum(Anterior lobe) damage. This would affect posture and movement of limbs as well are lurching to side of lesion. This is associated with alcoholics

B A lesion to the Posterior lobe, Cerebro-cerebellum, such as Cerebellar Cognitive affective Syndrome(CCAS) is associated with dysfunctional cognitive and emotional system leading to depression and psychosis. Patient will also so disturbances in accuarand and timing of movements.

C. Louis-Bar is autosomal recessive not x linked

D. Damage to the vertebral Artery System would cause Cerebellar stroke. With motor signs of intention tremor, rebound phenomenon ect.

F. Lesion to the Vestibulocerebellum, Flocculonodular lobe, would result in lost of equilibrium functions: tilted head, nystagmus, titubation, ect.

Question 4

You perform a MRI of your patients head and find a Cerebro-cerebellar lesion. They present with dysmetria, speaking problems, diplopia, dyssynergia, and depression. what is your diagnosis?

A) Malnutrition
B) Louis- Bar Syndrome
C) CCAS
D) Restiform Body lesion

Answer 4

Answer = C b/c it give post lobe symptoms fucking up accuracy and timing.

a- would give ant lobe symptoms, lesion lurching, posture probs, alocholic related
b - gives eyes that look like ur high, motor level delay, inc infection risk, and inc cancer risk

follicular node lesion - head nodding , nystagmus, titlted head, wide base walking

Question 5

You are driving at night while being home for winter break from medical school and get pulled over. The cop makes u get out of the car and perform the drunk test and you fail walking in a straight line. he checks your eyes and you fail that test too, your head keeps nodding.
The cop yells at you for being a drunk piece of shit but you tell him you are just tired af cuz u finished ur semester at a Caribbean medical school. The cop made up his mind because Caribbean students love going to brewery and it gets stupid packed on the weekends so clearly u like to drink.
You actually haven’t had anything to drink you are extremely obese though. You pass out they are taken to the hospital were an MRI is done and a lesion is found. where is the lesion?

A) Spino - Cerebellum
B) Cerebro - Cerebellum
D) Vestibulo- Cerebellum
E) Internal Capsule

Answer 5

Answer is D

txt book definition of the symptoms of a vestibule-cerebellum lesion

int capsule lesion - contralateral hemiplegia, lick away from lesion, look toward lesion, contralateral lwr facial muscle paralysis

Question 6

Josh Gad kicks you in the head and your Right inferior cerebellar peduncle is destroyed. Which symptoms will be present?

A) Right Arm Probs
B) Right Trunk Probs
C) Left Arm Probs
D) Left Leg Probs 
E) Bilateral Leg Probs

Answer 6

Answer = A

cerebellar lesions are ipsiliateral. the inferior peduncle is responsible for the Cuneocerebellar tract which is responsible for the Upper Limbs
inf peduncuxle also does dorsal spinocerebellar tract for lwr leg but there is no answer choice for that