Snell’s Clinical Neuroanatomy Chapter 6 - Cerebellum and Its Connections

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Questions and Answers

Damage to the right cerebellar hemisphere is most likely to result in deficits on which side of the body?

  • The right side (correct)
  • Both sides equally
  • Neither side, as the cerebellum only affects cranial nerve function
  • The left side

Which of the following is the MOST accurate description of the cerebellum's role in motor function?

  • Directly stimulating lower motor neurons
  • Coordinating and smoothing voluntary movements (correct)
  • Providing the primary motor output to skeletal muscles
  • Initiating voluntary movements

A patient exhibits dysdiadochokinesia during a neurological exam. Which area of the brain is MOST likely affected?

  • Primary motor cortex
  • Spinal cord
  • Cerebellum (correct)
  • Basal ganglia

Which of the following cerebellar peduncles primarily transmits afferent information from the spinal cord?

<p>Inferior cerebellar peduncle (A)</p> Signup and view all the answers

After suffering a stroke, a patient has difficulty coordinating movements. When asked to touch their nose with their right index finger, they overshoot the target. Which cerebellar structure is MOST likely affected?

<p>Right cerebellar hemisphere (A)</p> Signup and view all the answers

A patient presents with truncal ataxia, demonstrating difficulties in maintaining balance while sitting or standing. Lesions in which part of the cerebellum are MOST likely responsible for these symptoms?

<p>Flocculonodular lobe and vermis (B)</p> Signup and view all the answers

Which type of cells' axons form the efferent output from the cerebellar cortex?

<p>Purkinje cells (D)</p> Signup and view all the answers

A lesion to the fastigial nucleus would MOST significantly impact which of the following?

<p>Balance and equilibrium (A)</p> Signup and view all the answers

What is the MOST accurate description of the function of mossy fibers in the cerebellum?

<p>They exert a diffuse excitatory effect on many Purkinje cells through granule cells. (D)</p> Signup and view all the answers

Which neurotransmitter do climbing fibers utilize to influence Purkinje cells?

<p>Glutamate (C)</p> Signup and view all the answers

A patient presents with a tumor affecting the cerebellum. The primary symptom is an inability to coordinate the muscles of the trunk, leading to difficulties in maintaining an upright posture. Which specific region of the cerebellum is MOST likely affected by the tumor?

<p>Flocculondodular lobe (A)</p> Signup and view all the answers

Damage to the cerebro-olivocerebellar pathway would MOST directly affect which type of fibers?

<p>Climbing fibers (A)</p> Signup and view all the answers

A lesion in the superior cerebellar peduncle would disrupt which of the following?

<p>Efferent fibers from the dentate nucleus (A)</p> Signup and view all the answers

Which of the following best describes the anatomical location of the cerebellum?

<p>Posterior cranial fossa, posterior to the pons and medulla (A)</p> Signup and view all the answers

What is the MOST accurate description of the arbor vitae within the cerebellum?

<p>The trunk and branches of white matter resembling a tree (B)</p> Signup and view all the answers

Which cerebellar structure is responsible for providing afferent nervous information regarding inhibitory axons from the purkinje cells?

<p>Intracerebellar Nuclei (C)</p> Signup and view all the answers

Damage to which structure would lead to the clinical presentation of deficits related to muscle tone in lower extremities and issues with balance when ambulatory?

<p>Cerebellum (B)</p> Signup and view all the answers

Regarding cerebellar efferent fibers that connect with the red nucleus, which also gives rise to axons of the ____, can be determined?

<p>rubrospinal tract (D)</p> Signup and view all the answers

Which cell type located within the Cerebellum is responsible for the release of GABA?

<p>Purkinje Cells (B)</p> Signup and view all the answers

What functional purpose do the climbing fibers serve in relation to Purkinje neurons?

<p>Make synaptic contact (D)</p> Signup and view all the answers

Which structure allows for the transmission of information from the cerebral cortex concerning initiation of movement so the movement can be monitored and adjusted?

<p>Reticulocerebellar fibers (B)</p> Signup and view all the answers

Damage to the Globose-Emboliform-Rubral Pathway would lead to direct synapsing with:

<p>Contralateral red nucleus (C)</p> Signup and view all the answers

The main connections of the cerebellum can be summarized as?

<p>The cerebellum influences on the same side of the body (C)</p> Signup and view all the answers

Loss of cerebellar function would influence all of the below areas EXCEPT:

<p>initiate muscle movement (C)</p> Signup and view all the answers

Difficulty to perform alternating movements regularly and rapidly is a sign of which condition?

<p>Dysdiadochokinesia (C)</p> Signup and view all the answers

What is pendular knee jerk?

<p>movement produced by tendon reflexes tends to continue for a longer period of time than normal (B)</p> Signup and view all the answers

What form does slow-phase followed by quick-phase?

<p>jerk nystagmus (A)</p> Signup and view all the answers

What area of the brain is impacted by medulloblastoma in children?

<p>Vermis (A)</p> Signup and view all the answers

What area of the brain can acute alcohol poisoning occur as a result?

<p>GABA (B)</p> Signup and view all the answers

What is the most prominent manifestation in reduced state of cerebellum?

<p>Hypotonia and loss of influence of the cerebrum on the activities of the cerebral cortex. (A)</p> Signup and view all the answers

Name the three afferent nerve bundles of fibers called of the cerebellum:

<p>Superior, middle and inferior (B)</p> Signup and view all the answers

The cerebellum is divided into three main lobes:which are?

<p>Anterior lobe, the middle lobe, and the flocculondodular lobe. (D)</p> Signup and view all the answers

Which of the following describes the Purkinje cells?

<p>Flask-shaped neurons arranged in a single layer (D)</p> Signup and view all the answers

Of the following, which is not contained in the molecular layer:

<p>Purkinje cell (A)</p> Signup and view all the answers

Name what cells are packed in the granular layer:

<p>small cells with densely staining nuclei and scanty cytoplasm. (C)</p> Signup and view all the answers

What is the intercerebellar nuclei composed of?

<p>large, multipolar neurons with simple branching dendrites. (C)</p> Signup and view all the answers

What fibers proceed to the cerebellar cortex through the inferior and middle cerebellar peduncles?

<p>Afferent Fibers (D)</p> Signup and view all the answers

What is sent directly the cerebellum through the inferior cerebellar peduncle on the same side?

<p>Vestibular Nerve (A)</p> Signup and view all the answers

Name the afferent cerebellar pathway that sends muscle spindle, tendon organ and joint receptor information from the lower body:

<p>Posterior Spinocerebellar (B)</p> Signup and view all the answers

The neurons in the ______________________ travel through the inferior cerebellar peduncle and end synapsing the neurons with the lateral vestibular nucleus?

<p>fastigial nucleus (A)</p> Signup and view all the answers

What is the functional consequence of damage to the intermediate zone of the cerebellar hemisphere?

<p>Compromised control over the muscles in the distal parts of the limbs, like hands and feet. (A)</p> Signup and view all the answers

If a patient has damage to the dentate nucleus, which subsequent motor function deficit is most likely to occur?

<p>Difficulties in coordinating muscle activity on the same side of the body during complex movements. (A)</p> Signup and view all the answers

Damage to the superior cerebellar peduncle disrupts the efferent pathway from which structure?

<p>Dentate nucleus (A)</p> Signup and view all the answers

What is the functional outcome of a lesion that impacts the fibers crossing in the decussation of the superior cerebellar peduncles?

<p>Compromised coordination and motor planning on the contralateral side of the body. (D)</p> Signup and view all the answers

If a patient's cerebellar function is compromised due to acute alcohol poisoning, what is the underlying mechanism affecting neuronal activity?

<p>Potentiation of GABA receptors, leading to increased inhibitory effects. (D)</p> Signup and view all the answers

What is the MOST likely outcome resulting from damage to the fastigial nucleus?

<p>Disturbances in balance and gait due to its influence on extensor muscle tone. (D)</p> Signup and view all the answers

Compromise to what structure leads to decomposition of movement?

<p>Cerebellum (D)</p> Signup and view all the answers

Following motor cortex initiation, where is the information sent to monitor precise movements and to make adjustments?

<p>Cerebellum (D)</p> Signup and view all the answers

A lesion involving the inferior cerebellar peduncle would MOST significantly disrupt afferent information from which source?

<p>Vestibular system concerning balance. (C)</p> Signup and view all the answers

What key function do the parallel fibers perform to allow for coordinated movement?

<p>Make synaptic contacts with the spinous processes of Purkinje cell dendrites. (B)</p> Signup and view all the answers

Describe the mechanism allowing the Cerebellum to function as a coordinator of precise movements?

<p>Continually comparing output of motor area of cerebral cortex with proprioceptive information received from muscle action site. (C)</p> Signup and view all the answers

How do mossy fibers contribute to cerebellar function?

<p>Exerting a diffuse excitatory effect on numerous Purkinje cells through granule cells. (B)</p> Signup and view all the answers

How do Purkinje cells contribute towards motor movement?

<p>Inhibiting the neurons of the cerebellar nuclei. (A)</p> Signup and view all the answers

What type of fibers communicate directly with the cerebellum through the inferior cerebellar peduncle related to motion from semicircular canals and position from the utricle and saccule?

<p>Vestibular Nerve Fibers (B)</p> Signup and view all the answers

Which ascending tract carries subconscious proprioceptive information from the lower limbs and trunk to the cerebellum?

<p>Posterior spinocerebellar tract. (A)</p> Signup and view all the answers

Where does the anterior spinocerebellar tract terminate after entering the cerebellum?

<p>Mossy fibers in the cerebellar cortex (C)</p> Signup and view all the answers

Where do the efferent Purkinje cell axons within the flocculonodular lobe terminate?

<p>Lateral vestibular nucleus (D)</p> Signup and view all the answers

Which pathway is involved in coordinating motor activity via the cerebral cortex?

<p>Dentatothalamic Pathway (A)</p> Signup and view all the answers

Which pathway facilitates influence mainly on the ipsilateral extensor muscle tone?

<p>Fastigial Vestibular Pathway (D)</p> Signup and view all the answers

Through what efferent pathway does the cerebellum influence spinal segmental motor activity?

<p>Fastigial Reticular Pathway (C)</p> Signup and view all the answers

Which tracts are responsible for influencing the motor neurons of the same side of the body?

<p>Globose-emboliform-rubral pathway / vestibulospinal tract (A)</p> Signup and view all the answers

What neuronal adaptation occurs over time that causes chronic cerebellar injuries to produce symptoms much less severe than those resulting from acute lesions?

<p>CNS area compensation for loss of cerebellar function. (C)</p> Signup and view all the answers

What would be the cause when a person is performing voluntary movements with precision with little effort exerted?

<p>Normal synergy of cerebellum (C)</p> Signup and view all the answers

If one experiences rhythmic oscillation of the eyes where is the point affection?

<p>Labyrinths, vestibular nuclei and cerebellum (D)</p> Signup and view all the answers

Why is articulation jerky, and syllables often separated in lesions of the anterosuperior cerebellum.

<p>Ataxia of the muscled of the larynx (D)</p> Signup and view all the answers

In lesions of where will paralysis and sensory changes be absent?

<p>Anterosuperior Cerebellum (B)</p> Signup and view all the answers

Deficits in the dentatothalamic pathway would cause symptoms and signs associated with

<p>The motor neurons of the opposite cerebral cortex (B)</p> Signup and view all the answers

How many efferent pathways originate in the fastigial nucleus?

<p>two (A)</p> Signup and view all the answers

Which of the following is NOT a role of the parallel fibers in the cerebellar cortex?

<p>Synaptic contacts with the cell bodies of the Purkinje cells (B)</p> Signup and view all the answers

Which structure is known for transverse fibers that cross the midline and enter into the opposite cerebellar hemisphere?

<p>Pontine Nuclei (A)</p> Signup and view all the answers

Why is the anterior spinocerebellar tract considered unique compared to other cerebellar pathways?

<p>It decussates twice, once in the spinal cord and again in the cerebellum (D)</p> Signup and view all the answers

Damage to the fastigial nucleus will implicate dysfunction of extensor musculature due to interactions with:

<p>Lateral Vestibular Nuclei (D)</p> Signup and view all the answers

How are the intrinsic fibers different from the afferent and efferent fibers?

<p>The intrinsic fibers do not leave the cerebellum (B)</p> Signup and view all the answers

Where do the reticular formation axons terminate in the Cerebellum?

<p>inferior cerebellar peduncles (C)</p> Signup and view all the answers

The lateral zone of each cerebellar hemisphere involves which primary action?

<p>Both A and B (A)</p> Signup and view all the answers

What is the functional consequence of damage to the interpositional nuclei (globose and emboliform) within the cerebellum?

<p>Ataxia of the distal limbs. (C)</p> Signup and view all the answers

A patient demonstrates an inability to perform rapid alternating movements (RAMs) with the hands and feet. Which of the following cerebellar pathways is MOST likely dysfunctional?

<p>Globose-emboliform-rubral pathway (A)</p> Signup and view all the answers

What functional outcome would be expected from a lesion exclusively confined to the cerebellar vermis?

<p>Impaired postural control and balance. (A)</p> Signup and view all the answers

If a patient is diagnosed with a lesion impacting the cerebro-olivocerebellar pathway. Disruption of what specific cerebellar structure would MOST immediately result?

<p>Climbing Fibers (A)</p> Signup and view all the answers

After an ischemic event, a patient exhibits deficits in coordinating movements on the ipsilateral side of the body. Assuming the damage is confined to a single cerebellar peduncle, which peduncle is MOST likely affected?

<p>Middle Cerebellar Peduncle (C)</p> Signup and view all the answers

The anterior spinocerebellar tract carries proprioceptive information to the cerebellum. What is a unique characteristic of its pathway compared to the posterior spinocerebellar tract?

<p>Its fibers cross twice, resulting in predominantly ipsilateral influence. (C)</p> Signup and view all the answers

A lesion involving the superior cerebellar peduncle after the decussation would MOST significantly impact motor control on which side of the body?

<p>Ipsilateral to the lesion (A)</p> Signup and view all the answers

If a patient experiences a stroke that damages the right inferior cerebellar peduncle, from which of the following structures would afferent information be MOST significantly disrupted?

<p>Right spinal cord and brainstem (A)</p> Signup and view all the answers

Within the cerebellar cortex, what is the functional consequence of the inhibitory signals transmitted by Purkinje cells to the deep cerebellar nuclei?

<p>To refine motor programs by modulating the output of the deep nuclei. (C)</p> Signup and view all the answers

What is the primary source of input that allows the cerebellum to act as a comparator, refining motor commands?

<p>Efferent copies of motor commands from the cerebral cortex and proprioceptive feedback. (D)</p> Signup and view all the answers

Clinically, the decomposition of movement is related to pathology of which structure?

<p>Cerebellar Hemisphere (B)</p> Signup and view all the answers

If a patient presents with a cerebellar lesion affecting the lateral zone of the cerebellar hemisphere, to what area with this information NOT project to?

<p>Fastigial nucleus (B)</p> Signup and view all the answers

If a patient is unable to coordinate voluntary movements, what cerebellum-related portion is damaged?

<p>Flocculonodular lobe (C)</p> Signup and view all the answers

A researcher is studying the effects of targeted drug therapies on specific cerebellar circuits. If the goal is to selectively enhance the inhibitory output of the cerebellar cortex, which cell type should the drug target?

<p>Purkinje cells (A)</p> Signup and view all the answers

Which afferent pathway to the cerebellum transmits highly processed information related to motor planning and error correction, rather than direct sensory inputs?

<p>Corticopontocerebellar pathway (B)</p> Signup and view all the answers

A patient suffers damage to the cerebellum, resulting in deficits primarily involving the coordination of axial muscles and balance. Which area would have the most prominent manifestation?

<p>Vermis (D)</p> Signup and view all the answers

What is hypotonia in relation to damage to the cerebellum?

<p>Loss of cerebellar influence (B)</p> Signup and view all the answers

During a neurological exam, a patient exhibits issues in the timing and sequence of firing of the alpha and gamma motor neurons. Which region of the brain is most likely affected?

<p>Cerebellum (A)</p> Signup and view all the answers

Axons of neurons in the dentate nucleus travel through the superior cerebellar peduncle and end by synapsing with cells in the contralateral ventrolateral nucleus of what structure?

<p>Thalamus (B)</p> Signup and view all the answers

Where will one likely see disturbances, such as movement that occurs and is self-limited by the stretch reflexes of the agonists and antagonists but continues as a series of flexion and extension movements after the tendons are stretched, impacting movement?

<p>Pendular Knee Jerk (A)</p> Signup and view all the answers

Which of the following statements BEST describes the role of the cerebellum in motor learning and adaptation?

<p>It compares intended movements with actual sensory feedback and motor commands. (B)</p> Signup and view all the answers

If a patient presents with cerebellar damage that primarily affects the lateral regions of the cerebellar hemispheres, which type of motor deficit would be MOST prominent?

<p>Intention tremor and dysmetria during limb movements. (A)</p> Signup and view all the answers

What mechanism in the cerebellum allows for precise control of the timing of muscle contractions during complex movements?

<p>The inhibitory influence of Purkinje cells on deep cerebellar nuclei. (D)</p> Signup and view all the answers

Within the cerebellar cortex, what is the functional relationship between mossy fibers and granule cells?

<p>Mossy fibers excite granule cells, which then excite Purkinje cells via parallel fibers. (C)</p> Signup and view all the answers

If a researcher were to selectively block the function of stellate and basket cells within the cerebellar cortex, what immediate effect would be observed on Purkinje cell activity?

<p>Uncontrolled excitation of numerous Purkinje cells (C)</p> Signup and view all the answers

Unlike most other cerebellar afferent projections, where do Purkinje cell axons within the flocculonodular lobe project?

<p>Lateral Vestibular Nucleus (D)</p> Signup and view all the answers

If a person is listing reasons why someone experiences disorders of speech, the articulation that is jerky, syllables that are separated between one another, and speech tending to be explosive with syllables that are often slurred. The issues can be related but not limited to which areas?

<p>Dysarthria occurs in cerebellar disease because of ataxia of the muscle in the larynx. (A)</p> Signup and view all the answers

A stroke patient exhibits cerebellar signs, and an MRI reveals damage primarily to the region supplied by the posterior inferior cerebellar artery (PICA). Which set of structures would be MOST likely affected?

<p>Flocculonodular lobe and inferior cerebellar peduncle (A)</p> Signup and view all the answers

If a patient with cerebellar dysfunction demonstrates an inability to perform alternating movements regularly and rapidly.

<p>Known for Dysdiadochokinesia. (A)</p> Signup and view all the answers

The cerebellum directly influences lower motor neurons without involving the cerebral cortex or brainstem.

<p>False (B)</p> Signup and view all the answers

The vermis influences the movements of the distal parts of the limbs, such as the hands and feet.

<p>False (B)</p> Signup and view all the answers

The dentate nucleus is a small nucleus, located medially within the white matter of the cerebellum.

<p>False (B)</p> Signup and view all the answers

The anterior spinocerebellar tract enters the cerebellum via the inferior cerebellar peduncle.

<p>False (B)</p> Signup and view all the answers

The cerebellum plays a key role in initiating voluntary muscular activity.

<p>False (B)</p> Signup and view all the answers

The flocculonodular lobe primarily coordinates movements of the trunk and hips.

<p>False (B)</p> Signup and view all the answers

The middle cerebellar peduncle mainly carries efferent fibers from the cerebellum to the pons.

<p>False (B)</p> Signup and view all the answers

The primary fissure separates the middle lobe from the flocculonodular lobe.

<p>False (B)</p> Signup and view all the answers

The corticoreticular fibers primarily originate from the visual cortex.

<p>False (B)</p> Signup and view all the answers

The superior cerebellar peduncle connects the cerebellum to the midbrain.

<p>True (A)</p> Signup and view all the answers

The anterior lobe is situated on the inferior surface of the cerebellum.

<p>False (B)</p> Signup and view all the answers

The Purkinje cells are small, Golgi type II neurons located in the molecular layer.

<p>False (B)</p> Signup and view all the answers

The arbor vitae is composed of gray matter and is located in the cerebellar cortex.

<p>False (B)</p> Signup and view all the answers

The cerebro-olivocerebellar pathway originates from the spinal cord and projects to the inferior olivary nucleus.

<p>False (B)</p> Signup and view all the answers

The posterior spinocerebellar tract ascends ipsilaterally in the spinal cord and enters the cerebellum via the inferior cerebellar peduncle.

<p>True (A)</p> Signup and view all the answers

The globose and emboliform nuclei influence motor activity on the opposite side of the body.

<p>True (A)</p> Signup and view all the answers

The cerebellum is located in the anterior cranial fossa.

<p>False (B)</p> Signup and view all the answers

The superior cerebellar peduncle carries mostly afferent fibers to the cerebellum.

<p>False (B)</p> Signup and view all the answers

The molecular layer of the cerebellar cortex only contains one type of neuron.

<p>False (B)</p> Signup and view all the answers

The corticopontocerebellar pathway travels through the inferior cerebellar peduncle.

<p>False (B)</p> Signup and view all the answers

Match each cerebellar lobe with its primary separating fissure:

<p>Anterior Lobe = Primary Fissure Middle Lobe = Primary and Uvulonodular Fissures Flocculonodular Lobe = Uvulonodular Fissure</p> Signup and view all the answers

Match each cerebellar cortical layer with its distinguishing cell type:

<p>Molecular Layer = Stellate and Basket Cells Purkinje Cell Layer = Purkinje Cells Granular Layer = Granule and Golgi Cells</p> Signup and view all the answers

Match each intracerebellar nucleus with its relative location from lateral to medial:

<p>Most Lateral = Dentate Nucleus Intermediate = Emboliform Nucleus More Medial = Globose Nucleus Most Medial = Fastigial Nucleus</p> Signup and view all the answers

Match each cerebellar peduncle with the primary brainstem structure it connects to:

<p>Superior Cerebellar Peduncle = Midbrain Middle Cerebellar Peduncle = Pons Inferior Cerebellar Peduncle = Medulla Oblongata</p> Signup and view all the answers

Match each cerebellar afferent fiber with its origin:

<p>Corticopontocerebellar Fibers = Frontal, Parietal, Temporal, and Occipital Lobes Cerebro-Olivocerebellar Fibers = Frontal, Parietal, Temporal, and Occipital Lobes Cerebroreticulocerebellar Fibers = Sensorimotor Areas</p> Signup and view all the answers

Match each type of cerebellar efferent pathway with the primary nucleus through which it travels:

<p>Globose-Emboliform-Rubral Pathway = Globose and Emboliform Nuclei Dentatothalamic Pathway = Dentate Nucleus Fastigial Pathways = Fastigial Nucleus</p> Signup and view all the answers

Match each spinal cord tract with the type of somatosensory information it conveys to the cerebellum:

<p>Anterior Spinocerebellar Tract = Muscle and Joint Information Posterior Spinocerebellar Tract = Muscle and Joint Information Cuneocerebellar Tract = Muscle and Joint Information from Upper Limb</p> Signup and view all the answers

Match the function with each of the following basal nuclei:

<p>Vermis = Movements of the long axis of the body Intermediate Zone of Cerebellar Hemisphere = Control of muscles in the distal parts of limbs Lateral Zone of Cerebellar Hemisphere = Planning of sequential movements</p> Signup and view all the answers

Match the definition with the correct disorder of speech:

<p>Dysarthria = Occurs in cerebellar disease because of ataxia of the muscles of the larynx. = Speech is explosive/slurred</p> Signup and view all the answers

Match each pathway with the lobe of the cerebral cortex from which it originates:

<p>Corticopontocerebellar Pathway = Frontal, Parietal, Temporal, and Occipital Lobe Cerebro-Olivocerebellar Pathway = Frontal, Parietal, Temporal, and Occipital Lobe Cerebroreticulocerebellar Pathway = Sensorimotor Area</p> Signup and view all the answers

Flashcards

Cerebellum Location

Located in the posterior cranial fossa, covered by the tentorium cerebelli.

Cerebellar Lobes

Anterior, middle (posterior), and flocculonodular lobes.

Cerebellar Peduncles

Superior, middle, and inferior cerebellar peduncles.

Cerebellar Cortex

Outer gray matter layer of the cerebellum.

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Cerebellar White Matter

Arbor vitae

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Cerebellar Cortex Layers

Molecular, Purkinje cell, granular layers.

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Neuron in Molecular layer

The outer stellate and the inner basket cell

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Intracerebellar Nuclei (Lateral to Medial)

Dentate, emboliform, globose, fastigial.

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Afferent Fibers of the Cerebellum

Climbing and mossy fibers

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Efferent Fibers of the Cerebellum

The axons of the Purkinue cells

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Cerebellar Peduncles

Superior, Middle, Inferior

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Cerebellum Function

To monitor and adjust movements.

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Corticopontocerebellar Pathway

Frontal, parietal, temporal, occipital lobes to pontine nuclei.

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Cerebro-Olivocerebellar Pathway

Cerebral cortex to inferior olivary nuclei.

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Cerebroreticulocerebellar Pathway

From sensorimotor areas of the cerebral cortex.

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Spinal Cord to Cerebellum Pathways

Anterior spinocerebellar tract, posterior spinocerebellar tract, cuneocerebellar tract

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Fibers from vestibular nerve to the cerebellum.

Through inferior cerebellar peduncle.

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Cerebellum Function

Motor activity coordination and balance.

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Cerebellar Dysfunction Indicators

Dysarthria, ataxia, hypotonia, tremor, and nystagmus.

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effect of cerebellum tumors

Motor activity will be weakened hypotonia and looseness on the tumor, and coordination

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Hypotonia

Loss of muscle tone

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Ataxia

Inability to coordinate muscles during movement.

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Dysdiadochokinesia

Inability to perform rapid, alternating movements.

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Nystagmus

Unstable and jerky eye movements

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Superior Cerebellar Peduncle

Connects cerebellum to midbrain.

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Middle Cerebellar Peduncle

Connects cerebellum to pons.

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Inferior Cerebellar Peduncle

Connects cerebellum to medulla oblongata.

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Dentate Nucleus

The largest of the cerebellar nuclei, having a crumpled bag shape w/ medial opening.

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Emboliform Nucleus

Ovoid nucleus medial to the dentate, partially covering its hilus.

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Globose Nucleus

Consists of one or more rounded cell groups medial to the emboliform nucleus.

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Fastigial Nucleus

Lies near midline in the vermis, close to the roof of the fourth ventricle, larger than globose.

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Climbing Fibers

Terminal fibers of olivocerebellar tracts, excitatory to Purkinje cells, wraps dendrites.

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Mossy Fibers

Terminal fibers of all other cerebellar afferent tracts, exert diffuse excitatory effect.

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Superior Cerebellar Peduncle Fiber Tracts

Fibers from the dentate, emboliform, and globose nuclei that leave the cerebellum.

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Inferior Cerebellar Peduncle Fiber Tracts

Fibers from the fastigial nucleus leave the cerebellum.

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Vermis function

Influences movements of long axis (neck, shoulders, thorax, abdomen, hips).

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Intermediate Zone Function

Controls muscles in distal parts of limbs (hands and feet).

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Lateral zone Function

Involved in planning sequential movements, assessment of movement errors.

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Past-Pointing

Inability to judge distance or scale.

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Rubrospinal tract

Red nucleus to spinal cord tract.

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Acute Alcohol Poisoning

Alcohol's effect involving GABA on the cerebellar neurons.

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Cerebellar Coordination

Coordinates voluntary movements by continuously comparing output.

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Friedreich Ataxia

Disease process involving more than one area of CNS

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Cerebellar Disease Symptoms

Irregular swaying gait, tendency to drift, balance issues when standing.

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Decomposition of Movement

Voluntary movements are broken into smaller, jerky parts.

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Arbor Vitae

The branched structure formed by white matter within the cerebellum.

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Cerebellum comparator

Compares motor output with proprioceptive input, adjusts as needed.

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Efferent fibers

Connects Cerebellar nuclei and cerebral cortex/spinal cord

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Impaired Coordination

Damage due to tumor in one hemisphere can have this effect

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Globose-Emboliform-Rubral Pathway

Relays cerebellar output to the contralateral red nucleus, influencing motor activity on the same side of the body.

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Dentatothalamic Pathway

Relays cerebellar outflow to the contralateral ventrolateral nucleus of the thalamus, influencing motor activity via the motor cortex.

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Fastigial Vestibular Pathway

Influences extensor muscle tone through the lateral vestibular nucleus and vestibulospinal tract.

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Fastigial Reticular Pathway

Modulates spinal motor activity through the reticulospinal tract.

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Purkinje Cell Axon

Passes through the granular layer to the white matter and synapses with intracerebellar nuclei.

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Cerebellar Vermis Cortex

In the midline, the vermis influences movements of the neck, shoulders, thorax, abdomen, and hips.

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Middle Lobe

Located between the primary and uvulonodular fissures and is the largest part of the cerebellum

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Cerebellar Folium

Each folium contains a core of white matter covered superficially by gray matter.

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Intrinsic Fibers

Do not leave the cerebellum but connect different regions of the organ.

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Vestibular Nerve

Provides positioning and motion from semicircular canals and utricle and saccule.

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Arbor Vitae Formation

A section through the cerebellum that divides the folia at right angles, displaying a branched appearance.

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Cerebellum Role

Influences contraction of voluntary muscles & coordinates actions with antagonists.

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Molecular Layer Components

Outer stellate and inner basket cells scattered among dendritic arborizations and axons.

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Parallel Fibers

Pass through granular layer, bifurcate at T junction, parallel to cerebellar folium axis.

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Purkinje Cells Role

Connect cerebellum to motor control areas, modifying activity through motor control.

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Gait Alterations

Swaying or staggering towards the affected side

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Cortico-olivary fibers

Arise from frontal, parietal, temporal, & occipital lobes to terminate bilaterally on inferior olivary nuclei.

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Study Notes

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Cerebellum Functions

  • The cerebellum plays a crucial part in managing voluntary movements and posture
  • It non-consciously facilitates the seamless contraction of muscles and their coordinated actions
  • It ensures muscles relax as needed
  • A key role involves coordinating synergistic actions for all muscular activity, both reflex and voluntary
  • It refines and synchronizes muscle tone and posture of the body
  • It enables smooth, precise, and efficient voluntary movements like walking
  • The cerebellum has no ability to initiate movements

Cerebellar connections

  • Each cerebellar hemisphere manages muscular movements on the same body side
  • Cerebellum controls the body via the cerebral cortex and brainstem, without directly accessing lower motor neurons
  • Each hemisphere is connected with nervous pathways from the same side of the body
  • Damage in one hemisphere can result in symptoms that are only seen on that side of the body

Gross Appearance

  • Cerebellum resides in the posterior cranial fossa, shielded superiorly by the tentorium cerebelli
  • It represents the hindbrain's largest component, situated behind the fourth ventricle, pons, and medulla oblongata
  • The cerebellum is an ovoid structure constricted centrally, featuring two cerebellar hemispheres linked by the median vermis
  • The cerebellum connects to the brainstem's posterior aspect via the superior, middle, and inferior cerebellar peduncles
  • Serves as the largest part of the hindbrain and is posterior to the fourth ventricle, pons, and medulla oblongata

Cerebellar Lobes

  • The cerebellum has three main lobes: anterior, middle (posterior), and flocculonodular
  • The anterior lobe is visible on the cerebellum's upper surface, split from the middle lobe by the primary fissure
  • The middle lobe, the cerebellum's largest section, sits between the primary and uvulonodular fissures
  • Flocculonodular lobe lies behind the uvulonodular fissure
  • A deep horizontal fissure runs along the margin of the cerebellum, separating superior and inferior surfaces

Cerebellar Cortex Structure

  • The cerebellum consists of an outer layer of gray matter (cortex) and inner white matter, with the intracerebellar nuclei embedded inside
  • The cerebellar cortex can be viewed as a sheet of folds, where each fold contains a white matter core coated with gray matter
  • Sections made parallel to the median plane reveal the arbor vitae, the branched look of the cut surface
  • The cortex has folds that lie in either the coronal or transfer plane

Layers

  • The gray matter of the cortex is divided into three layers with uniform structure:
  • Molecular Layer
  • Purkinje Cell Layer
  • Granular Layer

Molecular Layer

  • the molecular layer features outer stellate and inner basket cells interspersed with dendritic arborizations and thin axons
  • Supporting neuroglial cells exist

Purkinje Cell Layer

  • Purkinje cells are flask-shaped Golgi type I neurons arranged in one layer
  • Dendrites project into the molecular layer for branching, and dendritic spines are formed for synaptic contacts
  • Axons from bases extend into the white matter, gain myelin sheaths, and connect with cells of the intracerebellar nuclei
  • Collateral branches connect with basket and stellate cell dendrites, while some pass to the vestibular nuclei

Granular Layer

  • A granular layer contains small cells with densely stained nuclei and little cytoplasm
  • Each cell extends 4- to 5 dendrites that end in claw-like endings and connect to mossy fiber input
  • Each granule cell axon extends into the molecular layer to bifurcate where branches run parallel to the cerebellar folium's long axis
  • Known as parallel fibers, they run perpendicular to the dendritic processes of Purkinje cells where most create synaptic contacts
  • Neuroglial and Golgi cells are spread throughout

Functional Areas

  • The cerebellar cortex comprises three functional areas per clinical and experimental research
  • Vermis cortex influences movements along the body's axis
  • The intermediate zone, adjacent to the vermis, manages distal limb muscles, like hands and feet
  • The lateral zone of each cerebellar hemisphere aids in planning sequential movements and assessing movement errors

Intracerebellar Nuclei

  • The Intracerebellar nuclei are four masses of gray matter that are embedded in the white matter on either side of the midline
  • From lateral to medial, these nuclei are the dentate, emboliform, globose, and fastigial

Dentate Nucleus

  • The dentate nucleus is the largest which has a shape similar to a crumpled bag, with its opening facing medially
  • Internally there are efferent fibers that exit through the opening, forming a large part of the superior cerebellar peduncle

Emboliform Nucleus

  • The emboliform nucleus is ovoid, located near the dentate nucleus covering part of its hilus
  • The globose nucleus includes one or multiple rounded cell groups, located medial to the emboliform nucleus

Fastigial Nucleus

  • The fastigial nucleus is found near the midline in the vermis near the roof of the fourth ventricle
  • The Intracerebellar nuclei is composed of large, multipolar neurons containing branching dendrites and axons
  • The axons make up the cerebellar outflow inside the superior and inferior cerebellar peduncles

White Matter

  • There is a small amount of white matter in the vermis, in the shape of a trunk and tree branches, also called arbor vitae
  • The amount of white matter is large in each cerebellar hemisphere
  • This part consists of intrinsic, afferent and efferent fibers

Interconnections

  • Intrinsic fibers connect regions of the cerebellum, some connecting folia of the cortex and vermis of the same side
  • Others connect both cerebellar hemispheres
  • Afferent fibers form the majority of the white matter and pass to the cerebellar cortex, entering mainly through the inferior and middle cerebellar peduncles
  • Efferent fibers are the axons of Purkinje cells constituting the cerebellum's output

Synapses

  • Purkinje axons synapse with cerebellar nuclei neurons, which then leave the cerebellum
  • Purkinje cell axons in the flocculonodular lobe and some in the vermis bypass the cerebellar nuclei and leave without synapsing

Fiber Output

  • Fibers from the dentate, emboliform, and globose nuclei exit via the superior cerebellar peduncle
  • Fibers from the fastigial nucleus exit through the inferior cerebellar peduncle

Cerebellar Cortical Mechanisms

  • Climbing and mossy fibers form the primary input to the cortex and are excitatory to Purkinje cells
  • Climbing Fibers
  • The olivocerebellar tracts' terminal fibers reach the cortex and terminate in the molecular layer
  • Each climbing fiber covers and creates synaptic connections with the dendrites of a Purkinje cell
  • A single Purkinje neuron makes synaptic contact with only one climbing fiber, although the climbing fiber makes contact 1-10 purkinje neurons
  • Mossy Fibers
  • The terminal fibers from the cerebellar afferent tracts exert a more scattered excitatory effect
  • One mossy fiber has the potential to excite thousands of Purkinje cells via granule cells

Cerebellar Interneurons

  • Stellate, basket, and Golgi cells serve as inhibitory interneurons, limiting the cortex's excited areas and the degree of Purkinje cell excitation
  • Fluctuating inhibitory impulses travel towards the Intracerebellar nuclei via the Purkinje cells
  • These modify muscular activity through the brainstem and cerebral cortex motor control areas
  • Purkinje cells form a functional unit's center

Communication with Cerebellar Nuclei

  • Deep cerebellar nuclei process the inhibitory axons information from the cortex that overlies it
  • This also includes the excitatory axons which are branches of the afferent climbing and mossy fibers
  • A sensory input relays excitatory information to the nuclei causing a short time delay
  • Efferent information from the deep cerebellar nuclei is distributed to other brain parts and the spinal cord after it leaves the cerebellum

Cerebellar Cortical Neurotransmitters

  • Glutamate found in excitatory climbing and mossy afferent fibers acts as the excitatory transmitter on Purkinje cell dendrites
  • Entering fibers have the ability to release norepinephrine, serotonin or modify the glutamate action on Purkinje cells

Cerebellar Peduncles

  • The Cerebellum is combined with the efferent fibers in the central nervous system gathered on both sides as peduncles
  • Superior cerebellar peduncles connect to the midbrain
  • Middle connect to the pons
  • Inferior connect the cerebellum to the medulla oblongata

Cerebellar Afferent Fibers

  • The cerebellum pulls information from the cerebral cortex, pons, medulla oblongata, and spinal cord

Fibers From The Cerebral Cortex

  • The cerebral cortex sends knowledge to the cerebellum among three routes
  • Corticopontocerebellar Pathway
  • Cerebro-Olivocerebellar Pathway
  • Cerebroreticulocerebellar Pathway

Spinal Cord Communication

  • The spinal cord transmits sensory receptor data to the cerebellum through three routes
  • Those routes are the anterior spinocerebellar tract
  • Axons from posterior root ganglions terminate by synapsing with neurons in the nucleus dorsalis (Clarke column)
  • Fibers enter the cerebellum through the superior peduncle
  • The posterior spinocerebellar tract
  • The cuneocerebellar tract

Efferent Fibers

  • The whole of the Cerebellar Cortex is emitted through axons of the Purkinje cells that form the Efferent fibers which output cerebellar information
  • Those Purkinje cell axons connect with neurons on the Dep Cerebellar Nuclei, except some Purkinje cell axons passing the lateral vestibular nucleus
  • The efferent fibers connect the cerebellum with the red nucleus, thalamus, vestibular complex, and reticular formation

Output Pathways

  • Axons in the globose and emboliform nuclei pass through The Superior Cerebellar peduncles ending at the Rubrospinal tract
  • The fibers traveling the dentate nucleus pass that nucleus though the superior cerebellar peduncle ending back in the contralateral Ventrolateral Nucleus, as well as the Cerebellar Cortex

Output Pathways Cont

  • Axons in the globose and emboliform nuclei pass through The Superior Cerebellar peduncles
  • Those fibers end at the Rubrospinal tract
  • The rubrospinal tract is a tract that crosses twice over influencing activity on the same side of the body

Function

  • The cerebellum coordinates precise movement by consistently comparing the output from the cerebral cortex to the proprioceptive knowledge that is also apparent from the input muscles

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