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Largest part of hind brain. LOCATION: Posterior cranial fossa behind pons & medulla. ANATOMY: Covered above by meninges (Tentorium Cerebelli). Has 2 hemispheres joined by Vermis.
LOBES: 3 1) anterior lobe 2) posterior / middle lobe 3) flocculo nodular lobe FISSURES: 2 1) Primary fissure (v shaped). Part of cerebellum above this fissure is anterior lobe. 2) Uvulo-nodular fissure (separates posterior lobe from flocculo nodular lobe)
Topographical representation: Vermis & Intermediate zone of cerebellar hemisphere. Each cerebellar hemisphere has 2 zones, intermediate zone & lateral zone. Axial parts of body represented in Vermis. Limbs & facial region Intermediate zone.
AFFERENTS TO TOPOGRAPHICAL REPRESENTATION: Corresponding areas of motor cortex. Corresponding parts of the body & Brain stem EFFERENTS: Cerebral cortex Red nucleus Reticular formation
I II III IV V VI
G E ( N.I)
CEREBELLAR CORTEX:
3 LAYERS:
DENDRITES
Outermost molecular layer 2nd layer purkinje cells layer 3rd later granular layer
MOLECULAR LAYER:
STELLATE CELLS BASKET CELLS Large no. of dendrites & nerve fibers from deeper layers.
GRANULAR LAYER:
Granule cells having Multiple dendrites synapse with incoming Mossy fibers. Their axons pass into molecular layer end into a T termination. These fibers also synapse with golgi cells, basket cells & stallate cells.
INTRINSIC FIBERS:
Pass between cerebellar cortex & vermis. Also pass from 1 cerebellar hemisphere to other. They remain in the cerebellum.
AFFERENT FIBERS:
2 TYPES: CLIMBING FIBERS (come from inferior olivary nucleus) MOSSY FIBERS (all the other afferent fibers except the climbing are called Mossy fibers).
EFFERENT FIBERS:
Start as axons of purkinje cells.
Most of these axons synapse onto deep nuclear cells. From deep nuclear cells, efferent fibers arise go to different parts of CNS . Only few purkinje fibers bypass deep nuclear cells go to vestibular nuclei (these are from vermis & flocculo-nodular lobe).
Mossy fibers collaterals synapse with deep nuclear cells. Mossy fibers granular layer synapse with dendrites of granule cell. 1 climbing fiber can synapse with about 10 purkinje cells. 1 mossy fiber can synapse with 100s of granule cells.
Excitatory: deep nuclear cells Granule cells Inhibitory: Purkinje cells Basket cells Golgi cells Stellate cells
When deep nuclear cells are to be excited, its through COLLATERALS from climbing & mossy fibers.
When inhibited, its through purkinje cells. Purkinje cells & deep nuclear cells discharge continuously (50-100 impulses/sec). This is the neuronal circuit in the cerebellum.
CONNECTIONS OF CEREBELLUM THROUGH 3 PEDUNCLES: AFFERENT EFFERENT Superior peduncle midbrain Middle peduncle pons Inferior peduncle medulla
Cuneo-cerebellar tract (from cuneate nucleus). Vestibulo-cerebellar fibers (from vestibular nuclei). Reticulo cerebellar (from reticular formation). Olivo-cerebellar (from inferior olivary nucleus).
MIDDLE PEDUNCLE:
Mainly AFFERENTS (Ponto-cerebellar fibers). These fibers arise from pontine nuclei & cross over to opposite side middle cerebellar peduncle. These fibers are part of cortico-pontocerebellar pathway.
SUPERIOR PEDUNCLE:
AFFERENTS: Anterior spinocerebellar tract. Rubro-cerebellar tract (from red nucleus).
EFFERENTS: To Red nucleus, then to thalamic nuclei then to Cerebral cortex. Other fibers go directly ventrolateral & ventro anterior thalamic nuclei cerebral cortex . Some basal ganglia.
FUNCTIONS OF CEREBELLUM:
Functionally divided into 3 parts: 1) lateral zone 2) intermediate zone 3) flocculo-nodular lobe & vermis.
In cerebellar disease loss of smooth progression of movements. Extra motor predictive function.
Helps to access timing of movement.
Cerebellum gets intended plan of movement from motor cortex & also from red nucleus.
Fig shows cerebral & cerebellar control of voluntary movements involving especially intermediate zone & its associated nucleus interpositus.
It recieves information actually performed movements from PROPRIOCEPTORS through spino-cerebellar tracts. Compared & corrected via signals through red nucleus & thalamic nuclei to motor cortex.
Also controls: rate, range & direction of movement. Damping function. Prevents pendular movements & tremors (pendular knee jerk in case of disease)
Also controls very rapid movements like typing (ballistic movements). Also controls very rapid eye movement (reading & when a person in a moving vehicle, fixate the outside scene).
CEREBELLAR DISEASE:
Involvement of cerebellar cortex & 1 or more of deep cerebellar nuclei. *No muscle paralysis & no sensory loss occurs. (MCQ)
FEATURES: 1) ATAXIA:
Incoordinate movements due to defect in control of RANGE, DIRECTION, RATE & TIMING of movement. Asynergia (no synergism between agonists & antagonists; normal synergism = when agonists contract, antagonists relax).
3) ADIADOCOKINESIA / DYSDIADOCOKINESIA:
Inability to perform RAPID, ALTERNATE, OPPOSITE movement (rapid supination & pronation of arm).
5) SLURRED SPEECH:
Due to dysarthria ( disordered articulation). Incoordination of muscles of articulation. Some words or syllables are spoken loud & others are spoken in weak tone. Some are held for long period & some are spoken short.
7) REBOUND PHENOMENON:
Patient cannot stop a movement abruptly. Example of flexion of elbow may hit his face.
8) DECOMPOSITION OF MOVEMENTS:
Patient is not able to perform actions involving simultaneous movement at more than 1 joint. Movements are broken into components. Loss of smooth progression of 1 movement to other.
9) NYSTAGMUS:
Rhythmic rapid movement of eyeballs when eyes are focused on 1 side. Cerebellum has a damping function, which is disturbed.
11) HYPOTONIA:
Due to loss of excitatory action of cerebellum on stretch reflex & muscle tone.