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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)
Anterior lobe + (pyramid + uvula of vermis) = Paleo-cerebellum. Posterior lobe (pyramid + uvula of vermis) = Neo-cerebellum. (largest portion of cerebellum) Flocculonodular lobe = Archi-cerebellum Developmentally, paleo old part, Neo new, Archi oldest.
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
Cerebellum has: 1) cortex cerebellar (grey matter on periphery) & 2) white matter core (having deep cerebellar nuclei, 4 on each side, from lateral to medial side: DENTATE, EMBOLIFORM, GLOBASE FESTIGEAL. (Lateral medial) DEGF! (dont eat greasy food) EMBOLIFORM + GLOBASE = NUCLEUS INTERPOSITUS.
G E ( N.I)
CEREBELLAR CORTEX:
3 LAYERS: Outermost molecular layer 2nd layer purkinje cells layer 3rd layer granular layer
DENDRITES PURKINJE CELL AXONS
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 nervous system. Only few purkinje fibers bypass deep nuclear cells go to vestibular nuclei (these are from vermis & flocculo-nodular lobe).
There is a neuronal circuit in cerebellum. Millions of functional units. Each functional unit consist of a purkinje cell & a deep nuclear cell. Climbing fibers give collaterals, which synapse with deep nuclear cells. collaterals from climbing fibers excite deep nuclear cells. Climbing fibers pass to molecular layer synapse with dendrites of purkinje cells.
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.
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 spino-cerebellar tract. Rubro-cerebellar tract (from red nucleus). Tecto-cerebellar (from tectum of midbrain).
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.
*cerebellum does not INITIATE movement BUT COORDINATES it. 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.