Cerebellum

Introduction
Largest art of hind brain Originates from dorsal aspect of brain stem Located dorsal to the pons and medulla

Lies over 4th ventricle

Superior & inferior medullary velum Thin sheet of tissue consisting a layer each of piamater+ ependyma with some nerve fibers in between Thick tracts connecting the cerebellum to the brain stem called cerebellar peduncles Superior cerebellar peduncles ( restiform body) connects it to mid brain Middle cerebellar peduncles (Brachium pontis) connects it to pons Inferior cerebellar peduncles (brachium conjunctivum) connects it to medulla

Cerebellum consists of

Vermis in the mid line A cerebellar hemisphere on either side

It lies in the posterior cranial fossa below tentorium cerebelli which separates it from cerebrum

Weight 150gm in adult male Size 1/8th part of cerebrum in adults

Relations

Anterior pons & medulla Postero-inferior- squamous occiput Superior- tentorium cerebelli

Surfaces

Superior- elevated in midline Inferior- deeply grooved in midline( groove=valecula)

Borders Anterolateral Posterior

3 Fissures

Fissura prima-on superior surface Horizontal fissure- separates superior from inferior surface Posterolateral fissure on inferior surface

2 Notches

Anterior cerebellar notch- wide & shallow{for pons & medulla} Posterior cerebellar notch- narrow & deep lodges falx cerebella

Internal structure Cerebellar cortex Cerebellar nuclei Functional anatomy Archicerebellum Paleocerebellum Neocerebellum

The Cerebellum- blood supply

Arterial supply
Superior surface Superior cerebellar branches of Basilar artery Inferior surface Antero inferior surface- superior cerebellar branches of Basilar artery

Postero inferior surface- superior cerebellar branches of vertibral artery

Venous drainage
Superior surface drains to -straight, transverse, superior petrosal sinus Inferior surface drains to

- sigmoid, inferior petrosal sinus, straight and occipital sinus

External features-Gross anatomy

2 hemispheres- divided into leaves folia cerebelli

Parts

Each hemisphere has 3 lobes Anterior Posterior Flocculonodular 01 Vermis-median Vermis has 2 parts Superior Inferior

Parts of superior vermis Lingula Central lobule Culmen Declive Folium Parts of inferior vermis

 Tuber Pyramid Uvula

Nodule

Cerebellum at a glance I

Stage

Lobe

Cortex

Intra cerebellar Extra nuclei cerebellar nuclei

1.Arche Flocculo 1. Nodule Nucleus Fastigii . Vestibular 1 cerebellum (old) nodular lobe Floculus 2. nucleus 2. Reticular nucleus 2.Paleo Anterior lobe Pyramid 1. Nucleus 1. Dorsal 1. cerebellum 2. Uvula Globose 2. Accessory (Intermediate) 3. Ant. Lobe 2. Nucleus Cuneate EmboliformiLateral 3. s Accessory olivary 3. Neo M iddle lobe iddle lobeDentate M Cerebellum nucleus 1. Nuclei pontis 2. Arcuate nucleus 3. Olivary nucleus 4. Red nucleus

Cerebellum at a glance-II

Stage

Connected Afferent to

Efferent

Function

1.Arche Vestibular 1.vestibulo -fastigial-nodulo fastigeal Equilibrium cerebellumsystem 2.vestibulo -nodular -fastigeo bulbar (old) 3.vestibulo -Vestibulo spinal floccular -M ed. . Longitu fasciculus 2.Paleo Spinal cord cerebellar -cortico -spino interm ediateuscle tone M cerebellum -post.ext.arcuate -interm edio rubral (Interm ediate) Fibers -rubro spinal -reticulo cerebellar fibers 3. Neo Cerebrum -cortico -ponto I-To brain stem Cerebellum cerebellar -cerebello dentate -ant.ext.arcuate -dentato rubral Fibers -rubro spinal -olivoerebellar -rubro c reticular II-to cerebrum -cerebello dentate -dentato rubral -rubro thalam ic -thlam ico cortical -co ordination -skilled m ovem ent

CEREBELLAR PEDUNCLES

Peduncle

Afferent tract

Efferent tract

A . Superior 1.Ventral c erebellar spino 1.Cerebello fibers rubral cerebellar tract 2.Cerebello thalam ic peduncle 2.Tectoerebeller c fibers fibers 3.Trigem cerebellar 3.Cerebello fibers ino olivary fibers 4.Cerebello reticular fibers B. M iddle Ponto cerebellar fibers -cerebellar cortico cerebellar Ponto peduncle pathw ay C . Inferior 1.post. cerebellar1.Cerebello Spino reticular cerebellar 2.Cuneo cerebellar 2.Cerebello vestibular peduncle 3.O livoerebellar c 4.Par c erebellar olivo 5.Retculo cerebellar 6.Vestibulo cerebellar 7.Trigem cerebellar ino 8.Ant .ext. arcuate fibers 9.Fibersstriae of m edullaris

The Cerebellums rule of 3

3 LOBESSUBDIVISIONS Anterior Posterior Flocculonodular 3 MAIN FISSURES Fissura prima Horizontal fissure Posterolateral fissure

3 MORPHOLOGICAL -Archi cerebellum -Paleo cerebellum -Neocerebellum 3 LAYERS OF CORTEX -Molecular layer -Intermediate layer -Granular layer 3 FUNCTIONAL -vermal-median zone -pair of paravermal -intermediate -pair of hemisphere-lateral zone
3 PATHWAYS FOR OUTPUT

3 TYPES OF FIBERS SUBDIVISIONS Climbing

Mossy zone parallel

3 SOURCES OF INPUT Vestibular apparatus Spinal cord Cerebrum

3 DISTINCT REGIONS

OF INFORMATION

-Ponto cerebellar tract -Olivo cerebellar tract - Reticulo cerebellar tract

RECEIVES INFORMATION

ABOUT

THINGS

Cortex gray matter

- On equilibrium - On current movements of - From the cerebral cortex

Internal white matter limbs, neck, trunk Deep cerebellar nuclei deeply situated gray matter

Cerebllum Applied

Ataxia- inability to maintain equilibrium while standing or walking Rombergs sign- ataxia becoming worse with eyes closed Asynergia- lack of coordination of muscles which interferes with purposeful movements. Movements are jerky and lack precision. Dysmetria- lack of coordination of movements: hand /finger overshoots the point Dysdiadokokinesis inability to perform repeated alternative movements as supination & pronation. Dysarthria- speech defect which becomes thick & monotonous Nystagmus- eyes are unable to fix the gaze at an object for any length of time. Attempts to bring back the gaze to same point results in jerky movements of the eyes Hypotonia/ asthenia- diminished muscle tone; muscles soft & tire easily Frail/flail joints- joints lack stability Intention tremors- cerebellar tremors are terminal occurring specifically at the end of certain movement: when dentate nucleus/ superior cerebellar peduncle are affected Diminished tendon reflexes- tapping a tendon results in oscillating movement of the part Flocculonodular syndrome: Mainly imbalance because connections are mainly vestibular Charcots triad- diagnostic for multiple sclerosis shows: Nystagmus Dysarthria Intention tremors