Presented by: Mustafa M. Yusuf 3rd Medical student.

Presentation Outline.
Gross Morphology. The cerebellum: Functional classification. Afferents to the cerebellum. The cerebellar penducles. Efferent from the cerebellum. Function of the cerebellum. Diseases of the cerebellum.

A) GROSS MORPHOLOGY
The cerebellum is the largest part of the hind brain, and the second largerst part of the brain as a whole. It is situated in the posterior cranial fossa of the skull, the cerebellum is separated from the overlying cerebrum by Tentorium cerebelli which is a transverse fold of dura matter, that stretches over the upper surface of the cerebellum. It is related laterally to the sigmoid sinus and mastoid atrum and mastoid air cells.

CONT.....
The cerebellum consists of two hemisphere and a central constricted area called the vermis. The Falx cerebelli is the portion of the meninges that partially extends btw the hemispheres.

Inferiorly the vermis is clearly seperated from the two cerebellar hemispheres and lies at the bottom of a deep groove btw them called Vallecula .

CONT......
Like the cerebrum, the cerebellum has a thin outer layer of gray matter, the Cerebellar cortex, and a thick, deeper layer of white matter that many nuclei are inside it. It is convulated on the surface into series of parallel folds called Folia.

The tracts of white matter within the cerebellum have a a distinctive branching pattern called the Arbo Vitae.

Surfaces and Notches of the Cerebellum

The cerebellum has two surfaces : Upper surface, has the shape of butterfly. Lower surface, has a rounded shape.

The cerebellum has ant. notch which is very wide and is related to the midbrain, pons and medulla whereas the post. notch is occupied by the falx cerebelli.

B) THE CEREBELLUM
The cerebellum is divided according to 3 different ways: 1) Anatomically: Vermis and 2 laterall cerebellar hemispheres. 2) By fissures: lobes and lobules. 3) Functionally: Vestibular part. Spinal part. Cerebral part.

Division by fissures
The true division of the cerebellum is not into a median vermis and 2 cerebellar hemispheres, but into lobes and lobules. Deep transverse fissures divide the cerebelllum into different lobes and lobules. The fissures cut the vermis (transversely) and extend laterally into the hemespheres. Therefore, each lobe has a median part(vermis) and a pair of lateral extensions (in the hemesphere).

cont....
Postero~lateral fissure separates the Flucculo~nodular lobe from the main part of the cerebellum. Primary fissure which is the most important one, divides the main part of the cerebellum into Anterior and Posterior.
Horizontal fissure runs through the posterior lope.

Funcational Division.
1) Vestibular part: (Archi-cerebellum or cerebellum of equilibrium) It is formed from the flocculo-nodule lobe which consists of two flocculi and the nodule of the vermis. It recieves fibers from the internal ear, namely from the: -- 3 semicircular canals. -- the utricle. -- the saccule. By means of the vestibulo-cerebellar tractsl ( direct and indirect).

cont..
2) Spinal part: ( Paleo-cererbellum or cerebellum of proprioception) It is formed from the vermis of the anterior lobe, the uvula and pyramid. It recieves fibres from the muscels land associated structures ,namely the : -- Muscle spindles. -- Tendon spinles. -- Pacinian corpuscles. By means of the spinocerebellar tracts ( dorsal and ventral) also by the D and V external arcuate fibres.

cont......
3) Cererbal part: ( Neo-cerebellum or cerebellum of the Cerebral cortex)
This is the largest part of the cerebellum and it is formed of the two cerebellar hemespheres and the middle part of the vermis. It receives impluses from the pontine nuclei which recieve impluses from the cerebral cortex.

AFFERENTS of the CEREBELLUM

PERIPHERAL ORGANS FROM THE INTERNAL EAR

THE CEREBELLUM RECIEVES IMPULSES FROM 2 MAIN SOURCES.

FROM THE MUSCLES

CEREBRO-PONTOCEREBELLAR PATHWAY

CEREBRAL CORTEX

CEREBRO-PALLIDO-OLIVOCEREBELLAR PATHWAY

A) AFFERENTS from the PERIPHERAL ORGANS

Direct Vestibulo- cerebellar FROM THE INTERNAL EAR Indirect Vestibulo- cerebellar

FLOCCULO-NODUL LOBE

D. Spino-cerebellar Tract FROM THE MUSCLES V. Spino-cerebellar Tract D. and V. ext. arcuate fibres

FLOCCULO-NODUL LOBE

NB:

All afferents mentioned above except the ventral spino-cerebellar tract-- pass through the inferior cerebellar peduncle. The ventral spinocerebellar tract enters the cerebellum via the sup. Cerebellar peduncle.

CEREBELLAR PENDUCLES
Three paired bundles of nerve fibres called CEREBELLAR PENDUCLES support the cerebellum and provide it with tracts for communicating with the rest of the brain.
Superior cerebellar penducles: connects with the midbrain. Middle cerebellar penducles: related to the pons. Inferior cerebellar penducles: connect with the medulla oblongata and the spinal cord.

B) AFFERENTS from the CEREBRAL CORTEX

1) CEREBRO-PONTO-CEREBELLAR PATHWAY
FRONTO-PONTINE TRACT

PONTO-CEREBELLAR
PONTIN E NUCLEI

NEO-CEREBELLUM

T-P-O-PONTINE T.

CONT......
2) CEREBRO-POLLIDO-OLIVO-CEREBELLAR PATHWAY
OLIVOCEREBRA L CORTEX GLOBUS PALLIDUS INF. OLIVE TO ALL PARTS OF CEREBELLUM

CEREBELLAR

The ponto-cerebellar fibres pass through the middle cerebellar peduncle while the olivo-cerebellar fibres pass through the inferior cerebellar peduncle. Most of the impluses to the inferior olive come from the globus pallidus.

EFFERENT from the CEREBELLUM

Nearly all the efferents which leave the cerebellum go from the cerebellar nuclei. How many nuclei are found in the cerebellum? -- Dentate most laterally. -- Fastigial most medially in the vermis. -- Interpositus btw the dentate and fastigial nuclei. The interpositus is formed of two smaller nuclei called globose and emboliform.

Cont...
Efferents from the cerebellar nuclei reach different nuclei in the brain stem and the thalamus as follows:
1. Efferents from the dentate and interpositus go to: -- lateral Ventral Nucleus of the Thalamus. -- Red nucleus in the midbrain.

2. Efferent from the fastigial nucleus go to: -- The vestibular nuclei. -- The inferior olive. -- The reticular formation

What happens to the impluses which leave the cerebullar nuclei and reach the brain stem and the thalamus?.

Efferents from the cerebellar nuclei go to:

1) THALAMUS.... and then ASCEND to the cerebral cortex. In this way the cerebellum can influence the activity of the pyramidal tract. 2) BRAIN STEM....and then DESCEND to the spinal cord( ant. Horn cells). In this way the cerebellum can influence the activity of the ant. Horm cells in the spinal cord.

The FUNCTION of the CEREBELLUM

A) The cerebellum is NOT a sensory organ, so the removal of the cerebellum or of any of its afferent connections does NOT result in loss of any sensation.!
B) The cerebellum is NOT a motor organ, because the electrical stimulations of the cerebellum does NOT produce movements. Also voluntary movements occur without the cerebellum, but such movements are clumsy and not properly organized, they are not smooth and accurate as well.

What is the function of the cerebellum then???

WELL....! cerebellum is responsible for the SYNERGY of the muscle actions.
By : - coordinating actions of the different muscle group together and timing their contraction properly. In this way movements are done smoothly and accurately.

How does the cerebellum perform its function?

The cerebellum is informed about the progress of any voluntary motor activity, impluses arrive to it from 2 sources: a) It is informed about the orders arising from the motor cerebral cortex- when the motor area gives any order to the ant.horn cells by way of the pyramidal tract simultaneous impluses reach the cerebellum by means of the fronto-ponto-cerebellar pathway. b) The cuerebellum is also informed(by proprioceptive impluses) about the state of tone in the muscles which are asked to do the voluntary movement.

Cont....
By knowing the state of tone in the muscles and the orders from the motor aea for these muscles to contract, the cerebelllum can correct any mistake that may occur during the muscle activity.

DISEASES of the CEREBELLUM

Disease of the cerebellum results in the inability to do movements smoothly and accurately, this condition is called Cerebelllar Ataxis or Cerebellar Asynergia.
This causes the following: 1- disturbance of posture and gait. 2- decomposition of movements. 3- dysmetria. (over and undershooting) 4- adiado-chokinesia.(rapid supination and pronation or taping quickly with fingers) 5- scanning speech.