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Anatomy 6.

February 14, 2012


Dr. Maj Deriada

Cerebellum
OUTLINE
I. CEREBELLUM
A. Gross
B. Function
II. DIVISIONS AND ORGANIZATION
A. Lobes (Transverse Division)
B. Longitudinal Zones (Sagittal Division)
C. Organization
III. CEREBELAR CORTEX: CELL LAYERS
A. Molecular Layer
B. Purkinje Layer
C. Granular Layer
D. Inner White Matter
IV. IMPORTANT SYNAPSES AND CIRCUITRY
A. Synaptic Organization
B. Patterns of Excitation
V. NEURONS AND FIBERS OF THE CEREBELLUM
A. Three Highways
B. Three Inputs
C. Three Outputs
VI. CEREBELLAR AFFERENT FIBERS
A. From the Cortex
B. From the Spinal Cord
C. From the Vestibular Nerve
VII. CEREBELLAR EFFERENT FIBERS
VIII. SUMMARY (CEREBELLAR CORTICAL CIRCUITRY)
IX. CLINICAL CORRELATIONS
Objectives:
Name the major lobes of the cerebellum and give the function of each
lobe.
Describe the division of the cerebellum into a midline vermis and lateral
cerebellar hemispheres.
Describe the histology of the cerebellar cortex.
Name the deep cerebellar nuclei and their general connections.
Name the types of afferent fibers to the cerebellar cortex and identify
their source.
Name the afferent fibers from the cerebellar cortex.
Trace the various circuitries within the cerebellar cortex.
Name the cerebellar peduncles and the fiber tracts (afferent and efferent)
that constitute them.
Describe the cerebellar connections of the vestibular system.

is ovoid in shape with 2 lateral rounded cerebellar hemisphere that


pinched in the middle by the vermis
fiber tracts called cerebellar peduncle connecting it to the midbrain or
medulla
o Superior Cerebellar peduncle (brachium conjunctivum)
midbrain
o Middle Cerebellar peduncle (B. Pontis) pons
o Inferior (restiform body) medulla
The medial part is the juxtarestiform body
B. FUNCTION
Coordination of voluntary muscle activity [maintaining fine and
complex]
Equilibrium
Muscle tonus
o [Helps maintain posture and maintain equilibrium while walking and
running; execute sequential movement like writing, putting on
buttons and brushing teeth and as well as rapidly, alternating and
repetitive movement.]
o Controls muscular movement ipsilateral or same side of the body
unlike cerebrum

The cerebellum has no direct PW to the LMNs


Exerts its control via the cerebral cortex and the brainstem
Does not initiate movement; regulation
A person with lesion on the cerebellum WILL NOT be paralyzed but will
have disorganized, uncoordinated, slow and tremulous movement in the
eye and limb movements
There will be problem in muscle tone and posture- either hyper tonus or
hypotonus; and when standing or walking he would or stagger or swaying
II. DIVISIONS AND ORGANIZATION
A. LOBES (Transverse division)
LOBES (transverse division)- divided by a transverse plane: giving
rise to Anterior, Posterior and Flocculonodular lobe

References
Snells Neuroanatomy
Lansangs Neuroananatomy Notes
Dr. Deriadas Slide Lecture
Legends
Text in Times New Roman are from reference books and 2014B trans
Text in Arial Narrow are from the recorded lecture of Dr. Deriada
Text in Calibri are from the powerpoint presentation of the lectures

I. CEREBELLUM
A. GROSS
Located in the posterior cranial fossa
roof over by a vault of dura matter separating from occipital lobe of
cerebrum (tentorium cerebelli)
lies posterior to the pons and medulla oblongata
Group 3A |Cy, CARA, Cring, Kenji

Fig. 1 Cerebellar Lobes in Transverse View. Take note of the fissures.

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Anatomic
Division

ANTERIOR

POSTERIOR OR
MIDDLE
(Largest)

FLOCCULONODULAR

Functional
Division
Phylogenetic
Division
Gross Location

Spinocerebellum

Cerebrocerebellum

Vestibulocerebellum

Paleocerebellum

Neocerebellum

Archicerebellum
(oldest)
With a pair of flocculus
and at the vermis there
is a nodulus (pl. Flocculi
and noduli)

Situated anterior to
primary fissure and
terminates at rostral
end of cerebellum

Posterior to the
primary fissure and
anterior lobe.
Limited by the
posterolateral fissure

Between anterior and


posterior lobe
Fissure

Input

Function

Primary Fissurewide v-shape


depression or
longitudinal fissure
that separates
anterior and posterior
lobe

Posterolateral
Fissure- separate
posterior lobe from
flocculonodular lobe

Spinocerebellar
and
trigeminocerebella
r pathways
Stance and gait

Cerebral cortex

Vestibular nuclei

Speech and
coordinated
movement

Equilibrium (balance,
posture and eye
movements)

Function

Control of
posture, muscle
tone,
locomotion and
equilibrium

spinal cord and


limbs [particularly
of hands and feet]
Thereby
responsible for
STANCE AND GAIT

Coordination of
ipsilateral
somatic motor
activity
Planning of
movements
Assessment of
errors

Damage/
Disease/
Lesion

Ataxiauncoordinated
voluntary
muscular
movements

Wide-based stance
Stagger walking

Cerebellar
incoordination
(asynergia- lack
of coordination.
Ergo
incoordination )

Dysmetria- refers
to a lack of
coordination of
movement typified
by the undershoot
or overshoot of
intended position
with the hand, arm,
leg, or eye.
Inability to judge
distance or scale

Three fissures of cerebellum:


1. Primary Fissure
2. Posterolateral or Uvulonodular Fissure
3. Horizontal Fissure- no significance and demarcates the superior
and inferior surfaces of the cerebellum

Past-pointing
Tremors

TONSILS ON THE NEOCEREBELLUM

Dysdiadochokine
sis- inability to
perform regular/
rapidly
alternating
movements
Rebound
phenomenon

In the neocerebellum there is a pair of tonsils (located at both side of the midline).
When ICP increase like of tumor may cause herniation through the foramen
magnum because it immediately lies to it, compressing the brainstem which is
essential for breathing and blood pressure

B. LONGITUDINAL ZONES (Sagittal Division)


Section made through the cerebellum parallel to the median plane
divides the folia at right angles and the cut surface has a branched
appearance called Arbor vitae.
This gives rise to the functional areas of the cerebellar cortex
VERMIS
Synonymous
term
Direction of
projection
fibers

INTERMEDIATE

Medial

VERMAL
PARAVERMAL
FLOCCULONOD
ULAR ZONE
To spinal cord
To cerebral
hemisphere
[efferent fibers:
[includes anterior
fastigial
lobe and the anterior
nucleussynaps part of vermis]
eaxon to
vestibular
[singals/ information
nucleiSC
from cereberal
long axis of the
cortext to emboliform
body]
and globose nuclei or
nucleus interposidus
axons
terminated
contralateral red
nucleus crossing
the other side of the
spinal cord]

Group 3A |Cy, CARA, Cring, Kenji

LATERAL

Lateral

[MOSTLY
POSTERIOR part]
[cerebral cortex
dendate nuclei
thalamus motor
cortex pontine
nuclei and anterior
horn of spinal
cord]

Fig. 2 Cerebellar Zones.

C. Organization
Outer layer of gray matter- cortex
Inner core of white matter
o Fold in cerebellum or folia would contain outer cortex and inner core
white matter
Deep in the white matter are four pairs of masses of gray matter
or the intracerebellar nuclei:
o Large, multipolar neurons; simple branching dendrites; and
Axons

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1.
2.
3.
4.

Dentate nucleus- largest, most lateral


Emboliform nucleus- ovoid and situated medial to dentate
Globose nucleus- small, rounded in pairs or single
Fastigial nucleus- the most medial on the sides of midline
The collection of globose and emboliform nucleus forms as
INTERPOSED NUCLEI or NUCLEUS INTERPOSIDUS

Fig. 3 Location of the Nucleus Interpositus

III. CEREBELAR CORTEX: CELL LAYERS


The cerebellar cortex can be regarded as a large sheet with folds
lying in the coronal plane. Each fold or folium contains a core of
white matter covered superficially by gray matter.
The gray matter of the cortex throughout its extent has a
uniform structure. It may be divided into 3 layers:
1. Molecular layer
External
2. Purkinje cell layer

Middle

3. Granular layer

Internal

The cell body of the purkinje cells lie in the purkinje cell layer
while the dendrites pass into the molecular layer where they
undergo profuse branching
The primary and secondary branches of the dendrites are
smooth
Dendritic spines- short and thick spines that cover the
subsequent branches which form synaptic contacts with the
parallel fibers derived from granule cell axons
Axons of the purkinje cells will project into the granular layer
and will acquire myelin sheath and terminate by synapsing with
the cells of one of the intracerebellar nuclei which will form the
cerebellar peduncle.
Collateral branches synapse with dendrites of the basket and
stellate cells.
Some pass directly to the end in the vestibular nuclei of the
brainstem. They by-pass the intracerebellar nuclei.
The axons of these cells are the ENTIRE OUTPUT FIBERS of the
cerebellar cortex.
Purkinje cells form the center of a functional unit of the
cerebellar cortex
C. Granular Layer
Found between purkinje cell layer and the cerebellar white matter.

Packed small cells with densely staining nuclei and scanty


cytoplasm

It has three structures. Each give rise to 4-5 dendrites which


make claw-like endings synapsing with mossy fiber output
1. Granule cells- smallest neurons in the body
2. Golgi Cells- scattered throughout and dendrites reach
molecular layer
3. Cerebellar glomeruli/cerebellar island

Cerebellar glomeruli are capped by glial cells which contain:


1. Mossy fiber rosette
2. Terminals of golgi type II axons
3. Dendrites terminal of granular cell

Dendrites synapse with mossy fiber output

Axons pass into the molecular layer where it bifurcates in a Tjunction forming parallel fibers that run at right angles and
synapse with dendritic processes of the purkinje cells

Neuroglial cells are found throughout

Fig.4 Cerebellar cortex layers.

A. Molecular Layer

B. Purkinje Cell Layer

Fig. 5 Photomicrograph of a cross-section of the folia showing the layers of


the cerebellar cortex

Contains two types of neurons: (1) outer: stellate cell (2) inner:
basket cell that are scattered among dendritic arborizations
and numerous thin axons running parallel to the folia.
Neuroglial cells are found in between

Purkinje cells- large, flask-shaped Golgi type 1 neuron arranged


in a single layer

Group 3A |Cy, CARA, Cring, Kenji

IV. INNER WHITE MATTER


There is a large amount of white matter in each cerebellar
hemisphere. The white matter is made up of three groups of
fibers: (1) intrinsic, (2) afferent, and (3) efferent
Intrinsic fibers- located in the cerebellum but connect different
regions of the organ. Within in the cerebellum only.

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A.

Afferent fibers- form the greater part of the white matter


coming from the cerebral cortex and proceed to cerebellar
cortex; enter the cerebellum mainly to inferior and middle
cerebellar peduncle.
**MIDDLE CEREBELLAR PEDUNCLE ONLY CONTAINS AFFERENT
FIBERS.
Efferent fiber- OUTPUT of cerebellum; commence as the axons
of the Purkinje cell and synapse with deep cerebellar nuclei.
** most of purkinje cell axons in flocculonodular lobe and vermis
efferent fibers leave cerebellum via juxtarestiform body w/o
synapsing in any cerebellar nuclei
V. IMPORTANT SYNAPSES AND CIRCUITRY

o
o

SYNAPTIC ORGANIZATION

PURKINJIE CELLS
Output cells of the cortex inhibit neurons of the
underlying deep cerebellar nuclei.
The inhibitory control of Purkinje cells over the
excitability of the deep cerebellar nuclei is a key aspect
of cerebellar function.
EXCITATORY
1. Mossy fibers: enter the cerebellum from the spinal cord,
pontine nuclei, vestibular ganglia and nuclei, trigeminal
nuclei, and reticular formation nuclei
o Glutamate (except those from the pedunculopontine
nucleus and some of the vestibular nuclei Ach)
2. Climbing fibers: originate exclusively in the inferior olive
o Glutamate and Aspartate (excite the purkinje cell
dendrites on which they synapse)
o GABA: inhibit the deep cerebellar nuclei
Inhibitory: noradrenergic (locus ceruleus superior
cerebellar peduncle), dopaminergic (substantia nigra
& ventral mesencephalic tegmentum nucleus
interpositus and dentate nuclei), and serotonergic
(raphe nuclei all parts of the cerebelar nuclei and
cortex
OTHER CELLS: INHIBITORY
1. Basket cells
o Inhibit the Purkinje neurons; synapse with climbing
fibers and purkinje dendrites
2. Stellate cells
o inhibit the Purkinje neurons; synapse with climbing
fibers and purkinje dendrites
o Golgi inhibits granule cell

B.

PATTERNS OF EXCITATION

Both mossy and climbing fibers input produce excitatory effects


in both the deep cerebellar nuclei and cortex
Mossy fiber input: indirectly activates the granule cells
(through their axonal processes, the parallel fibers) and their
axons
o Ends of all other afferent cerebellar tracts (except the
olivocerebellar tract)
o Have multiple branches
o Exert much more diffuse excitatory effect
o A single mossy fiber can stimulate thousands of Purkinje
cells through the granule cells

1.

Group 3A |Cy, CARA, Cring, Kenji

Terminate at the granular layer to form the cerebellar


island
1 mossy fiber: 20 granule cell dendrites
1 mossy fiber synapse with golgi neurons
A. Granule cells excite purkinje, basket, stellate
and golgi type ii
B. Basket & stellate inhibit purkinje and golgi type
ii
C. Golgi type ii inhibit granule cells
D. Purkinje cells, the only route for all information
exiting from the cerebellar cortex, inhibit the
deep cerebellar and vestibular nuclei.
Consequently, within it, only the granule cells
cause excitation.

MOSSY FIBERS CIRCUITRY:


*(+) = excitatory synapses
*(-) = inhibitory synapses
o Mossy fiber (+) Granule cell axon (Parallel
fiber) to (+) Golgi cell axon to (-) Granule
cell
o Mossy fiber (+) Granule cell axon (Parallel
fiber) to (+) :
2.

Climbing fiber input: directly


o Directly synapse with the dendrites of Purkinje cells
(molecular layer)
o Terminal fibers of the olivocerebellar tracts
o Pass through the granular layer of the cortex and
terminate in the molecular layer by dividing repeatedly (Tjunction forming parallel fibers that run at right angles to
the dendritic processes of the purkinje cells)
o One climbing fiber makes contact with 1 to 10 Purkinje
neurons
o Synapse with cells: (collaterals)

Purkinje

Golgi Type II

Basket cells

Stellate cells
CLIMBING FIBERS CIRCUITRY:
Climbing fiber (+) Dendrites of Purkinje cell axon to (-)
Dentate nucleus
o Dendrite of Purkinje cell Axon to (-) Deep
cerebellar nuclei
o Dendrite of Basket cell Axon to (-) Purkinje cell at
axon hillock
o Dendrite of Stellate cell Axon to (-) Purkinje cell

*Purkinje Cell = Functional Unit

Sole output neuron of the cerebellar cortex

It will accept excitatory impulses but in return, as it forms


it axon, its output is inhibitory.

Where modulation and regulation of impulses occur

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Small
granules
Cells

Granular
layer

Golgi
Type II
cells

Granular
layer

climbing fibers
Granular layer and
synapse with axons
of Golgi type II and
mossy fibers

Molecular layer and


synapse with mossy
fibers

nuclei to inhibit them


Molecular layer and
bifurcates to form
parallel fibers. They
synapse with dendrites
of purkinje, basket,
stellate and golgi type II
cells
Granular layer and
synapse with mossy
fiber and small granule
dendrites

VI. CEREBELLAR CORTEX CIRCUITRY


A.

THREE HGHWAYS

1.

Fig. 6 Perpendicular arrangement of parallel fibers to purkinje cells

Superior Cerebellar Peduncle


Midbrain (Brachosyncytium)

Afferent:
o Ventral spinocerebellar Tract (unconscious)
o Some trigeminocerebellar Fibers

Efferent (*largest cerebellar efferent bundle):


o Projections from the cerebellar cortex originate
from the dentate nucleus
o Origin of most efferent fibers from lateral
cerebellar hemisphere (most fibers) to form:
Dentatorubral Tract
Dentatothalamic Tract
Dentatoreticular Tract
NOTE: These tracts cross in the lower midbrain level as the
decussation of the superior cerebellar peduncle

2.
Fig. 7 Cerebellar Cortex Circuitry
*Excitatory climbing and mossy fibers use GLUTAMATE as excitatory
transmitter on the dendrites of the Purkinje cells. Other afferent
fibers entering the cortex liberate NOREPINEPHRINE AND
SEROTONIN at their endings that possibly modify the action of the
glutamate on the Purkinje cells.

3.

V. NEURONS AND FIBERS OF THE CEREBELLUM


Afferent fibers
a. Climbing Fibers
-arise ONLY from olivocerebellar afferent pathway from
inferior olive nucleus into superior cerebellar peduncle
b.

Mossy Fibers
- Terminal fibers of all other cerebellar afferent fibers
- synapses with golgi neurons
- influence the degree of purkinje cell stimulation
produced by climbing and mossy fiber input
Efferent Fibers: neuron location and synapses
Neuron
Purkinje
Fibers

Cell body
Location
Purkinje
layer

Dendrites Location

Axons Location

Molecular layer
synapsing with
parallel fiber/axons
of granule cell and

Granular layer
extending to white
matter and synapse
with deep cerebellar

Group 3A |Cy, CARA, Cring, Kenji

B.

Middle Cerebellar Peduncle


Pons (Brachiobodies)

Afferent ONLY:
o Pontocerebellar Tract (Cross tract / Contralateral)
Inferior Peduncle
Medulla (Lentiform bodies)
Mainly afferent

Afferent:
o Dorsal Spinocerebellar Tract
o Cuneocerebellar Tract
o Reticulocerebelllar Tract
o Olivocerebellar Tract (important)
o Trigeminocerebellar Fibers (some)
o Vestibulocerebellar Fibers

Efferent:
o
Fastigiobulbar Tract

Juxtarestiform body to Vestibular Nuclei

THREE INPUTS

1.

Mossy Fibers
Spinocerebellar pathways
o Ends in the granular layer

2.

Climbing Fibers
From the inferior olive
Ends in the molecular layer

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3.

C.

Flocculonodular
Cortex

Vestibular Nuclei

Inferior
(juxtarestiform)
Inferior
(juxtarestiform)

THREE OUTPUTS
1.

2.

3.

More Mossy Fibers


From the pons, which are carrying information from the
cerebral cortex

Fastigial Nuclei
Concerned with balance; sends information mainly to
the vestibular and reticular nuclei (Medial)
Receives purkinje cell output from the vermal zone,
send efferent fibers to the reticular and vestibular nuclei
of the brainstem project into the spinal cord
control of posture and balance
Interposed Nuclei
Same as dentate nucleus; Globose + Emboliform
Receives input from purkinje cell in the paravermal and
vermal zone magnocellular division of the red
nucleus rubrospinal tract crosses midline and
descend into the SC. locomotion and coordinated
movements of the extremities
Dentate Nuclei
Concerned more with voluntary movement and send
axons mainly to the thalamus and red nucleus (lateral &
biggest)

OTHER EFFERENTS

o Lateral zone
Lateral part of the posterior lobe send purkinje cell
axon dentate and interposed nucleus
Fibers from the dentate nucleus terminate in the
parvocellular division of the red nucleus rubro-olivary
tract descend ipsilaterally terminate in the inferior
olivary complex feedback to the dentate and lateral
zone
o Thalamocortical fibers
Ventral lateral thalamic nucleus motor regions of the
ipsilateral frontal lobe
o Intralaminar nuclei
Prefrontal cortex executive functioning
Parietal lobe visuospatial processing
Frontal lobe linguistic activity
Cingulate and parahippocampal region affective and
motivational phenomena
SOURCE
Dentate Nucleus
-voluntary movt
Nucleus
Interpositus
Fastigial Nucleus
-balance
and
sends info

TERMINATION
VL Thalamic nucleus
Red nucleus
Reticular Formation
VL thalamic nucleus
Red nucleus
Reticular Formation
Vestibular Nuclei

Reticular Formation

Group 3A |Cy, CARA, Cring, Kenji

VI. CEREBELLAR AFFERENT FIBERS

From the Cerebral Cortex


o Important in the control of voluntary movement;
initiation of movement
1. Corticopontocerebellar pathway
2. Cerebro-olivocerebellar pathway
3. Cerebroreticulocerebellar pathway
From the Spinal Cord
o Receives muscle joint information from muscle spindles,
tendon organs, and joint receptors of the upper and
lower limbs
1. Anterior spinocerebellar tract
2. Posterior spinocerebellar tract
3. Cuneocerebellar tract
From the Vestibular Nerve (Vestibulocerebellar)
o From the vestibular nerve to flocculonodular lobe
o Receive information from the inner ear: motion
(semicircular canal) and position (utricle and saccule)

A. From the Cerebral Cortex

Corticopontocerebellar Pathway
o Information from cerebral cortex particularly primary
motor and sensory areas and associative areas
(different lobes of the cerebrum)
o Info descend through the corona radiata and internal
capsule
o Terminate on the pontine nuclei (corticopontine fibers)
o The pontine nuclei give rise to the transverse fibers of
the pons

PEDUNCLE USED
Superior

Superior

Superior
(Uncinate
fasciculus)
Inferior
(juxtarestiform)
Superior
(Uncinate
fasciculus)

o Neurons project its axons from pontine nuclei to


contralateral cerebellar cortex which cross the midline
and enter the opposite cerebellar hemisphere as the
middle cerebellar peduncle.

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Cerebro-olivocerebellar Pathway
o Descend through the corona radiata and internal
capsule to terminate bilaterally on the inferior olivary
nuclei.
o The inferior olivary nuclei give rise to fibers that cross
the midline and enter the opposite cerebellar
hemisphere through the inferior cerebellar peduncle.
o Information: motor area
**Fibers that arise from inferior olivary nuclei terminate as
the climbing fibers in the cerebellar cortex, the rest will
terminate as mossy fibers

Cerebroreticulocerebellar Pathway
o Descend to terminate in the reticular formation on the
same side and on the opposite side in the pons and
medulla
o Cells in the reticular formation give rise to the
reticulocerebellar fibers that enter the cerebellar
hemisphere on the same side through the inferior and
middle cerebellar peduncles.
o Information: motor areas

B. From the Spinal Cord


The spinal cord sends information to the cerebellum from
somatosensory receptors (like muscles, tendons, joints)

Anterior Spinocerebellar Tract


o Reach the posterior root ganglion

Group 3A |Cy, CARA, Cring, Kenji

o Terminate by synapsing with the neurons in the nucleus


dorsalis (Clarke's column)
o Nucleus dorsalis located at the base of the posterior
gray matter.
o Axons of these neurons go to anterolateral part of white
matter and ascend to reach brain stem and go through
superior cerebellar peduncle
o Fibers that cross over to the opposite side in the spinal
cord cross back within the cerebellum
o Believed that the cerebellum receives information from
the skin and superficial fascia by this tract
o Involve all segments of spinal cord
o Convey muscle-joint information of upper and lower
limbs, skin and superficial fascia
o Majority of fibers will cross

Posterior Spinocerebellar Tract


o From the posterior root ganglion to the posterior gray
column
o Project fibers in nucleus dorsalis (Clarke's column)
o Posterolateral part of white matter cerebellar cortex
o Enter cerebellum through inferior cerebellar peduncle
on same side then synapse in cerebellar cortex
o Collateral branches that end in the deep cerebellar
nuclei are also given off
o Convey muscle-joint information of trunk and lower
limbs

Cuneocerebellar Tract
o Originate in the nucleus cuneatus
o Enter the cerebellar hemisphere on the same side
through the inferior cerebellar peduncle
o The fibers terminate as mossy fibers in the cerebellar
cortex
o Collateral branches that end in the deep cerebellar
nuclei

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Receives muscle joint information from the muscle


spindles, tendon organs, and joint receptors of the
upper limb and upper part of the thorax
Convey muscle-joint information particularly upper
Limb and upper part, thorax

C. From the Vestibular Nerve


VII. CEREBELLAR EFFERENT FIBERS

Vestibulocerebellar
o receives information from the inner ear
o Project axons directly to cerebellum
o Directly synapse with neurons in cerebral cortex through
inferior cerebellar peduncle
o All the afferent fibers from the inner ear terminate as
mossy fibers in the flocculonodular lobe of the cerebellum.
*All afferent fibers terminate in flocculonodular lobe
*Other Afferent Fibers

Cerebellum receives small bundles of afferent fibers from


the red nucleus and the tectum.

Receives information from the inner ear:


o Motion - semicricular canal
o Position relative to gravity - utricle and saccule.

Entire output of the cerebellar cortex is through the axons of


the Purkinje cells.
Axons of the neurons that form the intracerebellar nuclei
constitute the efferent outflow from the cerebellum
Few Purkinje cell axons from the flocculonodular lobe bypass intracerebellar nuclei pass through the juxtarestiform
body of the inferior cerebellar peduncle directly synapse
with the lateral vestibular nucleus
Efferent fibers from the cerebellum connect with the red
nucleus, thalamus, vestibular complex, and reticular
formation.

1.

Group 3A |Cy, CARA, Cring, Kenji

Globose-Emboliform-Rubral Pathway
Contained in the intracerebellar nuclei (via Globose and
Emboliform or Nucleus interpositus) to the red nucleus/-i.
Axons travel through the superior cerebellar peduncle and
cross the midline to the opposite side in the decussation of
the superior cerebellar peduncles
Fibers end by synapsing with cells of the contralateral red
nucleus, which give rise to axons of the rubrospinal tract

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Some Purkinje cell axons project directly to the lateral


vestibular nucleus.
The neurons of the lateral vestibular nucleus form the
vestibulospinal tract.
The fastigial nucleus exerts a facilitatory influence mainly on
the
ipsilateral
extensor
muscle
tone.

pathway crosses twice, once in the decussation of the


superior cerebellar peduncle and again in the rubrospinal
tract close to its origin.
influence motor activity on the same side of the body
(ipsilateral motor activity)
2.

Dentothalamic Pathway
Axons travel through the superior cerebellar peduncle
Cross the midline to the opposite side in the decussation of
the superior cerebellar peduncle
Fibers end by synapsing with cells in the contralateral
ventrolateral nucleus of the thalamus
Axons of the thalamic neurons ascend through the internal
capsule and corona radiata and terminate in the primary
motor area of the cerebral cortex.
Influence motor activity by acting on the motor neurons of
the opposite cerebral cortex
Impulses from the motor cortex are transmitted to spinal
segmental levels through the corticospinal tract.
Deccusation of pyramid

4.

Fastigial Reticular Pathway


The axons travel through the inferior cerebellar peduncle
and end by synapsing with neurons of the reticular
formation.
Axons of these neurons influence spinal segmental motor
activity through the reticulospinal tract.
The efferent cerebellar Influences ipsilateral muscle tone

o Remember that most of the fibers of the corticospinal tract


cross to the opposite side in the decussation of the pyramids or
later at the spinal segmental levels

Influences ipsilateral motor activity


o Cerebellum indirectly influences on the same side

3.

Fastigial Vestibular Pathway


The axons of neurons in the fastigial nucleus travel
through the inferior cerebellar peduncle and end by
projecting on the neurons of the lateral vestibular nucleus
on both sides

Group 3A |Cy, CARA, Cring, Kenji

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cerebellar peduncle to thalamus (thereby uncross prior reaching the


thalamus- DENTATO-THALAMIC FIBERS) then back to cortex

Double decussation- [refer to the image above: at Pontine


level, Superior Cerebellar Puduncle (synapse)
2. Vestibulo-archicerebellar Loop
st
1 pair to develop
Balancing: Vestibular sytem
Impluses from the vestibular nerve go to flocculonodular lobe
cortex (via vestibulocerebellar projection) and fastigial nucleus
Projections go to the vestibular and reticular nuclei in
brainstem
Exit via vestibulocerebellar peduncle
Influences to spinal motor activity occur through the
vestibulospinal tracts

VIII. FEEDBACK LOOPS


1. Cortico-ponto-cerebello-dentato-thalamo-cortical Pathway
Cerebral cortex -> pontine nuclei via corticopontine fibers
Synapses at pontine nuclei > Crosses then enter cerebellum
via the middle peduncle > dentate nucleus > Crosses again at
superior cerebellar peduncle to thalamus then back to cortex
Double decussation > at PONTINE LEVEL, SUPERIOR
CEREBELLAR PEDUNCLE (synapse)
Enter cerebellar cortex through the middle cerebellar peduncle
Primary Motor Cortex -> descending motor pathways
Thalamus : primary motor cortex
Dentatothalamic fibers project to the VL of the thalamus
From motor cortex to loop influences descending motor PWs
Cortex > purkinje cell axons -> dentate nucleus

Vestibular nuclei Flocculonodular lobe cortex and fastigial


nucleus
o Projects to the VESTIBULAR AND RETICULAR nuclei in
brainstem (via juxtarestiform body at Inferior peduncle)
o Influence spinal motor activity through the vestibulospinal
tracts
3.

Brainstem-nuclei-cerebellar Loop
Olivocerebral and Reticulocerebral enters thru the inferior
middle peduncle to the cortex (Lateral/Posterior) then go to
Purkinje cells to the Nucleus Interpositus / Dentate Nuclei
then to the Red / Reticulospinal then finally the spinal cord
Also follow Double Decussation
Dentate Nucleus and Interposed Nucleus

Red Nucleus

Rubrospinal Tract Reticulospinal Tract

Reticular Nucleus

Spinal Motor Activity

Synapses at pontine nuclei Crosses then enter cerebellum via the


middle peduncle Dentate nucleus Crosses again at superior
Group 3A |Cy, CARA, Cring, Kenji

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Lower brainstem nuclei and inferior olivary nucleus


Reticulocerebellar and olivocerebellar tract Cerebellar
cortex
Cerebellar cortex Purkinje cell axons Cerebellar deep
nuclei

VIII. SUMMARY (CEREBELLAR CORTICAL CIRCUITRY)

Origin:
o cerebral cortex
o muscles, tendons, and joints
o vestibular nerve
Cerebellum
o NO DIRECT neuronal connections with LMNs (indirect)
o coordinator of precise movements, bring about the
necessary adjustments
o influence activity of LMNs Cerebellum
o send back information -> inhibit agonist muscles
o stimulate antagonist ms. -> limits voluntary movement

direction in which the object was displaced


when presented monocularly in the
direction of action of a recently paralysed
extraocular muscle.
Heel to shin test
Dysdiadochokinesiainability
to
perform
rapid
opposing/alternating movements
Disturbances: Reflexes = Pendular knee reflexes
Disturbances of Ocular Movement: Nystagmusinvoluntary eye movement
Dysarthria- difficulty speaking

B.

COMMON DISEASES
1. Acute Alcohol Poisoning
Alcohol acting on GABA receptors of the
cerebellar neurons
2. Alcohol Cerebellar Degeneration
Severe chronic alcoholism with malnutrition
Vermal degenerative changes
o Ataxia of gait but with normal speech and muscle
coordination of upper extremities
3. Tumors
Vermis Syndrome = Medulloblastoma (in Children)
Cerebellar Hemisphere Syndrome
o Ataxia is very noticeable

C.

ABNORMALITIES IN THE CEREBELLUM


1. Neocerebellar Syndrome Lesion of the lateral
hemispheric zone; asynergia, dysmetria, intention tremor
Asyngeria
Dysmetria
Past-pointing
Intention tumor
Dysdiadochokinesia
Rebound phenomenon
Decomposition of movement-scanning speech
o = Dysarthria
Ataxia
2.

Archicerebellar Syndrome Damage to the


flocculonodular lob and the related vermis; ataxia,
uncoordinated gait, vomiting, and nystagmus

IX. CLINICAL CORRELATIONS


A.

CEREBELLAR DISORDERS AND SYMPTOMS

Hypotonia - decreased muscle tone

Postural changes & alteration of gait

Ataxia-gross lack of coordination or muscle movements


o Intention tremors tremor during voluntary
movements
o Decomposition of movement
Pastpointing-Misjudging the location of an
object and pointing too far in the same

Group 3A |Cy, CARA, Cring, Kenji

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