The Cerebellum o develops from the alar plates (rhombic lips) of the metencephalon.

o is located infratentorially within the posterior fossa o it lies between the temporal and occipital lobes and the brainstem. o three primary functions maintenance of posture and balance maintenance of muscle tone coordination of voluntary motor activity. Major Divisions of the Cerebellum o consists of a midline vermis and two lateral hemispheres. o is covered by a three-layered cortex, which contains folia and fissures. o contains a central medullary core white matter that contains myelinated axons four cerebellar nuclei (dentate, emboliform, globose, and fastigial nuclei). The emboliform and globose nuclei are called the interposed nucleus. Cerebellar lobes o Anterior lobe receives input from stretch receptors (muscle spindles) and Golgi tendon organs (GTOs) via the spinocerebellar tracts. plays a role in the regulation of muscle tone. o Posterior lobe receives massive input from the neocortex via the corticopontocerebellar fibers plays a role in the coordination of voluntary motor activity. o Flocculonodular lobe (vestibulocerebellum) consists of the nodulus (of the vermis) and the flocculus receives input from the vestibular system. plays a role in the maintenance of posture and balance. Longitudinal organization of the cerebellum o includes three functional longitudinal zones that are associated with specific cerebellar nuclei and pathways. o Median (vermal) zone of the hemisphere contains the vermal cortex, which projects to the fastigial nucleus. o Paramedian (paravermal) zone of the hemisphere contains the paravermal cortex, which projects to the interposed nuclei (emboliformand globose nuclei). o Lateral zone of the hemisphere contains the hemispheric cortex, which projects to the dentate nucleus. Cerebellar peduncles o Inferior cerebellar peduncle connects the cerebellum to the medulla. consists of two divisions: Restiform body o is an afferent fiber system containing: Dorsal spinocerebellar tract Cuneocerebellar tract

Olivocerebellar tract Juxtarestiform body o contains afferent and efferent fibers: Vestibulocerebellar fibers (afferent) Cerebellovestibular fibers (efferent) o Middle cerebellar peduncle connects the cerebellum to the pons. is an afferent fiber system containing pontocerebellar fibers to the neocerebellum. o Superior cerebellar peduncle connects the cerebellum to the pons and midbrain. represents the major output from the cerebellum. Efferent pathways Dentatorubrothalamic tract Interpositorubrothalamic tract Fastigiothalamic tract Fastigiovestibular tract Afferent pathways Ventral spinocerebellar tract Trigeminocerebellar fibers Ceruleocerebellar fibers Cerebellar Cortex o Three-layered cerebellar cortex Molecular layer is the outer cell-sparse layer that underlies the pia mater. contains o dendritic arborizations of Purkinje cells o parallel fibers of the granule cells. o stellate (outer) cells and basket (inner stellate) cells. Purkinje cell layer is found between the molecular layer and the granule cell layer. Granule cell layer is found between the Purkinje cell layer and the cerebellar white matter contains granule cells, Golgi cells, and cerebellar glomeruli. Neurons and fibers of the cerebellum o Purkinje cell conveys the only output from the cerebellar cortex.(MCQ) projects inhibitory output (gamma-aminobutyric acid [GABA]) to the cerebellar and vestibular nuclei. is excited by parallel and climbing fibers. is inhibited (by GABA) by basket and stellate cells. o Granule cell excites (by glutamate) Purkinje, basket, stellate, and Golgi cells via parallel fibers. is inhibited by Golgi cells.

is excited by mossy fibers. o Mossy fibers are the afferent excitatory fibers of the spinocerebellar and pontocerebellar tracts terminate as mossy fiber rosettes on granule cells. excite granule cells to discharge via their parallel fibers. o Climbing fibers are the afferent excitatory fibers of the olivocerebellar tract. terminate on neurons of the cerebellar nuclei and on dendrites of Purkinje cells. Major Cerebellar Pathways o Vestibulocerebellar pathway plays a role in the maintenance of posture, balance, and the coordination of eye movements. receives its major input from the vestibular receptors of the kinetic and static labyrinths. Semicircular ducts and otolith organs project to the flocculonodular lobe and the vestibular nuclei. Flocculonodular lobe receives visual input from the superior colliculus and the striate cortex. projects to the vestibular nuclei. Vestibular nuclei project via the medial longitudinal fasciculi (MLFs) to the ocular motor nuclei of CN III, CN IV, and CN VI o it coordinate eye movements. project via the medial and lateral vestibulospinal tracts to the spinal cord o it regulates neck and antigravity muscles, respectively. o Vermal spinocerebellar pathway maintains muscle tone and postural control over truncal (axial) and proximal (limb girdle) muscles. Vermis receives spinocerebellar and labyrinthine input projects to the fastigial nucleus. Fastigial nucleus has excitatory output. projects via the vestibular nuclei to the spinal cord. projects to the ventral lateral nucleus of the thalamus. Ventral lateral nucleus of the thalamus receives input from the fastigial nucleus. projects to the trunk area of the precentral gyrus. Precentral gyrus gives rise to the ventral corticospinal tract, which regulates muscle tone of the truncal and proximal muscles o Paravermal spinocerebellar pathway

maintains muscle tone and postural control over distal muscle groups. Paravermis receives spinocerebellar input from distal muscles. projects to the interposed nuclei. Interposed nuclei (emboliform and globose) have excitatory output. project to: Ventral lateral nucleus and Red nucleus Ventral lateral nucleus o projects to the extremities area of the precentral gyrus o The precentral gyrus gives rise to the lateral corticospinal tract, which regulates the distal muscle groups. Red nucleus o gives rise to the crossed rubrospinal tract, which mediates control over distal muscles. o receives input from the contralateral nucleus interpositus and bilateral input from the motor and premotor cortices. o Lateral hemispheric cerebellar pathway is also called the neocerebellar or pontocerebellar pathway. regulates the initiation, planning, and timing of volitional motor activity. Cerebellar hemisphere receives input from the contralateral motor and sensory cortex via the corticopontocerebellar tract. projects via Purkinje cell axons to the dentate nucleus. Dentate nucleus has excitatory output. projects via the superior cerebellar peduncle to the o contralateral red nucleus o ventral lateral nucleus of the thalamus o inferior olivary nucleus. Red nucleus pathway o The red nucleus projects to the inferior olivary nucleus. o The inferior olivary nucleus projects via the contralateral inferior cerebellar peduncle to the cerebellum. Ventral lateral nucleus pathway o The ventral lateral nucleus of the thalamus projects to the motor (4) and premotor (6) cortices. o The motor and premotor cortices give rise to the following tracts: Corticobulbar tract innervates cranial nerve nuclei. Lateral corticospinal tract

regulates volitional synergistic motor activity. Corticopontocerebellar tracts regulate the output of the neocerebellum. Inferior olivary nucleus pathway The inferior olivary nucleus receives direct input from the dentate nucleus via the crossed descending fibers of the superior cerebellar peduncle. The inferior olivary nucleus projects directly to the dentate nucleus via the contralateral inferior cerebellar peduncle.

o Cerebellar Lesions and their clinical presentation o Cerebellar Dysfunction is characterized by the triad Hypotonia Disequilibrium dyssynergia. o Hypotonia is a loss of the resistance normally offered by muscles to palpation or to passive manipulation. results from the loss of cerebellar facilitation of the motor cortex via tonic firing of the cerebellar nuclei. results in a floppy, loose-jointed, rag-doll appearance with pendular reflexes; the patient appears inebriated. o Disequilibrium refers to loss of balance, characterized by gait and trunk dystaxia. o Dyssynergia is a loss of coordinated muscle activity and includes: Dysarthria - is slurred or scanning speech. o Dystaxia is a lack of coordination in the execution of voluntary movement (e.g., gait, trunk, leg, and arm dystaxia). o Dysmetria is the inability to arrest muscular movement at the desired point (past-pointing). Intention tremor is a type of dysmetria that occurs during a voluntary movement. o Dysdiadochokinesia is the inability to perform rapid alternating movements (e.g., rapid supination and pronation of the hands). o Nystagmus is a form of dystaxia consisting of to-and-fro eye movements (ocular dysmetria). o Decomposition of movement (by-the-numbers phenomenon) consists of breaking down a smooth muscle act into a number of jerky awkward component parts. o Rebound or lack of check results from the inability to adjust to changes in muscle tension.

is caused by loss of the cerebellar component of the stretch reflex. How is it tested : Ask patient flex the forearm at the elbow against resistance; sudden release results in the forearm striking the patients chest. o Cerebellar Lesions o Anterior vermis syndrome involves the leg region of the anterior lobe. results from atrophy of the rostral vermis most commonly caused by alcohol abuse. results in gait, trunk, and leg dystaxia. o Posterior vermis syndrome involves the flocculonodular lobe. is usually the result of brain tumors in children. is most frequently caused by medulloblastomas or ependymomas results in truncal dystaxia. o Hemispheric syndrome usually involves one cerebellar hemisphere. is frequently the result of a brain tumor or an abscess. results in arm, leg, trunk, and gait dystaxia. results in cerebellar signs that are ipsilateral to the lesion.