Faculty of Dental Medicine and Surgery. Sem 4 Cerebellum Dr. Abbas

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1 Faculty of Dental Medicine and Surgery Sem 4 Cerebellum Dr. Abbas

2 Anatomy of the cerebellum

3 Cerebellum Configurations External - located in posterior cranial fossa - communicate with other structure via superior, middle, and inferior cerebellar peduncle - longitudinal division Vermis, Paravermal Region, Cerebellar Hemisphere - transverse division Anterior Lobe primary fissure Posterior Lobe posterolateral fissure Flocculonodular Lobe

4 Cer ebellmn Stl}Jetior Stuface Roatral(anter lor) lohe lobule A-rt:erior cerebellar notch adrangular Central lobule of superior vermi Primary fissure Horizontal fissure, simplex lobule eclive of superior vermi Postlunate fissure Rostral (superior) semilunar lobule Folium of superior vermis dal Onferior) semilunar lobule Posterior cerebellar notch Caudal (posterior)lobe r ra / % e Clfift-GEIGV

5 f erebellmn Infetior Stuface Flocculonodular lobe Ungula of superior verm Superior medullary vel Central lobule of superior verm of central lobule uperior cerebellar peduncle Mddle cerebellar peduncle nferior cerebellar peduncle Dorsolateral (posterolateral) fissure audal Onferior) semilunar lobule Tuber of inferior vermi Posterior cerebellar notch econdary (postpy ramidal) fissure Cauda l (posterior) lobe r L ;, f$ e ClfiA-GEIG'{

6 Anatomy of the cerebellum Forms roof of 4th ventricle Lobes of cerebellum: anterior, posterior, flocculonodular Primary fissure; tonsil Nolte 20-2d; DE Haines 382c

7 Cerebellar divisions Spinocerebellum (Vermis + Intermed. Hem) Control of limbs and trunk Cerebrocerebellum (Lateral hemisphere) Planning of movement+ Vestibulo-cerebellum (Floculo-nodular lobe) Control of eye & head movements Balance IVth vent Spinocerebellum: Vermis Intermediate hem. Cerebrocerebellum: Lateral hem. Vermis Intermediate hem. Lateral hem. NTA Fig Floculo-nodular lobe

8 Indirect influence on LMNs Thalamus Cortex UMN (CST) Cerebellum UMN CNS LMN Cerebellum directly or indirectly influences UMN systems that control LMNs PNS muscle

9 DE Haines. 380 A, B Cerebellar peduncles

10 Inferior cerebellar peduncle DeArmond 89

11 Middle cerebellar peduncle

12 Superior cerebellar peduncle DeArmond 99, 105

13 Cerebellmn Sectio11it1Pla11e of SU}Jetior C erebellar Pedtn1cle Decussation o1 superior cerebellar peduncles Cerebral peduncle Superior medullary vel Fa:::tigial nucleus 4th ventricl / Medi llong udin l f sciculus Nuclear layer of medulla oblongata Superior cerebellar peduncle Globose nuclei nucleus Dentate nucleus is

14 Deep Nuclei 1. fastigial nucleus 2. globos e nucleus 3. embolifor m nucleus 4. dentate nucleus

15 Main Connections of the Vestibulocerebellum Vestibular Organ VESTIBULAR NUCLEUS Floculonodular Lobe Vermis vestibulospinal tract MLF FASTIGIAL NUCLEUS lower motor neuron ARCHICEREBELLUM LMN

16 Main Connections of the Paleocerebellum RED NUCLEUS NUCLEUS INTERPOSITUS rubrospinal tract Inferior Olivry Nucleus ANTERIOR LOBE PARAVERMAL ZONE lower motor neuron SPINAL CORD spinocerebellar tract PALEOCEREBELLUM

17 Main Connections of the Neocerebellum CEREBRAL CORTEX THALAMUS DENTATE NUCLEUS pyramidal tract Pontine Nucleus POSTERIOR LOBE CEREBELLAR HEMISPHERE lower motor neuron LMN NEOCEREBELLUM

18 Cerebellar cortex Three layers: Molecular, Purkinje, Granular Wheater 370 DE Haines 386

19 T he im age cannot be display ed. Y our com puter may not hav e enough mem ory to open the im age, or the im age m ay hav e been corrupted. Restart y our com puter, and then open the file again. If the red x still appears, y ou may hav e to delete the im age and then insert it again. Cerebellar Cortex Inputs Climbing fibers from Inferior olive Mossy fibers Output Purkinje neurons Interneurons Granule neurons Stellate neurons Basket neurons Molecular Golgi neurons Purkinje Granular NTA Fig

20 Layers Cerebellar cortex: cell types, connections Molecular Cell types -basket, stellate -Purkinje project to deep nuclei -Granule, Golgi Purkinje Granular Fibre types -Climbing (from inferior olive, direct to Purkinje) -Mossy (all other input, to granule cells, which project to Purkinje neurons)

21 Blood supply of the cerebellum

22 Damage to the cerebellum Ataxia: uncoordinated movement Muscles tend to be hyporeflexic, hypotonic Midline damage (vermis/fastigal) causes ataxia of trunk musculature Lateral damage (paravermis/interposed and lateral/dentate) causes ipsilateral ataxia of limbs Intension (action) tremor Dysmetria (inaccurate reaching) Decomposition of movement Dysdiadochokinesia (inability to perform rapid alternating movements)

23 a b c Cerebellar Ataxia d Ataxic gait and position: Left cerebellar tumor a. Sways to the right in standing position b. Steady on the right leg c. Unsteady on the left leg d. ataxic gait

24 Diseases affecting the cerebellum Tumours (medulloblastoma or astrocytoma) Strokes (hemorrhagic or ischemic) Alcoholism (malnutrition, thiamine deficiency) Spinocerebellar degeneration Netter 24 CIBA Collection

Located below tentorium cerebelli within posterior cranial fossa. Formed of 2 hemispheres connected by the vermis in midline.

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