THE CEREBELLUM & ITS RELEVANT CONNECTIONS

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THE CEREBELLUM & ITS RELEVANT CONNECTIONS Dr. Mohammed Ahamed Abuelnor

OBJECTIVES At the end of the lecture, students should: Describe the External features of the cerebellum (lobes, fissures). Describe briefly the Internal structure of the cerebellum. List the name of Cerebellar Nuclei. Relate the Anatomical to the Functional Subdivisions of the cerebellum. Describe the Important connections of each subdivision. Describe briefly the Main Effects in case of lesion of the cerebellum.

CEREBELLUM Development : From Hindbrain. Position : lies behind Pons & Medulla Separated from them by Fourth ventricle.

THE CEREBELLUM CONNECTION TO BRAIN STEM: by Inferior, Middle & Superior Cerebellar Peduncles.

EXTERNAL FEATURES It consists of two Cerebellar Hemispheres joined in midline by the Vermis. Its surface is highly convoluted forming Folia, separated by Fissures.

ANATOMICAL SUBDIVISION Primary Fissure Superior Surface Posterolateral = Secondary Fissure Anterroinferior Surface Anterior lobe: in front of primary fissure, on the superior surface. Posterior (middle) lobe: behind primary fissure (Between Primary & Secondary fissures = posterolateral). Flocculonodular lobe: in front of secondary (Posterolateral) fissure, on the inferior surface .

ANATOMICAL SUBDIVISION

CONSTITUENTS (Internal Structure and Nuclei of Cerebellum) Outer grey matter: cerebellar cortex. Inner white matter: cerebellar medulla. Deeply seated nuclei in white matter: from medial to lateral: Fastigial nucleus. Globose nucleus. Emboliform nucleus. Dentate nucleus: largest one.

CEREBELLAR CORTEX Divided into 3 layers: Outer molecular layer Intermediate Purkinje cell layer Inner granular layer

CEREBELLAR MEDULLA AFFERENT FIBRES: Climbing fibres: from inferior olivary nucleus, relay to purkinje cells Mossy fibres: rest of fibres: From vestibular nuclei From spinal cord From pons They relay to granule cells which in turn relay to purkinje cells. all afferent fibres relay to purkinje cells in the cortex.

CEREBELLAR MEDULLA The great majority of cortex axons do not leave cerebellum & end in deep cerebellar nuclei, specially Dentate nucleus. Some of axons leave cerebellum as efferent fibres. Dendato-rubro-thalamic

CEREBELLAR MEDULLA EFFERENT FIBRES: Most of efferent fibres are axons of deep cerebellar nuclei. Main Efferents go to: Vestibular nuclei (cerebello-vestibular tract). Red nucleus (Dendato-rubro-thalamic tract). Ventral lateral nucleus of thalamus (Dendato-thalamic).

ARCHICEREBELLUM Vestibular Part of cerebellum: Flocculonodular lobe. Green = Archi-cerebellum, Blue= Paleo-cerebellum. Pink= Neo-cerebellum.

ARCHICEREBELLUM Nuclei Related: Fastigial Afferents: from Vestibular nuclei (Vestibulocerebellar fibres),(through ICP) Efferents cortical (purkinje cell) Fibres project : to Fastigial nucleus, which projects to vestibular nuclei (through ICP) + to Reticular formation Function: controls body Balance (via vestibulospinal & reticulospinal tracts). Control of eye movement (via VO Reflex)

PALEOCEREBELLUM Spinal Part of cerebellum: Vermis & Paravermis Green = Archi-cerebellum, Blue= Paleo-cerebellum. Pink= Neo-cerebellum.

PALEOCEREBELLUM Nuclei Related: globose & emboliform Afferents: from spinal cord (dorsal & ventral spinocerebellar tracts through ICP & SCP, respectively) Efferents : to globose&embliform nuclei which project to red nucleus (through SCP) Function: controls posture & muscle tone (via Rubrospinal tract).

NEOCEREBELLUM Cerebral Part of cerebellum: Rest of Cerebellum.

NEOCEREBELLUM Nuclei Related: Dentate Afferents: from Pons (Pontocerebellar fibres) (through MCP) Efferents: to Red nucleus but mostly to Ventral Lateral Nucleus of Thalamus (through SCP) then to motor cortex Function: coordination of voluntary movements (via descending corticospinal & corticobulbar tracts or rubrospinal tract).

CEREBELLAR LESIONS MIDLINE LESION: Loss of postural control. UNILATERAL LESION: “Cerebellar ataxia” causes ipsilateral : Incoordination of arm: intention tremors (on performing voluntary movements) Incoordination of leg: unsteady gait Incoordination of eye movements: nystagmus Slowness of speech: dysarthria (difficulty of speech).

References: Gray's Anatomy for Students- Second edition. Clinically Oriented Anatomy , Keith L. Moore- Sixth edition. Netter’s Clinical Anatomy, Second edition.