mbbs student study materiaol

1. Dr Pramod Narnolia
M.D. Physiology
Deptt. Of Physiology
S.P. Medical College, Bikaner

2. Connetions of the cerebellum
Affarents connections :-
1.Dorsal spinocerebellum tracts
2.ventral spinocerebellum tracts
3. Olivocerebeller tract
4.Vestibulocerebeller tract
5.Cuneocerebeller tract
6.Tectocerebeller tract
7.cotico-ponto-cerebeller tract
8.Rubrocerebeller tract
9.Reticocerebeller tract

3. • Efferent fiber s from cerebellem :- these fibers arise from
4 deep cerebeller nucleus which are supplied by purkinje
cells. The affarents connection s are
1. From dentate nucleas :- via superior cerebeller peduncle
to red nucleas and medullary reticuler formation and
projected to the area 4 and 6 of moter cortex.
2. Fastigeal nucleas- a . via inferior cerebeller peduncle to
vestibular nucleus and medulary reticular formation
b.medial longitudinal bundle
c. asending reticular formation .
3.Emboliform nucleus :- via superior cerebeller peduncle to
red nucleus tored nucleus
4.Globose :- via superior cerebeller peduncle to red nucleus
and also to reticular formation of midbrain
Efferent connections of cerebellum

4. Cerebellum External
Configurations
- located in posterior cranial fossa
- tentorium cerebelli (cerebrum), 4th ventricle (brain stem)
- 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

5. Subdivision of Flocculonodular Lobe
Nodulus Flocculus
Subdivision of Anterior Lobe
Vermis Hemisphere
Lingula
Central Lobule Ala Central Lobule
postcentral fissure
Culmen Quadriangular Lobule
Cerebellum External
Configurations

6. Subdivision of Posterior Lobe
Vermis Hemisphere
Declive Simple Lobule
postcentral fissure
Folium Superior Semilunar Lobule
horizontal fissure
Inferior Semilunar Lobule
Tuber
Gracile Lobule
prepyramidal fissure
Pyramis Biventer Lobule
secondary fissure
Uvula Tonsil
Cerebellum External
Configurations

8. Cerebellar Cortex
Molecular Layer
Purkinje Cell Layer
Granular Layer
Corpus Medullare (Medullary Center)
Deep Cerebellar Nuclei
Fastigial Nuclei
Nucleus Interpositus
Emboliform Nucleus
Globose Nucleus
Dentate Nucleus
Cerebellum Internal
Configurations

9. 1. fastigial
nucleus
2. globose
nucleus
3. emboliform
nucleus
4. dentate
nucleus
Deep Nuclei

10. Cerebellar Cortex
I. Molecular Layer
Stellate Cell --- taurine (inhibitory)
afferent: parallel fiber
efferent: Purkinje cell dendrite
Basket Cell ---- GABA (inhibitory)
afferent: parallel fiber
efferent: Purkinje cell soma
Parallel Fiber
granule cell axon
Purkinje Cell Dendrite
Cerebellum Internal
Configurations

11. Cerebellar Cortex
II. Purkinje Cell Layer
Purkinje Cell
-- 15,000,000 in number
-- GABA (inhibitory)
afferent: parallel fiber
climbing fiber
stellate cell
basket cell
efferent: deep cortical nuclei
Cerebellum Internal
Configurations

12. Cerebellar Cortex
III. Granular Layer
Granular Cell
-- 50,000,000,000 in number
-- glutamic acid (excitatory)
afferent: mossy fiber
efferent: Purkinje cell dendrite
basket cell, stellate cell
Golgi cell
Golgi Cell
-- GABA (inhibitory)
afferent: parallel fiber, mossy fiber rosette
efferent: granule cell dendrite
Cerebellum Internal
Configurations

13. l
1. Purkinje cell
2. granule cell
3. basket cell
4. Golgi cell
5. stellate cell
6. climbing
fiber
7. mossy fiber
8. parallel fiber
9. inferior
olivary
nucleus
10. deep cerebellar

14. 1. Purkinje cell
2. granule cell
3. basket cell
4. Golgi cell
5. stellate cell
6. climbing fiber
7. mossy fiber
8. parallel fiber
9. inferior olivary
nucleus
10. deep cerebellar

15. Synaptic Glomerulus
Afferent terminals on granular layer
 Mossy Fiber Rosette
-- afferent fibers except
inferior olivary input
-- 2/3 of medullary center
 Granular Cell Dendrite
-- main afferent input
 Golgi Cell Axon
-- synapse on granule cell dendrite
-- GABA (inhibitory)
- Surrounded by Astrocyte Foot Process
Cerebellum Internal
Configurations

16. Synaptic Glomerulus

17. Classification by Phylogenetic and Ontogenic Development
Archicerebellum
Paleocerebllum
Neocerebellum
Classification by Afferent Connection
Vestibulocerebellum
Spinocerebellum
Pontocerebellum
Classification by Efferent Connection
Vermis
Paravermal Region
Cerebellar Hemisphere
Cerebellum
Classifications

18. Archicerebellum
(nodulus)
Archicerebellum
(flocculus)
Paleocerebellum
Neocerebellum

19. Spinocerebellum
Pontocerebellum
Vestibulocerebellum

20. Connetions of the cerebellum
Affarent connections :-
1.Dorsal spinocerebellum tracts
2.ventral spinocerebellum tracts
3. Olivocerebeller tract
4.Vestibulocerebeller tract
5.Cuneocerebeller tract
6.Tectocerebeller tract
7.cotico-ponto-cerebeller tract
8.Rubrocerebeller tract
9.Reticulocerebeller tract

21. Afferent Connections (1):
1. Inferior Cerebellar Peduncle
Restiform Body
Posterior Spinocerebellar Tract
Olivocerebellar tract
Cuneocerebellar Tract
Reticulocerebellar Tract
Juxtarestiform Body
Vestibulocerebellar Tract
Primary Vestyibular Fiber
Cerebellum
Connections

22. Afferent Connections (2):
2. Middle Cerebellar Peduncle
Pontocerebellar fiber
Corticopontocerebellar Fiber
Reticulocerebellar Fiber
3. Superior Cerebellar Peduncle
Anterior Spinocerebellar Tract
Cerulocerebellar fiber
Raphecerebellar fiber
Rubrocerebellar fiber
Hypothalamocerebellar fiber
Cerebellum
Connections

23. Efferent connections of
cerebellum
• Efferent fiber s from cerebellem :- these fibers arise from 4 deep
cerebeller nucleus which are supplied by purkinje cells. The affarents
connection s are
1. From dentate nucleas :- via superior cerebeller peduncle to red
nucleas and medullary reticuler formation and projected to the area 4
and 6 of moter cortex.
2. Fastigeal nucleas- a . via inferior cerebeller peduncle to vestibular
nucleus and medulary reticular formation
b.medial longitudinal bundle
c. asending reticular formation .
3.Emboliform nucleus :- via superior cerebeller peduncle to red nucleus
tored nucleus
4.Globose :- via superior cerebeller peduncle to red nucleus and also to
reticular formation of midbrain .

24. Efferent Connections :
1. Superior Cerebellar Peduncle
Cerebellothalamic fiber
- from 3 deep nuclei to VPLo, VLc, CL
Cerebellorubral fiber
- from nucleus interpositus
and dentate nucleus
ascending portion of
uncinate fasciculus of Russell
2. Inferior Cerebellar Peduncle
Fastigiovestibular fiber
descending portion of
uncinate fasciculus of Russell
Cerebellum
Connections

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

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

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

28. upper motor neuron
UMN
BASAL
GANGLIA
Pyramidal Tract and Associated Circuits
lower motor neuron
UMN
pyramidal tract
Cerebellum

29. Reticular
Formation
CEREBELLUM
Cerebellum and Automatic Motor Control
Lower Motor Neuron (LMN)
Motor Cortex
Red Nucleus
Vestibular
Nucleus
Proprioceptors

30. Corticonuclear Connections
A zone ---------- fastigial nucleus
medial vestibular nucleus
B zone ---------- lateral vestibular nucleus
C1, C3 zone --- emboliform nucleus
C2 ---------------- globose nucleus
D1 ---------------- parvocellular portion of dentate nucleus
D2 ---------------- magnocellular portion of dentate nucleus
Cerebellum
Connections

31. 1. vermis
2. paravermal region
3. cerebella hemisphere
4. nodulus
5. flocculus
6. fastigial nucleus
7. globose nucleus
8. emboliform nucleus
9. dentate nucleus
10. medial vestibular
nucleus
11. lateral vestibular
nucleus

32. Olivocerebellar Connections
Caudal portion of
medial and dorsal accessory olivary nucleus
----------------- vermis of cerebellar cortex (A and B)
fastigial nucleus
vestibular nucleus
Rostral portion of
medial and dorsal accessory olivary nucleus
----------------- paravermal region (C1, C2, C3)
nucleus interpositus
Principal Inferior Olivary Nucleus
----------------- cerebellar hemisphere (D1, D2)
dentate nucleus
Cerebellum
Connections

33. medial and dorsal accessory olivary nucleus
caudal portion rostral portion Principal
Inferior Olivary
Nucleus

34. Cerebellum
Function
 Maintenance of Equilibrium
- balance, posture, eye movement
 Coordination of half-automatic movement of
walking and posture maintenace
- posture, gait
 Adjustment of Muscle Tone
 Motor Leaning – Motor Skills
 Cognitive Function

35. Balance

36. Motor Skill
Pablo Casals

37. Cerebellum Clinical
Syndromes
Ataxia: incoordination of movement
- decomposition of movement
- dysmetria, past-pointing
- dysdiadochokinesia
- rebound phenomenon of Holmes
- gait ataxia, truncal ataxia, titubation
Intention Tremor
Hypotonia, Nystagmus
Archicerebellar Lesion: medulloblastoma
Paleocerebellar Lesion: gait disturbance
Neocerebellar Lesion: hypotonia, ataxia, tremor

38. Posture
Gait – Ataxia
Tremor

39. Cerebellar
Ataxia
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
a b c
d

40. Cerebellar tumors on vermis
- Truncal Ataxia
- Frequent Falling
The child in this picture:
- would not try to stand
unsupported
- would not let go of the bed rail
if she was stood on the floor.
Cerebellar
Medulloblastoma

41. THANKS