The document discusses the anatomy and function of the cerebellum. It describes the cerebellum's location in the posterior cranial fossa and its connections to other structures via peduncles. The cerebellum is divided longitudinally into the vermis, paravermal region, and hemispheres, and transversely into the anterior, posterior, and flocculonodular lobes. It discusses the internal structure of the cerebellar cortex and its layers, as well as the connections between different cell types. The cerebellum is involved in motor coordination, balance, posture, eye movements, motor learning, and cognitive functions.

1. CEREBELLUMCEREBELLUM
Prof. Branislav Filipović, M.D., D.Sc.

2. CerebellumCerebellum ExternalExternalCerebellumCerebellum ExternalExternal
- located in- located in posterior cranial fossaposterior cranial fossa
- tentorium cerebelli (cerebrum), 4th ventricle (brain stem)- tentorium cerebelli (cerebrum), 4th ventricle (brain stem)
- communicate with other structure via- communicate with other structure via
superior, middle, and inferior cerebellar pedunclesuperior, middle, and inferior cerebellar peduncle
-- longitudinal divisionlongitudinal division
Vermis, Paravermal Region, Cerebellar HemisphereVermis, Paravermal Region, Cerebellar Hemisphere
-- transverse divisiontransverse division
Anterior LobeAnterior Lobe
------------------------ primary fissureprimary fissure
Posterior LobePosterior Lobe
------------------------ posterolateral fissureposterolateral fissure
Flocculonodular LobeFlocculonodular Lobe

3. PartsParts
Vermis (“the worm”)Vermis (“the worm”)
HemisphereHemisphere

Anterior lobeAnterior lobe

Posterior lobePosterior lobe

Flocculonodular lobeFlocculonodular lobe
Its surface is divided inIts surface is divided in
many segments namedmany segments named
folia (eng. “the leaves”)folia (eng. “the leaves”)
by cerebellar fissures.by cerebellar fissures.
Actually, it resembles toActually, it resembles to
the skin of an old Indianthe skin of an old Indian

4. DORSAL SURFACEDORSAL SURFACE
•Looking at the dorsal surface of the
cerebellum, you can see that there is a
midline zone called the vermis (worm)
and more lateral zones on each side
called hemispheres. There also are
major fissures called the primary and
the horizontal. Rostral to the primary
fissure is the anterior lobe of the
cerebellum, while caudal to it is the
posterior lobe (all the way back and
under to the posterolateral fissure, which
separates the posterior lobe from the
nodule/flocculus). The horizontal fissure
does not separate lobes of the
cerebellum but is just another darn
fissure that lies in the posterior lobe!!).
Both the anterior and posterior lobes of
the cerebellum have vermal and
hemispheric areas.

5. A – CerebellarA – Cerebellar
hemispherehemisphere
B – vermisB – vermis
C – culmenC – culmen
D – decliveD – declive
1 – ala of the central1 – ala of the central
lobule, 2 – anteriorlobule, 2 – anterior
quadrangular lobule, 3 –quadrangular lobule, 3 –
fissura prima, 4 –fissura prima, 4 –
posterior quadrangularposterior quadrangular
lobule, 5 – posteriorlobule, 5 – posterior
superior fissure, 6 –superior fissure, 6 –
superior semilunarsuperior semilunar
lobule 7 – horizontallobule 7 – horizontal
fissure 8 – inferiorfissure 8 – inferior
semilunar lobulesemilunar lobule
Anterior cerebellar notch
Posterior cerebellar notch

6. VENTRAL SURFACEVENTRAL SURFACE
Now let's look at the ventral surface of the cerebellum (the part that
overlies the fourth ventricle and faces the dorsal (top) part of the pons.
The midline vermis and laterally placed hemispheres are apparent, as are
parts of each posterior hemisphere called the "tonsils". On this ventral
view the midline nodule and its lateral extension, the flocculus can be
seen. The posterolateral fissure (sorry about these darn fissures) lies
just caudal to the nodule, and separates the nodule/flocculus or
flocculonodular lobe from the posterior lobe. Finally, you can see the
three infamous cerebellar peduncles going into and out of the
cerebellum, the inferior, middle and superior.

7. 1.1. VermisVermis
2.2. Central lobuleCentral lobule
3.3. Anterior lobeAnterior lobe
4.4. Superior cerebellar peduncleSuperior cerebellar peduncle
5.5. Middle cerebellar peduncleMiddle cerebellar peduncle
6.6. Nodule of vermisNodule of vermis
7.7. Inferior cerebellar peduncleInferior cerebellar peduncle
8.8. FlocculusFlocculus
9.9. Posterior lobePosterior lobe
Image Copyright 1997Image Copyright 1997
The Anatomy Project,The Anatomy Project,
Published byPublished by
Parthenon Publishing Group,Parthenon Publishing Group,
Unauthorized use prohibited.Unauthorized use prohibited.
ANTERIOR ASPECTANTERIOR ASPECT
(brainstem removed)(brainstem removed)

8. Subdivision ofSubdivision of Flocculonodular LobeFlocculonodular Lobe
Nodulus FlocculusNodulus Flocculus
Subdivision ofSubdivision of Anterior LobeAnterior Lobe
Vermis HemisphereVermis Hemisphere
LingulaLingula
Central LobuleCentral Lobule Ala Central LobuleAla Central Lobule
postcentral fissurepostcentral fissure
CulmenCulmen Quadriangular LobuleQuadriangular Lobule
CerebellumCerebellum ExternalExternal
ConfigurationsConfigurations
CerebellumCerebellum ExternalExternal
ConfigurationsConfigurations

9. Subdivision ofSubdivision of Posterior LobePosterior Lobe
Vermis HemisphereVermis Hemisphere
DecliveDeclive Simple LobuleSimple Lobule
postcentral fissurepostcentral fissure
FoliumFolium Superior Semilunar LobuleSuperior Semilunar Lobule
horizontal fissurehorizontal fissure
Inferior Semilunar LobuleInferior Semilunar Lobule
TuberTuber
Gracile LobuleGracile Lobule
prepyramidal fissureprepyramidal fissure
PyramisPyramis Biventer LobuleBiventer Lobule
secondary fissuresecondary fissure
UvulaUvula TonsilTonsil
CerebellumCerebellum ExternalExternalCerebellumCerebellum ExternalExternal

10. Cerebellar CortexCerebellar Cortex
Molecular LayerMolecular Layer
Purkinje Cell LayerPurkinje Cell Layer
Granular LayerGranular Layer
Corpus Medullare (Medullary Center)Corpus Medullare (Medullary Center)
Deep Cerebellar NucleiDeep Cerebellar Nuclei
Fastigial NucleiFastigial Nuclei
Nucleus InterpositusNucleus Interpositus
Emboliform NucleusEmboliform Nucleus
Globose NucleusGlobose Nucleus
Dentate NucleusDentate Nucleus
CerebellumCerebellum InternalInternalCerebellumCerebellum InternalInternal

11. CEREBELLAR CORTEXCEREBELLAR CORTEX
molecular layer:
outer stellate cells
parallel axons of granule cells (extending
from granular layer)
Purkinje cell layer (sub-layer of the
molecular) :
Purkinje Cells:
dendrite (multibranched)
nucleus
axon (difficult to see)
axons of deep stellate (basket) cells,
(alongside Purkinje cells)
granular layer:
granule cells (very numerous)
axon of Purkinje cell
myelinated fibers of white matter (deep)
outerlayer

12. Cerebellar CortexCerebellar Cortex
I. Molecular LayerI. Molecular Layer
Stellate CellStellate Cell --- taurine (inhibitory)--- taurine (inhibitory)
afferent:afferent: parallel fiberparallel fiber
efferent: Purkinje cell dendriteefferent: Purkinje cell dendrite
Basket CellBasket Cell ---- GABA (inhibitory)---- GABA (inhibitory)
afferent:afferent: parallel fiberparallel fiber
efferent: Purkinje cell somaefferent: Purkinje cell soma
Parallel FiberParallel Fiber
granule cell axongranule cell axon
Purkinje Cell DendritePurkinje Cell Dendrite
CerebellumCerebellum InternalInternalCerebellumCerebellum InternalInternal

13. Cerebellar CortexCerebellar Cortex
II. Purkinje Cell LayerII. Purkinje Cell Layer
Purkinje CellPurkinje Cell
-- 15,000,000 in number-- 15,000,000 in number
-- GABA (inhibitory)-- GABA (inhibitory)
afferent:afferent: parallel fiberparallel fiber
climbing fiberclimbing fiber
stellate cellstellate cell
basket cellbasket cell
efferent:efferent: deep cortical nucleideep cortical nuclei
Bergman’s glial cellBergman’s glial cell
CerebellumCerebellum InternalInternal
ConfigurationsConfigurations
CerebellumCerebellum InternalInternal
ConfigurationsConfigurations

14. Cerebellar CortexCerebellar Cortex
III. Granular LayerIII. Granular Layer
Granular CellGranular Cell
-- 50,000,000,000 in number-- 50,000,000,000 in number
-- glutamic acid (excitatory)-- glutamic acid (excitatory)
afferent:afferent: mossy fibermossy fiber
efferent:efferent: Purkinje cell dendritePurkinje cell dendrite
basket cell, stellate cellbasket cell, stellate cell
Golgi cellGolgi cell
Golgi CellGolgi Cell
-- GABA (inhibitory)-- GABA (inhibitory)
afferent: parallel fiber, mossy fiber rosetteafferent: parallel fiber, mossy fiber rosette
efferent: granule cell dendriteefferent: granule cell dendrite
CerebellumCerebellum InternalInternal
ConfigurationsConfigurations
CerebellumCerebellum InternalInternal
ConfigurationsConfigurations

15. 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
nuclei

17. Synaptic GlomerulusSynaptic Glomerulus
Afferent terminals on granular layerAfferent terminals on granular layer
 Mossy Fiber RosetteMossy Fiber Rosette
-- afferent fibers except-- afferent fibers except
inferior olivary inputinferior olivary input
-- 2/3 of medullary center-- 2/3 of medullary center
 Granular Cell DendriteGranular Cell Dendrite
-- main afferent input-- main afferent input
 Golgi Cell AxonGolgi Cell Axon
-- synapse on granule cell dendrite-- synapse on granule cell dendrite
-- GABA (inhibitory)-- GABA (inhibitory)
-- Surrounded bySurrounded by AstrocyteAstrocyte Foot ProcessFoot Process
CerebellumCerebellum InternalInternal
ConfigurationsConfigurations
CerebellumCerebellum InternalInternal
ConfigurationsConfigurations

18. Synaptic GlomerulusSynaptic Glomerulus

19. medial and dorsal accessory olivary nucleusmedial and dorsal accessory olivary nucleus
caudal portioncaudal portion rostral portionrostral portion PrincipalPrincipal
Inferior OlivaryInferior Olivary
NucleusNucleus

20. CerebellumCerebellum
FunctionFunction
CerebellumCerebellum
FunctionFunction
 Maintenance of EquilibriumMaintenance of Equilibrium
- balance, posture, eye movement- balance, posture, eye movement
 Coordination of half-automatic movement ofCoordination of half-automatic movement of
walking and posture maintenacewalking and posture maintenace
- posture, gait- posture, gait
 Adjustment of Muscle ToneAdjustment of Muscle Tone
 Motor Leaning – Motor SkillsMotor Leaning – Motor Skills
 Cognitive FunctionCognitive Function

21. BalanceBalance

22. Motor SkillMotor Skill
Pablo CasalsPablo Casals

23. The White MatterThe White Matter
On the sagittal section resembles to the treeOn the sagittal section resembles to the tree
with the branches (often called “the tree ofwith the branches (often called “the tree of
life” – “arbor vitae”)life” – “arbor vitae”)
Cerebellar pedunclesCerebellar peduncles

superiorsuperior

medialmedial

inferiorinferior

24. Arbor VitaeArbor Vitae

25. Superior cerebellar
peduncle: to red nucleus,
thalamus and cortex.
Decussate in mesencephalic
tegmentum
Contains also ventral
spinocerebellar tract
Medial cerebellar peduncle:
from cortex (corticopontine
fibers)
Inferior cerebellar
peduncle: from spinal cord
and brainstem to
cerebellum and from
cerebellum to the brainstem

26. CEREBELLAR NUCLEICEREBELLAR NUCLEI
Buried deep in theBuried deep in the
white matterwhite matter
Dentate nucleusDentate nucleus
Interposed nucleus:Interposed nucleus:

Emboliform nucleusEmboliform nucleus

Globose nucleusGlobose nucleus
Fastigial nucleusFastigial nucleus
The Fourth Ventricle

27. 1. fastigial1. fastigial
nucleusnucleus
2. globose2. globose
nucleusnucleus
3. emboliform3. emboliform
nucleusnucleus
4. dentate4. dentate
nucleusnucleus
Deep NucleiDeep Nuclei

28. Organization of the cerebellumOrganization of the cerebellum
Archeocerebellum (vestibulocerebellum):Archeocerebellum (vestibulocerebellum):
Flocculonodular lobe + Fastigial nucleusFlocculonodular lobe + Fastigial nucleus
Paleocerebellum (spinocerebellum): AnteriorPaleocerebellum (spinocerebellum): Anterior
lobe + Interposed Nucleuslobe + Interposed Nucleus
Neocerebellum (pontocerebellum,Neocerebellum (pontocerebellum,
cerebrocerebellum): Posterior lobe + Dentatecerebrocerebellum): Posterior lobe + Dentate
NucleusNucleus

29. Classification by Phylogenetic and Ontogenic DevelopmentClassification by Phylogenetic and Ontogenic Development
ArchicerebellumArchicerebellum
PaleocerebllumPaleocerebllum
NeocerebellumNeocerebellum
Classification by Afferent ConnectionClassification by Afferent Connection
VestibulocerebellumVestibulocerebellum
SpinocerebellumSpinocerebellum
PontocerebellumPontocerebellum
Classification by Efferent ConnectionClassification by Efferent Connection
VermisVermis
Paravermal RegionParavermal Region
Cerebellar HemisphereCerebellar Hemisphere
CerebellumCerebellum ClassificationsClassificationsCerebellumCerebellum ClassificationsClassifications

30. Spinocerebellum
Pontocerebellum
Vestibulocerebellum

31. Afferent ConnectionsAfferent Connections (1):(1):
1. Inferior Cerebellar Peduncle1. Inferior Cerebellar Peduncle
Restiform BodyRestiform Body
Posterior Spinocerebellar TractPosterior Spinocerebellar Tract
Olivocerebellar tractOlivocerebellar tract
Cuneocerebellar TractCuneocerebellar Tract
Reticulocerebellar TractReticulocerebellar Tract
Juxtarestiform BodyJuxtarestiform Body
Vestibulocerebellar TractVestibulocerebellar Tract
Primary Vestyibular FiberPrimary Vestyibular Fiber
CerebellumCerebellum ConnectionsConnectionsCerebellumCerebellum ConnectionsConnections

32. Afferent ConnectionsAfferent Connections (2):(2):
2. Middle Cerebellar Peduncle2. Middle Cerebellar Peduncle
Pontocerebellar fiberPontocerebellar fiber
Corticopontocerebellar FiberCorticopontocerebellar Fiber
Reticulocerebellar FiberReticulocerebellar Fiber
3. Superior Cerebellar Peduncle3. Superior Cerebellar Peduncle
Anterior Spinocerebellar TractAnterior Spinocerebellar Tract
Cerulocerebellar fiberCerulocerebellar fiber
Raphecerebellar fiberRaphecerebellar fiber
Rubrocerebellar fiberRubrocerebellar fiber
Hypothalamocerebellar fiberHypothalamocerebellar fiber
CerebellumCerebellum
ConnectionsConnections
CerebellumCerebellum
ConnectionsConnections

33. Efferent ConnectionsEfferent Connections ::
1. Superior Cerebellar Peduncle1. Superior Cerebellar Peduncle
Cerebellothalamic fiberCerebellothalamic fiber
- from 3 deep nuclei to VPLo, VLc, CL- from 3 deep nuclei to VPLo, VLc, CL
Cerebellorubral fiberCerebellorubral fiber
- from nucleus interpositus- from nucleus interpositus
and dentate nucleusand dentate nucleus
ascending portion ofascending portion of
uncinate fasciculus of Russelluncinate fasciculus of Russell
2. Inferior Cerebellar Peduncle2. Inferior Cerebellar Peduncle
Fastigiovestibular fiberFastigiovestibular fiber
descending portion ofdescending portion of
uncinate fasciculus of Russelluncinate fasciculus of Russell
CerebellumCerebellum
ConnectionsConnections
CerebellumCerebellum
ConnectionsConnections

34. MLFMLF
Main Connections of the VestibulocerebellumMain Connections of the VestibulocerebellumMain Connections of the VestibulocerebellumMain Connections of the Vestibulocerebellum
lower motor neuronlower motor neuron
LMNLMN
vestibulospinal tractvestibulospinal tract
FASTIGIALFASTIGIAL
NUCLEUSNUCLEUS
VestibularVestibular
OrganOrgan
FloculonodularFloculonodular
LobeLobe
VermisVermis
ARCHICEREBELLUMARCHICEREBELLUM
VESTIBULAR NUCLEUSVESTIBULAR NUCLEUS

35. Main Connections of the PaleocerebellumMain Connections of the PaleocerebellumMain Connections of the PaleocerebellumMain Connections of the Paleocerebellum
lower motor neuronlower motor neuron
SPINAL CORDSPINAL CORD
rubrospinalrubrospinal
tracttract
NUCLEUSNUCLEUS
INTERPOSITUSINTERPOSITUS
InferiorInferior
OlivryOlivry
NucleusNucleus
ANTERIORANTERIOR
LOBELOBE
PARAVERMALPARAVERMAL
ZONEZONE
PALEOCEREBELLUMPALEOCEREBELLUM
REDRED
NUCLEUSNUCLEUS
spinocerebellarspinocerebellar
tracttract

36. CEREBRALCEREBRAL
CORTEXCORTEX
CEREBRALCEREBRAL
CORTEXCORTEX
DENTATEDENTATE
NUCLEUSNUCLEUS
DENTATEDENTATE
NUCLEUSNUCLEUS
Main Connections of the NeocerebellumMain Connections of the NeocerebellumMain Connections of the NeocerebellumMain Connections of the Neocerebellum
lower motor neuronlower motor neuron
LMNLMN
pyramidalpyramidal
tracttract POSTERIORPOSTERIOR
LOBELOBE
CEREBELLARCEREBELLAR
HEMISPHEREHEMISPHERE
POSTERIORPOSTERIOR
LOBELOBE
CEREBELLARCEREBELLAR
HEMISPHEREHEMISPHERE
THALAMUSTHALAMUSTHALAMUSTHALAMUS
NEOCEREBELLUMNEOCEREBELLUM
PontinePontine
NucleusNucleus
PontinePontine
NucleusNucleus

37. upper motor neuronupper motor neuron
UMNUMN
upper motor neuronupper motor neuron
UMNUMN
BASALBASAL
GANGLIAGANGLIA
BASALBASAL
GANGLIAGANGLIA
Pyramidal Tract and Associated CircuitsPyramidal Tract and Associated CircuitsPyramidal Tract and Associated CircuitsPyramidal Tract and Associated Circuits
lower motor neuronlower motor neuron
UMNUMN
lower motor neuronlower motor neuron
UMNUMN
pyramidal tractpyramidal tract
CerebellumCerebellumCerebellumCerebellum

38. Reticular
Formation
Reticular
Formation
CEREBELLUMCEREBELLUM
Cerebellum and Automatic Motor ControlCerebellum and Automatic Motor ControlCerebellum and Automatic Motor ControlCerebellum and Automatic Motor Control
Lower Motor Neuron (LMN)Lower Motor Neuron (LMN)Lower Motor Neuron (LMN)Lower Motor Neuron (LMN)
Motor CortexMotor Cortex
Red NucleusRed Nucleus
Vestibular
Nucleus
Vestibular
Nucleus
ProprioceptorsProprioceptorsProprioceptorsProprioceptors

39. Corticonuclear ConnectionsCorticonuclear Connections
A zone ---------- fastigial nucleusA zone ---------- fastigial nucleus
medial vestibular nucleusmedial vestibular nucleus
B zone ---------- lateral vestibular nucleusB zone ---------- lateral vestibular nucleus
CC11, C, C33 zone --- emboliform nucleuszone --- emboliform nucleus
CC22 ---------------- globose nucleus---------------- globose nucleus
DD11 ---------------- parvocellular portion of dentate nucleus---------------- parvocellular portion of dentate nucleus
DD22 ---------------- magnocellular portion of dentate nucleus---------------- magnocellular portion of dentate nucleus
CerebellumCerebellum
ConnectionsConnections
CerebellumCerebellum
ConnectionsConnections

40. 1. vermis1. vermis
2. paravermal2. paravermal regionregion
3. cerebella hemisphere3. cerebella hemisphere
4. nodulus4. nodulus
5. flocculus5. flocculus
6. fastigial6. fastigial nucleusnucleus
7. globose7. globose nucleusnucleus
8. emboliform8. emboliform nucleusnucleus
9. dentate9. dentate nucleusnucleus
10. medial vestibular10. medial vestibular
nucleusnucleus
11. lateral vestibular11. lateral vestibular
nucleusnucleus

41. Olivocerebellar ConnectionsOlivocerebellar Connections
Caudal portion ofCaudal portion of
medial and dorsal accessory olivary nucleusmedial and dorsal accessory olivary nucleus
----------------- vermis of cerebellar cortex (A and B)----------------- vermis of cerebellar cortex (A and B)
fastigial nucleusfastigial nucleus
vestibular nucleusvestibular nucleus
Rostral portion ofRostral portion of
medial and dorsal accessory olivary nucleusmedial and dorsal accessory olivary nucleus
----------------- paravermal region (C----------------- paravermal region (C11, C, C22, C, C33))
nucleus interpositusnucleus interpositus
Principal Inferior Olivary NucleusPrincipal Inferior Olivary Nucleus
----------------- cerebellar hemisphere (D----------------- cerebellar hemisphere (D11, D, D22))
dentate nucleusdentate nucleus
CerebellumCerebellum
ConnectionsConnections
CerebellumCerebellum
ConnectionsConnections

42. Cerebellar AfferentsCerebellar Afferents
•Ventral Spinocerebellar Pathway:Ventral Spinocerebellar Pathway: The ventral spinocerebellarThe ventral spinocerebellar
pathway is similar in organization to the dorsal spinocerebellarpathway is similar in organization to the dorsal spinocerebellar
pathway, although it is more complex and provides less specificpathway, although it is more complex and provides less specific
information. Its afferents arise in the dorsal horn and run in theinformation. Its afferents arise in the dorsal horn and run in the
ventral spinocerebellar tract, entering the cerebellum throughventral spinocerebellar tract, entering the cerebellum through
the superior cerebellar peduncle. The projection is bilateral, withthe superior cerebellar peduncle. The projection is bilateral, with
approximately 75% of fibers projecting to the ipsilateralapproximately 75% of fibers projecting to the ipsilateral
hemisphere, and 25% of fibers projecting to the contralateralhemisphere, and 25% of fibers projecting to the contralateral
hemisphere. The ventral spinocerebellar pathway also receiveshemisphere. The ventral spinocerebellar pathway also receives
inputs from cutaneous receptors, Golgi tendon organs andinputs from cutaneous receptors, Golgi tendon organs and
muscle stretch receptors.muscle stretch receptors.
•Dorsal Spinocerebellar Pathway:Dorsal Spinocerebellar Pathway:
Afferent fibers originating from cellsAfferent fibers originating from cells
in Clarke's column ascend in thein Clarke's column ascend in the
dorsal spinocerebellar tract. Itsdorsal spinocerebellar tract. Its
axons project through the inferioraxons project through the inferior
cerebellar peduncle to the ipsilateralcerebellar peduncle to the ipsilateral
cerebellar hemisphere. Thiscerebellar hemisphere. This
pathway receives inputs frompathway receives inputs from
cutaneous receptors, Golgi tendoncutaneous receptors, Golgi tendon
organs and muscle stretch receptors.organs and muscle stretch receptors.
•Corticopontocerebellar Pathway:Corticopontocerebellar Pathway:
Afferent fibers from the temporal,Afferent fibers from the temporal,
parietal, occipital and frontal lobes ofparietal, occipital and frontal lobes of
the cerebral cortex pass through thethe cerebral cortex pass through the
internal capsule and crus cerebri andinternal capsule and crus cerebri and
synapse in the pontine nuclei. Fromsynapse in the pontine nuclei. From
here, the fibers enter the cerebellumhere, the fibers enter the cerebellum
through the middle cerebellarthrough the middle cerebellar
peduncle and terminate in thepeduncle and terminate in the
contralateral cerebellar hemisphere.contralateral cerebellar hemisphere.

43. Cerebro-olivocerebellar Pathway:
Afferent fibers from the temporal,
parietal, occipital and frontal lobes
of the cerebral cortex pass through
the internal capsule and synapse in
both the ipsilateral and
contralateral inferior olivary nuclei.
From here, the fibers enter the
cerebellum through the inferior
cerebellar peduncle and terminate
in the contralateral cerebellar
hemisphere. NB: This pathway
differs from all other afferents in
that its fibers terminate in the
cerebellum as climbing fibers,
whereas all other afferents
terminate as mossy fibers.
Cerebroreticulocerebellar Pathway:
Afferent fibers from all over the
cerebral cortex terminate in the
pontine and medullary reticular
formation, both ipsilaterally and
contralaterally. From here, the fibers
enter the cerebellum through the
middle cerebellar peduncle and
terminate in the ipsilateral cerebellar
hemisphere.
Vestibulocerebellar Pathway:
Afferent fibers of the vestibular system
project to the cerebellum in two ways.
Primary vestibular afferents project
directly to the ipsilateral cerebellar
hemisphere (primarily to the
flocculonodular lobe) through the
inferior cerebellar peduncle. Other
vestibular afferents first synapse in the
vestibular nuclei, and then also enter
the cerebellum through the inferior
cerebellar peduncle

44. CEREBELLAR EFFERENTSCEREBELLAR EFFERENTS
through the superior Globose-
Emboliform-Rubral Pathway:
Efferent fibers from the globose
emboliform nuclei exit the
cerebellum cerebellar peduncle
and synapse in the contralateral
red nucleus in the midbrain.
They therefore influence
neurones of the rubrospinal
tract.
Fastigial Reticular Pathway:
Efferent fibers from other parts
of the fastigial nucleus exit the
cerebellum through the inferior
cerebellar peduncle and
synapse with neurones of the
reticular formation. They
therefore influence neurones of
the reticulospinal tract.
Dentatothalamic Pathway: Efferent fibers
from the dentate nucleus exit the
cerebellum through the superior
cerebellar peduncle and synapse in the
contralateral ventrolateral nucleus of the
thalamus, from where they project to the
motor cortex via the internal capsule.
They therefore influence neurones of the
corticospinal tract.
Fastigial Vestibular Pathway: Efferent
fibers from parts of the fastigial nucleus
exit the cerebellum through the inferior
cerebellar peduncle and synapse in both
the ipsilateral and contralateral vestibular
nuclei. They therefore influence neurones
of the vestibulospinal tract.
NB: THE CEREBELLUM EXERTS
CONTROL OVER IPSILATERAL
MUSCLE GROUPS

45. Impairments of the CerebellarImpairments of the Cerebellar
FunctionFunction
Hypotonia - Loss of muscle tone so
that, for example, shaking the arm
would produce excessive movements
at the wrist.
Dysarthria - A disorder of speech
production / inability to perform
correct articulation of words. This leads
to a slurred and jerky speech and is due
to lack of coordination of
oropharyngeal muscles. This can also
be known as 'scanning speech'.
Nystagmus -A condition describing
rapid and jerky eye movements. It is
caused by dysfunction of the
connections of the vestibular nucleus.
Ataxia - This term describes the
incoordination or decomposition of
movements. For example, tasks such
as doing a button up would be found
difficult
Dysdiadochokinesia - This is the
inability to perform rapid repeated
movements, such as repeatedly
pronating and supinating the
forearm.
Intention tremorIntention tremor - condition whereby- condition whereby
a tremor results on purposefula tremor results on purposeful
movements such as bringing a cup upmovements such as bringing a cup up
to the mouth to drink.to the mouth to drink.
DysmetriaDysmetria - The inability to- The inability to
terminate movements correctly.terminate movements correctly.

46. CerebellumCerebellum -- ClinicalClinical SyndromesSyndromesCerebellumCerebellum -- ClinicalClinical SyndromesSyndromes
AtaxiaAtaxia: incoordination of movement: incoordination of movement
- decomposition of movement- decomposition of movement
- dysmetria, past-pointing- dysmetria, past-pointing
- dysdiadochokinesia- dysdiadochokinesia
- rebound phenomenon of Holmes- rebound phenomenon of Holmes
- gait ataxia, truncal ataxia, titubation- gait ataxia, truncal ataxia, titubation
IntentionIntention TremorTremor
Hypotonia,Hypotonia, NystagmusNystagmus
Archicerebellar LesionArchicerebellar Lesion: medulloblastoma: medulloblastoma
Paleocerebellar LesionPaleocerebellar Lesion: gait disturbance: gait disturbance
Neocerebellar LesionNeocerebellar Lesion: hypotonia, ataxia, tremor: hypotonia, ataxia, tremor

47. PosturePosture
Gait – AtaxiaGait – Ataxia
TremorTremor

48. CerebellarCerebellar
AtaxiaAtaxia
Ataxic gait andAtaxic gait and
position:position:
Left cerebellar tumorLeft cerebellar tumor
a. Sways to the right ina. Sways to the right in
standing positionstanding position
b. Steady on theb. Steady on the
right legright leg
c. Unsteady on thec. Unsteady on the
left legleft leg
d. ataxic gaitd. ataxic gait
a b c
d

49. Cerebellar tumors onCerebellar tumors on vermisvermis
- Truncal Ataxia- Truncal Ataxia
- Frequent Falling- Frequent Falling
The child in this picture:The child in this picture:
- would not try to stand- would not try to stand
unsupportedunsupported
- would not let go of the bed rail- would not let go of the bed rail
if she was stood on the floor.if she was stood on the floor.
CerebellarCerebellar
MedulloblastomaMedulloblastoma

50. The Forth VentricleThe Forth Ventricle
Central cavity in the RhombencephalonCentral cavity in the Rhombencephalon
Only two walls: roof and the floorOnly two walls: roof and the floor
The floor is formed by the rhomboid fossaThe floor is formed by the rhomboid fossa
Connected with the third ventricle by theConnected with the third ventricle by the
Sylvian aqueductSylvian aqueduct
Caudally, continues to the central canalCaudally, continues to the central canal

51. 1. Superior medullary velum
2. Pons
3. Medulla oblongata
4. Pia mater
5. Ependyma
6. Choroid plexus
The roof is formed by superior
medullary vellum, inferior
medullary vellum and tectorial
lamina with three apertures

52. Apertures of the Fourth VentricleApertures of the Fourth Ventricle
1. Cerebellum
2. Central foramen of Magendie
3. Lateral foramen of Luschka
4. Rhomboid fossa
5. Flocculus
6. Middle cerebellar peduncles
To ponto-
cerebellar
cistern
To cerebellomedullary
cistern
are leading to the enlargements of the subarachnoid space, called cisterns