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Updated: May 17 2020


  • Overview
  • Introduction
    • Function
      • to smoothly coordinate movement
      • to play a role in motor planning and balance
    • Anatomy
      • the cerebellum is derived from the metencephalon and is found
        • dorsally to the pons and rostral medulla which are attached by cerebellar peduncles
          • between the cerebellum and this portion of the brainstem you will find the
            • fourth ventricle
      • the cerebellum contains
        • the vermis and flocculonodular lobes which play an important role in
          • proximal and truncal muscle control (vermis)
          • vestibulo-ocular control (flocculonodular lobes)
        • cerebellar hemisphere can be divided into
          • intermediate hemisphere which plays an important role in
            • distal appendicular muscle control
          • lateral hemisphere which plays an important role in
            • motor planning
        • cerebellar peduncles
          • superior cerebellar peduncles
            • mainly carries output signals
          • middle and inferior cerebellar peduncles
            • mainly carries input signals to the cerebellum
      • deep cerebellar nuclei can be arranged from lateral → medial as
        • Dendate nuclei
        • Eboliform
        • Globos
        • Fastigial
        • mnemonic: "Dont Eat Greasy Food"
    • Circuitry
      • input
        • brain (via the pontocerebellar and climbing fiber) to the cerebellum via the
          • middle cerebellar peduncle
        • spinal cord (via the spinocerebellar and climbing fibers) to the cerebellum via the
          • inferior cerebellar peduncle (there are exceptions)
        • vestibular system to the cerebellum via
          • juxtarestiform body (in the inferior cerebellar peduncle)
      • output
        • all cerebellar outputs are carried by Purkinje cells which synapse in the
          • deep cerebellar nuclei or vestibular nuclei
            • which deep cerebellar nuclei the Purkinje cell synapse with is dependent on where the Purkinje cell arose from
              • Purkinje cells from
                • lateral cerebellum synapse to the dendate nucleus which
                  • exits the cerebellum via the superior cerebellar peduncle → contralateral VL of the thalamus → motor cortex and supplementary motor areas to influence the corticospinal system for motor planning
                • intermediate cerebellum synapses to the eboliform and globose nucleus
                  • exits the cerebellum via the superior cerebllar pendcuncle → contralateral VL of the thalamus → motor cortex and supplementary motor areas to influence the lateral corticospinal tract
                • vermis synapses to the fastigial nucleus
                  • eventually influencing the medial motor system
                • flocculonodular lobe synapses to the vestibular nucleus
                  • eventually leading to vestibulo-ocular control
    • Clinical correlate
      • cerebellar disorders typically results in
        • nausea, vomiting, and vertigo
        • slurred speech
        • uncoordinated limb movements
          • dysmetria (under- or over-shooting towards a target)
          • dysrhythmia
        • unsteadiness
      • lesion localization
        • lesions to the vermis results in
          • truncal ataxia
        • lesions to the flocculonodular lobe results in
          • eye movement abnormalities
        • lesions to the cerebellar hemispheres results in
          • ipsilateral ataxia
    • Physical exam
      • physical exam maneuvers to test the cerebellum include
        • finger-to-nose and heel-to-shin test
        • finger tapping
        • rapid alternating movement
        • gait testing
          • truncal ataxia can present with
            • a wide-based and unsteady gait
        • testing for ocular dysmetria and nyastagmus
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