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Cerebellum. Won Taek Lee , M.D. Ph.D . Department of Anatomy, Yonsei University College of Medicine. Cerebellum External Configurations. - located in posterior cranial fossa - tentorium cerebelli (cerebrum), 4th ventricle (brain stem) - communicate with other structure via

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slide1

Cerebellum

Won Taek Lee, M.D. Ph.D.

Department of Anatomy, Yonsei University College of Medicine

slide2

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

slide3

Cerebellum External Configurations

Subdivision of Flocculonodular Lobe

Nodulus Flocculus

Subdivision of Anterior Lobe

Vermis Hemisphere

Lingula

Central Lobule Ala Central Lobule

postcentral fissure

Culmen Quadriangular Lobule

slide4

Cerebellum External Configurations

Subdivision of Posterior Lobe

Vermis Hemisphere

Declive Simple Lobule

postcentral fissure

FoliumSuperior Semilunar Lobule

horizontal fissure

Inferior Semilunar Lobule

Tuber

Gracile Lobule

prepyramidal fissure

Pyramis Biventer Lobule

secondary fissure

Uvula Tonsil

slide6

Cerebellum Internal Configurations

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

slide7

Deep Nuclei

1. fastigial

nucleus

2. globose

nucleus

3. emboliform

nucleus

4. dentate

nucleus

slide8

Cerebellum Internal Configurations

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

slide9

Cerebellum Internal Configurations

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

Bergman’s glial cell

slide10

Cerebellum Internal Configurations

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

slide11

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

slide13

Cerebellum Internal Configurations

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

slide15

Cerebellum Classifications

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

slide16

Archicerebellum

(nodulus)

Archicerebellum

(flocculus)

Paleocerebellum

Neocerebellum

slide17

Spinocerebellum

Pontocerebellum

Vestibulocerebellum

slide18

Cerebellum Connections

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

slide19

Cerebellum Connections

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

slide20

Cerebellum Connections

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

slide21

Main Connections of the Vestibulocerebellum

Vestibular

Organ

Floculonodular

Lobe

Vermis

VESTIBULAR NUCLEUS

vestibulospinal tract

MLF

FASTIGIAL

NUCLEUS

lower motor neuron

ARCHICEREBELLUM

LMN

slide22

Main Connections of the Paleocerebellum

RED NUCLEUS

NUCLEUS

INTERPOSITUS

rubrospinal

tract

Inferior

Olivry

Nucleus

ANTERIOR

LOBE

PARAVERMAL

ZONE

lower motor neuron

PALEOCEREBELLUM

SPINAL CORD

spinocerebellar tract

slide23

Main Connections of the Neocerebellum

CEREBRAL

CORTEX

THALAMUS

DENTATE

NUCLEUS

pyramidal

tract

Pontine

Nucleus

POSTERIOR

LOBE

CEREBELLAR

HEMISPHERE

lower motor neuron

NEOCEREBELLUM

LMN

slide24

Pyramidal Tract and Associated Circuits

upper motor neuron

UMN

Cerebellum

BASAL

GANGLIA

pyramidal tract

lower motor neuron

UMN

slide25

Cerebellum and Automatic Motor Control

Motor Cortex

CEREBELLUM

Red Nucleus

Vestibular

Nucleus

Reticular

Formation

Lower Motor Neuron (LMN)

Proprioceptors

slide26

Cerebellum Connections

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

slide27

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

slide28

Cerebellum Connections

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

slide29

caudal portion rostral portion

Principal

Inferior Olivary

Nucleus

medial and dorsal accessory olivary nucleus

slide30

CerebellumFunction

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

slide32

Motor Skill

Pablo Casals

slide33

CerebellumClinical Syndromes

Ataxia: incoordination of movement

- decomposition of movement

- dysmetria, past-pointing

- dysdiadochokinesia

- rebound phenomenon of Holmes

- gait ataxia, truncal ataxia, titubation

IntentionTremor

Hypotonia, Nystagmus

Archicerebellar Lesion: medulloblastoma

Paleocerebellar Lesion: gait disturbance

Neocerebellar Lesion: hypotonia, ataxia, tremor

slide34

Posture

Gait – Ataxia

Tremor

slide35

a

b

c

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

d

slide36

Cerebellar

Medulloblastoma

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.