detailed description about cerebellum

1. CEREBELLU
M
Presented by:-
Mr. Suresh Kumar Sharma
RN, ACCN, MSN(PSYCHIATRY)
BY
1

3. DIVISIONS OF THE BRAIN
Forebrain Midbrain Hindbrain
Cerebrum
Thalamus
Hypothalamus
Cerebral peduncle
Tectum
Brainstem
Cerebellum
Pons
Medulla Oblongata
Sagittal View of the Brain
3

4. FUNCTIONAL REGIONS OF
THE BRAIN
The Cerebrum The Cerebellum The Brain Stem
4

5. ANATOMY OF THE CEREBRUM
Cerebral
Hemispheres
(View from Above)
LeftRight
5

6. FUNCTIONS OF THE CEREBRUM
Frontal lobe:
•Voluntary movement
•Higher intellectual functions
Temporal lobe:
•Speech & Sound
•Complex visual perceptions
Occipital lobe:
•Vision
Parietal lobe:
•Sensory processes
•Attention
•Language
6

7. CONTRALATERAL FUNCTION
OF THE CEREBRUM
7

8. ANATOMY OF THE CEREBELLUM
1. Left Cerebellar Hemisphere
2. Right Cerebellar Hemisphere
3. Vermis
21
3
Spinal cord
8

9. CEREBELLAR FUNCTIONS
9

10. ANATOMY OF THE BRAINSTEM
10

11. FUNCTION OF THE BRAINSTEM
Midbrain:
•Visual & auditory processing and reflexes
•Fine-tuning of voluntary movements
Pons:
•Relay station for cerebellum
•Control of sub-conscious movement
Medulla Oblongata:
•Control of cardiovascular functions
•Control of respiration
•Control of gastrointestinal functions
11

12. CEREBELLUMCEREBELLUM
12

13. GROSS ANATOMY OF CEREBELLUMGROSS ANATOMY OF CEREBELLUM
Location:
 The term cerebellum is from
“Latin meaning” the little brain.
 part of the hindbrain situated in
the posterior cranial fossa.
 behind the Pons and medulla
oblongata, separated from two
structures by the cavity of fourth
ventricle.
 It is covered by tentorium
cerebelli and is connected to
brain stem by three cerebellar
peduncles.
 In adults the weight ratio
between cerebellum and
cerebrum is 1:10,Infants 1:20
13

14. Consists of two laterally, large
hemisphere which are united by
midline vermis.
Cerebellar surface is divided by
numerous curve transverse
fissures giving it a laminated
appearance
One conspicious fissure
“horizontal fissure" extends around
dorsolateral border of each
hemisphere from middle
Cerebellar peduncle to vallecula,
separating superior and inferior
surface
Horizontal
fissure
Vermi
s
Hemisphere
Superior surface
Anatomy of cerebellum......contd.
14

15. The deepest fissure in the
vermis is primary fissure,
which curves ventrolaterally
in the superior surface of the
cerebellum to meet
horizontal fissure.
Primary fissure divides the
cerebellum into anterior and
posterior lobe.
Primary fissure
Anterior lobe
Posterior lobe
Primary fissure
External surface of cerebellum
15

16. Horizontal fissure
vermi
s
Primary fissure
Anterior
lobe
Posteriorlobe
Hemisphere
External surface of cerebellum
16

17. Fourth ventricle
Arbor vitae cerebelliArbor vitae
•In Latin “ tree of life” it is
the white matter of the
cerebellum.
•It is so called because of
the tree like appearance.
•It brings sensory and
motor sensation to
and from cerebellum.
17

18. Vermis
Hemisphere
Parts of the cerebellum
18

19. LOBES OF
CEREBELLUMDivisions of lobes
Anatomical
Flocculonodular lobe
Anterior lobe
Posterior lobe
Anterior lobe
Posterior lobe
Flocculonodular lobe
Inferior surface
Superior surface
Anterior lobe
Posterior lobe
19

20. Functional(Evolutionary)
 Paleocerebellum
 Neocerebellum
 Archicerebellum
Division of lobes…..contd.
20

21. Archi-cerebellum
posterior lobe
(Vestibular part)
•It is
formed of the flocculo-nodular
lobe + associated Fastigial
nuclei, lying on inf. Surface in
front of postero-lateral fissure.
•Embryo logically, it is the
oldest part of cerebellum.
•It receives afferent Fibres.
From vestibular apparatus of
internal ear Via vestibulo-
cerebellar tracts.
•It is concerned with
equilibrium
Neocerebellum
Archicerebellum
Paleocerebellum
21

22. Paleo-cerebellum (spinal
part) •it is
formed of midline vermis +
surrounding paravermis +
globose & emboliform nuclei.
•It receives afferent
proprioceptive impulses from
Ms.& tendons Via
spinocerebellar tracts (dorsal
& ventral) mainly.
•it sends efferent to red
nucleus of midbrain.
•it is concerned with muscle
tone & posture.
Paleocerebellum
22

23. Neo-cerebellum
(cerebralpart)
•It is the remaining largest
part of cerebellum.
•It includes the most 2-
cerebellar hemispheres +
dendate nuclei.
•It receives afferent impulses
from the cerebral cortex +
Pons Via cerebroponto-
cerebellar pathway.
•it sends efferent to Ventro
lateral nucleus of thalamus.
•it controls voluntary
movements (muscle
Neocerebellum
23

24. Archicerebellum
Nodulus
Archicerebellum
flocculus
Palaeocerebell
um
Neocerebellum
Spinocerebellum
Pontocerebellum
Vestibulocerebellu
Summary of classification
24
Classification byClassification by
phylogeneticphylogenetic
Ontogenic developmentOntogenic development
• ArchicerebellumArchicerebellum
• PaleocerebllumPaleocerebllum
• NeocerebellumNeocerebellum
Classification by AfferentClassification by Afferent
ConnectionConnection
• VestibulocerebellumVestibulocerebellum
•SpinocerebellumSpinocerebellum
•Ponto cerebellumPonto cerebellum
Classification by EfferentClassification by Efferent
ConnectionConnection
•VermisVermis
•Paravermis RegionParavermis Region
•Cerebellar HemisphereCerebellar Hemisphere

25. 25

26. 26

27. INTERNAL STRUCTURE:-INTERNAL STRUCTURE:-
 Cerebellum consists of
outer layer of grey matter
known as cortex and
inner layer of white matter
known as medulla.
 The medullary core is
composed of incoming
and outgoing fibres
projecting to and from the
Cerebellar cortex.
 Medullary core also
contain the nucleuses of
the cerebellum which are
four in number.
27

28. CortexMedullaStructure of cerebellum
28

29. Structure of Cerebellar……contd.
Cerebellar Cortex:-Cerebellar Cortex:-
Molecular LayerMolecular Layer
Purkinje Cell LayerPurkinje Cell Layer
Granular LayerGranular Layer
Corpus Medullare (Medullary Center)Corpus Medullare (Medullary Center)
Deep Cerebellar Nuclei:-Deep Cerebellar Nuclei:-
Fastigial NucleiFastigial Nuclei
Nucleus InterpositusNucleus Interpositus
Emboliform NucleusEmboliform Nucleus
Globose NucleusGlobose Nucleus
Dentate NucleusDentate Nucleus
29

30. Dentate nucleus
Emboliform nucleus
Globose nucleus
Fastigial nucleus
Nucleus Interpositus
Deep nucleuses of cerebellum
30

31. White matter of the cerebellum
 Consists of three types of nerve fibres in the
white matter
A.Axons of purkinje cells
The only axons to leave Cerebellar cortex to end
in deep
Cerebellar nuclei specially dendate nucleus.
B.Mossy fibres
They end in the granular layer.
C.Climbing fibres
They end in the molecular layer 31

32. The internal circuity of cerebellum:-
 Don't leave the cerebellum, interconnect
different regions of cerebellum.
 Some connect the same side.
 Some connect the two Cerebellar hemisphere
The Cerebellar efferent via middle Cerebellar
peduncle(MCP) and inferior Cerebellar peduncle
(ICP)
The Cerebellar afferent via superior Cerebellar
peduncle(SCP) and from Fastigial from inferior
Cerebellar peduncle(ICP)
White matter of cerebellum
32

33. The cerebellum is connected to
Brain stem by three peduncles
Midbrain
Middle Cerebellar peduncle
Pons
Inferior Cerebellar peduncle
Medulla oblongata
33
Superior Cerebellar peduncle

34. Peduncles of the cerebellum
34

35. res entering and leaving through Cerebellar pedunc
1.Superior cerebellar peduncle
A.Fibres entering the cerebellum
1. Ventral spino-cerebellar tract
2. Rostral spino-cerebellar tract
3. Tecto-cerebellar fibres
4. Rubro-cerebellar fibres
5. Trigemino-cerebellar fibres
6. Hypothalamo-cerebellar fibres
7. Coerulo-cerebellar fibres
B.Fibres leaving the cerebellum
1. Cerebello-rubral fibres
2. Cerebello-thalamic fibres
3. Cerebello-reticular fibres
4. Cerebello-olivary fibres
5. Cerebello-nuclear fibres
6. Some fibres to hypothalamus
and thalamus
Superior cerebellar peduncl
35

36. 2.Middle cerebellar peduncle
Pontocerebellar fibres
3.inferior cerebellar peduncle
A.Fibres entering cerebellum
1. Posterior spino cerebellar tract
2. Cuneo-cerebellar tract
3. Olivo-cerebellar fibres
4. Reticulo-cerebellar fibres
5. Vestibulo-cerebellar fibres
6. Anterior external arcuate fibres
7. Fibres of striae medullaries
8. Trigemino-cerebellar fibres
B.Fibres Leaving the cerebellum
1. Cerebello-olivary fibres
2. Cerebello-vestibular fibres
3. Cerebello spinal and cerebello reticular
fibres
Middle cerebellar peduncle
Inferior cerebellar peduncle
36

37. CT SCAN OF BRAIN WITH CEREBELLUM
37

38. MRI OF BRAIN WITH CEREBELLUM
38

39. Blood supply to brain
Arch of aorta
1. Brachiocephalic trunk
i. right common carotid artery
2. Left common carotid artery
3. Left subclavian artery
right common carotid artery
1. External carotid artery
2. Internal carotid artery
39

40. Blood supply to brain
Anterior cerebral arteries –2
Internal carotid arteries –2
Anterior communicating artery-1
Posterior communicating artery-1
Posterior cerebral arteries -2
Basilar artery-2
40
Circulus arterious
(circle of Willis)

41. circle of Willis
41

42. Blood supply to cerebellum
• Superior surface of cerebellum – superior
Cerebellar branches of basilar artery(SCA)
• Inferior surface
– Anterior part -(AICA)
• Anterior inferior Cerebellar
branches of basilar artery
– Posterior part- (PICA)
• Posterior inferior Cerebellar
• branches of basilar artery
42

43. Functions
of
cerebellu
m
43

44. 44
Maintenance of EquilibriumMaintenance of Equilibrium
- balance, posture, eye movement- balance, posture, eye movement

45. 45
Motor Leaning – Motor SkillsMotor Leaning – Motor Skills

46.  Coordination of half-automatic movementCoordination of half-automatic movement
of walking and posture maintenanceof walking and posture maintenance
- posture -gait- posture -gait
46

47. Adjustment of Muscle ToneAdjustment of Muscle Tone
,
47

48.  Cognitive FunctionCognitive Function
48

49. CEREBELLAR FUNCTION TEST
• FINGER TO FINGER FINGER TO NOSE
TEST TEST
49

50. CEREBELLAR FUNCTION TEST
• ROMBERG TEST TANDOM TEST
50

51. Ataxia:Ataxia: incoordination of movementincoordination 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
Intention TremorIntention Tremor
Hypotonia,Hypotonia, NystagmusNystagmus
Archicerebellar Lesion:Archicerebellar Lesion: medulloblastomamedulloblastoma
Paleocerebellar LesionPaleocerebellar Lesion: gait disturbance: gait disturbance
Neocerebellar LesionNeocerebellar Lesion: hypotonia, ataxia, tremor: hypotonia, ataxia, tremor
SyndromeS
51

52. CerebellarCerebellar
AtaxiaAtaxia
Ataxic gait and position:Ataxic gait and 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
52

53. CerebellarCerebellar
MedulloblastomaMedulloblastoma
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 standwould not try to stand
unsupportedunsupported
- would not let go of the- would not let go of the
bed railbed rail
if she was stood on theif she was stood on the
floor.floor. 53

54. .
54

55. NOW TIME FOR
ASSIGNMENT
55
WRITE DOWN DIFFERENT DISEASES
RELATED TO THE CEREBELLUM
FUNCTION LOST???????