Cerebellum

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DR. JAMIL
styleANWAR
The cerebellum is
situated in the
posterior cranial
fossa. It is the
largest part of the
hindbrain and lies
posterior to the
fourth ventricle,
the pons, and the
medulla oblongata.
 Cerebellum
 The cerebellum is
located behind the dorsal
aspect of the pons and
the medulla.
 A midline portion, the
vermis, separates two
lateral lobes, or
cerebellar hemispheres.
 The cerebellum consists
of the cerebellar cortex
and the underlying
cerebellar white
matter
 Four paired deep
cerebellar nuclei are
located within the white
matter of the cerebellum
The cerebellum is
divided into three
main lobes:
Øthe anterior lobe

Øthe middle(posterior)

lobe
Ø the flocculonodular

lobe.
A deep horizontal
fissure that is found
along the margin of
the cerebellum
separates the
superior from the
inferior surfaces; it is
of no morphologic or
Structure of the Cerebellum
The cerebellum is composed
of an outer covering of gray
matter called the cortex and
inner white matter.
A section made through the cerebellum
parallel with the median plane divides the
folia at right angles, and the cut surface
has a branched appearance, called the
arbor vitae.
The gray matter of the
cortex throughout its
extent may be divided
into three layers:
(1) an external layer,
the molecular layer
(2) a middle layer, the
Purkinje cell layer
(3) an internal layer,
the granular layer .
Functional Areas of the Cerebellar Cortex
Clinically it is possible to divide up the cerebellar
cortex into three functional areas.
1.The cortex of the vermis influences the
movements of the long axis of the body, namely,
the neck, the shoulders, the thorax, the abdomen,
and the hips.
2.Immediately lateral to the vermis is a so-called
intermediate zone of the cerebellar hemisphere.
This area has been shown to control the muscles
of the distal parts of the limbs, especially the
hands and feet.
3.The lateral zone of each cerebellar hemisphere
appears to be concerned with the planning of
sequential movements of the entire body and is
involved with the conscious assessment of
movement errors.
Intracerebellar Nuclei
Four masses of gray matter are embedded in the
white matter of the cerebellum on each side of the
midline. From lateral to medial, these nuclei are
the dentate, the emboliform, the globose, and the
fastigial.
White Matter
There is a small amount of white
matter in the vermis; it closely
resembles the trunk and branches of
a tree and thus is termed the arbor
vitae . There is a large amount of
white matter in each cerebellar
hemisphere.
The white matter is made up of three
groups of fibers:
(1) intrinsic,
(2) afferent,
(3) efferent.
Cerebellar
Peduncles
ØThe cerebellum is linked to
other parts of the central
nervous system by numerous
efferent and afferent fibers
that are grouped together on
each side into three large
bundles, or peduncles.
Ø The superior cerebellar

peduncles connect the

cerebellum to the midbrain,
Ø the middle cerebellar

peduncles connect the

cerebellum to the pons, and
Øthe inferior cerebellar

peduncles connect the

cerebellum to the medulla
oblongata.
Cerebellar functions

 The cerebellum has several main functions:

 coordinating skilled voluntary movements by
influencing muscle activity,
 controlling equilibrium and muscle tone
through connections with the vestibular
system and the spinal cord.
 There is a somatotopic organization of body
parts within the cerebellar cortex.
 In addition, the cerebellum receives collateral
input from the sensory and special sensory
systems.
Each cerebellar hemisphere is
connected by nervous pathways
principally with the same side of the
body; thus, a lesion in one cerebellar
hemisphere gives rise to signs and
symptoms that are limited to the
same side of the body.
Diagnosis of Cerebellar disorders
ØThe main clinical features of cerebellar disorders
include incoordination, imbalance, and troubles with
stabilizing eye movements.
There are two distinguishable cerebellar syndromes –
1. midline and
2.hemispheric.
Ø1.Midline cerebellar syndromes are characterized by

imbalance.
ØPersons are unsteady, they are unable to stand in with

eyes open or closed, and are unable to well perform

tandem gait.
Øtrunkal ataxia .

Ø"titubation" or a bobbing motion of the head or trunk.

Øalso often affect eye movements.

Ø There may be nystagmus, ocular dysmetria.

ØHemispheric cerebellar syndromes are characterized by
incoordination of the limbs.
ØThere may be decomposition of movement, dysmetria,

and rebound.
Ø Dysdiadochokinesis is the irregular performance of rapid

alternating movements.
ØIntention tremors may be present on an attempt to touch

an object.
ØA kinetic tremor may be present in motion.

ØThe finger-to-nose and heel-to-knee tests are classic

tests of hemispheric cerebellar dysfunction.

thanks