CEREBELLAR EXAMINATION

FUNCTION OF THE CEREBELLUM

FLOCCULONODULAR LOBE MODULATES
EQUILIBRATION AND THE ORIENTATION OF HEAD
AND EYES
HAS CONNECTIONS WITH VESTIBULAR NUCLEI

LESIONS PRODUCE TRUNCAL ATAXIA

AND NYSTAGMUS
CAUDAL VERMIS SYNDROME
NEOPLASM(MEDULLOBLASTOMA,EPENDYMOMA,ASTROCYTOMA)

FUNCTIONS OF THE CEREBELLUM

ANTERIOR LOBE ROSTRAL
VERMIS

CONCERNED WITH
POSTURE GAIT AND
TRUNCAL TONE
LESIONS
UNSTEADY WALKING
GAIT ATAXIA
HYPOTONIA
ALCOHOLISM AND
NUTRITIONAL

POSTERIOR LOBE-HEMISPHERE

COORDINATION OF SKILLED
ACTION
LESIONS
LIMB ATAXIA
DYSMETRIA
TREMOR
DYSSYNERGIA
INFARCT,
HEMORRHAGE,NEOPLASM,
ABSCESS, TRAUMA

EFFECT OF CEREBELLAR LESION ON

SPEECH
DYSARTHRIA CONSISTS OF SLOWNESS,
SLURRING OF WORDS AND SCANNING SPEECH
VOICE VARIES FROM A LOW VOLUME TO A
HIGH VOLUME;
FAILURE TO METER AND MODULATE THE
STRENGTH OF THE MUSCULAR CONTRACTION
THAT PRODUCE THE SPEECH SOUNDS
VERMIAN LESIONS

EFFECT OF CEREBELLAR LESION ON

EYE MOVEMENT

NYSTAGMUS
DYSMETRIA OF SACCADES
JERKY PURSUIT
SLOWNESS IN INITIATING EYE MOVEMENTS

CLINICAL TEST FOR DYSTAXIA OF

STATION AND GAIT
SWAYING WHEN STANDING EVEN WITH EYES
OPEN
BROAD BASED GAIT AND STANCE
IMPAIRED TANDEM WALKING

CLINICAL TESTS FOR ARM DYSTAXIA

POSTURAL TREMOR
INTENTION TREMOR
DYSMETRIA ON FINGER TO NOSE TEST
UNDERSHOOTS OR OVERSHOOTS THE TARGET
DYSTAXIA-DYSMETRIA OF RAPID ALTERNATING
MOVEMENT =DYSDIADOCHOKINESIA
1. THIGH PATTING TEST
2. FINGER TAPPING TEST

CLINICAL TESTS FOR ARM DYSTAXIA

DYSDIADOKOKINESIA=
DYSTAXIA-DYSMETRIA OF RAPID ALTERNATING
MOVEMENT =DYSDIADOCHOKINESIA
1. THIGH PATTING TEST
MAKE SURE TO MAKE AN AUDIBLE SOUND
WITH EACH PAT
2. FINGER TAPPING TEST

OVERSHOOTING AND CHECKING TESTS

OF THE ARMS
1. WRIST TAPPING TEST
PT STAND WITH EYES
CLOSED
PT HOLDS THE ARMS
EXTENDED OUT FRONT
EX STRIKES BACK OF PT
WRIST A SHARP BLOW
STRONG ENOUGH TO
DISPLACE ARM

2. ARM PULLING TEST

EX PULLS HARD
AGAINST THE PTS
FLEXED ARM
EX SUDDENLY
RELEASES THE PTS
ARM
CEREBELLAR PT
FAILSTO CHECK THE
ARMS FLIGHT

CLINICAL TESTS FOR LEG DYSTAXIA

1. HEEL TO SHIN TEST
PT SUPINE OR SITTING
PT TO PLACE ONE HEEL PRECISELY ON THE
OPPOSITE KNEE
PT TO RUN THE HEEL IN A STRAIGHT LINE
PRECISELY DOWN THE SHIN
2. HEEL TAPPING TEST
PT TO PLACE ONE HEEL OVER THE OTHER SHIN
AND TAP THE SHIN WITH THE HEEL AS RAPIDLY
AS POSSIBLE ON ONE SPOT

OTHER MANIFESTATION OF
CEREBELLAR DYSFUNCTION
1.DECOMPOSITION OF
MOVEMENT

MOVEMENT 1
LIFTS ARM AT THE LEVEL OF
THE NOSE
MOVEMENT 2
BRINGS FINGERTIP TO THE
NOSE

2. HYPOTONIA
FLOPPY POSTURE
RAG DOLL GAIT
PENDULOUS MSRS
3. MILD ASTHENIA

SUMMARY
1. OBSERVE SPONTANEOUS ACTIVITY
GAIT, SPEECH, EYES, EXTREMITY MOVEMENTS
2. FORMAL TESTS
EYE MOVEMENTS
SUSTAINED POSTURE A(UPRIGHT STANCE AND ARM
SUSPENSION)
GAIT (FREE WALKING AND TANDEM WALKING)
FINGER TO NOSE TEST
ALTERNATING MOVEMENTS
OVERSHOOTING
HEEL TO SHIN , HEEL TAPPING
HYPOTONIA (PASSIVE MOVEMENT, PENDULOUS REFLEXES)