小腦內(nèi)部結(jié)構(gòu)及小腦病變?cè)斫榻B

1、小腦 the cerebllum,南京大學(xué)醫(yī)學(xué)院人體解剖教研室,小腦 the cerebllum,1、位于顱后窩，上面平坦，下面中部凹 陷，容納延髓。2、小腦與乙狀靜脈竇、乳突小房、鼓室 相近，中耳炎、乳突炎可侵蝕骨質(zhì)。3、中間縮窄為蚓部，兩側(cè)為半球。,小腦的發(fā)生,1、圓口類動(dòng)物（水生脊椎動(dòng)物）-運(yùn)動(dòng)方位靠前庭位覺器-前庭小腦-絨球小結(jié)葉-調(diào)節(jié)軀體運(yùn)動(dòng)，維持身體平衡。古小腦2、水棲動(dòng)物、兩棲動(dòng)物、爬行動(dòng)物

2、-小腦前葉-接受脊髓小腦束的纖維-肌張力調(diào)節(jié)、姿勢(shì)的維持、肌肉運(yùn)動(dòng)協(xié)調(diào)。舊小腦3、哺乳類動(dòng)物-抗地心引力-小腦后葉-四肢精細(xì)運(yùn)動(dòng)的協(xié)調(diào)。新小腦,http://www.120sysdyy.com/jrsy/ http://www.120sysdyy.com/jrsy/by/http://www.120sysdyy.com/jrsy/wh/http://www.120sysdyy.com/jrsy/yf/http://www.1

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7、issure、原裂primary fissure、 后外側(cè)裂dorsolateral fissure，小腦小葉（絨球 小結(jié)葉、小腦前葉、小腦后葉）,http://www.sdwtrl.com/wtrl/http://www.sdwtrl.com/zy/http://www.sdwtrl.com/yc/http://www.sdwtrl.com/yl/http://www.sdwtrl.com/shqh/ht

8、tp://www.sdwtrl.com/gwy/,,,,小腦的內(nèi)部結(jié)構(gòu),1、小腦皮質(zhì) the cortex（the gray matter）2、小腦髓質(zhì) the white matter—小腦活樹 the branch of a tree3、小腦中央核 the cerebellum nuclei or central nuclei4、小腦三對(duì)腳 three paired peduncles of

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14、/zhengxing/xyczx/http://www.xasg120.com/zhengxing/ydjss/http://www.xasg120.com/zhengxing/ydzx/,小腦皮質(zhì)The cortex of cerebellum,1、面積為1000平方厘米，1/3露在表面。2、分子層：星形細(xì)胞（水平細(xì)胞）、筐狀細(xì)胞。3、蒲肯野氏細(xì)胞層：4、顆粒層：顆粒細(xì)胞Golgi‘s細(xì)胞5、攀緣纖維、苔蘚纖維,小腦內(nèi)局

15、部神經(jīng)原回路,1、顆粒、高爾基、筐狀、星狀、浦氏細(xì)胞其中 顆粒細(xì)胞是興奮性神經(jīng)原，其余都是抑制性 神經(jīng)原。2、下橄欖核-攀緣纖維-興奮浦氏細(xì)胞3、傳入纖維-苔蘚纖維-興奮顆粒細(xì)胞→ Golgi‘s細(xì)胞→抑制顆粒細(xì)胞 興奮 浦氏細(xì)胞 筐狀、星狀細(xì)胞→抑制浦氏細(xì)胞,,4、苔蘚纖維直接興奮顆粒細(xì)胞，其外周顆粒細(xì)胞則處于抑制狀態(tài)。5、苔蘚纖維沖動(dòng)

16、進(jìn)入小腦皮質(zhì)后，出現(xiàn)許多興奮與抑制鑲嵌區(qū)域。改變大腦與腦干的活動(dòng)，使肌肉運(yùn)動(dòng)在空間上協(xié)調(diào)進(jìn)行。6、攀緣纖維：測(cè)試蒲氏細(xì)胞的興奮與抑制狀態(tài)；清除蒲氏細(xì)胞活動(dòng)的后作用,小腦中央核the central nuclei of cerebellum,1、頂核the fastigial nuclei：前庭纖維2、球狀核the globose nuclei：舊皮質(zhì)3、栓狀核the emboliform nuclei：新、舊 小腦皮

17、質(zhì)4、齒狀核the dentate nuclei：新皮質(zhì)纖維,小腦的白質(zhì)the white matter of cerebellum,1、小腦皮質(zhì)蒲氏細(xì)胞發(fā)到中央核的纖維2、相鄰葉片的聯(lián)絡(luò)纖維3、左、右小腦半球的連合纖維4、傳入、傳出纖維，傳入纖維比傳出纖 維多三倍。由小腦三對(duì)腳出入。,小腦上腳 The superior cerebellar peduncle,2、傳出纖維① Russel’s鉤束② 結(jié)合臂纖維

18、,1、傳入纖維：① 脊髓小腦前束② 三叉小腦束③ 頂蓋小腦束,小 腦 下 腳 the inferior cerebellar peduncle,傳入纖維：1、前庭小腦束2、脊髓小腦后束3、楔小腦束4、網(wǎng)狀小腦束5、橄欖小腦束,6、弓狀小腦束7、三叉小腦束傳出纖維： 1、小腦前庭束2、頂核延髓直接束,小 腦 中 腳 the middle cerebellar peduncle,1、腦橋核小腦束2、腦橋被蓋網(wǎng)狀

19、核小腦束3、頂蓋腦橋小腦束,小 腦 上 腳the superior cerebellar peduncle,1、傳入纖維：脊髓小腦前束三叉小腦束頂蓋小腦束,2、傳出纖維： Russel‘s鉤束 結(jié)合臂纖維,小腦的功能the function of the cerebellum,1、古小腦—維持身體平衡2、舊小腦—調(diào)節(jié)肌肉張力3、新小腦—協(xié)調(diào)肌肉運(yùn)動(dòng)小腦—前庭核、網(wǎng)狀結(jié)構(gòu)、紅核、丘腦、大腦運(yùn)動(dòng)區(qū)—前

20、庭脊髓束、網(wǎng)狀脊髓束、紅核脊髓束、皮質(zhì)脊髓束—а、r神經(jīng)原—梭內(nèi)、外肌,小腦調(diào)節(jié)α、r神經(jīng)原順序方面起重要作用1、靜止時(shí)：靜力性 r神經(jīng)原發(fā)放沖動(dòng)增強(qiáng)肌梭的敏感性。2、某些運(yùn)動(dòng)： r運(yùn)動(dòng)神經(jīng)原首先被興奮3、另一些運(yùn)動(dòng)： α、r神經(jīng)原可同時(shí)被興奮。4、一些快速運(yùn)動(dòng)： α神經(jīng)原可較早被興奮。小腦患病時(shí)， r運(yùn)動(dòng)神經(jīng)原活動(dòng)低下，肌梭不能反映正常肌肉的準(zhǔn)確長度，從而導(dǎo)致運(yùn)動(dòng)力量和速度方面紊亂。,小腦的病變,1、古小腦：小腦性共濟(jì)

21、失調(diào)-平衡失調(diào)、站立不穩(wěn)、有傾跌趨勢(shì)、睜眼閉眼一樣2、舊小腦：軀干性共濟(jì)失調(diào)-步態(tài)蹣跚、兩腿分開求穩(wěn)、舉步幅度不定、不能沿直線行走。對(duì)大關(guān)節(jié)肌肉運(yùn)動(dòng)起協(xié)調(diào)作用通過網(wǎng)狀結(jié)構(gòu)、紅核-r神經(jīng)原-調(diào)節(jié)肌張力、維持身體平衡和姿勢(shì)。,3、新小腦大腦皮質(zhì)—腦橋核—小腦皮質(zhì)—齒狀核—紅核—丘腦腹外側(cè)核—大腦皮質(zhì) 該環(huán)路是小腦對(duì)大腦皮質(zhì)的反饋路，對(duì)大腦皮質(zhì)發(fā)起運(yùn)動(dòng)的一種抑制作用，能制動(dòng)運(yùn)動(dòng)的惰性，防止運(yùn)動(dòng)過度并能使動(dòng)作迅速轉(zhuǎn)換。損傷

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