CEREBELLAR

FUNCTION
Clinical Pharmacy 5-A
GROUP 5
Gabayoyo, Jade – Leader
Blanco, Chelea
Dayon, Nina
 Reporters

Nina V. Dayon Chelea I. Blanco Jade B. Gabayoyo

Full-Time Student
Full-Time Student Full-Time Student
Bacolod City
Koronadal City Bacolod City
 Cerebellum
• “Little brain”
• Located between the
cerebrum and the brain stem
• Responsible for controlling
motor (movement) such as
eye movement and tracking of
moving objects, as well as
coordination and balance in
behaviors
 Cerebellum
Functions:
• Maintaining balance
• Coordinating movement
• Vision
• Motor learning
 ASSESSMENT
The following are used to assess cerebellar function:
• Finger-to-nose test
• Heel-to-shin test
• Rapid alternating movements test
• Romberg’s test
• Gait test
Definition of Terms
Meaning
Abduction Movement away from the body
Adduction Movement towards the midline of the body

Clonus Rhythmic oscillation between extension and flexion

Eversion Turning of the toes onto the great toe (turning of the foot
turned outward)
Extension Bending of a joint to bring the joint parallel to the long axis
Flexion Being of a joint to bring the parts of the joint into close
approximation
Inversion Turning of the toes onto the small toes (bottom of the foot
turned inward)
Pronation Placement into a downward-facing position
Supination Placement into an upward-facing position
 Finger-to-nose Test
1. Finger-to-nose test
Used to measures smooth, coordinated upper-
extremity movement

• How the test is performed: Hold your finger about an

arm’s length in front of the patient. Ask the patient
quickly and repeatedly touch his nose and then your
finger
 Finger-to-nose Test
1. Finger-to-nose test
 Heel-to-shin Test
2. Heel-to-shin test
Used to test the lower limb coordination and position
sense

• How the test is performed: Instruct the patient to rub

the heel down the shin of the opposite leg.
 Heel-to-shin Test
2. Heel-to-shin test
Rapid Alternating Movements
Test
3. Rapid alternating movements test
Used to measure motor control and coordination

• How the test is performed: Ask the patient to pronate

and supinate the hands rapidly and repeatedly.
Rapid Alternating Movements
Test
 Romberg’s Test
4. Romberg’s test
measures the sense of balance

• How the test is performed: Instruct the patient to

stand with the feet together, arms extended with
palms up, and eyes closed.
 Gait Test
5. Gait test
an analysis of a person’s ability to walk, especially
to identify those that limit safe walking.

How the test is performed: Ask the patient to walk

straight ahead, turn, return walking on tiptoes, turn,
walk away on the heels, turn, and return walking heel to
toe
 Gait Test
4. Gait test
 Gait Test
4. Gait test Abnormalities
Definition of Terms
Meaning
Asterixis Involuntary movements characterized by non-rhythmic
flapping of the extremities
Athetosis Involuntary movements characterized by slow, twisting
irregular motions
Chorea Involuntary movement characterized by brief, rapid,
irregular, jerky motions
Dyspraxia Difficulty in coordinating body movements
Dystaxia Difficulty with muscle coordination
Dystonia Abnormal slow, twitching, irregular movements
Fasciculation Involuntary movements characterized by fine twitching
that rarely moves a joint
Intention tremor Involuntary movements characterized by tremors that are
absent at rest but appear with intentional movement
Myoclonus Involuntary movements characterized by sudden, brief,
unpredictable jerks
Definition of Terms
Meaning
Nystagmus Involuntary oscillation of the eyeball

Lateral –side to side

Vertical –up and down
Rotatory –oscillates in a circle
Opthalmoplegia Optic movement disorder
Postural Tremor Involuntary tremor that occurs when the affected part
maintains a given position
Resting Tremor “Static tremor”; involuntary movement at rest
Tics Involuntary movements characterized by brief, repetitive
movements at irregular intervals
REFLEXES
 Reflexes

• an involuntary and automatic action in the body in response to a stimulus.

• They work to protect the body from injury and adapt to changes in the
environment
REFLEX RATING SCALE
Scale Meaning

0 No response

1+ Diminished response

2+ Normal physiologic response

3+ Increased response

4+ Hyperreactive; often associated with

clonus
 Reflex
• Deep tendon Reflexes
o Biceps Reflex (C5, C6)
o Triceps Reflex (C6, C8)
o Brachioradialis Reflex (C5, C6)
o Patellar Reflex (L2 to L4)
o Achilles Reflex
• Superficial Reflex
o Abdominal Reflex x (S1, S2)

• Pathologic Reflexes
o Babinski’s Reflex
o Snout Reflex
o Sucking Reflex
o Grasp
o Hoffmann’s Reflex
o Oculocephalic Reflex
o Oculovestibular Reflex
 Deep Tendon Reflexes
1. Biceps Reflex
- examines the function of the C5 reflex arc and the C6 reflex
arc
- elicited by placing your thumb on the biceps tendon and
striking your thumb with the reflex hammer and observing the
arm movement
 Deep Tendon Reflexes
2. Triceps Reflex
- elicits involuntary
contraction of the
triceps brachii muscle
 Deep Tendon Reflexes
3. Brachioradialis Reflex

- reflex involving the C5

and C6 nerve roots through
its innervation by the radial
nerve
 Deep Tendon Reflexes
4. Patellar Reflex
- occurs when an abrupt change arises in muscle length
- Reflex produced by the tendon stretching, which is
caused when the hammer stroke is applied.
- The normal response must be a sudden leg extension.
 Deep Tendon Reflexes
4. Patellar Reflex
 Deep Tendon Reflexes
5. Achilles Reflex
- “Ankle Jerk Reflex”
- occurs when the Achilles tendon is
tapped while the foot is dorsiflexed.
- It is a type of stretch reflex that
tests the function of the gastrocnemius
muscle and the nerve that supplies it.
 Pathologic Reflexes
• Babinski Reflex
• Snout Reflex
• Sucking Reflex
• Grasp
• Hoffmann’s Reflex
• Oculocephalic Reflex
• Oculovestibular Reflex
 Pathologic Reflexes
1. Babinski Reflex
- Also called the plantar reflex or Babinski sign

- Testing that is used to check for healthy development or

underlying neurological conditions

- A marker for the health of the cortical spinal tract, which is a

nerve channel sending information between the brain and the
body and limbs

- Dorsiflexion the the great toe and spreading of the other four
toes
 Pathologic Reflexes
1. Babinski Reflex
 Pathologic Reflexes
2. Snout Reflex
- “Pout”
- Seen in infancy
- seen in disorders that
affect the frontal lobes,
such as dementias,
metabolic
encephalopathies,
closed head trauma, and
hydrocephalus
 Pathologic Reflexes
3. Suck Reflex
- Observed in infants

- Gently stroke the patient’s

lips from side to center with a
tongue depressor. A positive
response indicates sucking
movement.
 Pathologic Reflexes
4. Grasp
- Observed in infants

- Gently stroking the palm of

the patient’s hand between
the thumb and the fingers. A
positive response is
characterized by flexion of
the fingers
 Pathologic Reflexes
4. Grasp
 Pathologic Reflexes
5. Hoffmann Reflex
- digital reflex, snapping reflex, or
the Jacobson reflex
- Used to examine the reflexes of the
upper extremities
- Dorsiflexing the patient’s wrist with
the fingers flexed and flicking the
middle finger. A positive response is
characterized by the adduction of
the thumb or index finger
 Pathologic Reflexes
5. Hoffmann Reflex
Used to determine whether a person has a medical condition that
affects the spine.
 Pathologic Reflexes
6. Oculocephalic Reflex
- also known as “Doll’s Eye
Test”
- Turning the patient’s head
quickly from side to side. If the
brainstem is intact, the eyes move
in the opposite direction and
maintain the straight ahead gaze
 Pathologic Reflexes
7. Oculovestibular Reflex
Elevate the patient’s head about 30 degrees and then instilling
cold water in the ear canal.
Definition of Terms
Meaning
Abstract The ability to think beyond concrete terms
reasoning
Affect The external expression of emotion
Attention Mental focus or concentration
Blocking Sudden interruption of speech in mid sentence
Clanging The use of words on the basis of sound
Confabulation Fabrication of facts or events to fill gaps in memory
Echolalia Repetition of words or phrases spoken by others
Judgement Ability to compare and evaluate alternatives
Mood Sustained emotional state
Perseveration Persistent repetition of words or phrases
Recent memory Information acquired a few hours or days previously
Remote memory Information from the distant past
Stereognosis Ability to identify, by touch, small objects placed in hand.
Definition of Terms
Meaning
Thought content What a person thinks about
Inability to
Acalculia Calculate
Agraphia Write
Anosognosia Recognize one’s own impairment
Aphasia Speak

Aphonia Loss of voice

Anosmia Complete loss of sense of smell
Definition of Terms
Meaning
Circumstantiality Abnormal thought process
-unnecessary detail that delays in reaching the point of
thought
Confusion Abnormality of consciousness
-mental slowness, inattentiveness, and incoherent thought
patterns
Decerebrate Abnormal body posture seen in comatose patients.
rigidity - Clenched jaws, extension of the neck and legs,
adduction of the arms, pronation of the forearms, flexion of
the wrists and fingers
Decorticate Abnormal body posture in comatose patients
rigidity - Flexion of the fingers and wrists, extension and rotation
of the legs
Delirium Abnormality of consciousness
-confusion, agitation, hallucinations
Dementia Acquired memory impairment
Definition of Terms
Meaning
Dysphasia Hesitancy and error in choosing words when speaking
Dysphonia Hoarseness
Neologism Use of invented words
Paparesis Slight degree of lower extremity paralysis
Paraplegia Paralysis of the lower extremities and trunk
Quadriplegia Paralysis of the upper and lower extremities
Scotoma Visual field defect associated with disorders of the optic
nerve
Stupor Abnormal state of consciousness
-reduced mental and physical activity, reduced response
to stimuli
 References
• H. Kenneth Walker. (n.d.). Clinical Methods: The History, Physical, and
Laboratory Examinations. 3rd edition. Chapter 71The Suck, Snout,
Palmomental, and Grasp Reflexes. Retrieved August 20, 2022 from
https://www.ncbi.nlm.nih.gov/books/NBK395/
• Stanford Medicine Children’s Health. (2022). Newborn Reflexes. Retrieved
August 20, 200 from https://www.stanfordchildrens.org/en/topic/default?
id=newborn-reflexes-90-P02630.
• Medical News Today. What does a positive or negative Hoffman sign
mean?. Retrieved August 20, 2022 from
https://www.medicalnewstoday.com/articles/322106.
• Medical News Today. (March 2022). The Babinski reflex: What to know.
Retrieved August 20, 2022 from
https://www.medicalnewstoday.com/articles/babinski-reflex.