1

LAB WORKSHEET 3
NEUROVASCULAR & VENTRICLE FUNCTION & DYSFUNCTION

HYPOTHESIS
Occupational therapy graduate students can correlate behavioral function and dysfunction as a
result of neurovascular and internal structures of the CNS with intensive and focused lab study.

GOAL
To identify the related behavioral functions and dysfunction of the neurovascular and internal
structures of the CNS.

OBJECTIVES
Knowledge and Application
1. Identify the major vascular structures of the nervous system
2. Describe the relationship between the vascular and gross brain structures
3. Correlate cerebral vascular pathologies with dysfunctional behavior
Professional Development
4. Demonstrate self-initiative with exploring appropriate resources

LEARNING STRATEGIES
The following learning strategies are recommended to master the content of this lab:
1. Draw diagrams, pictures, or flow charts of the artery locations and functional implications
2. Create organized matrix worksheets (see guiding sheets).
3. Use complete sentences when articulating or describing the location and functions of the
neurological structure to your peers or instructors.

LEARNING ACTIVITIES Meninges

1. In your own words,
a. Describe a subarachnoid hemorrhage (the structures involved, the pathology,
and the potential issues related to this type of hemorrhage).
With a hemorrhage, blood would seep into the tissue between the
subarachnoid mater and pia mater, damaging the tissue surrounding the brain.
The blood could cause pressure and fluid buildup in the ventricles causing
severe headaches, brain damage, stroke, neck stiffness, swelling of the brain,
and amorism. It could also affect motor function and visual functions. Additionally,
the blood would seep into the surrounding CSF, impacting nutrient supply to the
brain and efficiency of drainage of CSF.

b. Describe the location and function of the arachnoid villi.

The arachnoid villi are located inferior to the subarachnoid space
surrounding the superior layer of pia mater around the brain. The function of the
villi is to help drain CSF fluid into the sinuses.

Ventricular Structures
1. In your own words, write out a description of how CSF flows through the ventricles and
into the superior sagittal sinus.
 2

The CSF is produced in the choroid plexus of the third, fourth, and lateral
ventricles. Then, the CSF travels from the lateral ventricles through the interventricular
foramen to the third ventricle and to the cerebral aqueduct. From the fourth ventricle, the
CSF travels through the medial and lateral foramen/apertures into the subarachnoid
space from the arachnoid villa that secretes into the sagittal superior sinus for drainage.

Ventricular Case Stories

Hydrocephalus
Sammy is 3 months old diagnosed with a condition called hydrocephalus. The
hydrocephalus is occurring in the lateral ventricles.

1. Describe the structures and cause of the condition.

Sine Sammy has hydrocephalus; this means there is CSF buildup in the
ventricular spaces. This impacts the drainage and flow of CSF, which can create
pressure that ultimately compresses his brain tissues, the ventricular spaces, sutures
and thus limits the flow of CSF due to the swelling.

2. Identify all the potential blockage points of Sammy’s ventricular system. Try drawing the
ventricular system and the potential blockage points.

3. In your drawing, identify where is the CSF being produced?

g = prod uct ion of CSF

= b l ck a g e
o
 3

Sammy eventually receives a catheter shunt placed from the lateral ventricles to the dural
sinuses for drainage.
4. Describe the flow of the CSF in Sammy’s body and how the CSF is absorbed (begin at
the lateral ventricle).
The CSF would bypass the other ventricles (other than the lateral ventricle),
subarachnoid space, and the arachnoid villi, going straight into the dural sinus.

Sammy is now 12 months old; he has had hydrocephalus since birth and recently had a
hemorrhage of his anterior and middle cerebral arteries.
5. What are the potential lobes and associated functions affected by the hemorrhage?
The frontal, temporal and parietal would be affected. The functions affected
would be problem solving, emotional traits, reasoning, speaking, and voluntary motor
activity (frontal lobe), understanding language, memory, hearing, object recognition
(temporal), and knowing right from left, sensation/somatosensory, body orientation, and
reading (parietal lobe).

Brain injury
Ariana is 25 years old with a brain injury after they were attacked on their way home from a
fun evening with friends. They are on an in-patient rehab unit. You are the OT working with
Ariana. During your initial evaluation, Ariana complains of visual distortions. You also find
yourself repeating questions because Ariana needs additional time processing what she is
hearing. Through the interview, you find that Ariana is employed as a personal trainer. They
live at home with their parents. They are in a long-term relationship. In their spare time,
Ariana likes listening to rock music, go to the gym, and read fitness magazines.
1. What area(s) of the brain do you suspect have been injured?
I would suspect her occipital (visual), and processing words (temporal and
parietal, Wernicke’s Area). She would have these issues because it is frontal issues, it is
anterior that is supplied by the ACA and PCA, and possibly the MCA that supplies the
lateral parts of the brain (the occipital and temporal areas).

2. What activities do you think Ariana will have the most trouble with? Explain.
She may have trouble communicating with coworkers and clients at her work,
using her work equipment at work (visual distortions may impact her use of machines,
watching her clients perform exercises, and balance with exercises), reading magazines
or other literature (visual distortion), socializing with her loved ones, and/or enjoying
music.

3. What cerebral vascular structures may be involved with Ariana’s issues?

The Anterior cerebral artery (the frontal and parietal lobes), the middle cerebral
artery (parietal and temporal lobes), and the anterior choroidal artery (frontal lobe).

4. Select one activity from Ariana’s occupational history. Hypothesize and describe what
the potential issues might they have with participating in associated activities.

Cerebral Vascular Accident

Lucia is 51 years old. She recently had a cerebrovascular accident (CVA or “stroke”). During
the evaluation, she looks all around the room and is distracted by noise in the hallway. She
has trouble verbally expressing her thoughts and remembering why she is in the hospital.
 4

Lucia is a police officer and has 3 children who still live at home with her. She is divorced
and has joint custody of her children. Prior to the stroke, Lucia was independent in all her
basic and instrumental activities of daily living. She enjoys spending time bike riding, hiking,
and vacationing at the beach with her children. She is also a voracious spy mystery novel
reader.
1. What lobe(s)/gyri/area(s) of the brain do you suspect have been affected by? Why?
It would affect the temporal (Broker’s Area) and auditory areas because she is having
difficulty with auditory activities. Also, the frontal lobe because of her memory issues.

2.What cerebral vascular structures may be involved with Lucia’s memory?

Parahyppocampal gyri.