Download 5E Lesson Plan on Cardiology and Vascular System

Houston Baptist University
School of Education
Name of Lesson Plan
Teacher’s Name
_____________________________________________________________
Subject: Subject: Biology
Grade Level: 9th
Time Estimate: 1(50-60 min)
Unit: Cardiology/vascular
Topic: Cardiac Cycle/Labs
Goal(s): TLW learn the main cardiac chambers, how blood circulates through the body.
TLW understand that cells need oxygen to survive and blood carries it through the body.
TLW appreciate the body’s cardiovascular warning system works by recognizing S/S that
potentially signal cardiac problems.
Objective(s): TLW identify the normal heart anatomy and electrical conduction system of
the heart.
TLW describe, trace and summarize normal cardiac blood flow and the meaning of blood
pressure.
TLW describe how the cardiac cycle and blood flow supports systemic blood throughout
the human body.
TLW determine blood pressure, solve cardiac output, and predict how these values relate
to ejected force from the cardiac chambers, how BP and stroke volume are measured in
lab.
TLW generate own ideas of cardiac functioning values that is considered within normal
range for adults.
TLW evaluate normal ranges of cardiac functioning in adults.
TEKS: 112.34.C.3ABCDF
Materials/Resources/Technology needs: White boards, markers, or active board, video
clips, EKG diagrams, health care aids and heart models, graphing paper, stethoscope and
blood pressure cuff.
Literature: 100,000 hearts: A surgeon’s memoir by Denton A. Cooley, MD
_______________________________________________________________________
5E Instructional Procedures
Engagement:
Activity 1: Read 100,000 Hearts book on page 126 and stop with page 127 at the end of
the first paragraph. Allow students to write brief phrases (such as a science journal)
during the “read aloud” passage. What events damaged Mr. Thomas’s heart so badly that
his surgery involved more than simply replacing three cardiac valves? When did Dr.
Cooley realize that Mr. Thomas’s only option was a heart transplant? In a turn of irony,
how did Dr. Cooley come to know the donor of the first human transplant recipient?
What is coarctation? What do we know about scientific terms? Where are they borrowed
from? Science is a field filled with borrowed scientific words from which languages?
Have students use cell phones to look up coarctation. Latin coarctation-, coarctatio
tightening, from coarctare, coartare to constrict, from co- + artare to fix firmly, from artus
close, tight; akin to Latin artus joint.
Activity 2: Next, transition class back to teacher and ask how many students have heart
disease in their families or know of someone who has died of heart related diseases. Take
a poll of the class. Heart disease is the number one killer in adults. In cooperative groups
fill out a KWL chart on what they know and what they want to know about heart disease,
blood pressure and heart healthy lifestyles. From a previous lesson, we know that
lifestyle can affect cardiovascular disease. How would knowing about the heart’s normal
electrical conduction path be helpful for us to know about heart rate, or heart rhythm?
What is a normal blood pressure? How would give us important information about an
individual’s health? Both of these videos will serve as a springboard for processing
information in the labs. Video 1: Your Heart’s Electric System.
http://www.nhlbi.nih.gov/health/health-topics/topics/hhw/electrical.html (1:30 min).
Video 2: How to Take a Blood Pressure at http://on.aol.com/video/nurses-videohandbook---how-to-take-blood-pressure-59578783 (1:15 min).
Exploration: Place directions of each lab station on an index card for directions. Keep a
data log of all pulse and blood pressure readings on the board. Instruct students to wait 2
minutes before taking another BP on the same person if they failed to take it correctly;
otherwise, a false reading may occur.
Lab (1) In pairs, have students look for and identify their partner’s pulse. What two sites
would they use? Count the pulse for one minute. Were their partner’s pulses rhythms
regular or irregular? Switch partners and perform the activity again. Next, have partners
take the pulse after one full minute of running in place and chart pulse rates. Switch
partners and measure again. Add the results to the running tally on the board. Explore the
data. Are the ranges within a short span of one another or do they vary greatly? What
could be differences in the ranges? Is there a homogenous age relation with students? Are
all students involved in sports? How would knowing this information help to make
predict information about BP and heart rate?
Lab (2) In small groups of students, explore the heart anatomy with models and identify
the various electrical impulses for the Cardiac Cycle using sticky notes. Place labels on a
table with the models and have students identify the each step in the cardiac cycle (have
the key for students to view after lab completed. (A PPP slide for cardiac conduction
enclosed).
Lab (3) With graph paper identify the QRST waves. What is the normal EKG reading
look like? Have a couple of samples of irregular cardiac rhythms (attached). What might
quivering waves indicate about an individual? What might a flat line indicate? What
would you observe before intervening with a person who has no heartbeat?
Lab (4) Have students use cardiac output formula to measure normal stroke volume on
an index card. Place a patient scenario on an index card. Calculate the cardiac output and
stroke volume. What is an average CO (cardiac Output)?
Explanation: Big Ideas/Concepts: teacher facilitated discussions.
Lab 1: From previous classes, encourage students to connect knowledge that blood
circulates from the left ventricle into the aorta to all parts of our and that oxygen; carbon
dioxide; nutrients and waste exchange in the capillary vessels. What do we already know
connection that as your heart pumps blood through your body, you can feel a pulsing in
some of the blood vessels close to the skin's surface, such as in your wrist, neck, or upper
arm? These vessels are arteries. Help students associate that the range of a normal heart
rate is 60-100 beats per min (bpm).
Lab (2) In small groups of students, trace the cardiac cycle in the heart models using
sticky notes and apply them to the internal parts of the heart model. Are students
developing and connecting the concept that the cardiac cycle occurs from within the
heart, via the cardiac’s electrical conduction system without input from the nervous
system? Ask students what they think might happen if the heart is electrical system was
interrupted. How would the heart respond?
Lab (3) Students should develop an understanding that during the period of the heart’s
contraction (systole), the heart pumps blood out through the arteries; during the period of
relaxation (diastole), the heart fills with blood.
Lab (4) Help students connect that normal ranges exist for cardiac output, stroke volume,
and heart rate. Ask students what they think would happen if one of these measures was
affected. Place the following questions on a note card at this station. What outwards
signs would the person develop? Would you expect sounds of heart to change from the
norm.
How would an inquiring student determine his/her own pulse rate? Share those results
and have KWL sheets taped to science journals after all responses are completed. Remind
students to take notes on the labs in their science journals to refer for tomorrow’s quiz.
Elaboration: work sheets attached.
Lab 1: Are students drawing conclusions that normal heart rate and blood pressure
ranges exist according to the American Heart Association (AHA). Major differences may
signify an occult cardiac problem. There are normal ranges for heart rate and the heart’s
electrical system is measured by beats per minute; it is one way to determine the health of
the cardiac system in an individual.
Lab 2: What is important to know about heart rate and blood pressure readings regarding
the cardiac system? Students should be developing a comprehension of normal and
abnormal readings. Encourage students to apply their knowledge of normal ranges in a
real world setting, such as a person with uncontrolled high blood pressure extending over
a period. At what point would you begin to worry: a month, a year?
Lab 3: Electrical impulses generated from the SA node spread through the heart via a
nodal tissue pathway that coordinates the events of the cardiac cycle through ECG/EKG
readings. What would a normal EKG look like? What do some more dangerous cardiac
rhythms look like?
Lab 4: What is a normal cardiac output and stroke volume look like? What does the
cardiac output measurement indicate? Identify a normal blood pressure reading and one
that is considered low and one considered elevated.
Evaluation: Teacher observes whether students show progress with the circulatory
system and using the appropriate vocabulary (i.e.: circulation, referring to blood vessels
by name, etc...) Students also need to understand how the lungs work to diffuse gases into
and out of cells. A diagram of the each system would help students visually trace the flow
of blood. A heartbeat is a single cycle in which your heart's chambers relax and contract
to pump blood. This cycle includes the opening and closing of the inlet and outlet valves
of the right and left ventricles of your heart. Students are demonstrating how one might
go about checking a sphygmomanometer pressure. In the event of a suspected cardiac
arrest, students need to identify and locate the best artery to check for circulation. Which
would be the carotid artery along the side of the neck? Help students develop a list of
factors that could contribute to an elevated blood pressure in humans. Help students infer
that a regular heart rate means a regular heart rhythm exists and the identifying features
of a normal EKG? Students should be determining that heart sounds have a normal
auscultation (the lub-dub sound).
Assessment/Summative Evaluation: Create a concept map (drawing) to illustrate
coronary artery disease. An alternative for those who do not draw is creating an anchor
map with characteristics of lifestyles changes to prevent a heart attack. Example attached
under “Anchor Chart.
________________________________________________________________________
Modifications/Notes: For students with disabilities, ensure the “big ideas” are
represented graphic organizers. For hearing impairment, seat students on the second row
during class, so they may lip-read their teacher and peers. Visualizations are used for
abstract concepts. Think pair-share may be used in cooperative activities and may be read
aloud for those with dyslexia. Have extra activity sheets for those gifted/talented and for
those with special needs. For practicing cardiac structures and extra practice with
information, have videos sites, worksheets, any web-based learning tools available for all
students. Have students cut out cardiac flip-charts and place in order of blood flow in the
heart.
Additional resources:
http://www.phschool.com/science/biology_place/biocoach/cardio1/cycle.html provides
excellent additional practice for identifying heart anatomy. Circulatory Rap song:
http://www.teachertube.com/viewVideo.php?video_id=196915
Cardiac conduction system:
http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000021.htm
http://www.nhlbi.nih.gov/health/health-topics/topics/hhw/electrical.html
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureM
atters/Why-Blood-Pressure-Matters_UCM_002051_Article.jsp
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureM
atters/Why-Blood-Pressure-Matters_UCM_002051_Article.jsp
Power Point Slides: Heart rate illustrated by a normal EKG reading.
An Electrocardiogram – EKG/ECG
•Cardiac muscle contracts as a result of electrical stimulation, this is detected with
recording electrodes.
• Electrical signals are shown on a cathode ray oscilloscope or a chart recorder;
this is an ECG.
R
P
T
Q S
A single cardiac cycle: P = atrial systole; QRS = wave of ventricular systole; T =
ventricular diastole
heart rate calculated from interval between P waves
• heart rate calculated from interval between P waves
P
Interpreting an EKG Tracing
Watch the EKG- Animation:
http://www.youtube.com/watch?v=4vkbywows-o
( 5:30 min.)
Lab #1 Name: __________________________________________
What is the AHA recommendation for healthy blood pressure?
This chart reflects blood pressure categories defined by the American Heart Association.
Blood Pressure
Category
Normal
Systolic
mm Hg (upper #)
Diastolic
mm Hg (lower #)
less than 120
and
less than 80
Prehypertension
120 – 139
or
80 – 89
High Blood Pressure
(Hypertension) Stage 1
140 – 159
or
90 – 99
High Blood Pressure
(Hypertension) Stage 2
160 or higher
or
100 or higher
Hypertensive Crisis
(Emergency care needed)
Higher than 180
or
Higher than 110
What is your partner’s blood pressure? _____________
What is your blood pressure? ___________
Write down a systolic reading and diastolic reading that would raise
concern?_________________Why? _______________________________
What is the AHA defined normal blood pressure on the chart above? _______________
Blood pressure is typically recorded as two numbers, written as a ratio like this: anything
much higher or much lower would generate investigation.
Systolic
The top number, which is also the higher of the two numbers,
measures the pressure in the arteries when the heart beats (when
the heart muscle contracts).
Read as "117 over 76
millimeters of
mercury"
Diastolic
The bottom number, which is also the lower of the two
numbers, measures the pressure in the arteries between
heartbeats (when the heart muscle is resting between beats and
refilling with blood).
Name_____________________
Lab #3 In cooperative groups have students trace the heart’s electrical conduction
system.
Track the heart’s electrical conduction path on the life size model with yellow sticky
notes indentifying each part of the conduction system. Students will copy their traces of
the heart and conduction system in their science journals. Have a diagram with answers.
Correct answers: SA node AV node AV Bundle of HIS Right and Left Bundle
Branches. The heart’s conduction system ends with the Right and Left Purkinje fibers.
Place a copy of the correct order of the heart’s conduction pathway after students
complete the diagram.
Lab 4 Name___________________________________
Date:_________________
How to determine Cardiac Output.
Cardiac output
Cardiac Output = Stroke Volume X Heart rate
( Volume of blood leaving
left ventricle with each beat)
(beats per
minute)
Ex: CO=HR X SV =75beats X 70ML
----- ---min beats
=5250ML (5.25L)
• Average resting for a man is 75cm3 (stroke) and 70
beats per minute (rate)
• When exercising both stroke and rate increase
• The fitter a person is the lower the resting rate
and higher stroke volume.
Scenario 1: A twenty-year-old male presents with a resting HR of 65 bpm and a stroke
volume of 80.
Calculate the cardiac Output (CO).___________________________________________
Scenario 2: An eighty-eight year old woman presents with a resting HR of 95 and a
cardiac output of 3.2 liters. What is the stroke volume of each beat of her heart?
Calculate the stroke volume.
___________________________________________________
Explain the differences in C.O. related to age and other co-morbidities.
________________________________________________________________________
________________________________________________________________________
Scenario 3: A young male walks to your Emergency Room with a HR of 85 beats per
minute, and a stroke volume of 80 ml. What is the cardiac output? Is the result within
normal limits? Why?
Lab #3: From the rhythms below, describe the features of the normal EKG from the
diagrams below. Identify the P, QRS complex and T waves.
Lethal Arrhythmias: What do you establish first before responding?
What would you observe in a person with either one of these rhythms? Can you identify
P, QRS complex, or T waves? What would you establish first?
References:
Bryne, F. (2001). 101 questions about blood and circulation. Minneapolis, MN: Twentyfirst Century Books.
Campbell, N., & Reece, J. (2005). Biology: AP edition. (7th ed.). San Francisco; CA:
Pearson Education, Inc.
Huff, J. (2006). ECG workout: Exercises in arrhythmia interpretation. (5th ed.).
Baltimore, MD: Lippincott Williams& Wilkins.