TTH Module 1 - Version 6.1MODULE 1: The Heart What Makes You Tick? Lesson 1: DVD - The Mysterious Human Heart – Episode 1 “Endlessly Beating” Lesson 2: Anatomy of the Heart – Sheep Heart Dissection Lesson 3: The Heart as a Pump – Siphon Pump Activity & What’s Flow Have to Do with It? Lesson 4: Heart Sounds – Stethoscope Activity Lesson 5: DVD - The Mysterious Human Heart – Episode 2 “The Spark of Life”Palazzo, S.J. 2015 1 Page 1 of 43
TTH Module 1 - Version 6.1Next Generation Science Standards (NGSS)Life SciencesHS-LS1-2. Develop and use a model to illustrate the hierarchical organization ofinteracting systems that provide specific functions within multicellular organisms.HS-LS1-3. Plan and conduct and investigation to provide evidence that feedbackmechanisms maintain homeostasis.Physical ScienceHS-PS3-2. Develop and use models to illustrate that energy at the macroscopic scalecan be accounted for as a combination of energy associated with the motions ofparticles (objects) and energy associated with the relative positions of particles(objects).Engineering DesignHS-ETS1-2. Design a solution to a complex real-world problem by breaking it down intosmaller, more manageable problems that can be solved through engineering.Common Core StandardsLiteracy in History/Social Studies, Science, & Technical SubjectsCCSS.ELA-Literacy.WHST.9-10.2 Write informative/explanatory texts, including thenarration of historical events, scientific procedures/ experiments, or technical processes.CCSS.ELA-Literacy.WHST.9-10.7 Conduct short as well as more sustained researchprojects to answer a question (including a self-generated question) or solve a problem;narrow or broaden the inquiry when appropriate; synthesize multiple sources on thesubject, demonstrating understanding of the subject under investigation.CCSS.ELA-Literacy.WHST.9-10.9 Draw evidence from informational texts to supportanalysis, reflection, and research.MathematicsMP.2 Reason abstractly and quantitatively.MP.4 Model with mathematics.Speech & ListeningSL.11-12.5 Make strategic use of digital media (e.g., textual, graphical, audio, visual,and interactive elements) in presentations to enhance understanding of findings,reasoning, and evidence and to add interest.Palazzo, S.J. 2015 2 Page 2 of 43
TTH Module 1 - Version 6.1NotebookThink about what makes your heart “tick” and write your thoughts in the TTH notebookprovided. You will be using this notebook throughout the program to record yourthoughts. Consider the following: What do you know about the heart? Provide evidence to support your claims. What have you always wondered about the heart and it’s structure and function.OverviewThe heart beats approximately 100,000 times per day (36,500,000 times a year) in theaverage person. It pumps enough blood in one year to fill and Olympic-sized swimmingpool (680,000 gallons). It beats consistently and reliably every moment, but many of usdo not understand how it works. Module 1 is designed to introduce you to the structureand function of the heart and what happens when it doesn’t work right.If students have already studied the cardiovascular system, this lesson will serve as areview to bring all students to the same level of proficiency.A fun introductory video: http://www.youtube.com/watch?v=LqhvmUEdOYYThe purpose of the heart is to pump oxygen (O2) and nutrient rich blood to all of thecells in the body and carry carbon dioxide (CO2) and waste products to the lungs,kidneys and other excretory organs for elimination. An important concept: Input Transfor- Output mationAs students, you will participate in a variety of situated-learning activities to reinforcecharacteristics of the heart. You and your classmates will watch parts of the PBS DVDseries “The Mysterious Heart,” use models and dissect sheep hearts, and participate inan activity that explores the importance of valves and one-way blood flow in thecirculatory system. You and your classmates will engage in a group activity thatinvestigates the physics of flow (a cross-cutting concept) and learn about theelectrophysiology of the heart and Sudden Cardiac Arrest (SCA).Finally, you and your classmates will use a schematic diagram to apply your knowledgeof the heart and the flow of blood.Palazzo, S.J. 2015 3 Page 3 of 43
TTH Module 1 - Version 6.1Mt. Tahoma High School students participating in Teen Take Heart YOUR ELECTRICAL HEARTInformation Tied to the Practices (Health Professions)Your heart beats about 70 times per minute for your entire life.Each heartbeat is triggered by electrical impulses that travel downa special pathway through your heart. These impulses start in theupper atria in an area called the Sinoatrial (SA) Node. Becausethis cluster of cells determines the rate of the beats, we call it the“Pacemaker” of the heart. From here, the impulse is transferred through the atria,down the wall between the ventricles and then up the outside walls of the ventricles. Asthis impulse moves through each area of the heart, it initiates the contraction of themuscles around it. The brain can send signals to speed up or slow down your heartrate. Also, exercise, fever and some medications can do the same.Palazzo, S.J. 2015 4 Page 4 of 43
TTH Module 1 - Version 6.1This video will introduce you to the electrical conduction system of the heart:http://www.youtube.com/watch?v=te_SY3MeWysWhen the heart beats too fast, too slow, or in an uncoordinated fashion, it iscalled an Arrhythmia.Here is a fun video that introduces you to the different heart rhythms (bothnormal and abnormal rhythms):http://www.youtube.com/watch?v=x5oq4ErAmW0When this happens, the heart cannot effectively pump blood to the rest of thebody. This can feel very uncomfortable and may even stop the heart. If theheart stops beating, this is called Cardiac Arrest. If this happens, an electricalshock can be delivered to the person so that their heart starts to beat normallyagain. An Automated External defibrillator (AED) is a computerized devicethat will prompt another person so they can use the machine to effectively deliverthe electric shock to the affected person.To treat this type of ailment, medication may be prescribed, or a device may beimplanted that monitors and regulates the heart rate, such as a Pacemaker orDefibrillator. A procedure may be done that destroys the heart tissue causingthe abnormal rhythm. This is called an Ablation.An Electrocardiogram (ECG or sometimes referred to as an EKG) is a test usedto study a person’s electrical activity of their heart. This test is used to identifyarrhythmias. It can also be used to see if a heart attack has taken place.Here is a very good video explaining how to read an ECG:http://www.youtube.com/watch?v=v3b-YhZmQu8A Heart Attack is when cells in heart tissue die due to the lack of oxygen. Thislack of oxygen is caused when the blood supply is cut off in one of the coronaryarteries by a blockage.This is an advanced video, but is a very good representation of the professionalrole of nurses and physicians in the emergency department:http://www.youtube.com/watch?v=qUNAyYCoOsQThe Coronary Arteries deliver oxygen and nutrients to the cells of the heart:http://www.youtube.com/watch?v=tBQa8IBzP6IAdvanced Concepts:When the coronary arteries become blocked by atherosclerosis (from poor dietand a lack of physical activity) they may be bypassed by a stent or bypasssurgery. A Stent is small, lattice shaped tube that is placed inside the blockageto hold the artery open: http://www.youtube.com/watch?v=i7oONw5B7hIA Bypass is when another blood vessel from the body is sewed around thePalazzo, S.J. 2015 5 Page 5 of 43
TTH Module 1 - Version 6.1blocked area of the blood vessel. If the heart becomes too damaged by heartattacks, the heart will no longer be able to pump the blood to meet the body’sneeds. This is called Heart Failure:http://www.youtube.com/watch?v=RHJBVTdBJvIThe American Heart Association has an interactive library that teachers/studentsmay find helpful:http://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=highbpMajor ConceptsThe main concepts explored in this lesson are the structure and function of the heartand the path the blood takes as it flows through the heart. The concept of flow (physics)is introduced as a cross-cutting concept. Additionally, the electrophysiology of the heartwill be explored in relation to Sudden Cardiac Arrest (SCA).Student Learning OutcomesAfter completing Module 1, students will be able to: 1. Ask questions: that arise from careful observation of phenomena, or unexpected results, to clarify and/or seek additional information. that arise from examining models or a theory, to clarify and/or seek additional information and relationships. to clarify and refine a model, an explanation, or an engineering problem. 2. Ask questions that can be investigated within the scope of the school laboratory with available resources and, when appropriate, frame a hypothesis based on a model or theory. 3. Plan an investigation or test a design (sheep’s heart dissection) individually and collaboratively about the structure and function of the human heart to produce data to serve as evidence as part of building and revising models, supporting explanations of phenomena, or testing solutions to problems. 4. Select appropriate tools to collect, record, and analyze data. 5. Manipulate variables and collect data about the structure and function of the heart to identify failure points or improve performance relative to criteria for success specific to heart disease, cardiac arrest, and heart failure. 6. Apply scientific reasoning, theory, and/or models to link evidence of the structure of the heart to the explanation of its function.Palazzo, S.J. 2015 6 Page 6 of 43
TTH Module 1 - Version 6.1 7. Develop, revise, and/or use a model based on evidence to illustrate and/or predict the relationships between pressure and resistance to investigate their effects on flow within the cardiovascular system. 8. Apply techniques of algebra and functions to represent and solve scientific and engineering problems related to vasoconstriction and vasodilation on the flow of blood to the tissues and organs of the body. 9. Critically read scientific literature adapted for classroom use to determine the central ideas or conclusions and/or to obtain scientific and/or technical information to summarize complex evidence, concepts, processes, or information presented in a text by paraphrasing them in simpler but still accurate terms. 10. Compare, integrate, and evaluate sources of information presented in different media or formats (e.g., visually, quantitatively) as well as in words in order to address a scientific question or solve a problem. 11. Communicate scientific and/or technical information or ideas in multiple formats (including orally, graphically, textually, and mathematically).Teacher and Student Background InformationThe goal of Module 1 is to enhance student intrinsic motivation to learn the scienceof the heart and cardiovascular system by situating the information in activities thatrequire application of knowledge. Very often, heart disease is disregarded by youngpeople as a disease that only affects the old. The TTH program is designed to scaffoldinformation from basic to complex and normal to abnormal before introducing studentsto lifestyle changes (attitudes and behaviors) that impact their risk for developingcardiovascular disease (Modules 2 and 3).Teachers may wish to augment this background information with additional readingmaterials and videos.Atherosclerosis is caused by the accumulation of fatty molecules called lipids, alongwith other molecules, on the inside of the inner lining of vessels. The specific lipid iscalled cholesterol.A Heart Attack or MI (Myocardial Infarction) occurs when arteries that bring oxygen tothe muscle cells of the heart become blocked by this accumulation. These arteries arecalled coronary arteries. Some families seem to have a predisposition to thisaccumulation. Smoking, high blood pressure, diabetes, high levels of lipids in theblood, and a history of family heart disease all increase the risk of having these types ofblockages.Palazzo, S.J. 2015 7 Page 7 of 43
TTH Module 1 - Version 6.1Blood is and flows like a fluid. Therefore, it flows from an area of high pressure to anarea of low pressure. When the muscles of each chamber of the heart contracts theblood pressure within the chambers increases. On each side of the heart the atriacontract first followed by the ventricles in a coordinated manner. When the ventriclescontract and the pressures rise, blood flows into the lower pressure vessel leaving theheart (either the pulmonary artery or the aorta). The valves keep the blood from flowingbackwards. The wall of muscle in the left ventricle is the thickest because it has to pumpthe blood the furthest…to all cells of the body. The wall of the right side of the heart ismuch thinner because blood only has to be pumped to the adjacent lungs.The heart beat that we can hear through a stethoscope is actually the closing of twodifferent pairs of valves in the heart. The pair of valves between the atria and ventriclesmakes the first sound (S1) and the pair of valves to the vessels leaving the heart makesthe second sound (S2) heard in the heart beat.Arteries take blood away from the heart to the systemic circulation. When blood leavesthe heart and travels to the lungs, it is deoxygenated. Veins carry blood to the heart.The blood that travels from the lungs to the heart is oxygenated. Gas exchange takesplace in the capillaries. The capillaries are the tiny vessels that connect arteries toveins. Their walls are one cell thick so the transfer of oxygen, and nutrients to the cellsfrom the blood, and wastes from the cells to the blood, happens easily.Heart Electrophysiology (Optional Lesson)Your heartbeat is triggered by electrical impulses that travel down a special pathwaythrough your heart. This path starts at the heart’s natural pacemaker, the SA node(Sinoatrial Node). The SA node is a small bundle of specialized cells located in theupper corner of the right atrium. The electrical impulse spreads through the walls of theatria and causes them to contract which forces blood into the ventricles. As thepacemaker, the SA node sets the rate and rhythm of your heartbeat. Normal heartrhythm is often called normal sinus rhythm because the SA (sinus) node fires regularly.The electrical impulse than arrives at a cluster of cells in the center of the heart betweenthe atria and ventricles, and acts like a gate to slow the electrical signal before it entersthe ventricles. This cluster of cells is known as the AV node (Atrioventricular Node).This delay gives the atria time to contract before the ventricles do. From here the pathruns through the wall between the ventricles. This path is known as the His-PurkinjeNetwork. This pathway of fibers sends the impulse to the muscular walls of theventricles and causes them to contract. This contraction forces blood out of the heart tothe lungs and body. The SA node then fires another impulse and the cycle beginsagain. At rest, a normal heart beats around 50 to 99 times a minute. Exercise,emotions, fever and some medications can cause your heart to beat faster, sometimesto well over 100 beats per minute.Palazzo, S.J. 2015 8 Page 8 of 43
TTH Module 1 - Version 6.1An Electrocardiogram (ECG or EKG) is a quick, painless test that records theelectrical activity of the heart. It may be taken at rest or during exercise. It is thestandard clinical tool for diagnosing arrhythmias (abnormal rhythms) and to check ifyour heart is getting enough blood or if areas of your heart are abnormally thick. Smallpatches called electrodes are placed on different parts of the body. Different tracings ofthe heart's electrical activity can be made and permanently recorded on paper or in acomputer. Three major waves of electric signals appear on the ECG. Each one shows adifferent part of the heartbeat. The P wave records the electrical activity of the atria. TheQRS wave records the electrical activity of the ventricles, and the T wave records theheart's return to the resting state. Doctors and nurses study the shape and size of thewaves, the time between waves, and the rate and regularity of beating. This tells them alot about the heart and its rhythm.Heart Disease (Optional Lesson)During an arrhythmia (abnormal heart rhythm), the heart will either beat too fast, tooslow, or irregularly. Healthcare practitioners can diagnose an arrhythmia by obtaining anECG (EKG), a recording of the heart's electrical activity. Quite often, an arrhythmia willnot occur in a brief period of actual recording like when you are getting an ECG at yourhealthcare provider’s office. If your healthcare provider suspects you have anarrhythmia, he or she will want to record the ECG when you are having symptoms. Ifyou have been having recurrent or infrequent symptoms, such as dizziness, chest pain,palpitation, or fainting spells, the healthcare provider will use an Event Recorder to helpdetermine if these symptoms are caused by an arrhythmia.An arrhythmia is a heartbeat that’s too fast, too slow or irregular (uneven). Tachycardiarefers to rapid beating of the heart. By convention it is defined as a heart rate greaterthan 100 beats per minute in adults. Atrial Tachycardia is an abnormal heartbeat thatis caused by an abnormal firing of electrical signals in the atria of the heart that interferewith electrical signals coming from the natural pacemaker of the heart (SA node).Ventricular tachycardia (VT) is a fast heart rate that starts in the heart's lowerchambers (ventricles). These abnormal firings of electrical signals in the ventricle alsointerfere with electrical signals coming from the SA node. VT may result from seriousheart disease; it usually requires prompt treatment. The rapid heartbeat does not allowenough time for the heart to fill before it contracts so blood flow to the rest of the body iscompromised which may lead to symptoms of dizziness, lightheadedness,unconsciousness, and cardiac arrest.In Atrial Fibrillation, disorganized electrical impulses in the heart’s upper chamberscause the rhythm of the lower chambers to be fast and irregular. Because contractionsare not coordinated as in a normal heartbeat; the heart does not pump blood effectivelyto the rest of the body. Ventricular Fibrillation (V-fib) is a very fast, irregular heartbeatPalazzo, S.J. 2015 9 Page 9 of 43
TTH Module 1 - Version 6.1that is caused by abnormal firing of electrical signals in the ventricles of the heart. Inventricular fibrillation, disorganized electrical impulses in the heart’s lower chamberscause the heart to stop beating (cardiac arrest). The ventricles quiver uselessly, insteadof pumping blood.Bradycardia is an arrhythmia in which the heart beats too slowly (less than 60 beatsper minute). It may be caused when electrical signals are not produced at a fast enoughpace by the SA node (the heart’s natural pacemaker) or these electrical signals do notreach the ventricle because of a problem in the conduction pathways of the heart .Cardiac Arrest is the sudden, abrupt loss of heart function. It is also called suddencardiac arrest (SCA). Most cardiac arrests occur when the electrical impulses in thediseased heart become rapid (ventricular tachycardia) or chaotic (ventricular fibrillation)or both. This irregular heart rhythm (arrhythmia) causes the heart to suddenly stopbeating in any coordinated manner. Cardiac arrest can be reversed if it's treated within afew minutes with cardiopulmonary resuscitation (CPR) and an electric shock(defibrillation) to the heart to restore a normal heartbeat. Sudden cardiac death (SCD)occurs within minutes after symptoms appear unless cardiac arrest is reversed.The term \"massive heart attack\" is often wrongly used in the media to describe suddendeath from cardiac arrest. The term Heart Attack refers to death of heart muscle tissuedue to the loss of blood supply, not necessarily resulting in a cardiac arrest or the deathof the heart attack victim. A heart attack is most often causes by a blockage of acoronary artery which supplies oxygenated blood to the heart muscle. A heart attackmay cause cardiac arrest and sudden cardiac death, but the terms are not synonymous.Heart Failure is a chronic condition in which the heart muscle gets progressivelyweaker and is unable to pump effectively to meet the body's need for blood and oxygen.It often causes shortness of breath, tiredness, and swelling of the legs and feet. Riskfactors for this condition include high blood pressure, a previous heart attack, coronaryartery disease, valvular heart disease and congenital heart disease.Treatments and TherapiesAn Echocardiogram is a procedure that sends ultrasound waves (like sonar) into thechest to create moving pictures of the heart. You may only think of ultrasound beingused to monitor a baby's growth, but ultrasound waves can also show the size of theheart’s chambers and how well they are working. This simple, painless test oftenprovides valuable information about damage to a heart and also helps gatherinformation about a heart with irregular beats (arrhythmia).An External Defibrillator is a machine that is used to deliver an electrical shock to theheart to restore a normal heart rhythm. It can recognize a rhythm that requires a shock.Palazzo, S.J. 2015 10 Page 10 of 43
TTH Module 1 - Version 6.1It is used to treat life-threatening heart rhythms such as ventricular fibrillation orventricular tachycardia. It can also be used for electric conversion of atrial fibrillation tonormal sinus rhythm. An AED (automated external defibrillator) is a computerizedmedical device that is portable. It can advise the rescuer when a shock is needed usingvoice prompts, lights and text messages to tell the rescuer the steps to take. An AEDmakes life-saving defibrillation available in places where large numbers of people gatheror people who are at high risk for heart attacks live.If treatment is required for Tachycardia, it includes medicines and treating the cause, ifpossible. The type and length of treatment depends on what's causing the problem.Beta Blockers are drugs that slow the heart rate, decrease cardiac output, lessen theforce with which the heart muscle contracts and reduce blood vessel contraction. Theydo this by blocking beta-adrenergic receptors in various parts of the body. This preventsadrenaline (epinephrine) from stimulating these receptors. They may be used to treatabnormal heart rhythms (arrhythmias) and prevent abnormally fast heart rate(tachycardia) or irregular rhythms such as premature ventricular beats. Since theyreduce the demand of the heart muscle for oxygen they may be useful in treating angina(chest pain), which occurs when the oxygen demand of the heart exceeds the supply.They have become an important drug in improving survival after a person has had aheart attack. Beta-blockers are also used to treat high blood pressure and other heartconditions.Bradycardia and atrial fibrillation associated with bradycardia may require treatmentwith a pacemaker. A Pacemaker is a battery-powered device that sends electricalsignals to your heart to help it beat at a proper rate or “pace”. The pacemaker goesunder your skin, beneath your collarbone and is connected to your heart by one or morewires (leads). The pacemaker delivers regulated electric signals to the heart muscle torestore a normal heartbeat rate.A stent is a small, lattice-shaped, metal tube that is inserted permanently into an arteryand helps hold open an artery so that blood can flow through it. The artery may havebecome too narrow due to atherosclerosis. In atherosclerosis, plaque builds upbeneath the inner walls of arteries, the blood vessels that carry oxygen-rich bloodthroughout the body. As the artery walls thicken, the pathway for blood narrows. Thiscan slow or block blood flow. Drug-eluting stents are stents that contain drugs thatpotentially reduce the chance the arteries will become blocked again.*Information retrieved from American Heart Association website, FDA Heart Onlinewebsite, CDC website, Fletcher Allen Healthcare website, and Cleveland Clinic website.Additional resources: Silverthorn, D.U. (2013). Human Physiology: An integratedapproach.6th Ed. Boston, MA. Pearson Education, Inc.Palazzo, S.J. 2015 11 Page 11 of 43
TTH Module 1 - Version 6.1Materials Siphon Pumps (16-one for each pair of students) 2 Glass containers for each pair of students that hold about 3 cups of water (Siphon Pump Lesson) Video –“Mysterious Heart-Endlessly Beating”- Episode 1 1 large heart model and sheep hearts (16 sheep hearts – one for each pair of students) Red and blue yarn (one roll of each) Dissection Kit (16 dissection kits – one for each pair of students) 32 disposable lab coats Non-latex gloves (1 box of each: small, medium, and large) Hand sanitizer (one for each group – 16) Goggles (32 – one for each student) Red and Blue Pencils (16 of each color) 32 large diameter straws (16 cut in half) 32 cocktail straws (16 cut in half) 32 small containers of pudding 32 water balloons each filled ¾ with water TTH PowerPoint “Electrophysiology” Student Worksheets Stethoscopes (one for each group of 4 – 8) Alcohol swabs (1 box)Teacher Preparation Set-up materials for lesson Set up Disc 1 and 2 of PBS’s “The Mysterious Heart” for ViewingEssential Vocabulary External Defibrillator Heart AttackAtrial Fibrillation Heart FailureAtrial Tachycardia Left AtriumArrhythmia Left VentricleAsystole Right AtriumAtrioventricular Node (AV) Right VentricleAutorhythmic Cells StentBeta Blockers Sinoatrial Node (SA)Bradycardia Tricuspid ValeCardiac Ablation Ventricular FibrillationCardiac Arrest Ventricular TachycardiaCoronary ArteriesEchocardiogramElectrocardiogramPalazzo, S.J. 2015 12 Page 12 of 43
TTH Module 1 - Version 6.1Prerequisite Knowledge/Skills High school students may have a basic knowledge of the structure and function of the cardiovascular system. It this is the case, this lesson will be reinforcement of what the students already know. If not, these basic concepts will be covered. The heart has 4 chambers; 2 upper atria and 2 lower ventricles. The naming of the sides of the heart is from the perspective of the heart’s owner and opposite when viewing from the front of the heart. The wall of the left ventricle is thicker because it has to pump with enough force to deliver blood to cells all over the body. Students should have basic Internet researching skills and proficiency in Word. Valves are found between chambers and in major vessels leaving the heart. These valves ensure that blood only flows in one direction; forward. There are 4 main valves: The tricuspid valve is found between the right atrium and right ventricle. The bicuspid (also known as the mitral valve) is found between the left atrium and left ventricle. The pulmonary valve is found between the right ventricle and the pulmonary artery. The aortic valve is found between the left ventricle and the aorta.Common Student Misconceptions Gravity versus Pressure Oxygenated versus Deoxygenated Blood: It is commonly said that blood with lots of oxygen in it is red and blood with less oxygen in it is blue. Deoxygenated blood is actually dark purple color. People frequently confuse the right and left side of the heart because it is opposite from their perspective when they are looking at the front of the heart. The cells of the heart are not fed by the blood flowing through the chambers. The heart has its own arteries, capillaries and veins that feed the cells of the heart and remove waste products. The vessels are found on the surface of the heart and within the muscle of the heart itself. If one of these arteries gets blocked, the cells of the heart will not get what they need to survive and those cells will die. Many people often think that an artery always carries oxygenated blood. Since arteries are vessels that carry blood from the heart, this is not true for the arteries carrying blood to the lungs. Students often think that a vein always carries deoxygenated blood. Since veins are vessels that carry blood to the heart, this is not true for the veins that carry blood back from the lungs. Most people think that heart disease is an old person’s disease. Researchers are now recognizing that the groundwork for heart disease starts early. In the Korean War, soldiers killed were found to already have significant atherosclerosis. Genetics starts its process early and lifestyle choices are cumulative, starting at an early age.Palazzo, S.J. 2015 13 Page 13 of 43
TTH Module 1 - Version 6.1Safety During the sheep heart dissection activity you and your classmates should wear gloves, a lab coat, and have access to hand sanitizer. Goggles are necessary and are provided for students.Module 1 Recommend Schedule (please revise to suit the needs of your class).Please note there are worksheets that accompany each lesson.Day 1: Orientation Orientation to the Teen Take Heart program. Introduction to Module 1(how to access and use the resources in the module) Student expectations (pre-readings, worksheets, group work rules/norms)Day 2: Lesson 1: The Mysterious Human Heart – Episode 1 “Endlessly Beating” DVD The Mysterious Heart-Episode 1 “Endlessly Beating” (55 minutes)Day 3: Lesson 2: Anatomy of the Heart—Sheep Heart Dissection - Prep Heart Dissection Lab Prep: orient students to the expectations of the activity Homework: Heart Diagram worksheet should be completed before the activity and used by the student as a reference during the dissectionDay 4: Lesson 2: Anatomy of the Heart—Sheep Heart Dissection Dissection of sheep heart and diagramming of the heart (in pairs). Each group will have one sheep’s heart, dissection kit, white lab coat, diagram of the heart, gloves, and hand sanitizer. HS-LS1-2, CCSS.ELA- Literacy.WHST.9-10.2, SL.11-12.5, CCSS.ELA-Literacy.WHST.9-10.9Day 5: Lesson 2 continued Continuation of heart dissection and debrief of activityDay 6: Lesson 3: The Heart as a Pump—Siphon Pump (Introduction to flow andpressure) The Heart as a Pump; siphon exercise – group activity. NGSS: HS-ETS1-2 CCSS.ELA-Literacy.WHST.9-10.7Palazzo, S.J. 2015 14 Page 14 of 43
TTH Module 1 - Version 6.1Day 7: Lesson 3: The Heart as a Pump—What’s Flow Have to Do with it? Begin with slide set about flow and pressure Balloon and pudding activities Why Are We Talking About Physics Activity? HS-PS3-2, MP.2, MP.4Day 8: Lesson 4: Heart Sounds—Stethoscope Activity Students reference accompanying diagramDay 9: Lesson 5: DVD The Mysterious Heart-Episode 2 “The Spark of Life”Day 10: Debrief Module 1ActivitiesExplain & ExploreLesson 1: The Mysterious Human Heart – Episode 1 “Endlessly Beating” Show Episode 1 of the PBS DVD series “The Mysterious Human Heart.” While the students are watching the DVD, have them answer questions on the DVD Worksheet located in the Module 1 folder on their tablet. The purpose of this DVD is to introduce students to real-world complications resulting from structural or functional defects of the heart.Practice, Engage, & EvaluateLesson 2: Dissection of the Sheep Heart 1. In pairs, students will each take one wax tray, one sheep heart, red and blue yarn, a dissection kit, and worksheets back to their workstation. Wearing their lab coat, gloves, and goggles, students will begin the dissection process described below using the model of the heart and their worksheets (completed as homework) as resources. This should be a facilitated exploration activity.Palazzo, S.J. 2015 15 Page 15 of 43
TTH Module 1 - Version 6.12. Hold and inspect the heart. How is it like a human heart? How is it different? Use a T Chart for your ideas (write this in your TTH Notebook).Like a human heart Different from a human heart3. Identify the right and left side of the heart (hint: remember, most heart diagrams display the heart as if you were looking at it in the person of a body facing you).4. With your partner, discuss and identify the anatomical landmarks on the outside of the heart. Write down your thoughts below:Palazzo, S.J. 2015 16 Page 16 of 43
TTH Module 1 - Version 6.1 Left Atrium Left VentricleRight Ventricle Apex5. You will notice a diagonal line that divides the heart. The half that includes the pointed end (apex) is the left side. Gently squeeze this side and you will notice it is firmer than the right side. Discuss with your partner why one side is thicker than the other and identify the right and left ventricle. Record your ideas in your TTH Notebook.6. Turn the heart over and inspect and identify the flaps of dark tissue on the top. There is a large opening next to the right atrium that you should identify and explain its purpose. Gently stick a probe into this opening and advance it into the right atrium. Record your ideas in your TTH Notebook.Palazzo, S.J. 2015 17 Page 17 of 43
TTH Module 1 - Version 6.1 7. Down and to the left of the superior vena cava there is another blood vessel opening. Carefully stick your probe into this opening and advance 8. Another blood vessel is next to the left atrium. Identify and explain its purpose. (These may be more difficult to identify). 9. Identify and explain the large opening at the top of the sheep’s heart.Palazzo, S.J. 2015 18 Page 18 of 43
TTH Module 1 - Version 6.1 10. Behind and to the left of the aorta is another large vessel. Identify and explain its purpose. 11. What questions do you have about the external structures of the heart? Record your thoughts in your TTH Notebook. 12. Once you are comfortable with identifying the anatomical landmarks, you may proceed to the dissection. 13. Use your scalpel to make a very deep incision into the left ventricle as shown on the diagram below. Carefully open this piece using your dissecting scissors and tweezers.Palazzo, S.J. 2015 19 Page 19 of 43
TTH Module 1 - Version 6.1 You will notice what looks like threads. These are the chordae tendineae attached to the papillary muscles. What are your first impressions of the heart? In your TTH Notebook write and answer the following: I never thought… and I wonder what… Chordae Tendineae 14. As you continue to spread and carefully remove the left ventricle, notice the bicuspid (mitral) valve. Continue to probe until you locate the semilunar valves. 15. Insert a probe into the aorta and observe where it connects to the left ventricle. Make an incision through the aorta and look for the semilunar valve (Atrioventricular valves) which prevents the backflow of blood from the left ventriclePalazzo, S.J. 2015 20 Page 20 of 43
TTH Module 1 - Version 6.116. Remove a section of the right ventricle as shown in the diagram below. Septamarginal Trabecular17. Lift the section of the right ventricle away carefully so you don’t tear the tricuspid valve (see picture below). Notice the flaps of tissue and the chordae tendineae attached to the papillary muscles. Now insert the probe into the pulmonary artery until you see it in the right ventricle. Make an incision in this vessel and look inside for 3 small membranous pockets (pulmonary semilunar valves of atrioventricular valve). In your TTH Notebook, write down and answer the following question:Palazzo, S.J. 2015 21 Page 21 of 43
TTH Module 1 - Version 6.1 How do you think the structure is related to the function? Tricuspid Valve18. Use your diagram to discuss how the blood flows through the heart. Use the 1 foot long piece blue yarn to represent deoxygenated blood. Using your probe (using the blunt end of the probe may be easier); guide the blue yarn through the superior or inferior vena cava and into the right atrium. Continue through the tricuspid valve into the right ventricle and then thread through the semilunar (pulmonic) valve into the pulmonary artery.Palazzo, S.J. 2015 22 Page 22 of 43
TTH Module 1 - Version 6.1 19. Using your probe, thread the red yarn through the pulmonary veins into the left atrium, through the bicuspid valve into the left ventricle, then through the semilunar valve into the aorta. Tie the four loose ends of the yarn into a knot. This represents the lung. In your TTH Notebook, explain why this knot represents the lungs.Palazzo, S.J. 2015 23 Page 23 of 43
TTH Module 1 - Version 6.120. Dispose of the heart as instructed by your teacher.For the teacher: 21. Have the students finish labeling the parts of the heart diagram using the red and blue colored pencils to trace the flow of oxygenated and deoxygenated blood through the heart. As the students label the structures, have them record their ideas in their TTH Notebook and then discuss how the structure dictates function. Also, review the right and left sides of the heart and the definition of arteries and veins. 22. Have students revisit their claims and evidence and update, revise, or add new ideas. They should be able to add their reasoning.Lesson 3: The Heart as a Pump: Divide the students into teams of 2 and give them a siphon pump. Put a container (at least 500 ml size) at a station of 2 people. If you don’t have sinks at your stations, place a second container (at least 500 ml size) at the station. Have the students fill one of the containers with water and add several drops of red food dye (optional) into the water. Have students put the open end of the straight tube of the siphon pump in a container of water. Make sure the knob is closed. Then, have the students place the open end of the bendable (corrugated) tube into either another container without water or in a sink. Students will pump the bulb 5-8 times and describe on the student worksheet what they observed happening to the water as they squeeze the bulb (question #2 on the accompanying worksheet). Students will then answer the remaining questions. Have the students pour out any containers that have water in them and wipe up water that was spilled At the end, have students facilitate a discussion of the moving parts in the pump (the bulb and the 2 flaps) and how the pump moves fluid (from high to low pressure and in one direction).Explain & ElaborateLesson 3: Why Are We Talking About Physics? Blood Flow, Blood Pressure, and ResistanceFor the teacher: Use the accompanying slide deck to reinforce the concepts. Fluid (blood) moves in a closed system because of a pressure gradient (from an area of high pressure to an area of low pressure). The formula for this is: Flow (Q) = ∆P (P1 – P2); where Q = flow, ∆P = change in pressure and P1 = pressure at beginning and P2 = Pressure at the end. There must be a pressure gradient (a difference in pressure from one to point to another inPalazzo, S.J. 2015 24 Page 24 of 43
TTH Module 1 - Version 6.1 order for flow to occur).For the Teacher: Topics for Exploration (Have students write in the TTH Notebook) What generates this drive in pressure? The heart. When the heart contracts it creates as area of high pressure (demonstrate this concept with a balloon 3/4 filled with water – squeeze the balloon and ask the students what happens to the water, where does it go. Your hand acts as the contraction (area of high pressure) of the heart (ventricle) and the fluid in the balloon “flows” to an area of lower pressure. This is a good point to ask students what generates the area of highest pressure in the cardiovascular system (the driving pressure). Ask the students if they think the pressure generated by the contracting heart stays the same throughout the entire circulatory system. Does it get higher or lower as it moves away from the heart? Now introduce the concept of friction. Let’s Talk About Friction: All movement creates friction. Pressure falls over a distance due to friction [Energy is converted to thermal energy (heat). Law of Conservation of Energy (1st Law of Thermodynamics)]. The farther something has to move without any additional input of energy it will slow until it comes to a stop. What affects flow (Q)? Resistance (R). When there is an increase in resistance (R), flow (Q) is diminished. Resistance (R) is affected by three things: 1) The radius of the tube (r) – in this case the blood vessels 2) The length of the tube (L) – longer tubes offer more resistance than shorter ones (due to friction) – this is not an issue in the circulatory system because the length of the system is constant 3) The viscosity (thickness) of the fluid (blood) Because the length of the circulatory system doesn’t change and the viscosity (thickness) of the blood doesn’t change, it is the radius of the tube (blood vessel) that creates resistance in the circulatory system. The equation looks like this:Palazzo, S.J. 2015 25 Page 25 of 43
TTH Module 1 - Version 6.1 Flow (Q) = ∆P (P1 – P2) / RWhere R = resistance of the vessel. Because resistance is in the denominator, it isinversely proportional to the change in pressure, in other words, an increase inresistance will result in a decrease in flow and a decrease in resistance will result in anincrease in flow. Why is this mechanism of controlling flow important in the circulatorysystem (think back to what the purpose is of our circulatory system)? Record your ideasin your TTH Notebook. Let’s now demonstrate the principles of flow and resistance in an activity: Each student should have the following supplies: 1 short and wide diameter straw, cocktail straw, 1 container of applesauce, 1 container of apple juice. Make the following predictions based on what you learned about flow and resistance (record in your TTH Notebook): 1) What do you think happens to flow when you “drink” your pudding with a short and wide straw? 2) What do you think happens to flow when you “drink” your pudding with a cocktail straw?3) Write done you predictions to these questions then perform each of the activities. Which straw made “drinking” your pudding the easiest? Hardest? Why? Which straw made “drinking” your pudding the easiest? Hardest? Why?4) How does this activity transfer to what is going on with flow in your circulatory system? Why is the ability for blood vessels to change diameter important? What questions do you have concerning your observations? The ability of the blood vessels to change their diameter is important in directing blood flow to areas of the body that need nutrients and oxygen or need waste removed. When the blood vessels get smaller in diameter (like the cocktail straw) this is called vasoconstriction. When they get larger inPalazzo, S.J. 2015 26 Page 26 of 43
TTH Module 1 - Version 6.1 diameter, like the wide and short straw, this is called vasodilation. Guided group activity: flow and pressure experiment (directions for this activity are provided in the slide set presentation)Lesson 4: ‘Heart Sounds’Students will have an opportunity to listen to their own and their partner’s heart soundsusing a stethoscope. Place the stethoscope on various landmarks identified for thestudent on the provided hand-out. Students will identify which sounds correspond tothe closure of which valve. 1. If you were a doctor or a nurse, how would you be able to tell if a person’s heart valves weren’t working correctly? 2. Describe the sound you hear at each of the 5 points that you place your stethoscope. Why are some spots louder than others?Lesson 5: The Mysterious Human Heart – Episode 2 “The Spark of Life” Show Episode 2 of the PBS DVD series “The Mysterious Human Heart.” While the students are watching the DVD, have them answer questions on the DVD Question sheet. The purpose of this DVD is to introduce the electrophysiology of the heart.Practice, Assessment, and Evaluation of Learning (see Module 1 Worksheets)Optional Lessons for Further Exploration: If time allows, there are two additional lessons with this module. An arrhythmia worksheet (all the information the student needs is presented in the background section of this module) and the electrophysiology of the heart slide deck (this lesson can scaffold on the “Spark of Life” DVD presentation). There is also a slide deck to accompany a discussion on Sudden Cardia Death (SCD). An important topic that may be useful when paired with your required CPR and AED lesson.Palazzo, S.J. 2015 27 Page 27 of 43
TTH Module 1 - Version 6.1Resources (internet, books, posters, other):The Franklin Institute: The Human Heart http://www.fi.edu/learn/heart/http://www.hughston.com/hha/a_16_4_4.htmhttp://www.parentheartwatch.org/http://video.about.com/heartdisease/How-the-Heart-Functions.htmhttp://www.king5.com/localnews/stories/NW_111108WAB_defibrillator_KS.1a3513f4c.htmlhttp://www.fda.gov/hearthealth/healthyheart/healthyheart.htmlhttp://www.geocities.com/CapeCanaveral/Hall/1410/lab-Project-10.htmlEKG Lab Resources with Zebrafish:http://www.labtechnologist.com/Applications/Zebrafish-used-to-catch-heart-datahttp://advan.physiology.org/cgi/content/full/31/2/211Web quest:http://web.mac.com/ryanpconnell/Site/TTH_Intro_Webquest.htmlAmerican Heart Association websitehttp://www.americanheart.orgFDA Heart Health Online websitehttp://www.fda.gov/hearthealth/Fletcher Allen Healthcare websitehttp://www.fahc.org/Medicine/Heartcenter/index.htmCleveland Clinic websitehttp://my.clevelandclinic.org/heart/default.aspxPalazzo, S.J. 2015 28 Page 28 of 43
Vocabulary Return to Word ListAtrial Fibrillation: A cardiac arrhythmia characterized by chaotic, rapid electrical impulses in the atria. Atria quiver instead of contracting, causing irregular ventricular response and the ejection of a reduced amount of blood. Blood in atria becomes static, increasing risk of clotting. Atrial Tachycardia: A rapid regular heart rate arising from an irritable focus in the atria, with a rate of more than 100 beats per minute but less than 220 bpm. Arrhythmia: Abnormal heart rhythm. Asystole: A condition in which the heart has ceased generating electrical impulses. Atrioventricular Node (AV): Located in the lower wall of the right atrium and sends an impulse through the bundle of His, which passes down between both ventricles and into the ventricles through Purkinje fibers. This results in the contraction of the ventricles. Autorhythmic Cells: Type of cardiac cell that are specialized for initiating and conducting action potentials for contraction. They themselves do not contract. aka pacemaker cells. Beta Blockers: Any of a class of drugs that prevent the stimulation of the adrenergic receptors responsible for increased cardiac action. are used to control heart rhythm, treat angina, and reduce high blood pressure. Bradycardia: Abnormally slow heartbeat. Cardiac Ablation: Cardiac ablation is a procedure that can correct heart rhythm problems (arrhythmias). Ablation typically uses catheters — long, flexible tubes inserted through a vein in your groin and threaded to your heart — to correct structural problems in your heart that cause an arrhythmia. Cardiac Arrest: Sudden, unexpected stopping of heart action; sudden cardiac death. Coronary Arteries: Blood vessels that supply the muscle of the heart. Echocardiogram: Diagnostic test to test for evidence of MI, valvular function, and ventricular function. Can also assess pericardial effusion, cardiac tamponade, idiopathic congestive CM, aortic stenosis/regurg/dissection, and patancy of MidCABG. Electrocardiogram: Graphic record of the electrical activity and contractions of the heart. Page 29 of 43
External Defibrillator: this is the devise that is used when someone is having a heart attack. Heart Attack: A cardiovascular disease when one or more coronary arteries become blocked, heart muscles die. SA Node unable to maintain a normal rhythm. Heart Failure: Develops when the heart's muscles become weakened. (NOT A HEART ATTACK which usually results from blockage in the blood vessels that cut off the supply of blood to the heart) as a result of heart attack, high blood pressure, or loss of ability to pump. Left Atrium: Chamber that receives oxygenated blood from the pulmonary veins and pumps it into systemic circulation. Left Ventricle: Chamber that receives reoxygenated blood from corresponding chamber and pumps it through the aorta artery to the body. Right Atrium: A chamber of the heart that receives oxygen depleted blood from the vena cava and pumps through the tricuspid valve into its ventricle. Right Ventricle: Contracts to pump oxygen-‐poor blood along the pulmonary arteries to the lungs. Stent: A tubular support placed temporarily inside a blood vessel, canal, or duct to aid healing or relieve an obstruction. Sinoatrial Node (SA): Located in the right atrium near the superior vena cava and is the primary pacemaker of the heart. Tricuspid Vale: the flaps between the right atrium and the right ventricle. it is composed of three leaf-‐like parts and prevents the back-‐flow of blood from the ventricle to the atrium. Ventricular Fibrillation: A condition in which the heart's electrical impulses are disorganized, preventing the heart muscle from contracting normally. Ventricular Tachycardia: A condition in which the heartbeat is quite rapid; if rapid enough, ventricular tachycardia will not allow the heart's chambers to fill with enough blood between beats to produce blood flow sufficient to meet the body's needs. Page 30 of 43
Superior vena cava Pulmonary Artery Pulmonary VeinLung LungSuperi Superior orvena venacava cava Right Ventricle Left Ventricle Inferior vena cava Aorta Tissue Cells Capillaries Page 31 of 43
TTH Module 1 (Student) – Version 6.1Name: _____________________________________Period:________Date:______________ MODULE 1: LESSON 1 DVD: THE ENDLESSLY BEATING HEARTPLEASE PROVIDE YOUR ANSWERS BELOW: 1. Why does the heart have to be the most “reliable” pump? 2. How many times does a heart beat in one day? 3. How old was Beth when she had her heart attack? 4. What caused Beth’s mild heart attack? 5. What was the result when a larger artery wall ruptured during the routine procedure to restore blood flow to the heart?Palazzo S.J. 2015 Page 32 of 43
TTH Module 1 (Student) – Version 6.1 6. Label the heart diagram with the letter of the correct part as the video covers each part: (a) right atrium (b) left atrium (c) right ventricle (d) left ventricle 7. Where does the blood from the left ventricle have to go? 8. How does the heart get its own oxygen supply? 9. What is the purpose of heart pumps otherwise known as “ventricular assist devices?” 10. Why would the heart compensate for the damage to the left ventricle by enlarging?Palazzo S.J. 2015 Page 33 of 43
TTH Module 1 (Teacher) – Version 6.1Name: _____________________________________Period:________Date:______________ MODULE 1: LESSON 2 Dissection of the Sheep HeartLabel the different structures of the heart.Palazzos, S.J. 2015 Page 34 of 43
TTH Module 1 (Student) – Version 6.1Name: _____________________________________Period:________Date:______________ MODULE 1: LESSON 3 SIPHON PUMP ACTIVITYThe Heart as a “Pump”:1. Explain the actions of a pump.2. Describe what you observe happening to the water as you squeeze and release the bulb.3. What is the purpose of a siphon pump?4. What is the role of the red bulb?5. Does squeezing the bulb move water up the straight tube or move the water out of the bulb and through the bendable tube?6. Does releasing the bulb (NOT squeezing it) pull water up the tube or push the water out of the bulb and through the bendable tube?7. When you are squeezing the bulb, is there more pressure in the bulb or in the tubes?Palazzo, S.J. 2015 Page 35 of 43
TTH Module 1 (Student) – Version 6.18. Do you think fluid flows from high to low pressure or low to high pressure? Try squeezing the bulb a few more times to see if this gives you an idea. Draw a diagram in your TTH Notebook of what you think is happening and explain your answer.9. What are the forces putting pressure on the water in the beaker? Draw a diagram in your TTH Notebook of what is happening and explain your answer (use arrows when appropriate).10. What actually moves the water up the straight tube? (Is it squeezing or releasing the bulb?) What does this do to the pressure in the bulb? How does this pressure compare to the air pressure on the water at the other end of the tube?11. What is the role of the 2 red flaps that are at one end of each tube?12. Make a claim about how the siphon pump is like a human heart. Which parts have a similar function? Provide evidence for your answer. .13. Make a claim about how the siphon pump is different from a human heart. Provide evidence for you answer.Palazzo, S.J. 2015 Page 36 of 43
Flow, Pressure, and Resistance Module # 1 Lesson 4 – Why Are We Talking About Physics? Steven J. Palazzo, PhD, MN, RN, CNE
Group Activity• For this presentation, you will be working with a partner or with a small group to explore the concepts of pressure, flow, and resistance and apply these principals to your understanding of how blood circulates through the cardiovascular system.
Pressure• The force created by a fluid on the walls of its container is equal in all directions. This pressure in the container is called Hydrostatic Pressure because the fluid is not moving. The pressure in a container increases as the height of the water increases. What do we call fluid in motion (like blood in the circulatory system)?
Water Balloon Activity• Fill a balloon ¾ full of water and tie the end.• Squeeze the balloon and have your partner(s) write down what you both observe.• Discuss with your partner(s) your observations.• What happened when you squeezed the balloon?• Discuss why this happened?• What created the change in pressure in the balloon?• Did the volume of water in the balloon change?• How is the water balloon like you heart? Unlike your heart?
Flow Equation Q ∝ ∆P/RQ flow∝ proportional to∆P change in pressure between 2 points (P1 – P2)R resistance of tubeSo, flow (Q) is proportional to (∝) a change in pressure (∆P)between 2 points divided by the resistance (R) of that tubeWe are going to continue our exploration of pressure…
Checking for Understanding ∆P between 2 points (P1-P2)P1 ∆P = ______ P2100mmHg 100mmHgP1 ∆P = ______ P2100mmHg 75mmHgP1 ∆P = ______ P250mmHg 25mmHgIf flow (Q) is proportional to a change in pressure (∆P) what is the flow (Q) foreach of the above examples? Did any of the results surprise you?
What is flow (Q)? .We use Q to represent flow in an equation• Discuss with your classmates the concept of flow. – What does flow mean? – How does flow happen? – How does blood flow in the body? – Does flow travel at different rates?
Let’s Explore Further• Fluids (like blood) flows from and area of high pressure to an area of lower pressure – this is called a pressure gradient (think back to the water balloon activity you just completed).• When fluid (blood) travels through a tube, pressure is lost because of friction.
Resistance (R)• Resistance (R) opposes flow.• If something is resistant, what does that mean?• If you remember back to the flow equation, Q ∝ ∆P/R resistance (R) is in the denominator of the equation, so resistance is inversely proportional to flow. Discuss this concept further with your partner(s).• So, if a vessel becomes resistant to flow, what do you think happens to the flow in that vessel?
Resistance (R)• The primary determinant of resistance in the vessels is the radius of the vessels.• How do you think the radius of a tube effects the flow within that tube?• Pudding activity.• So, if you have a large diameter blood vessel, will flow through that vessel be greater or less than flow through a narrow vessel?
Putting it All Together• With your partner, please collect the following items: – 12oz paper cup with 2 straws – 12oz cup filled with water – Two 500mL plastic containers – One 6 inch plastic block to place your empty 12 oz. cup on – Worksheet
TTH Module 1 (Student) - Version 6.1 Period:_ Date: __Name: MODULE 1: Lesson 3 WHY ARE WE TALKING ABOUT PHYSICS? Q (Flow) ∝ ∆ P/R1. Brainstorm ways blood flow (Q) in the vessels could increase or decrease.2. As a healthy adult, Carlos has a pressure difference of 100mmHg between his right and left ventricles and a blood flow (Q) of 5L/minute. Calculate the total resistance (R) that’s created by his circulatory system.3. Diego is not as healthy as Carlos. Even though he has the same pressure difference (ΔP) across the left and right ventricles, his vascular resistance (R) is 25mmHg/L/min. Calculate Diego’s blood flow (Q).Palazzo, S.J. 2015 1 Page 37 of 43
TTH Module 1 (Student) - Version 6.1 4. What do you think are some consequences of Diego’s decreased blood flow in comparison to Carlos? Carry out an Investigation - Analyze and Interpret Data 5. Bring your empty 12oz. paper cup containing the 2 straws to your table.Palazzo, S.J. 2015 2 Page 38 of 43
TTH Module 1 (Student) - Version 6.1 6. Place the cup containing the straws on the plastic block. Place a 500mL plastic container on each side of the box directly under the straws.Palazzo, S.J. 2015 3 Page 39 of 43
Search
