about broken bones essential question: how do bones heal? elt l3.pdf · 6 health sciences module:...

1 Health Sciences Module: About Broken Bones Pathways to Prosperity Network

ABOUT BROKEN BONES

Essential Question: How Do Bones Heal?

Learning Targets:

Students will:

Explain the role of bones in the functioning of the human body.

Summarize the stages of how bones heal.

Use a variety of media to develop and deepen understanding of a topic or idea.

Practice a standard technique, revising work when needed.

Justify thinking using evidence to solve x-ray mysteries.

Lesson Overview

This lesson introduces the fields of EMT, x-ray technician, and radiologist, as well as the big

picture of the hidden functions of bones. After learning how bones heal and key new vocabulary

through a quick charades activity, the young professionals will face a splinting design challenge

before practicing a standardized splinting technique. Finally, they will use critical thinking to

puzzle out a short series of x-ray mysteries.


Lesson Agenda Opening (5 min)

Emergency Scenario: Broken Radius and Ulna

Work Time

How Bones Heal (10 min)

Vocabulary Preview (5 min)

Splinting Design Challenge (15 min)

Splinting Practicum (20 min)

X-Ray Mysteries (10-15 min)

Closure (10 min)

Career Venn Diagram

Materials

□ Splinting practicum (1 set per group)

□ Splint (magazine/notebook)

□ Wrapping bandage

□ Two triangle bandages

□ Padding (can be t-shirts, cut up towels, etc.)

□ Supportive materials (SAM splint)

□ Young Allied Health Professional student packet

□ <How Does a Bone Heal> video to project

□ <Getting an X-ray> and <How Dangerous Are X-rays> videos to project

□ <X-ray Images> to project

FACILITATION NOTES

The Narrative Arc. The more each <Emergency Scenario> can be presented as if telling a

story, the more engaged the audience will be. Work to avoid a stale reading and lean towards

bringing the information to life as in a conversation or a “reveal” of the next chapter. Think of

creative ways to make the story your own.

Background Knowledge. Familiarize yourself with information on x-rays:

https://www.youtube.com/watch?v=gsV7SJDDCY4.

Time Management. This lesson may take two class periods.

https://www.youtube.com/watch?v=gsV7SJDDCY4


Extensions. The following activities have been built in as extensions to the main lesson. If you

extend the lesson to two class periods, you can choose to complete one or more of these

stations.

o Rotation Stations. To implement the Rotation Stations Protocol, set up the station

materials and display the student directions and the sentence starters around the room.

Decide how you will group students. If you do not feel comfortable implementing this

protocol for classroom management reasons, pace all students through each activity as

a whole group. These stations were adapted from the haspi.com health science

curriculum.

IN ADVANCE

□ Preview the videos on splinting: https://www.youtube.com/watch?v=Ot7c3syPtr4 and

https://www.youtube.com/watch?v=0dzk5ROSSxI cover how to properly splint an

extremity arm fracture. Please review these BEFORE assisting students. One video

models using stabilizers other than SAM splints

(http://www.sammedical.com/products/sam-splint/).

□ Not all students have had an x-ray; this video provides a visual so that they can

understand the process you go through when you see an x-ray technician. Show to 1:30-

https://www.youtube.com/watch?v=DhVKdhtKBFE.

□ Are x-rays dangerous? https://www.youtube.com/watch?v=vmdemMnkSKo helps to

answer commonly asked questions about x-rays.

□ Preview How Does a Bone Heal: http://askabiologist.asu.edu/bone-healing. This video is

a computer graphic that illustrates the healing process. The video can give students

ideas about how to take notes on the steps of bone healing on the <How Bones Heal

Graphic Organizer>.

Vocabulary

Content Tier II

forearm, blood clot, callus, x-ray, radiology,

fractures, splint, joint, extremity

synthesize, remodeling, compare & contrast,

immobilize, stabilize, secure

https://www.youtube.com/watch?v=Ot7c3syPtr4

https://www.youtube.com/watch?v=0dzk5ROSSxI

http://www.sammedical.com/products/sam-splint/

https://www.youtube.com/watch?v=DhVKdhtKBFE

https://www.youtube.com/watch?v=vmdemMnkSKo

http://askabiologist.asu.edu/bone-healing


Opening (5 min)


1. Invite the young professionals to turn to a colleague and share any personal

stories they have about broken bones.

2. Ask: “What might you do to help someone with a broken bone?”

3. Invite volunteers to answer the question. Listen for: Splinting, calling 911, going

for help.

4. Share the <Emergency Scenario: Broken Ulna and Radius> in a

conversational, engaging manner.

Say: The skateboard patient’s arm was splinted in the field by the first responder. First,

let’s learn about how bones heal and how to do first aid in the field if someone breaks a

forearm.

Work Time

How Bones Heal (10 min)

How Bones Heal

When a bone breaks, what happens? Are all breaks the same? How do bones heal? These are

questions that are important for both the patient and for the health care team helping them heal.

Unlike machines, our bodies can repair themselves. The next video will help us learn how bones

heal. Focus on the function of each stage if some of the vocabulary is new. As you watch the

video, be sure to record the functions of each in the <How Bones Heal Graphic Organizer>.

1. Project: http://askabiologist.asu.edu/bone-healing

2. Stop the video at each stage so students can fill out their graphic organizers:

o Day 1: Blood Clot (0:35)

o Day 7: Soft Callus (1:15)

o Day 28: Hard Callus (1:37)

o Month 3: Remodeling (1:39)

The personal

connections

help students

activate prior

knowledge and

connect to the

day’s material.

Even if using a

different hook,

we recommend

including this

time to connect

“the known to

the new.”

http://askabiologist.asu.edu/bone-healing


3. Ask: Now that you know how bones heal, why would we splint broken bones? Cast

them?

Splinting Vocabulary Preview (5 min)

1. Say: Let’s take a moment to learn some new words.

2. Project the new vocabulary words.

3. Invite volunteers to act the words out. Have other YPs guess them like charades.

splint

immobilize

joint

extremity

stabilization

secure (i.e. hold still)

Now we are going to learn about a process that first responders use in the field. Has anyone

here ever had a splint? The splint is a temporary way to immobilize an extremity—an arm, leg,

wrist, finger, etc. Why do you think we would want to immobilize a broken limb on the way to a

hospital?

While an EMT or paramedic often work in professionally stocked ambulances, many first

responders have to improvise until help arrives. At other times, more advanced medical

equipment may be far away, or in cases of wilderness settings or natural disasters, a well-

stocked ambulance is not always available. In this case, first responders must improvise using

specific principles to help guide their work.

Imagine you came upon someone with a broken arm and help was far away—what would you

do? What are important things to think about?

Listen for: Reduce pain, immobilize the break so the patient can be moved, reduce swelling,

keep the bone from breaking through the skin, support the injury.

Splinting Design Challenge (15 min)

Ask: If you were far from help and came across a hiker with a fractured forearm, how would you

respond? (Invite a few students to share their responses.) In the next activity, we will explore

how to splint this type of injury.

Take a

moment to

“bring alive”

the key

vocabulary for

this lesson to

ensure equity

of access for

all students.


1. Pair the students for the <Splinting Design Challenge>.

2. Ask the pairs to take three minutes to 1) look through the <Splinting Design

Challenge> and 2) discuss a plan.

3. Have one person in each pair raise their hand. This arm becomes the broken arm, and

they are now the patient.

o The “non-injured” partner has 7-8 minutes to create a splint that meets the design

constraints below (write on the board or project):

Protect the injury.

Immobilize the joint above and below the break.

Make sure the patient has pulse, sensation, and movement in the fingers (this

shows you have not cut off circulation, which would damage the nerves and

flesh).

Support the injury.

4. After the allotted time, ask the patients to line up in the front of the room, and the “first

responders” to take a seat.

5. Take a moment to critique each (or selected) splint/s.

o For selected splint, ask: Which constraints were met? Which ones were not?

o After each critique, consider asking the first responder what challenges they

faced and what they would do differently next time.

Splinting Practicum (20 min)

Luckily, allied health professionals are trained to deal with emergencies. They spend time

practicing standard ways of treating emergencies in the field. We are now going to learn how

professionals apply a splint and then practice a more standard approach.

1. Project selected video: https://www.youtube.com/watch?v=Ot7c3syPtr4 or

https://www.youtube.com/watch?v=0dzk5ROSSxI.

Say: We are going to practice splinting based on a simplified checklist an EMT uses in their

practicum test—this is in your Young Allied Health Professional packet.

Before you start splinting, I want to model the key steps that first responders do in the splinting

process. After each one, I would like someone to share why this is critical, or very important,

to the splinting process.

1. Model each step as you state it aloud. Then ask why the step is important.

In this design

challenge, the

YPs are given a

set of design

constraints.

These will guide

them as they

design a

solution. After

the feedback,

YPs will think

about what they

would change in

their next

iteration.

Emphasize

experimentation

over perfection

during this

challenge—

what did they

learn during this

quick problem-

solving

process?

https://www.youtube.com/watch?v=Ot7c3syPtr4

https://www.youtube.com/watch?v=0dzk5ROSSxI


2. Select a volunteer patient.

3. Say or show safety precautions (I am putting on gloves or act it out, etc.).

o Ask: Why do this?

4. Keep the extremity still and stabilized with a SAM splint or magazine (to

reduce pain and further damage to site).

5. Immobilize the joint above and below the injury (to reduce pain and

further damage to the site).

6. Place something under the hand (for comfort and circulation).

7. Wrap the forearm using an ace bandage (to stabilize injury).

8. Access motor, sensory, and circulation before and after splinting (to

ensure blood flow is not cut off from fingers and that the wrap is not too

tight).

9. Use a triangle bandage to create a sling (to support and protect injury in

transport and reduce pain).

Paired Splinting Activity

1. Provide time for partners to splint each other.

o Begin with partners trading roles.

2. Circle and provide support.

o Students should provide support and padding to the wound!

o Provide formative assessment so students meet criteria.

3. Sign off on each young First Responder’s sheet.

Say: It is important to note that practicing splinting once does not make you a real Allied Health

Professional. From First Responders to EMTs to Paramedics, our health care professionals go

through rigorous training and practice before they work in the field.

Reading X-rays (10-15 min)

What happens once a patient with a suspected broken bone arrives at the hospital? Often, they

go to have the bone x-rayed. X-ray or radiology technicians learn how take different kinds of X-

rays. These images are then read by radiologists, or doctors who use medical images to

diagnose diseases and injuries. For our patient, it is important to know the bones that are

It may be

temping to tell

students the

reason for each

step. Instead,

encourage them

to think with a

problem-solving

approach. Use

wait time if

needed to

encourage

participation.


fractured and the type of fracture, or the break, in order to treat it correctly and effectively.

Today, we will experience this as a radiologist’s mystery, where you will problem solve to match

the x-ray image to the cause/definition.

Say: We are going to take a moment to learn about x-rays and the allied health career of

X-ray Technician. What are x-rays? Are they dangerous?

Project video: https://www.youtube.com/watch?v=vmdemMnkSKo.

Say: Now let’s learn how x-rays are used and the role of the X-ray Technician.

Since not everyone has had an x-ray, this video will help share the process.

Show to 1:30: https://www.youtube.com/watch?v=DhVKdhtKBFE.

1. Review the common types of fractures with students, asking them to follow

along on their <Types of Fractures> student sheet. Share some observations

on what makes each fracture unique.

2. Model the problem solving: reading an x-ray of a “transverse fracture.”

3. Project x-ray of the transverse fracture.

o Ask: What do you notice about this break? What evidence suggests it is

a transverse fracture?

o Listen for: There is a clean, horizontal break in the bone.

4. Project each x-ray image.

o Answer Key: Oblique, Avulsion, Impacted, Comminuted, Greenstick

5. Ask: What kind of fracture is illustrated? What is your evidence?

o Students should use the images on the <Types of Fractures> sheet as a basis

for comparison.

The power of this activity is as a reasoning/mystery activity. Push students to move from

making guesses to finding evidence or clues to support their thinking.

This short activity

provides the YPs

an opportunity to

apply

contextualized

critical thinking

skills. Push

students to supply

the reasoning

behind their

answers, justifying

their ideas by

using evidence

when possible.

https://www.youtube.com/watch?v=vmdemMnkSKo

https://www.youtube.com/watch?v=DhVKdhtKBFE


Closure (10 min)

Venn Diagram: X-ray Tech & Radiologist

What is the difference between a x-ray technician and a radiologist? Both have important

roles in helping patients on the road to recovery.

1. Highlight the <Career Venn Diagram>.

2. Ask: Who here knows how to use a Venn diagram?

3. Explain that they will compare and contrast the two careers.

4. Model inputting information that is shared by each career and information that is

specific to one or the other.

o Use the Lenses on the Future language when possible.

5. Ask students to work individually or in assigned pairs to complete the Venn

diagram.

6. Debrief with the class, ensuring key points are called out.

7. Invite students to reflect on the <What Are Bones? Quick Write> questions

privately and record their answers.

This activity has

students comparing

and contrasting two

careers. While both

work with medical

imaging, one is a

technical career that

provides a family-

sustaining wage and

requires less

investment in terms

of years of

education.

Highlighting

technical careers as

well as the more

recognized “doctors

and nurses”

demonstrates the

diverse professional

opportunities in the

growing sector of

Health Science.

Ensure that during

the activity one

career is not

presented as “more

important” or “better

than” the other.


Extensions

Rotation Stations: What Are bones?

Many allied health workers take courses in anatomy and physiology to better understand the

body. Medical professionals who work with the skeletal system also have to know a lot about

the composition of bones and how they heal. As a body system, it has a crucial role in

supporting our tissues and allowing us to move.

For this activity, the young professionals will move around in small groups to different stations

as they work together to respond to prompts or completing tasks.

1. Explain to the young professionals that the activity will get them moving around the

room to different stations in order to explore bones.

Moving around and talking with your group about the task at each station keeps your brains

alert and helps you remember what you are learning.

2. Draw the young professionals’ attention to the different stations by explaining what they

can expect to learn about at each station.

a. Station #1: Long Bone Strength- You will build a model bone from paper and test

the strength it has based on its shape.

b. Station #2: Skeletal System Histology- Histology just means you are studying the

microscopic parts of tissues. You will examine the insides of bones closely,

sketch what you see, and answer a few questions.

c. Station #3: Bone Length and Height- You will take measurements of yourself and

your colleagues to see the relationship between the length of certain bones in the

body and height.

3. Review the student directions.

a. Tell the young professionals they will have 10 minutes at each station, and they

may collaborate together in a whisper.

b. Emphasize that the young professionals are expected to interact with their group

members to process the material at each station.


c. Remind young professionals that the <Sentence Starters> can help them

communicate with each other about their work.

4. Assign each group to a station and instruct them to move there and begin.

5. Circulate, listen and support the young professionals as needed.

6. Use a timer to keep the young professionals on track with how many minutes they spend

at each station. Check in to see if groups need more time and make adjustments as

needed.

7. Before changing stations, provide feedback about ways the young professionals are

interacting effectively.

a. I notice…

b. I like the way that…

8. Continue until the young professionals have rotated through all the stations.


Name:

Date:

ABOUT BROKEN BONES: How Do Bones Heal?

Today’s Learning Objectives:

I can:

Explain the role of bones in the functioning of the human body.

Summarize the stages of how bones heal.

Use a variety of media to develop and deepen understanding of a topic or idea.

Practice a standard technique, revising work when needed.

Justify thinking using evidence to solve x-ray mysteries

This lesson introduces the fields of EMT, x-ray technician, and radiologist, as well as the big

picture of the hidden functions of bones. After learning how bones heal and key new vocabulary

through a quick charades activity, I will face a splinting design challenge before practicing a

standardized splinting technique. Finally, I will use critical thinking to puzzle out a short series of

x-ray mysteries.

Today’s Activities:

How Bones Heal; Vocabulary Preview

Splinting Design Challenge

Splinting Practicum

X-ray Mysteries

Career Venn Diagram and Quick Write Exit Ticket



As the emergency room x-ray technician, the person who administers and reads x-rays, you

are very familiar with your patient’s diagnosis: a broken radius and ulna in the forearm. Broken

forearms are often caused by an impact injury, such as from a fall (when a child uses their

outstretched arm to break a fall) or a direct blow. They are the most common fractures in

children, especially if they’re active.

You have already taken the X-ray of the adolescent male’s broken forearm. While he is sedated

for suturing his facial laceration, the doctor works to set his broken bones. His fracture is a

closed fracture, one of the least complicated to set. This type of fracture means that the bones

are broken but no bone has broken through the skin, an open fracture. And, luckily, the bones

did not fragment into smaller pieces as we see in a comminuted fracture.

In this case, the bones are set in alignment and then splinted so they will be immobilized, or

unable to move. The patient is later supplied with a sling to further minimize movement. He will

receive physical therapy to help reduce the stiffness he will feel in his shoulder and to help

restore muscle strength. The treatment plan states that his arm will be X-rayed again in 5-7

days, and the splint may be replaced with a cast.


How Bones Heal Graphic Organizer

Stages Functions

List the four stages of the

regenerative process in order.

1.

2.

3.

4.

Describe the function of each stage. (In other words,

what is the body doing at each stage?)

1.

2.

3.

4.

Word Bank

Soft Callus

Blood Clot

Hard Callus

Remodeling


Types of Fractures

The type and severity of a fracture is dependent on the strength and direction of the forces

that cause a bone to break. The following image summarizes the common types of

fractures.

X-Ray Image Type of Fracture Evidence


X-Ray Image Type of Fracture Evidence


Splinting Design Challenge!

Scenario: You are a first responder who has come across an injured hiker with a fractured

forearm. You are far from help, so you must splint the forearm in order to prevent further injury.

Follow the directions below.

Directions: You will have 7-8 minutes to create a splint that meets all of the design constraints

below. Take some time to discuss a plan with your partner now.

Design Constraints:

1. The injury must be protected.

2. The joint above and below the break must be immobilized.

3. Make sure the hiker has pulse, sensation, and movement in the fingers (this shows

you have not cut off circulation, which would damage the nerves and flesh).

The injury must be supported.


EMT Splinting Practicum Checklist

Directions: With your group, use this chart to check each step of splinting a broken limb. Score

each section; scores below 10 will try again.

Long Bone Immobilization Points

Possible

Points

Earned

Say or show safety precautions (I am putting on gloves or act it out,

etc.).

1

Keep the extremity still and stabilized with a SAM splint or magazine

(to reduce pain and further damage to site).

1

Immobilize the joint above and below the injury (reduce pain and

further damage to the site).

1

Place something under the hand (for comfort and circulation). 1

Wrap the forearm using an ace bandage (stabilizes injury). 1

Access motor, sensory, and circulation before and after splinting (to

ensure blood flow is not cut off to fingers and that the wrap isn’t too

tight).

1

Use triangle bandage to create a sling (to support and protect injury in

transport and reduce pain).

1

TOTAL 7


What are Bones? Quick Write

Summarize what you learned about bones in today’s activities.

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Which activity was the most challenging? What are some reasons it was challenging?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

What did you do to persist through those challenges?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________


Rotation Stations

Directions:

1. At the signal, move to your assigned station.

2. Work with your group to respond to complete the task.

3. Complete the task on a graphic organizer or data table. 4. At the signal, move to the next station and repeat.

Sentence Starters:

What does everyone think about…? I’m wondering if we want to… I agree/disagree with the idea _______ because _______. So we’re saying… It sounds like we agree that… What will we all write down? What are some additional ideas about…? Do we all agree that…? Is there anything here we have a question about?


Rotation Stations: Station #1 Long Bone Strength

Long bones are hard, dense bones that provide strength, structure, and movement. The femur

(thigh bone) is a long bone. A long bone has a shaft and two ends.

There are also bones in the fingers that are classified as "long bones," even though they are

short in length. This name is due to the shape of the bones, not the actual size.

Long bones contain yellow bone marrow and red bone marrow, which produce blood cells.

The construction materials and shape of bone give it its strength and the ability to deal with

great amounts of force.

Collagen fibers, formed from a type of protein, allow bone to endure stretching forces.

Harder mineral salts allow bone to endure compression forces.

Bone construction is similar to that of reinforced concrete in that steel rebar allows

concrete to resist stretching forces, while the cement resists compression.

The circular shape of osteons, or round structures in the bone, are able to deal with

greater amounts of force.

Unfortunately, bone construction does not tend to resist twisting forces. In fact, twisting is the

primary cause of bone fractures. In this activity, you will examine the ability of the concentric

circular shape of bone to withstand direct forces.


Rotation Stations: Station #2

Skeletal System Histology

Histology is a fancy name for the study of the microscopic structures of tissues–bones, in this

case. At this station, you will be analyzing a chicken bone to examine the internal structures of

bones.

Instructions

1. Observe the outsides of the bones with and without the magnifier.

2. In your notebook, draw the exterior view of the bone.

3. Ask your teacher to break open the bones for your group.

4. Observe the insides of the bone with and without a magnifier.

5. In your notebook, draw the interior view of the bone.

6. Answer the following questions in your notebooks:

Are bones solid or hollow?

What might be the advantages of this type of structure?

7. Summarize this statement:

What is inside bones?

Bone marrow is another important component of the bone matrix. Bone marrow is a gelatinous

organic tissue (tissues are a group of identical cells) found within the cavities of spongy bone in

some of our bones, such as the hip and thigh. Bone marrow contains stem cells which give rise

to the different blood cells. There are two kinds of bone marrow: red marrow and yellow marrow.

Red marrow produces red blood cells, platelets, and white blood cells and is found in the ends

of long and flat bones (i.e. femur, ribs, vertebrae, and pelvic bones). Yellow marrow stores fat

and is found in the middle of long bones (i.e. most of the bones of our limbs).


Rotation Stations: Station #3 Bone Length and Height

Inferring the height of an individual based on the length of long bones is common in forensic

pathology, or crime scene investigation. When skeletal remains are found, the sex, race, and

height can be crucial clues to identify the patient. In fact, a single long bone can be used to

calculate approximate height. Gender and race also contribute to these numbers to give a close

approximation of height. In this activity, you will calculate your height using the length of your

long bones.


Facilitator Documents: X-ray Images to Project


Venn Diagram to Project