D.2 D.

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ADDED:
Difference between exocrine and endocrine gland.
Endocrine into the blood
- Gastric gland, pancreatic gland
Exocrine into a duct onto epithelial surface
- Surface of the body, lumen of the digestive track
- Composed of a cluster of secretory cells
State how gastrin stimulated and its function in digestion.
- Nervous mechanism and hormonal mechanism
Nervous Mechanism:

- The sight and smell of food triggers an immediate response by which gastric juice is secreted by
the stomach pre-ingestion
- When food enters the stomach it causes distension, which is detected by stretch receptors in the
stomach lining
- Signals are sent to the brain, which triggers the release of digestive hormones to
achieve sustained gastric stimulation

Hormonal Mechanism:

- Gastrin is secreted into the bloodstream from the gastric pits of the stomach and stimulates the
release of stomach acids
- If stomach pH drops too low (becomes too acidic), gastrin secretion is inhibited by gut
hormones (secretin and somatostatin)
- When digested food (chyme) passes into the small intestine, the duodenum also releases
digestive hormones:
- Secretin and cholecystokinin (CCK) stimulate the pancreas and liver to release digestive juices
- Pancreatic juices contain bicarbonate ions which neutralize stomach acids, while the liver
produces bile to emulsify fats

Two functions of secretin during digestion.

- a hormone released into the bloodstream by the duodenum (especially in response to acidity)
to stimulate secretion by the liver and pancreas.
- secretin inhibits the production of gastrin
- secretin stimulates pancreas and liver to release digestive juices
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 Be able to read an ECG (electrocardiogram) and know what is happening

1a. [1 mark]
An electrocardiogram (ECG) records the electrical activity of the heart over a period of time using
electrodes placed on the skin. The ECG shown is from a patient whose heart was beating irregularly
until it was treated using a defibrillator (arrows) which restored normal electrical activity.

State how many normal heartbeats are shown in the ECGs.

Markscheme
8 ✔ [unsure why this is 8]
1b. [2 marks]
Outline how a defibrillator is used to restore normal heartbeat.

Markscheme
a. «paddles/electrodes/defibrillator» deliver an electric shock to the heart ✔
b. depolarizes cardiac muscle ✔
c. enables the pacemaker/SA node to regain control ✔
1c. [2 marks]
Explain what is occurring in the heart during the peak of electrical activity as indicated by the R wave
on the ECG.

Markscheme
a. impulses initiated from the AV node spread across heart ✔
b. impulses travel along Purkinje fibres/across ventricles ✔
c. causing depolarization of the ventricles
OR
that triggers ventricular contraction ✔
2a. [1 mark]
The image shows a section through the ileum as viewed under the light microscope.

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 On the diagram, label the epithelial cell layer.

Markscheme
arrow pointing at an epithelial cell ✔

Accept a bracket label to show the epithelium epithelial cell layer

2b. [2 marks]
Explain how the epithelial cells are adapted for absorption.

Markscheme
a. microvilli/brush border to increase surface area ✔
b. numerous mitochondria for energy for active transport ✔
c. have transport proteins for specific nutrients ✔
d. single layer of cells/short distance allowing for diffusion ✔

Explanation must be included for each characteristic eg: “glucose, amino acids”

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3a. [1 mark]
State one role of fibre in the diet.

Markscheme
aids peristalsis / reduces risk of intestinal disorders/cancer/constipation / reduces hunger
3b. [2 marks]
Outline control of digestive juice secretion so that digestive juices are only secreted into the gut when
there is food present.

Markscheme
a. combination of nervous AND hormonal control
b. food in stomach stimulates chemoreceptors/stretch receptors / stretches the wall
c. causes production of gastrin
d. arrival of chyme to the small intestine triggers the release of hormones/secretin
e. volume and composition of gastric juices are controlled
3c. [2 marks]
Outline the role of intestinal villi.

Markscheme
a. villi/microvilli provide large surface area
b. capillary network for absorption and transport
c. lacteal for absorption and transport of lipids/fatty acids/glycerol / bile resorption
d. mitochondria in epithelial cells provide energy for absorption
4a. [3 marks]
Explain the relationship between infection by the bacterium Vibrio cholerae and dehydration.

Markscheme
a. V. cholerae releases toxin
b. chloride channels activated
c. chloride ions are pumped out of cells
d. leading to fluid loss from intestine/diarrhea
e. associated vomiting contributes to dehydration
4b. [3 marks]
Severe dehydration can lead to cardiac arrest. Outline the use of defibrillation to treat life-threatening
cardiac conditions.

Markscheme
a. defibrillator is electrodes / a metal paddle or / a pad that is placed on the patient’s chest
b. the device determines whether fibrillation is happening
c. a series of electrical shocks are delivered «through the electrodes»
d. electrical impulse is used to depolarize the heart muscle
e. to re-establish the function of the SA node / natural pacemaker / natural rhythm «of the heart»

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5. [3 marks]
The bar chart indicates that both males and females in the US eat, on average, less fibre than is
recommended.

Explain the importance of dietary fibre.

Markscheme
a. ensure correct transit rate / movement of food through the intestines
b. avoid constipation / difficulty in empty bowels / difficulty in egestion
c. correct levels of water reabsorbed
d. avoid overlong exposure to fat soluble chemicals
e. decreased risk of colon cancer/hemorrhoids/appendicitis
f. decreases the rate of absorption of glucose
g. decreases hunger so less obesity/diabetes
6a. [2 marks]
State two roles of hydrochloric acid in gastric juice.
Role 1:
Role 2:

Markscheme
a. activation of enzymes/protease/pepsinogen
b. bactericidal action / kills pathogens
c. hydrolysis / breakdown of food
6b. [3 marks]
Pancreatic juice is secreted into the pancreatic duct which carries these secretions to the small intestine.
The hormone secretin is released by the small intestine when hydrochloric acid enters it from the
stomach. The data below show the volume of pancreatic juice released after an injection of secretin.

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 Pancreatic secretions contain sodium hydrogen carbonate, making them basic.
Deduce the significance of the response by the pancreas to secretin.

Markscheme
a. secretin stimulates an increase in pancreatic secretions
b. pancreatic secretions are released rapidly / within 10 minutes
c. «NaHCO3 in pancreatic secretions» neutralises stomach acid / HCI
d. provides optimal conditions for digestion / enzymes «in the small intestine»
e. by 40 minutes no more hydrochloric acid enters the small intestine
6c. [1 mark]
State one cause of stomach ulcers.

Markscheme
an infection by Helicobacter pylori / H. pylori
OR
overuse of NSAIDs /aspirin / ibuprofen
7a. [1 mark]
The graph below shows a normal electrocardiogram (ECG) trace.

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 Using the letters provided, identify the parts of the ECG where the ventricle muscles are contracting.

Markscheme
QRS/ Q to S
7b. [1 mark]
State what is represented by the period between the points R and R’.

Markscheme
one cardiac cycle
7c. [2 marks]
Outline the use of artificial pacemakers for patients with a heart condition.

Markscheme
a. artificial pacemakers deliver electrical impulses «to heart muscle»
b. they maintain a regular heart rate / supplement the natural pacemaker
c. they sense missing heart beats and stimulate the heart
OR
correct malfunction of SAN / sinoatrial node
d. they coordinate contractions of atria and ventricles / left and right atria
8a. [2 marks]
The diagram shows a cell in the lining of the stomach.

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 Outline the importance of the proton pumps in the digestion of foods.

Markscheme
a. pumps protons/H+ into the stomach

b. allows for the production of «hydrochloric» acid

c. «hydrochloric» acid accelerates digestion/activates enzymes
d. gives optimal pH for pepsin/enzyme digestion
8b. [3 marks]
Explain the use of proton pump inhibitors to treat patients complaining of stomach pain.

Markscheme
a. proton pump is a «transmembrane» protein

b. proton pump inhibitors bind to the proton pump

c. hydrogen ions are not sent into stomach lumen
OR
reduction of «gastric» acid production
d. increase in pH of stomach
e. relieve symptoms of acid reflux/gastritis/ulcers
9a. [1 mark]
The diagram shows the use of a sphygmomanometer in the measurement of blood pressure.

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 Identify the systolic pressure and diastolic pressure for this adult male.
Systolic pressure (mm Hg):
Diastolic pressure (mm Hg):

Markscheme
systolic: 115
diastolic: 77 «mmHg»
Both needed for the mark.
9b. [3 marks]
Explain the meaning of systolic and diastolic pressure.

Markscheme
a. «systolic/diastolic» pressure is the force of blood on arteries

b. systolic pressure is measured when the ventricle contracts

OR
systolic pressure is when blood is being pumped out of the heart
c. diastolic pressure is measured when the ventricles are filled with blood
OR
heart is at rest/relaxed
9c. [2 marks]
The photomicrograph shows cardiac muscle. Label the structures I and II.

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 Markscheme
I: nucleus

II: intercalated disc

10a. [2 marks]
Outline the importance of acid conditions in the stomach.

Markscheme
Acidity activates digestive enzyme «pepsinogen»
Hydrolysis/breakdown of food
Acidity destroys unwanted bacteria/pathogens
Provides optimum pH for enzymes/pepsin to function
10b. [1 mark]
Suggest one reason for a correlation between a low-fibre diet and a higher incidence of gastrointestinal
problems.

Markscheme
Increased contact time between intestinal wall and food
Increase interaction with surface and undesirable food chemicals
The density/hardness of the stool can make it harder to egest causing damage to tissues
Increases digestive tract conditions/diseases/constipation
11a. [3 marks]
Outline the importance of fibre as a component of a balanced diet.

Markscheme
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 fibre/cellulose cannot be digested;
aids peristalsis/helps to prevent constipation/adds bulk;
prevents obesity by increasing bulk in the stomach;
reduces the risk of appendicitis/cancer/hemorrhoids;
slows the rate of sugar absorption/helps prevent diabetes;
11b. [1 mark]
Distinguish between minerals and vitamins.

Markscheme
minerals are inorganic elements (simple compounds from elements in ionic form) and vitamins are
organic compounds (which cannot be synthesised by the body);
minerals are all water soluble but only some vitamins are water soluble (others are lipid soluble);
some vitamins are destroyed by exposure to oxygen, minerals are not;

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