Topic 6.

4 [223 marks]
1. 23M.1.HL.TZ2.19

What occurs during inspiration?

A. Internal intercostal muscles contract, increasing the pressure in the thorax.

B. Internal intercostal muscles contract, decreasing the pressure in the thorax.

C. External intercostal muscles contract, decreasing the pressure in the thorax.

D. External intercostal muscles contract, increasing the pressure in the thorax.

[1]

2. 23M.1.HL.TZ2.39

At what stage of spermatogenesis does the first division of meiosis occur?

A. Spermatogonium to primary spermatocyte

B. Primary spermatocyte to secondary spermatocyte

C. Secondary spermatocyte to spermatid

D. Spermatid to mature sperm cell

[1]

3. 23M.1.HL.TZ2.40

Which statement applies to the placenta?

A. Carbon dioxide diffuses from fetus to mother across the placenta.

B. Maternal and fetal blood mix at the placenta.

C. If an ovum is not fertilized the placenta is lost during menstruation.

D. The umbilical cord connects the placenta to the mother’s abdomen.

[1]

4. 23M.3.HL.TZ1.8

Explain how breathing is controlled by the brain.

[6]
5. 22N.1.SL.TZ0.28

The graph shows the concentration of the lipid lecithin in the amniotic fluid surrounding the fetus
during normal gestation. This lipid is produced in the lungs of the fetus and acts as a surfactant.

[Source: Gluck, L. and Kulovich, M., n.d. [Concentrations of phospholipids]. [graph online]
Available at:
http://www.columbia.edu/itc/hs/medical/humandev/2004/Chpt12-LungDev.pdf [Accessed 28
October 2021].]

What problem may occur in a baby born before 34 weeks gestation?

A. Type I pneumocytes do not produce sufficient surfactant for lungs to inflate.

B. There are no type II pneumocytes.

C. The alveolar walls stick together.

D. The alveoli are too large.

[1]

6. 22N.1.HL.TZ0.22
The diagram shows a section through an alveolus.

[Source: Bergman, Ronald A., Ph.D., and D'Alessandro, Michael P., M.D. Pulmonary alveoli,
“Anatomy Atlases”. Available online: http://www.anatomyatlases.org/ [Accessed 02/01/2023].]

What are the functions of the following labelled structures?

[1]
7. 22M.1.SL.TZ1.27

A cell from the lungs, observed under the microscope, contains a large number of secretory
organelles. Which conclusion can be drawn about the cell?

A. It is a type I pneumocyte.

B. It is a type II pneumocyte.

C. It could be either a type I or type II pneumocyte.

D. It is a red blood cell.

[1]

8. 22M.1.SL.TZ2.27

Pressure changes inside the thorax cause the movement of air in and out of the lung alveoli
during ventilation. Alveolar pressure correlates to thoracic pressure. The diagram shows
pressure changes in lung alveoli during ventilation in relation to normal atmospheric pressure.
What causes forced movement of air out of the lungs at T?
 [1]

9. 21N.1.SL.TZ0.27

What occurs during inhalation?

[1]

10. 21N.2.SL.TZ0.2

(a) The figure shows a tripeptide.

 Label one peptide bond in this molecule.

[1]

(b) Outline the specific functions of three named proteins.

[3]

(c) Outline the action taken by the diaphragm during inhalation.

[1]

11. 21N.2.HL.TZ0.4

(a) The figure shows a tripeptide.

Label one peptide bond in this molecule.

[1]

(b) Describe the secondary structure of proteins.

[2]

(c) Outline the action taken by the diaphragm during inhalation.

[1]

12. 21M.1.SL.TZ2.27

Which is an adaptation to increase rates of gas exchange in the lung?

 A. Small surface area

B. Dry surface

C. High vascularization

D. Muscular alveoli

[1]

13. 21M.1.SL.TZ2.28

Where in the body are type I pneumocytes found?

A. Alveoli

B. Nephrons

C. Capillaries

D. Trachea

[1]

14. 21M.1.HL.TZ1.21

Which process results in the exchange of gases across the membrane of pneumocytes?

A. Active transport

B. Simple diffusion

C. Facilitated diffusion

D. Mass flow

[1]

15. 21M.2.SL.TZ1.7

(a) Outline the process of inhalation.

[4]

(b) Explain the process of gas exchange taking place in the alveoli.

[7]

(c) Discuss the relationship between atmospheric carbon dioxide concentration and global
temperatures.

[4]

16. 20N.1.SL.TZ0.28

The graph shows a spirometer trace of oxygen consumption when breathing at rest and during
exercise.
 [Source: Courtesy of Dr. Dafang Wang for his work at University of Utah.]

What explains the difference between the traces at regions X and Y on the graph?

A. At X, the internal intercostal muscles contract more than the external intercostal muscles.

B. At Y, the ribcage moves up and out more than at X.

C. At X, the diaphragm flattens more per breath than at Y.

D. At Y, the intercostal muscles contract more slowly than at X.

[1]

17. 19N.1.HL.TZ0.23

Which factors could cause emphysema?

I. Air pollution

II. Genetic predisposition

III. Tobacco smoke

A. I and II only

B. I and III only

C. II and III only

D. I, II and III

[1]

18. 19N.2.SL.TZ0.6
 (a) Outline how cuts in the skin are sealed to prevent blood loss.

[4]

(b) Outline how two parents could have a child with any of the four ABO blood groups.

[4]

(c) Explain how ventilation and lung structure contribute to passive gas exchange.

[7]

19. 19M.1.SL.TZ2.26

In premature babies born earlier than the 30 th week of pregnancy, type II pneumocytes are
usually not fully developed, so they do not carry out their function normally. What is a possible
consequence of this?

A. The number of alveoli reduces.

B. The size of the alveoli increases.

C. Capillary networks do not develop fully and oxygen is not absorbed.

D. Surface tension between alveoli does not decrease and the alveoli stick together.

[1]

20. 19M.1.HL.TZ1.23

What is produced by type II pneumocytes?

A. Epinephrine

B. Elastase

C. Pulmonary surfactant

D. Alpha 1-antitrypsin

[1]

21. 19M.2.SL.TZ1.4

The diagram shows the structure of an alveolus and an adjacent capillary.

 [Source: © International Baccalaureate Organization 2019]

(a) Outline the functions of type I and type II pneumocytes.

[2]

(b) Explain how gases are exchanged between the air in the alveolus and the blood in the
capillaries.

[3]

22. 19M.2.HL.TZ1.6
 (a) Outline the process of inspiration in humans.

[4]

(b) Describe the functions of valves in the mammalian heart.

[4]

(c) Explain how blood solute concentrations are kept within narrow limits in the human body.

[7]

23. 19M.3.SL.TZ2.3

A study was conducted on 25 healthy, non-smoking males to look at the effect of exercise and
altitude on ventilation rate. Subjects were first asked to rest in a sitting position for six minutes.
They then pedalled for three periods of six minutes at increasing exercise intensity: at 20 %, 30
% and 40 % of their maximal aerobic power. The entire study was conducted either in normal
sea level oxygen conditions or in lower oxygen conditions simulating an altitude of 4000 m. The
results are shown in the bar chart.

[Source: E Hermand, et al., (2015), Periodic breathing in healthy humans at exercise in hypoxia,
Journal of Applied Physiology, 118, pages 115–123.
https://doi.org/10.1152/japplphysiol.00832.2014]

(a) State one other variable that should have been controlled in this study.

[1]

(b) Compare and contrast the effect of increasing exercise intensity at sea level and at an
altitude of 4000 m.
 [2]

(c) Outline how ventilation rate could have been monitored in this study.

[2]

24. 18N.2.SL.TZ0.1

Trends in tobacco smoking and mortality due to lung cancer were measured in male and female
smokers aged 35 to 59 living in the United Kingdom from 1950 to 2000. The first graph
represents the proportion of smokers in the population. The second graph represents the
mortality rate (deaths per year per 100 000 people) from lung cancer.
(a) Calculate the change in the percentage of the male population that smoked from 1950 to
2000.

[1]

(b) Compare and contrast the trends in smoking behaviour between males and females between
1950 and 2000.

[2]

(c) Evaluate the evidence provided by the data in the graphs for smoking as a cause of lung
cancer.

[3]

The incidence of lung cancer in 75-year-old males was studied comparing current smokers,
former smokers and non-smokers.
 (d) Describe the relationship between the incidence of lung cancer and stopping smoking.

[2]

(e) Explain evidence from the data in the table that could be used to persuade a smoker to give
up smoking.

[2]

(f) Among 75-year-old lifelong non-smokers the percentage incidence of lung cancer was
0.01 %. Suggest one possible cause of lung cancer in non-smokers.

[1]

(g) State two respiratory diseases, other than lung cancer, caused by smoking.

[2]

25. 18N.2.SL.TZ0.1

Trends in tobacco smoking and mortality due to lung cancer were measured in male and female
smokers aged 35 to 59 living in the United Kingdom from 1950 to 2000. The first graph
represents the proportion of smokers in the population. The second graph represents the
mortality rate (deaths per year per 100 000 people) from lung cancer.
(a) Calculate the change in the percentage of the male population that smoked from 1950 to
2000.
 [1]

(b) Compare and contrast the trends in smoking behaviour between males and females between
1950 and 2000.

[2]

(c) Evaluate the evidence provided by the data in the graphs for smoking as a cause of lung
cancer.

[3]

The incidence of lung cancer in 75-year-old males was studied comparing current smokers,
former smokers and non-smokers.

(d) Describe the relationship between the incidence of lung cancer and stopping smoking.

[2]

(e) Explain evidence from the data in the table that could be used to persuade a smoker to give
up smoking.

[2]

(f) Among 75-year-old lifelong non-smokers the percentage incidence of lung cancer was
0.01 %. Suggest one possible cause of lung cancer in non-smokers.

[1]

(g) State two respiratory diseases, other than lung cancer, caused by smoking.
 [2]

26. 18N.2.HL.TZ0.6

(a) Calcium is absorbed from food in the human gut by both active and passive processes.
Outline active transport, including the benefits of the process.

[3]

(b) Describe the role of oxygen in aerobic cell respiration.

[5]

(c) Adult humans may absorb more than five hundred litres of oxygen per day. Explain how gas
exchange is maintained in the human respiratory system.

[7]

27. 18N.3.SL.TZ0.2

Measurements of the lung capacity of a student were recorded using a spirometer and displayed
with a data logger. Initially the student was at rest, then changed to carrying out strenuous
exercise. The results are displayed in the graph.

(a) Calculate the ventilation rate at rest, giving the units.

[1]

(b) Explain the changes in ventilation after 35 seconds.

[2]
 (c) Suggest how the total lung volume at rest would differ for a patient with emphysema.

[1]

28. 18N.3.HL.TZ0.1

Measurements of the lung capacity of a student were recorded using a spirometer and displayed
with a data logger. Initially the student was at rest, then changed to carrying out strenuous
exercise. The results are displayed in the graph.

(a) Calculate the ventilation rate at rest, giving the units.

[1]

(b) Explain the changes in ventilation after 35 seconds.

[2]

(c) Suggest how the total lung volume at rest would differ for a patient with emphysema.

[1]

(d) Outline the function of pneumocytes in the lungs.

[2]

29. 18M.1.SL.TZ1.28

How are the insides of alveoli prevented from sticking together?

 [1]

30. 18M.1.SL.TZ2.28

What is the role of type II pneumocytes?

A. To carry out gas exchange

B. To keep the alveoli moist

C. To increase surface tension

D. To maintain partial pressures of gases

[1]

31. 18M.2.SL.TZ1.6

(a) Outline the role of the parts of an alveolus in a human lung.

[4]

(b) Explain how antibiotic resistance can evolve in bacteria, such as those causing pneumonia.

[4]

(c) Many diseases are caused by bacteria and other pathogens. Explain, using examples, how
other factors can lead to disease in humans.

[7]

32. 18M.2.HL.TZ2.6

All living organisms depend on a continuous supply of energy.

(a) Explain the stages of aerobic respiration that occur in the mitochondria of eukaryotes.

[8]

(b) Outline how ventilation in humans ensures a supply of oxygen.

[4]
 (c) Describe the reasons for the shape of a pyramid of energy.

[3]

33. 18M.3.SL.TZ2.3

In an experiment to explore the effect of exercise on ventilation rate, a subject breathed into a
data logging sensor that measured air flow.

The graphs show the result before the subject exercised and immediately after the exercise had
finished.
(a) Determine the ventilation rate after exercise.

[2]

(b) Describe how the mean tidal volume after exercise could be determined using the graph.

[2]

(c) Predict, with a reason, the effect of exercise on the rate of cell respiration.

[1]

(d) Identify a muscle responsible for increasing the volume of the chest cavity.
 [1]

34. 18M.3.HL.TZ1.2

The graph shows the ventilation rate and tidal volume of a well-trained runner during exercise on
a treadmill. The tidal volume is the volume of air being moved in and out of the lungs in each
breath.

(a) State the apparatus used to measure the tidal volume.

[1]

(b) Calculate the total volume of air inhaled during one minute during the highest velocity of the
treadmill in this test, giving the units.

[2]

(c) Compare and contrast the effect of increasing treadmill speed on the ventilation rate and tidal
volume in this runner.
 [2]

35. 17N.1.HL.TZ0.23

Which type of cell is specialized to facilitate gas exchange?

A. Type I pneumocytes

B. Type II pneumocytes

C. Internal intercostal muscle fibres

D. External intercostal muscle fibres

[1]

36. 17N.2.SL.TZ0.01

Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive airflow

limitation. Classification of COPD as mild, moderate or severe is based on measurement of
Forced Expiratory Volume (FEV), which is the maximum volume of air that can be exhaled in
one second.

The table shows the numbers of individuals in each COPD class and their mean FEV for a
Swedish study of 349 people.

[Source: Reproduced with permission of the © ERS 2012. European Respiratory Journal Apr
2012, 39 (4) 839–845; DOI: 10.1183/09031936.00064611]

(a) State the level of COPD that has the lowest FEV.

[1]

(b) Explain how a low FEV can be used to indicate emphysema.

[2]

The elasticity and resilience of the lungs are mainly provided by the protein elastin. Degradation
of elastin produces peptides called desmosines.

Desmosines in urine or blood plasma have been proposed as biomarkers of lung degradation.
The relationship between urine desmosines, plasma desmosines and COPD severity in patients
was assessed.
[Source: Reproduced with permission of the © ERS 2012. European Respiratory Journal Apr
2012, 39 (4) 839–845; DOI: 10.1183/09031936.00064611]

(c) State the disease severity group that has the highest range of plasma desmosines.

[1]

(d) Evaluate which of the two biomarkers would be the most useful indicator of COPD severity.

[2]

(e) Elastin is also an important component of other tissues such as arteries and ligaments.
Evaluate how these other sources of elastin could affect the interpretation of the biomarker
as an indicator of COPD.

[2]

The graph shows the relationship between the diffusion capacity of the lungs for carbon
monoxide (CO) and urine desmosines.
 [Source: Reproduced with permission of the © ERS 2012. European Respiratory Journal Apr
2012, 39 (4) 839–845; DOI: 10.1183/09031936.00064611]

(f) State the relationship between diffusion capacity and urine desmosines.

[1]

(g) Other studies on pulmonary diseases have shown a wide variety of results. Apart from age,
sex and severity of COPD, list two other factors that may explain the inconsistent results
between studies.

[2]

(h) Discuss whether measurements of desmosine concentration would be useful for monitoring
changes in the health of a patient.

[3]

37. 17N.2.SL.TZ0.01

Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive airflow

limitation. Classification of COPD as mild, moderate or severe is based on measurement of
Forced Expiratory Volume (FEV), which is the maximum volume of air that can be exhaled in
one second.

The table shows the numbers of individuals in each COPD class and their mean FEV for a
Swedish study of 349 people.
[Source: Reproduced with permission of the © ERS 2012. European Respiratory Journal Apr
2012, 39 (4) 839–845; DOI: 10.1183/09031936.00064611]

(a) State the level of COPD that has the lowest FEV.

[1]

(b) Explain how a low FEV can be used to indicate emphysema.

[2]

The elasticity and resilience of the lungs are mainly provided by the protein elastin. Degradation
of elastin produces peptides called desmosines.

Desmosines in urine or blood plasma have been proposed as biomarkers of lung degradation.
The relationship between urine desmosines, plasma desmosines and COPD severity in patients
was assessed.

[Source: Reproduced with permission of the © ERS 2012. European Respiratory Journal Apr
2012, 39 (4) 839–845; DOI: 10.1183/09031936.00064611]

(c) State the disease severity group that has the highest range of plasma desmosines.

[1]

(d) Evaluate which of the two biomarkers would be the most useful indicator of COPD severity.
 [2]

(e) Elastin is also an important component of other tissues such as arteries and ligaments.
Evaluate how these other sources of elastin could affect the interpretation of the biomarker
as an indicator of COPD.

[2]

The graph shows the relationship between the diffusion capacity of the lungs for carbon
monoxide (CO) and urine desmosines.

[Source: Reproduced with permission of the © ERS 2012. European Respiratory Journal Apr
2012, 39 (4) 839–845; DOI: 10.1183/09031936.00064611]

(f) State the relationship between diffusion capacity and urine desmosines.

[1]

(g) Other studies on pulmonary diseases have shown a wide variety of results. Apart from age,
sex and severity of COPD, list two other factors that may explain the inconsistent results
between studies.

[2]

(h) Discuss whether measurements of desmosine concentration would be useful for monitoring
changes in the health of a patient.

[3]

38. 17N.2.HL.TZ0.01
Hypoxia is a condition in which tissues of the body are deprived of an adequate oxygen supply. A
study was carried out in rats to examine the effects of continuing hypoxia on the structure of the
diaphragm, and to determine whether nitric oxide is implicated in adaptation of the diaphragm to
hypoxia. The diaphragm helps to supply oxygen to tissues and organs in the body by ventilating
the lungs.

A group of 36 adult male rats were kept for 6 weeks in low oxygen while 36 adult male rats were
kept in normal oxygen levels.

[Source: Reproduced with permission of the © ERS 2011. European Respiratory Journal June
2011, 37 (6) 1474–1481; DOI: 10.1183/09031936.00079810]

(a) Outline the effect of hypoxia on body mass and erythrocyte percentage.

[1]

The graph shows the effect of hypoxia on the endurance of rats’ diaphragm muscle after 6
weeks. Endurance is the change in force measured as a percentage of the initial force.
[Source: Reproduced with permission of the © ERS 2011. European Respiratory Journal June
2011, 37 (6) 1474–1481; DOI: 10.1183/09031936.00079810]

(b) Using the data in the graph, deduce whether hypoxia increases or decreases the endurance
of the rats’ diaphragm muscle.

[2]

(c) Using the data presented in this question, explain the effect of hypoxia on the body.

[2]

The sodium–potassium pump plays a role in muscle activity. Nitric oxide may have a role in the
recovery of hypoxic muscles. The production of nitric oxide can be blocked with an inhibitor of
the enzyme nitric oxide synthase. The graph shows the concentration of sodium–potassium
pumps in the diaphragm of control and hypoxic rats without and with nitric oxide synthase
inhibitor.
[Source: Reproduced with permission of the © ERS 2011. European Respiratory Journal June
2011, 37 (6) 1474–1481; DOI: 10.1183/09031936.00079810]

(d.i) Analyse the graph to obtain two conclusions about the concentration of sodium–potassium
pumps.

[2]

(d.ii) Muscle fibres are stimulated to contract by the binding of acetylcholine to receptors in their
membranes and the subsequent depolarization.

Suggest a reason for increasing the concentration of sodium–potassium pumps in the

membranes of diaphragm muscle fibres.

[1]

Skeletal muscle contractions can take two different forms: if they are stimulated by a single
action potential they take the form of a twitch and if they are stimulated by a series of action
potentials the contraction is longer lasting (tetanic). The table shows the effects of hypoxia on
the force of twitch and peak tetanic contraction in the diaphragm.
[Source: Reproduced with permission of the © ERS 2011. European Respiratory Journal June
2011, 37 (6) 1474–1481; DOI: 10.1183/09031936.00079810]

(e.i) Outline the effect of hypoxia on the force of contraction of the diaphragm.

[1]

(e.ii) Hypoxia caused a 13 % increase in the surface area to volume ratio of the diaphragm.
Suggest a reason for this change.

[1]

(f) Using all relevant data in the question, evaluate the effectiveness of the rats’ adaptation to
hypoxia.

[3]

(g) Discuss the advantages and disadvantages of using rats as models in this investigation.

[2]

© International Baccalaureate Organization, 2023