2nd Year Books Flashcards
(212 cards)
1
Q
What level does the isthmus of the thyroid lie?
A
Lies opposit the 2nd - 4th tracheal rings
2
Q
How are the suprarenal glands peritonised?
A
They are retroperitoneal
3
Q
What exists within the free border of the falciform ligament?
A
Round ligament
Paraumbilical veins
4
Q
What vertebral level are renal veins given off at?
A
L1 - L2
5
Q
What is the level of the thyroid?
A
C5 - T1
Lies between the 6th tracheal ring and the thyroid cartilage
6
Q
What is the terminal group of lymph nodes for the head and neck?
A
The deep cervical nodes - they are found surrounding the internal jugular vein and are contained within the carotid sheath
At the inferior end of the deep cervical chain of lymph nodes, the efferent lymphatic vessels join together to form the jugular lymph trunk on each side
7
Q
Aneurysms in what artery result in palsy of the third cranial nerve?
A
Posterior cerebral artery
8
Q
With what two areas does the cavity of the middle ear communicate?
A
Tympanic cavity - nasal cavity via eustachian tube
Mastoid antrum via air cells
9
Q
Which veins of the stomach drain into the hepatic portal vein, which ones don’t?
A
Right and left gastric veins drain into the hepatic portal vein
Left and right gastro omental veins ultimately drain into the superior mesenteric veins
10
Q
Where does the septum pellucidum project to?
A
Superiorly = corpus callosum
Inferiorly = fornix
Poseriorly = interventricular foramen
11
Q
Where do the superior thyroid artery and inferior thyroid artery come from?
A
Superior - branch of ECA
Inferior thyroid artery - subclavian artery?
12
Q
What are the branches of the ECA
A
Some Anatomists Like Freaking Out Poor Medical Students
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
13
Q
What is the funcion of the tensor tympani?
A
Tenses the tympanic membrane
14
Q
What is the fornix?
A
A bundle of fibres that links the hippocampus with the mamillary bodies of the hypothalamus
15
Q
SADPUCKER
A
Suprarenal glands
Aorta/IVC
Duodenum 2nd and 3rd parts
Pancreas (except the tail)
Ureters
Colon (ascending and descending(
Kidneys
Oesophagus
Rectum
16
Q
Which branch of the renal artery supplies the nephron?
A
Interlobular branches
17
Q
What do the tracheal nodes drain and where do you find them?
A
Drain the trachea and the thyroid gland - found around the trachea
18
Q
What structures pass through the cavernous sinus?
A
Oculomotor
Trochlear
Abducent
Opthalmic
Maxillary
Internal carotid
19
Q
What part of the brain lies immediately superior to the midbrain?
A
Thalamus
20
Q
What is contained within the diencephalon?
A
The hypothalamus, thalamus and pineal gland
21
Q
Which 4 bones form the pterion?
A
Frontal
Temporal
Parietal
Sphenoid
22
Q
What ioens into the sphenoethmoid recess?
A
Sphenoid sinus
23
Q
Into which vein does the suprarenal vein drain into?
A
RHS = IVC
LHS = Renal vein
24
Q
Which strutures pass through the parotid?
A
Facial nerve
Retromandibular vein
ECA
25
What travels through the superior orbital fissure?
3,4,5(V1), 6
Opthalmic vein
26
At what level does the spinal cord terminate ni the adult and a new born?
Adult = L1
Newborn = L2/L3
27
What is the extraocular muscle that does not arise from the posterior aspect of the orbit?
Inferior oblique
28
How many permanent teeth do we have?
28/32
I=8
C=4
P=8
M=8/12
29
What is the apex of the bladder the site of?
Site where median umbilical ligament ascends to the umbilicus
Remnant of embryonic urachus
30
What are the layers if the eye and what do they contain?
Tunica fibrosa - corne and sclera
Tunica vasculosa - Iris, cilliary body, choroid
Tunica neurosa oculi - Retina
31
What type of ossification occurs in flat bones of the vault of the skull?
Membranous ossification
32
Which bone is the styloid process part of?
Temporal bone
33
What are the 4 parts of the corpus callosum?
Rostrum, genu, body , splenium
34
The chorda tympani is part of the facial nerve, what does it supply?
Secromotor to submandibular and sublingual salivary glands
Carries special sense of taste to anterior 2/3rds
35
What separates follicles in the thyroid gland?
Fibrous septae
36
In which layer of the scalp are blood vessels present?
In the superficial fascia (connective tissue)
37
What is the nerve supply to the abdominal viscera?
Sympathetic: Abdominal pelvic splanchnic nerves
Prevertebral sympathetic ganglia
Abdominal aortic plexuses
Parasympathetic: Anterior and posterior vagal trunks (vagus)
Pelvic splanchnic nerves
38
What forms the roof of the nasopharynx?
The body of the sphenoid
39
What is the embryological origin of the components of the suprarenal glands?
Cortex = mesodermal epithelium
Medulla - neuroectoderm
40
What are the acidophils and what do they secrete?
Acidophils = somatotrophs = GH
Mammotrophs = Prolactin
41
What are emissary veins
Valveless veins that connect the extracranial venous system with the intracranial venous sinuses - THEY ARE VALVELESS
42
Opposite which upper tooth does the parotid duct open into the oral cavity?
Maxillary second molar
43
What is the cutaneous innervation of the scalp?
Anterior part = V1, V2 and V3 of the trigeminal nerve
Posterior part = cutaneous branches of cervical spinal nerves C2 and C3 (both anterior and posterior rami)
44
What is the appearance of white matter on a section of a spinal cord?
Spinal cord sections are almost always stained, therefore white matter appears darkly stained
45
How does a double ureter form?
Ureteric bud is duplicated from the mesonephrotic duct
46
What is the nerve supply to the kidneys?
Sympathetic nerves originate in the T12 and L1 spinal segments and coeliac ganglion
Parasympathetic nerves are derived from the vagus
47
Where are the adenoids found?
Just below the sphenoid sinus
48
Which part of the temporal bone does the inner ear lie?
Petrous part of the temporal bone
49
What is the vertebral level of the transpyloric plane
L1
50
What do the retropharyngeal nodes drain and where do you find them?
Drain the nasopharynx
Auditory tube
Upper cervical vertebral column
They lie between the pharynx and the vertebral bodies
51
Between what two layers are the venous sinuses found?
Periosteum and cranial dura
52
Where do the anterior and posterior spinal veins drain into?
They communicate freely with each other and join the **internal vertebral venous plexus** - it lies in the epidural space
The internal vertebral venous plexus communicates with the dural sinuses and veins within the skull.
It also communicates with the external vertebral venous plexus on the external surface of the vertebrae
53
Where do you find aqeous humour and vitreous humour?
Aqeous = anterior segment
Vitreous = posterior segment
54
What do the posterior spinal arteries form from?
The vertebral artery (25%)
or the posterior inferior cerebellar artery (75%)
55
Where does the facial artery end?
Ends just lateral to the pitiform arpeture - it continues as the angular artery
56
To which bony points does the anterior edge of the tentorium cerebelli attach to?
Superior angle of the petrous part of the temporal bone
57
What level does the dura mater and the arachnoid mater terminate?
Dura mater = S2
Arachnoid mater = S2
At S2 the two layers fuse into 1 and end in the filum terminal
58
What is the dural fold that separates the two cerebelar hemispheres called?
Falx cerebelli
59
What are the three muscles that form the inner longitiudinal layer of the outer layer of the pharynx?
Stylopharyngeus
Salpingopharyngeus
Palatopharyngeus
60
What type of fibres does the cerebral peduncle contain?
Corticofugal fibres
Contains corticospinal and corticopontine tracts
61
Where deos sensory innervation to the pharynx arise from?
Arises from the glossopharyngeal
Glossopharyngeus also supplies the motor innervation for the stylopharyngeus
(motor innervation is mainy supplied by the vagus)
(Pharyngeal plexus ting)
62
Where do the following arteries arise from:
## Footnote
Left and right gastric
Left and right gastro omental
Left gastric = Directly from coeliac trunk
Right gastric = Branch of the common hepatic
Left gastro omental = Branch of the splenic
Right gastro omental = Terminal branch of gastroduodenal which arises from the common hepatic
63
Which cranial nerve emerges just above the superior cerebellar artery?
Occulomotor
64
What is the blood supply to the pituitary and the hypothalamus?
Internal carotid and its branches:
Superior hypophyseal = hypothalamus
Inferior hypophyseal = Posterior pituitary
65
What are the basophils and what do they secrete?
Basophils = Corticotrophs (ACTH and MSH)
Thyrotrophs = TSH
Gonadotrophs = FSH and LH
66
Which sinus does the superior ophthalmic vein drain into?
Into the cavernous sinus within the cranial cavity - on the outside of the cranial cavity it is continuous with the facial vein
67
What lymph nodes are responsible for draining the middle ear and the external auditory meatus?
Middle ear - parotid nodes
External auditory meatus - mastoid nodes
68
What arteries form the basillar artery?
Left and right vertebral arteries
69
What are the cell types contained within the parathyroid gland?
Chief cells, pale stain - secrete hormones
Oxyphil cells - Contains adipocytes
70
What position is the eye if there is third cranial nerve palsy?
Abducted and depressed
71
What do the anterior cervical nodes drain and where do you find them?
Drain superficial structures of anterior neck
Lie along anterior jugular veins
72
What bones form the roof of the nose?
From anterior to posterior
Nasal
Frontal
Ethmoid
Body of sphenoid
73
What cartilage forms a complete ring in the larynx?
The cricoid cartilage
74
How does the hypothalamus commuicate with the anterior pituitary?
Hypothalamo-hypophydseal portal system
75
Which lymph nodes drain the floor of the mouth and the anterior tongue?
Submandibular and submental
76
What are the actions of the pterygoid muscles?
Medial - protraction and elevation of mandible
Lateral - protraction of mandible
77
What are the two articular processes that form this joint?
Mandibular fossa of the temporal bone
Condylar process of the mandible
78
What artery supplies primary auditory area and area for olfaction?
MCA
79
What is the innervation of the following air sinuses?
1. Frontal
2. Maxillary
3. Sphenoid
4. Ethmoid
1. Frontal = V1
2. Maxillary = V2
3. Sphenoid = V1 and V2
4. Ethmoid = V1
80
Which triangle of the neck does the accessory nerve lie?
Posterior
81
What are the two folds found in the larynx?
Vestibular fold
Vocal fold
82
What are the three layers of the pharynx?
The outer circular
Middle fibrous
Inner mucous membrane
83
Where is the glottis?
The space between the t sets of vocal chords
84
What is the point between the posterior of the tongue and the epiglottis?
Valecula
85
Where does the inferior thyroid vein drain?
Bracocephalic vein
86
What type of ossification occurs in irregular bones of the base of the skull?
Endochondral ossification
87
What vertebral level does the common carotid artery divide?
C4/C5 (upper level of the thyroid cartilage)
88
Which part of the spinal column has a large ventral horn?
Cervical and lumbar regions - contain limb plexuses
89
Through which foramen does the facial nerve exit the posterior cranial fossa?
Internal acoustic foramen
Vestibulocochlear also exits through this foramen
90
What type of cells are follicular cells?
Cuboidal
Stain pink
91
What is the function of the thalamus?
Sensory relay station
92
What separates the anterior horns of the two lateral ventricles?
Septum pellucidum
93
What arteries supply the primary visual cortex?
Posterior cerebral arteries
94
What makes up the floor of the inguiunal canal?
Inguinal ligament
Lacunar ligament
95
What are the ligaments of the liver?
Coronary
Falciform (remnant of left umbilical vein)
Round ligament
96
Which arteries supply the primary motor cortex and the primary sensory area?
ACA and MCA
97
What is the innervation of the rectus abdominis?
Thoracoabdominal nerves T7-T11
98
What structure does the open part of the medulla connect with?
Connects with the fourth ventricle
99
Which muscle attaches to the medial pterygoid plate?
Superior pharyngeal constrictor
100
What are the actions of the following muscles:
## Footnote
Genioglossus
Hyoglossus
Sytloglossus
Palatoglossus
Genioglossus - protudes tongue to opposite side
Hyoglossus - retracts and depresses side of the tongue
Sytloglossus - retraction and elevation of the tongue
Palatoglossus - raises back of tongue
101
102
What is the arterial and venous supply of the parathyroid glands?
Arterial = Inferior thyroid arteries
Venous = Internal jugular veins
103
What are the extrinsic muscles of the tongue?
Genioglossus
Hyoglossus
Sytloglossus
Palatoglossus
104
Where is the third and fourth ventricle located?
Third ventricle = diencephalon between the two thalami
Fourth ventricle = Within the pons and the upper part of the medulla
105
What is the vein that lies next to the frenulum?
Lingual frenulum
106
What would happen if the recurrent laryngeal nerve was transected?
Hoarseness of voice and loss of voice
107
What are the nerves that supply the vocal cords?
Recurrent laryngeal (runs between trachea and oesophagus)
Superior laryngeal
108
What are the attachments of the SCM?
Clavicle
Manubrium
Mastoid process
Lateral part of the superior nuchal line
109
Which lymph nodes drains the chin?
Submental
110
What type of cell secretes calcitonin?
Parafollicular C cells
Clear
111
What type of cell surrounds the mucous acini?
Myoepithelial cells
112
What is contained within calots triangle?
Common hepatic duct
Cystic duct
Inferiorsurface of the liver
113
Which lymph nodes does the lateral aspect of the eye drain into?
Drains into the parotid nodes
114
What structure lies immediately lateral to the pyramids?
Olives
115
What is the foramen on the back of the tongue?
Foramen caecum
116
What is the course of the right recurrent laryngeal and the left recurrent laryngeal?
Right = Loops under right subclavian artery before ascending to the larynx
Left = Lops under the arch of the aorta before ascending towards the lasrynx
117
What do serous and mucous acini secrete?
Serous = Proteins - they stain strongly
Mucous acini = glycoprotein mucous which stains poorly
118
What passes through the inferior orbital fissure?
Maxillary division of the trigeminal
119
What type of epithelium lines the dorsal surface of the tongue?
Keratinised squamous epithelium
Skeletel muscle fibres underlie the epitelium of the tongue
120
What makes up the roof of the inguinal canal?
Internal oblique
Transversus abdominis
Transversalis fascia
121
What is the neve supply to the intrinsic muscles of the larynx?
Recurrent laryngeal nerve apart from the cricothyroid which is supplied by the superior laryngeal nerve
122
What happens to the pia matter after the end of the spinal cord?
Projects inferiorly forming a slender filament called the filum terminal
123
What passes through the foramen magnum?
Spinal cord (medulla oblongata)
Vertebral arteries
Posterior and anterior spinal arteries
124
What is contained within the lentiform nucleus?
The globus pallidus and the putamen
125
What structures are present in the subarachnoid space?
Blood vessels
Arachnoid trabeculae
126
What controls the tensor tympani?
Branch of CN5 V3
127
What opens into the middle meatus?
Maxillay sinus
Frontal sinus
Anterior and middle ethmoidal air cells
128
What colour does the anterior pituitary stain with H and E stain?
Anterior is DARK
129
What passes through the superior orbital fissure
Occulomotor nerve
IV nerve - trochlear
Abducens nerve
Ophthalmic division of the trigeminal
Ophthalmic veins
130
What makes up the anterior wall of the inguial canal?
Aponeurosis of external oblique
Internal oblique
131
What are the attachments of the medial and lateral pterygoid muscles?
Lateral pterygoid muscle attaches to the lateral surface of the lateral pterygoid plate
Medial pterygoid muscle attaches to the medial surface of the lateral pterygoid plate, also attaches to the medial surface of the angle and ramus of mandible
132
From which arteries does the left and right vertebral arteries arise from?
Arised from the subclavian
133
What is the innervation of the muscles of the soft palate?
All supplied by the pharyngeal plexus with the exception of the tensor veli palatini - supplied by the CNV (V3)
134
Which extrinsic muscle of the tongue is not innervated by the hypoglossal nerve?
Palatroglossus - supplied by the pharyngeal plexus
135
Which cerebral artery through one of its branches supplies the internal capsule?
Middle cerebral artery
136
What are the muscles of the soft palate?
Tensor veli palatini
Palatoglossus
Palatpharyngeus
Levator veli palatini
Musculus uvulae
137
What is contained within the porta hepatis of the liver?
Contains right and left hepatic ducts
Right and left hepatic arteries and the portal vein
138
Which two vesicles of the neural tube give rise to the brainstem?
Mesencephalon and the rohmbencephalon
Mesencephalon = Midbrain
Rhombencephalon = metencephalon (pons) and myencephalon (medulla)
139
What is the fold of dura mater that surrounds the pituitary stalk?
Diaphragm sellae
140
Which dural venous sinus runs along the attachment of the falx cerebri to the tentorium?
Straight sinus
141
What opens into the inferior meatus?
Nasolacrimal duct
142
What are the main secretory cells of the hypothalamus?
Magnocellular neurosecretrory cells
143
Which part of the skull are the ear ossicles found?
Petrous part of the temporal bone
144
What arteries supply the suprarenal glands?
The suprarenal arteries - branches of inferior phrenic arteries, aorta and the renal arteries
145
What part of the hypothalamus can be seen from the surface?
Mamillary bodies
146
What are the Compartments of the neck?
Vertebral compartment (cervical vertebrae and postural muscles)
Vascular compartments (major blood vessels and the vagus nerve)
Visceral compartment (contains the thyroid, parathyroid glands, pharynx, larynx, trachea and oesophagus)
All enclosed by a musculofascial collar
147
What do the laryngeal nodes drain and where do you find them?
Drains the larynx and adjacent structures
Lie around the cricothyroid ligament
148
What is the function of aqueous humour and vitreous humour?
Aqueous = maintains intraocular pressure
Vitreous = helps cushion the retina
149
What are the 5 layers of the scalp?
Skin
Conenctive tissue
Aponeurosis of the occipitofrontalis muscle
Loose connective tissue
Pericranium
150
When do the following fontanelles fuse?
Anterior
Posterior
Anterior = 18-24 months
Posterior = 2 months
151
What structures pass through the transverse foramen of cervical vertebrae?
Vertebral artery and vein
Sympathetic nerve plexus
152
Where do the superior thyroid vein and the middle thyroid vein drain?
IJV
153
What are the two bones that form the nasal septum?
1. Vomer
2. Perpendicular plate of the ethmoid
154
What is the level of the transtubercular line?
L5
155
What is the bulbous projection on the floor of the lateral ventricle?
Caudate nucleus
156
What two bones form the zygomatic arch?
Zygomatic bone
Temporal bone
157
What makes up the brachial plexus?
Anterior rami of C5-T1
158
What are the 4 main arteries of the stomach?
Left and right gastric
Left and right gastro omental
159
What is the sensory nerve supply to the mucous membrane of the larynx?
Internal laryngeal nerve
160
What do the superficial cervical nodes drain and where do you find them?
Parotid nodes
Angle of mandible
Structures that lie at the junction between the neck, the face and the scalp
Lie along the external jugular vein
161
What are the missing structures?
162
What structures go through the oesophageal opening?
Left and right vagus
Oesophageal branches of the left gastric artery and vein
Phreno-oesophageal ligament
Lymphatics
163
What are the missing areas on the kidney?
164
What travels through the optic canal?
The opthalmic artery
The central retinal vein
CN2
165
Opposite what tracheal rings does the thyroid gland lie?
Opposite the 2nd and 3rd tracheal rings
166
What type of fibres corss over at the decussation of the pyramids?
Corticospinal
167
What is the innervation of the external oblique?
Thoracoabdominal nerves (T7-T11) and subcostal nerve (T12).
168
What nerve is the buccinator innervated by?
Facial nerve
169
What is the nerve innervation of the stapedius?
Facial nerve
170
Which layer of the peritoneal cavity is more sensitive to pain?
Parietal
171
What is the function of the stapedius?
Dampens vibration
172
What papillae have taste buds?
The fungiform and the circumvalate
173
Where does sympathetic innervation of the parotid gland arise from?
Arises from the superior cervical ganglion - part of the paravertebral chain
174
What two bones form the hard palate?
Palantine process of the maxilla
Horizontal plate of the palantine bone
175
What are the arcades and vasarecta like in the jejunum vs ileum?
And fat in mesentry
Vasa recta in jejunum = long
In ileum = short
Arcades in jejunum = few large loops
In ileum = many short loops
Fat in mesentry in jejunum = less
In ileum = more
176
Which lymph nodes drain the cheek region?
Buccal
177
Which lymph nodes drains the ethmoidal, frontal and maxillary sinuses?
Submandibular nodes
178
Where do the facial vein and the superficial temporal vein drain into?
Facial vein = IJV
Superficial temporal = retromandibular
179
What curvature exists in the cervical portion of the spine
Lordosis
180
What fissures are assocaited with the following arteries?
1. Anterior cerebral
2. Middle cerebral
3. Posterior cerebral
1. Longitudinal fissure
2. Lateral fissure
3. Calcarine sulcus
181
Whata re the suprahyoid muscles and what are their nerve innevations?
Mylohyoid - CNV3
Geniohyoid - hypoglossal nerve
Digastric - anterior belly = CN5 V3 posterior belly = posterior facial
Stylohyoid = facial nerve
These muscles elevate the hyoid bone and widen the oesophagus during swallowing
182
What are the following fissures
183
What ligaments prevent overadduction and overabduction of the eye?
Medial and lateral check ligaments
184
Which nucleus of the thalamus is related to general sensory information from the body?
Ventro-postero-lateral nucleus of the thalamus
185
What is the paired cartilage of the larynx?
Arytenoid
186
What are the layers of the outer muscular layer of the pharynx?
Contains an outer circular layer and an inner longitudinal layer
Outer circular = superior, middle and inferior constrictors
187
What is the nerve that passes through the mandibular foramen?
Inferior alveolar nerve - branch of C5V3 - provides sensory innervation to the mandibular area
188
Which foramen lies immediately anterior to the groove for the cavernous sinus?
Optic canal
189
at makes up the posterior wall of the inguinal canal?
Transversalis fascia
190
How does CSF pass into the subarachnoid space from the 4th ventricle?
1 x foramen magendie
2 x foramen lusceka
191
What opens into the superior meatus?
Posterior ethmoidal air cells
192
Name three of the organs that are within the stomach bed?
Pancreas
Spleen
Left kidney
193
What are the following fissures
194
What is the innervation of the internal oblique/transversus abdominis?
Thoracoabdominal nerves (T6-T11), subcostal nerve (T12) and branches of the lumbar plexus.
195
What is the purpose of the ureters?
Transports urine from renal pelvis to bladder
196
What is the hole in the centre of the spinal cord - what does it contain?
Central canal - contains ependymal cells that produce CSF
197
What are the attachment of the following muscles?
Genioglossus
Hyoglossus
Sytloglossus
Palatoglossus
Genioglossus - Inner surface of the mandible
Hyoglossus - Hyoid bone
Sytloglossus - Styloid process
Palatoglossus - Soft palate
198
What is the function of the salpingopharyngeus?
Opens the eustachian tube during swallowing and yawning
199
What are the muscles that attach to the hyoid bone?
Suprahyoid muscles
Infrahyoid muscles
Sternohyoid
Middle pharyngeal constrictor
200
What are the cervical plexus root values?
C1-C5 - emerge between the scalene muscles (anterior and medial)
Contains the phrenic nerve
Ansa cervicalis is the loop of nerves that are part of the cervical plexus
201
Which muscle lies posterior the ureter?
Psoas major
202
Which embryological structure are the ventricles formed from?
Formed from the neural tube
203
What does the anterior spinal artery form from?
Vertebral arteries
204
What muscle does the parotid duct pierce to enter the oral cavity?
The buccinator muscle
205
What type of fibres does the middle cerebellar peduncle contain?
Contains centripetal fibrs
206
Which part of the bladder does the urethra exit?
Internal urethral orifice
207
Which lymph nodes drain the scalp?
Parotid - drains the scalp surrounding the carotid
Mastoid - middle region of the scalp
Submandibular - front of the saclp
Occipital - back of the scalp
208
What is the innervation of the ciliaris muscle, constrictor pupillae and the dilator pupillae?
Cilliaris - cranial nerve 3
Constrictor pupillae - cranial nerve 3
Dilator pupillae - sympathetic innervation
209
What passes through the optic foramen?
Optic nerve
Ophthalmic artery
210
What are the infrhyoid muscles and what are their nerve innervations?
Thyrohyoid - C1 (hitches a ride on the hypoglossal nerve)
Omohyoid - Ansa cervicalis
Sternohyoid - Ansa cervicalis
Sternothyroid - Ansa cervicalis
Depress the hyoid bone and larynx during swallowing and speech
211
What are the attachments of the masseter?
Zygomatic bone and arch
Outer surface of the ramus and angle of the mandible
212
How many decidous teeeth do we have?
20
I = 8
C = 4
M = 8
