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Sección especial: Monitoreo y ejecución del gasto en salud

Capítulo 5. Prácticas y procedimientos presupuestarios

5.7. Sección especial: Monitoreo y ejecución del gasto en salud

LBS

LBS (LB Surface Burial) consists of most of the frontal and some of the left parietal (plate 5-13). A male status can be preferred on the basis of a moderately well-developed glabella (Martin Type 3), "medium" super­ ciliary ridges, and the mandible (chapter 8), although the zygomatic trigones are only "slight". In addition the ophryonic grooves show "slight" development (see Larnach and Macintosh 1966:15-16) though without trace of a

supraglabellar fossa. As for LB3 the (mandibular) second and third molars show only enamel polishing, bar the

appearance of one tiny area of exposed dentine on the left M2, whereas the left coronal suture is completely closed

and even completely fused at the level of the temporal fossa,

a condition occurring for only about 5% before their middle twenties (McKern and Stewart 1957:Table 8 (p.28)). An age at death between 20 and 30 years seems highly probable with slow dental wear but fairly precocious coronal suture closure. The large wound on LBS 1s left frontal region (plate 5-13) penetrates the bone completely and there is no sign of healing of the bone on the inner table; this wound, in connection with LBS's burial

circumstances, suggest that LBS had been hastily disposed of after an untimely death.

Brow ridges are of Cunningham's type 2. Fairly

large frontal sinuses are present. Their shape is less exactly indicated by superciliary ridge shape than with LB3,

since LBS's frontal sinuses are lower, superiorly commencing at a level equivalent to the supraorbital notches and

extending inferiorly below the fronto-maxillary articulation. Both left and right sinuses are single-chambered. The

right sinus is the larger, extending medially as far as the midline and laterally almost as far as the supraorbital notch (a transverse diameter of some 24 mm), with a

superio-inferior diameter of some 24mm and a maximum depth of about 7 mm. The left frontal sinus is slightly lower, extending from almost the most medial point of the left superciliary ridge almost to the left supraorbital notch

(a transverse diameter of some 16 mm) with a superio-inferior diameter of some 20 mm and a maximum depth of about 7.5 mm.

The frontal part of the face is flat with a nasio- frontal subtense of 15 mm. From the shape of the frontal, the nasofrontal articulation is omega shaped (see

Pietrusewsky 1976:84) and wide (width about 13 mm), nasion sits in only a modest depression, and the nasal bones would have been flat and would have projected anteriorly from nasion. As a whole the nasofrontal articulation is high in relation to the orbits. Supraorbital notches in association with a supraorbital foramen are present, in addition the left side exhibits another supraorbital foramen at the most projecting point of the superciliary ridge. The superior

borders of both orbits are strongly and evenly curved, unlike LB3's comparatively straight superior orbital borders.

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The frontal bone is generally smooth with no trace of a median frontal ridge. A low and broad, transversely-oriented hump occurs about halfway up the frontal, connecting the frontal bosses which are thus only laterally discernable. Frontal recession is right on the borderline between "medium" and "marked". Like LB3, LBS shows a median frontal profile with a slight bulge at glabella and a smooth but fairly low

continuous curve from supraglabellare to bregma. There is no trace of a metopic suture. The frontal temporal lines are fairly gently marked but can still be discerned as a "slight" temporal crest on the left parietal. A longitudial depression is present on the left parietal from just superior to the squamous suture, running superiorly just posterior to the coronal suture and

disappearing at about the temporal crest. As a whole the frontal is fairly long but quite broad, with very little post-orbital constrietion.

Thickness measurements of the cranial vault are 13.5 mm at nasion, 15 mm at glabella, 7.5 mm close to bregma, and 7 mm at metopion. Thus LBS is probably

slightly less thick than the average Australian Aboriginal frontal (Brown et al 1979:Table 6).

The Leang Tuwo Mane'e material

The various fragments have been labelled for convenience in description, but unlike the LB material there is no implication that different labels within the same class (here crania) refer to different individuals

(see Appendix A). Stratigraphic position of the fragments is given in table A-2.

LTM P/Q 1, a right malar/maxillary fragment,

probably older than 25 years at death from the three-

quarters closure of the malar-maxillary suture. Present are a "slight" malar tuberosity in the form of a long

unprominent roughened area running parallel with the inferior border of the malar about halfway up the main body, and a knob-like tuberosity on the malar process of the maxilla at about the same level as the malar

tuberosity, separated from the masseteric attachment by a shallow, faintly palpable furrow. The malar-maxillary suture is moderately everted. The main body of the malar is quite strongly angled with the change of gradient from the transverse to the obliquely posterior plane of the cheek occurring at a low, roughly-hewn ridge running

parallel and about 5 or 6 mm lateral to the malar-maxillary suture. The orbital border of the malar shows "distinct" rounding; the extant frontal process of the malar is thick and strongly built with a marginal process of either

"medium" or "large" development. The cheek is very tall (WHM = 27 mm). An infraorbital foramen is present about 7 mm below the corner of the orbit; a slight infraorbital bar runs the length of the inferior border of the orbit. The concavity of the inferior margin of the maxillary process is moderately developed; the lateral border of the canine fossa is clearly etched. Generally, this fragment indicates a moderately massive and rugged cheek.

LTM P/Q 2 , a left upper cheek tooth row and associated alveolar process, probably from a young adult

3

given the complete eruption of M and the presence of

2 3

only enamel polishing on the premolars and M and M . Buccal or lingual maxillary hyperostosis is lacking. The hypocone

1 2

pattern is 4,4,3+; P has two distinct roots, P has two fused roots; a buccal pit is present on . B-L/M-D index

1 2

is 135.7 and 137.0 for P and P respectively, values indicating quite high premolar robusticity particularly

2 1

as interstitial wear is negligible; P /M M-D index is 67.5. Thus apart from premolar robusticity the toothrow is typically southeast Asian (chapters 3 and 4). Teeth are large,

especially the premolars which are outside the LB range.

162 . Odontometrlcs are M-D B-L M-D B-L P 1 8.4 11.4 M 1 12.0 12.7 CN 1 c u 8.1 11.1 M 2 11.2 13.4 M 3 9.0 13.0

LTM P/Q 3, a nasal process and partial left frontal showing no closure of the extant coronal suture The left superciliary ridge is of "small" development, glabella is moderately well-developed and of Martin

Grade 4, brow-ridges are probably of Cunningham's type 1 (median) as the superciliary ridge springs medially

from the glabellar prominence. There is a "medium" ophryonic groove and a "slight" supraglabellar fossa. Though very incompletely preserved the frontal sinuses would have been large, with a large median chamber, posteriorly divided into lateral and medial pockets,

From the nasal root the left sinus extends laterally just beyond the lateral extent of the superciliary ridge and medio-

posteriorly to be deep to the supraglabellar fossa;

maximum depth is unrecordable but would be at least 7 mm. Only the medial border of the smaller right chamber is present. A moderately developed frontal boss is present, and the faintest median frontal ridge can be palpated medial to the boss. Both superior and inferior temporal crests are distinct. The median profile shows a bulge at glabella, a broad elevated hump at the region of the

frontal boss, and then a distinct flattening for the posterior third to bregma. Despite this slight vaulting the frontal shows "marked" recession with a curvature index between 22.5 and 23.5. The bone is guite thick, measuring 9 mm about the region of metopion and 13 mm at nasion.

Nasion sits in a slight or moderate depression and is moderately low. The superior part of the nasal bones projects anteriorly guite strongly relative to the frontal processes of the maxilla. The superior edges of the nasal bones climb reasonably sharply to produce an irregular

omega shape; nasofrontal articulation is moderately

broad (12 mm). The superior orbital border, at least for the medial half, is fairly gently curved.

LTM P/Q 4 , a left occipital and parietal fragment which articulate at a part of the lambdoid suture

showing half-closure so indicating probably adult status (McKern and Stewart 1957:28). A "slight" temporal crest can be seen as it runs into the lambdoid suture, and the lateral beginnings of a transverse occipital torus can be seen extending nearly to the suture. The small lateral portion of occipital markings extant suggest

'medium' development of Larnach and Freedman (1964:298).

LTM P/Q 5 , a right parietal fragment, an

associated fragment of the mastoid portion of the right temporal, and a small associated right occipital fragment, articulating at a portion of the lambdoid suture showing half-closure. The parieto-mastoid suture shows no closure

(the usual condition throughout life (McKern and Stewart 1957:Table 11, p.31)). The beginning of the digastric

fossa is present as is the most superior part of the mastoid process, neither complete enough to allow any observations. The posterior part of the supramastoid crest is present

and judging from that, the crest would have been of "marked" development. A triangular-shaped ossicle is present anterior to asterion and just posterior to the supramastoid crest. Though incomplete the parietal boss would probably have been of "medium" development.

Though it cannot be proven the above fragments, none of them overlapping, could well have come from the same individual, a fairly rugged and thick-vaulted male in his twenties at the time of death (given the pattern of suture closure and slight toothwear).

LTM P/Q 6 , a left malar fragment metrically and morphologically dissimilar from P/Q 1 so probably coming from a different individual. There is some very early

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closure of the malar-maxillary but no closure of the temporo-malar suture, so age status is best described as 'possibly adult' . The malar tuberosity shows very

"slight" development but is otherwise similar in form to the other fragment. Like P/Q 1 there is a single

infraorbital malar foramen, strong eversion of the malar-maxillary suture, a slight infraorbital bar, and rounding (here "trace") of the malar orbital border. Unlike P/Q 1 the inferior margin of the malar is

considerably thinner, the change in gradient of direction clearly occurs at the malar-maxillary suture, a ridge parallel and lateral to the suture is lacking, and the cheek is much less tall (WMH = 23 mm). Though the

inferior margin of the malar is quite gracile, there is a reasonably prominent tuberosity either directly inferior or slightly medio-inferior to the jugalia region, which appears possibly to divide the concavely-shaped inferior attachment regions of the anterior and posterior masseter muscles. There is also a small tuberosity slightly

medio-inferior to the superior edge of the temporo-malar articulation, which is quite distinct from the malar tuberosity and may represent the attachment of the

posterior masseteric fibres. (Such a tuberosity is absent on LB3). Generally speaking this fragment is less massive and rugged than LB3 or P/Q 1, and may be female.

The LTM H/K cranial fragments consist only of

a frontal fragment with a powerful temporal crest extending from the fronto-malar suture, but a virtually absent

zygomatic trigone; a partial nasal saddle again showing the superior borders of the nasal bones climbing slightly medially to form a low omega shape, with a nasofrontal

articulation of "medium" width (10-12 mm) if symmetry holds; and various fragments of a six-month old infant.

Section 3: LBP

LBP (Preceramic Burial) consists of most of the calvarium and face (plates 5-15 to 5-19). It was more or less complete at excavation (plate 1-4) but crumbled as it was unearthed. A major problem with reconstruction was some medial warping of the inferior walls of the neurocranium

producing a 'multiplier effect' on the face such that, despite extensive juggling, the right half of the face is too high and the right zygomatic arch hovers well above and lateral to its root. Emphasis was placed on getting the left side of the face as correct as possible.

All sutures show no or only the most incipient closure; this includes the basilar suture which suggests an absolute age limit at death of 19 or 20 (McKern and Stewart 1957:34). The left upper second molar and premolars have erupted but show only slight enamel

polishing. From the shape of the alveolus the left upper third molar appears to have had its crown completely formed with early root formation, and to have erupted to approximately the level of the cervicc-enamel junction

of the second molar, so to be in the process of eruption through the gums. The pattern of dentäL wear, in combination with

the tendency for third molars often to erupt earlier in Filipinos and Malays than Europeans (Bean 1914:129;

Laband 1941:997), suggests 15 or 16 as the probable age at death with 14 to 19 the outside limits. Adolescents are frequently difficult to sex but the combination of

"slight" zygomatic trigone, glabellar, superciliary ridge, occipital markings, transverse occipital torus, and

(almost absent) malar tuberosity development, strongly supporis a female status (Larnach and Macintosh 1966:44; Larnach and Freedman 1964:291). The probably "medium" mastoid process and palate size are also commensurate with a female status.

In general terms, LBP has a very long and narrow (hyperdolichocephalic, index = 66.8) and moderately high (height/length index = 74.5, at the top of the ortho- cephalic range) cranium, with a relatively squat and very low face. The face is also flat, gracile, non-prognathous, and 'rectangular' in anterior view, and while it sits well forward of the transmeatal axis as a single massif, the anterior neorocranium is long and the face nestles neatly beneath the frontal. In vertical view LBP shows a long

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ellipsoid neorocranium and "marked" phaenozygy; in occipital view it is slab-sided with "slight" sagittal keel i n g .

There is no trace of ophryonic grooves or

supraglabellar fossa. The right frontal boss is moderately

developed, the left slightly or moderately (preservation is not good here), and both are strongly anteriorly

placed with their centres only some 33 mm posterior to the

upper orbital borders. The median frontal ridge shows

clear trace development; there is no trace of metopism. Temporal crests are "slightly" developed on the frontal. Despite the poor brow ridge development frontal sinuses

are large, if shallow. A left chamber extends from just

right of the glabellar region laterally about one third along the upper orbital border (a transverse diameter of some 22 mm) and supero-inferiorly from supraglabellare almost to the naso-frontal articulation (some 20 mm);

superiorly at least this chamber is divided into a smaller

medial and larger lateral division. Another very small

chamber is present just infero-lateral to the left

chamber. The right chamber is smaller and clearly single,

extending from just lateral to the midline, to a position laterally equivalent to that of the left (transverse diameter about 20 mm), and extending not quite as far

inferiorly as the left (supero-inferior diameter about 17 mm). Frontal sinus maximum depth would be in the order of 8-10 mm

(see f i g . 5-4).

The median frontal profile is a long,gentle, uninterrupted curve from nasion to bregma, with only a

slight vaulting in the middle third of the frontal, commencing

anteriorly at the same level as the bosses. The frontal

bone is "markedly" receding with a curvature index of 22.1.

Postorbital constriction is "marked", measuring about 25 mm

though this is slightly exaggerated by post mortem warping.

Unlike other Leang Buidane frontals which tend to be quite broad at the frontoparietal articulation, L B P 1s frontal is narrow for its entire length.

The parietals are long, narrow and tall; the occiput is relatively small and in posterior view extends only about half way up the cranium. Parietal bosses are

"slight". Bilaterally there are occasional faint hints of a temporal crest until the temporalis attachment approaches the supramastoid crest where, though still "slight", clear temporal crests are discernible. Wide flattish furrows extend from the upper limits of the temporalis attachments, parallel and about 25 mm posterior to the coronal suture, to meet at the sagittal suture. The median profile shows a slowly ascending, more or less straight line (in

association with a "slight" sagittal ridge) for the anterior half of the sagittal suture, then a fairly sharp change in gradient into a slight but broad obelionic depression, then another fairly sharp change of gradient into a larger, more or less circular flattened region for the last 25 mm of the sagittal suture and the occiput to the bosses. This

flattened region has a breadth of some 52 mm, and lambda

sits on a slight eminence within it. The occipital bosses are moderately developed with a diameter of some 35 mm, and

nestle into the pars media of the lambdoid suture.

Occipital bunning is absent. The median profile of the occiput descends in a furrow between the bosses till the transverse torus, in a slight and almost vertically oriented curve. The incompletely preserved transverse occipital torus

is very low on the occiput, of "slight" development with a low "ridge" shape, is broadest and most prominent in the midline, and extends to the right side (and the left as well?) as a progressively thinning, slightly curved ridge terminating about one third of the way to the

occipito-mastoid suture. The lateral beginnings of a "distinct" but probably fairly small external occipital protuberance

are discernable. There is a fairly sharp change in gradient at the torus into a short, strongly curved region ending at opisthion (plates 5-17 and 5-19). Computation of the angles of the neurocranial bones shows LBP, relative to recent

groups, to have a fairly angled occipital and parietal but a flat frontal chord (cf. table 5-1 and Howells 1973a:202).

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The lambdoid suture is markedly complex with two tiny lambdoid bones bilaterally present at about the middle of the pars media. The foramen magnum is incomplete, but is fairly long and narrow (breadth/length index

approximately 81). There is no trace of precondylar