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THE LIBRARY

OF

THE UNIVERSITY
OF CALIFORNIA



PRESENTED BY

PROF. CHARLES A. KOFOID AND
MRS. PRUDENCE W. KOFOID





QUAIN'S

EMENTS OF ANATOMY



EDITED BY



EDWARD ALBERT SCHAFER, F.R.S.

PROFESSOR OF PHYSIOLOGY AND HISTOLOGY IN UNIVERSITY COLLEGE, LONDON.



AND



GEORGE DANCER THANE,

PROFESSOR OF ANATOMY IN UNIVERSITY COLLEGE, LONDON.



IK" THREE VOLUMES.

VOL. III. PART IV.
S PLANCH NO LOGY.

BY PROFESSOR E. A. SCHAFER, F.R.S.

AND

PROFESSOR JOHNSON SYMINGTON, M.D.

PROFESSOR OF ANATOMY IN QUEEN'S COLLEGE, BELFAST.

ILLUSTRATED BY 337 ENGRAVINGS.

CentI) (Jctrtttoit.



LONGMANS, GREEN, AND CO.

LONDON, NEW YORK, AND BOMBAY.
1896.

[All rights reserved.]



LONDON
BRADBURY, AONEW, & CO. LD., PRINTERS, WHITEFRIAR8.






I




\-v\0

ADVERTISEMENT TO THE TENTH EDITION.

THE successive Editions of Dr. Jones Quain's " Elements of Anatomy "
were, up to the Fourth inclusive, published under the superintendence of
the original author. At his death the duty of editing the Fifth Edition,
which was published in 1845, was undertaken by Mr. Eichard Quain, then
Professor of Anatomy, and by Dr. William Sharpey, who occupied the chair
of General Anatomy and Physiology in University College. On that
occasion extensive changes were made throughout the work, and a great
part was rewritten. This applies especially to the General and Visceral
Anatomy, edited by Sharpey, in which that distinguished Anatomist and
Histologist published many valuable original observations. Indeed from
this time for 35 years the influence of Sharpey was conspicuous throughout
this part of the work, which was frequently referred to as " Quain and
Sharpey's Anatomy."

In the Sixth Edition the place of Mr. Richard Quain was taken by
Mr. G. V. Ellis, his successor in the chair of Anatomy in University College ;
Sharpey editing as before the General Anatomy and the Descriptive
Anatomy of the Viscera.

In the Seventh Edition, which was published in 1867, while the General
Anatomy continued to be edited by Sharpey, the whole of the Descriptive
and Visceral Anatomy was taken in hand by Dr. Allen Thomson, Professor
of Anatomy in the University of Glasgow, and by Dr. John Cleland, then
Professor in Galway, now the successor of Allen Thomson in Glasgow.
This portion of the work was in great measure recast by Cleland, and many
new figures from the facile pencil of Allen Thomson were added.

The changes in the Eighth Edition, which was published in 1876, and
was the first appearing under the auspices of the present publishers, were
still greater. On this occasion most of the Descriptive Anatomy was under-
taken by Dr. Allen Thomson, who also contributed a chapter on Embryology,
while the account of the Brain and Spinal Cord was placed under the editor-
ship of Dr. W. R. Gowers. The section on General Anatomy and the
chapters on the Thoracic, Abdominal and Pelvic Organs, and the Organs of
the Senses, were again edited by Sharpey, with the assistance of one of the



IV ADVERTISEMENT TO THE TENTH EDITION.

present Editors (Professor Schafer), much of this part of the work being
re-written and many new illustrations introduced.

In 1882 the Ninth Edition was published under the editorship of
Dr. Allen Thomson, Mr. E. A. Schafer, then Assistant Professor of Physiology
in University College, and Mr. G. D. Thane, the successor of Ellis in the
chair of Anatomy. Dr. Allen Thomson undertook the revision of the
chapter on Embryology. Professor Thane re-edited the Descriptive Anatomy;
while the General Histology and the Special and Minute Anatomy of the
Viscera, including the Brain and Spinal Cord, fell to Professor Schafer.

The preparation of the present Edition was commenced in 1890 by
Professors Schafer and Thane. It was decided to entirely remodel the
work, to increase the size of the page and the number of illustrations, and
to publish the several parts separately as they might be got ready for press :
each part being thus a special treatise on the particular subject denoted by
its title, and the whole being intended to form collectively a complete text-
book and work of reference in Anatomy. With this end in view a copious
Bibliography has been provided for each subject, and the illustrations have
been greatly multiplied. Many have been re-drawn upon a larger scale to
suit the page, and many original figures have been added, other illustrations
having been copied from various monographs .and standard works. Little
of the original book now remains beyond the title, greater alterations having
been made in this than in any previous Edition since 1845.

The first parts to appear (1890) were those on Embryology (Professor
Schafer), and Osteology (Professor -Thane). In 1891 the General Anatomy
or Histology (Professor Schafer); and in 1892 the Arthrology, Myology and
Angeiology (Professor Thane) were published. In 1893 the Brain and
Spinal Cord made its appearance, and in the following year the Organs of the
Senses, both the work of Professor Schafer. A part dealing with the Nerves,
undertaken by Professor Thane, was published this summer, and a final
part, containing the Anatomy of the Digestive, Respiratory, Urinary and
Generative Organs has now been added, thus completing the work. In
this part the anatomical descriptions have been allotted to and in many
cases entirely re -written by Dr. J. Symington, Professor of Anatomy in
Queen's College, Belfast, while the histological portion of the Splanchnology
has been re-edited by Professor Schafer. A chapter on Superficial Anatomy
will appear in the form of an Appendix, under the joint editorship of
Professor Thane and Mr. R. J. Godlee, M.S., Professor of Clinical Surgery
in University College.

The publication in separate parts will, it is hoped, be found convenient
to students and others using the work. The parts have been arranged so
as to facilitate their being bound up into volumes, although each part is
complete with Table of Contents and Index. Most of the labour, pf



ADVERTISEMENT TO THE TENTH EDITION. V

preparing the Index, which also partakes of the nature of a Glossary, has
fallen to Mr. T. W. P. Lawrence, M,B., F.K.C.S., Curator of the Museum
in University College, who has devoted much time and attention to rendering
this important addendum as complete as possible.

The new illustrations in the first and third volumes have mostly been
executed by Mr. J. T. Balcomb, who has taken a large amount of pains to
meet the requirements of the Editors. The illustrations of the bones and
other new figures in the second volume have been engraved by Mr. C.
Butterworth, from drawings by Mr. Donald Gunn, Mr. T. W. P. Lawrence,
and Professor Thane.

The Editors are indebted to Mr. R. J. Smith for kindly looking through
many of the proofs of the final part.

December. 1895.



CONTENTS OF VOL. III., PART IV.



THE ORGANS OP DIGESTION.

PAGE

THE MOUTH i

THE TONGUE 3

Mucous Membrane .... 4
Foramen caecum and Thyro-glossal

Duct 8

Glands 9

Muscular Substance . . . . 9

THE PALATE n

Hard Palate 1 1

Soft Palate . . . . . 13

THE SALIVARY GLANDS . . . . 15

Parotid Gland 15

Submaxillary Gland . . . . 16

Sublingual Gland . . . 17

Structure 17

Miicous Alveoli . . . . 19

Serous Alveoli . ... 20

Ducts ... . .21

THE TEETH . , . . . . 24

Special Characters .... 26

Permanent Teeth . . 26

Homologies . .' . -29

Milk-teeth 30

Structure . .'.'. . . 30

Pulp 30

Dentine ..... 32

Enamel . . . . . 34

Crusta Petrosa or Cement . . 36

Varieties of Dentine . . 37

Development of Teeth 37

Changes in the Dental Lamina . 40

Formation of Dentine . . 44

Formation of Enamel . . . 45

Formation of Cement . . 46

Dental Sacs . . . . . . 47

Formation of Alveoli . . . ' . 48
Eruption of the Milk-teeth . . . 49
Development of the Permanent Teeth 49
Eruption of the Permanent Teeth . 51
Historical Account of the Develop-
ment of the Teeth . . 53

THE PHARYNX 57

Nasal Part 57

Oral Part. . . ' . . . 59

Tonsils 59

Laryugeal Part . . . . 61

Structure and Attachments . . 61

Structure of the Mucous Membrane . 62

THE (ESOPHAGUS 64

THE ABDOMEN 68

THE PERITONEUM 69

THE STOMACH 71

Variations in Position . . ..71

Cardiac Orifice 72

Pylorus . . . . 72
Dimensions . . . . -75

Structure . . . . . . 76



THE STOMACH continued. PAGE

Gastric Glands ..... 78

THE SMALL INTESTINE . . . . 86

Structure ...... 86

Valvulse conniventes . . . . 88

Villi 89

Glands . . . . 93
Duodenum . . . . .100
Jejunum and Ileum . . . .
Meckel's Diverticulum
THE LARGE INTESTINE . . . .

Structure

Caecum . . . . . .

Vermiform Appendix

Ileo-colic or Ileo-csecal Valve . .

Colon ......

Rectum . . . . . .

Anal Canal .....

THE LIVER ......

Dimensions and Weight .

Fissures . . . . . .

Ligaments and Omentum . .
Position with regard to Abdominal
and Thoracic Parietes . . .
Excretory Apparatus

Hepatic Duct . . . .

Gall-bladder ....

Cystic Duct ... . .

Common Bile-duct
Liver in the Infant . . . .
Structure ......

Portal Vein .....

Hepatic Veins ....

Hepatic Cells . . . .

Biliary Ducts ....
THE PANCREAS .



1 02

103
103
105
108
109
no
III

"3
116

121
121
124



"5
127
127
127
128
128
128
129
I 3
132
132

133
139



ORGANS OP RESPIRATION
AND VOICE.

THE LARYNX 146

Thyroid Cartilage . . . . 147
Cricoid Cartilage . . . .148
Arytenoid Cartilage . . . . 148
Cornicula Laryngis .... 149
Cuneiform Cartilages . . *. . 149

Epiglottis 149

Peculiarities according to Age and Sex 149
Ligaments and Joints . . .151

Interior 152

Vocal Cords . . . . .154
Rima Glottidis . . . . . 156
Ventricles ..... 156
Mucous Membrane , . . . 156

Muscles 158

THE TRACHEA AND BRONCHI . . . 162
THE MEDIASTINUM THORACIS . 168



Vlll



CONTENTS OF PART IV.



ORGANS OF RESPIRATION AND VOICE

continued. PAGE

THE PLEURA , 169

THE LUNGS 174

Roots 176

Dimensions and Physical Properties . 180

Condition in the Foetus . . . 181

Minute Structure . . . .181

Bronchial Tubes . . . . 181

Pulmonary Alveoli . . . 183



THE URINARY ORGANS.

THE KIDNEYS , . . . .189

Structure 192

Excretory Apparatus . ' . 193

Tubuli Uriuiferi ... . . 195
Bloodvessels . . . . .201

THE URETERS 204

THE URINARY BLADDER ... . 206

Ligaments . . . . . . 211

Peculiarities in Shape and" Position
according to Age . . . .212

Interior . . . . . 212

Structure 213



REPRODUCTIVE ORGANS.

THE TESTES AND ACCESSORY STRUCTURES 218

Spermatic Cord 218

Inguinal Canal . . . .218

Scrotum . . . . . . 219

Testicles 221

Structure of Testicles . . . . 222

Tunica albuginea . . . 222

Seminiferous Tubules . . . 224

Spermatozoa .... 225
Epithelium of Seminiferous

Tubules . ; . . . 226

Interstitial Tissue . . . 230

Ducts of Testicles . . . . 230

Tubuli Recti .... 230

Rete Testis 230

Vasa Efferentia . 230

Canal of Epididymis . . . 231

Vas Deferens .... 232

Vas Aberrans . . . . 233

Organ of Giraldes .... 234

Seminal Vesicles ..... 234

Ejaculatory Ducts .... 235

THE PENIS 236

Corpora Cavernosa .... 239

Corpus Spongiosum . . . . 241



REPRODUCTIVE ORGANS THE PENIS

continued. PAGE

Male Urethra ..... 243

Prostatic Portion . . . . 243

Membranous Portion . . 246

Spongy Portion . . . . 246

Cowper's Glands .... 247

Prostate Gland . . . . 247

THE VULVA OR PUDENDUM . . . 253

Mons Veneris .... 253

Labia Majora ... 253

Labia Miuora . . ... 254

Clitoris 255

Erectile Tissue . . . . 255

Uro-genital Space .... 256

Glands of Bartholin . . . . 256

THE FEMALE URETHRA . . . 258

THE HYMEN AND VAGINA . . . 258

THE UTERUS . . . . . 260

Cavity ...... 262

Position ...... 262

Ligaments . . . . . . 263

Structure ..... 264

Periodic Structural Changes . . 267

Peculiarities according to Age . . 268

THE FALLOPIAN TUBES . . . . 269

THE OVARIES . . . . .271

Peculiarities according to Age . . 272

Epithelium and Stroma . . . 273

Graafian Follicles . . . . 275

Structure of Ovarian Ovum . . 279

Structure of Corpora lutea . . . 280

Parovarium ..... 282

THE MAMMARY GLANDS . . . 285

Nipple . ' . . . 285

Structure . . . 286

Varieties ...... 290

Milk . . . . . . . 291



THE DUCTLESS GLANDS.

THE SPLEEN 292

Accessory Spleens . . . . 296

Structure ..... 29
Splenic Pulp ... .298
Malpighian Corpuscles

THE SUPRARENAL CAPSULES . . . 302

Structure 303

Function ...... 305

THE THYMUS GLAND .... 307

THE THYROID BODY . . . . 311

THE PARATHYROIDS . . . -315

THE CAROTID AND COCCYGEAL GLANDS 317

THE PERITONEUM . . . . . 319

Omenta ...... 322



ORGANS OF DIGESTION.

BY E. A. SCHAFER AND J. SYMINGTON.



THE digestive apparatus consists of the alimentary canal, the teeth, and various
glands, the secretions of which are discharged through ducts opening into the canal.

The alimentary canal commences at the mouth and terminates at the anus. Its
total length is, on an average, about thirty feet.

The part situated in the head, neck, and thorax is comparatively straight, and
measures from its commencement at the opening into the mouth to its termination
in the stomach about 15 to 18 inches. The rest of the canal lies in the abdomen
and pelvis. If this portion extended in a straight line from the cesophageal opening
of the stomach to the anus, it would not exceed in length the part above the
diaphragm ; but in consequence of its convoluted and tortuous course, it is nearly
twenty times as long.

The part of the alimentary canal which lies above the diaphragm consists of the
mouth, throat, and gullet ; while that contained in the abdomen and pelvis consists
-of the stomach and the small and large intestines. Numerous small glands are
situated in the wall of the alimentary canal, some in its mucous membrane, and
others in its submucous tissue. The larger glands, the ducts of which open into the
canal, are the salivary glands and the liver and pancreas. The ducts of the salivary
glands open into the mouth, and those of the liver and pancreas into the upper part
of the small intestine. Below and behind the tongue the alimentary canal is joined
by the wind-pipe. Since the respiratory tract is developed much in the same way
as a gland by an outgrowth from the ventral wall of the fore-gut and remains
permanently connected with it, the alimentary canal and respiratory organs are often
grouped together as the gastro-pulmonary system.

THE MOUTH.

The cavity of the mouth opens anteriorly on the face by a transverse aperture
called the rima or is, while posteriorly it communicates with the pharynx through the
fauces (isthmus famium). This cavity is divided into two parts, an outer and an
inner, by the alveolar arches and teeth (see fig. 1). The outer part (vestibulum,
oris) is bounded externally by the lips and cheeks, and internally by the teeth and
gums, covering the outer aspect of the alveolar processes of the upper and lower
jaws. The roof and floor of the vestibule are formed by the reflection of the
mucous membrane of the lips and cheek inwards to the alveolar processes, which
it joins about the level of the middle of the fangs of the teeth. The exten-
sion of the vestibule upwards and downwards external to the gums may be called
the superior and inferior alveola -labial sulci. Each of these sulci is interrupted in
the middle by a small vertic.il fold of the mucous membrane called the frc&num
labii. The fold connecting the upper lip with the gum is larger than that of the
lower lip. The vestibulum oris receives on each side the secretion of the parotid
gland. The inner portion of the mouth (cavum oris) lies within the concavity of
the alveolar arches, and is bounded above by the palate, while in its floor is situated
the tongue. It receives the secretions of the submaxillary and sublingual glands.

VOL. III., J>T. 4. B



ORGANS OF DIGESTION.



When the teeth of the upper and lower jaws are in contact, the vestibule of the
mouth communicates with the cavity of the mouth proper merely by the narrow




Fig. 1. CORONAL SECTION OP MOUTH BEHIND THE SECOND MOLAR TEETH. (J. S. ) Natural size.

1, nasal fossa ; 2, maxillary antrum ; 3, cavum oris ; 4, superior alveolo-labial sulcus ; 5, vestibulum
oris ; 6, buccinator muscle ; 7. inferior alveolo-labial sulcus ; 8, sublingual gland ; 9, duct of Wharton ;
10, superior lingualis muscle ; 11, inferior lingualis ; 12, genio-glossus ; 13, genio-hyoid ; 14, mylo-
hyoid ; 15, anterior belly of digastric ; 16, platysma.

clefts between the teeth and a somewhat larger opening placed behind the last molar
tooth and in front of the ramus of the jaw.





Fig. 2. THREE PAPILLAE FROM THE LIP, WITH THE BLOOD-VESSELS INJECTED. (Toldt.)

Fig. 3. PART OF A SMALL MUCOUS GLAND OF THE MOUTH. (Klein.)
a, alveoli ; d, duct.

The lips and cheelcs are composed externally of skin, and internally of mucous
membrane, between which are included muscles, vessels, and nerves fully described in



THE TONGUE.



3



other parts of this work, areolar tissue, fat, and numerous small glands. The free
border of the lips is protected by a dry mucous membrane, which becomes continuous
with the skin, is covered with numerous minute vascular papillas (fig. 2), and is
highly sensitive. In some of these papillae nerve end-bulbs, approaching in character
to tactile corpuscles, are found.

Numerous small racemose glands (labial glands) open on the inner surface of the
lips near the oral aperture. They are situated between the mucous membrane and
the orbicularis oris muscle.

Other small glands (buccal glands) lie between the buccinator muscle and the
mucous membrane of the cheek. Two or three, larger than the rest, found between
the masseter and buccinator muscles, and opening by separate ducts near the last
molar teeth, are called the molar glands. The secretion of these glands is under-
stood to be mucus ; whether it has any of the specific properties of saliva is not
known. Small sebaceous glands occur on the outer part of the red border of the lips.

The posterior part of the cheek contains a pad of fat surrounded by a well-defined
capsule (see Vol. II., Part 2, p. 293).

Immediately within the lips and cheeks are the dental arches, consisting of the
teeth, gums, and alveolar borders of the maxillse. The gums (gingivce) are composed
of dense connective tissue, cohering very closely with the periosteum of the alveolar
processes, and covered by a red and highly vascular mucous membrane, which is
smooth in its general surface, but is beset with fine papillae in the immediate
vicinity of the teeth.

The mucous membrane of the mouth is lined by scaly stratified epithelium, the
cells of the deeper layers of which are united by intercellular bridges like those of
the rete Malpighii of the epidermis.

THE TONGUE.

The tongue is a muscular organ, situated in the floor of the mouth and in the
anterior wall of the oral portion of the pharynx. It consists of a main portion or




11



16 15 14 13 12

Fig- 4. COROKAL SECTION OF THE LOWER PART OF THE FACE AT THE ISTHMUS OF THE FAUCES. (J. S. )

1, pharynx ; 2, levator palati ; 3, palato-glossus ; 4, glands of soft palate; 5, internal pterygoid ;
6, ranius of lower jaw; 7, masseter ; 8, stylo-glossus ; 9, septum linguce ; 10, hyo-glossus ; 11, sub-
maxillary gland ; 12, mylo-hyoid ; 13, digastric ; 14, genio-glossus ; 15, genio-hyoid ; 16, platjsffia.

body, an anterior free extremity or tip, and a lower fixed part or root, which is
attached to the lower jaw and hyoid bone. Its upper or dorsal surface, which is

B 2



4



ORGANS OF DIGESTION.



covered in its entire extent by mucous membrane, is convex from before backwards,
and from side to side, with a slight median depression. This surface is in relation
with the hard and soft palate, the posterior wall of the pharynx, and the upper part
of the anterior surface of the epiglottis (see fig. 18). The under surface is tree
and covered with mucous membrane in its anterior part only, the larger and
posterior portion of this aspect not being free, but connected by various muscles
with the lower jaw, hyoid bone, and styloid process. Here also enter its blood-
Fig. f>. VlEW OF THE UNDER SURFACE OF THE

ANTERIOR PART OF THE TONGUE AND OF THE
SUBLINGUAL PORTION OF THE FLOOR OF THE

MOUTH. (Modified from Testut.) (J. S.)

On the left side part of the mucous mem-
liraue of the tongue has been removed, and also
.>-onie fibres of the inferior lingualis muscle, in
order to expose the ranine artery, the lingual
nerve, and the glands of Blandin.

1, glands of Blandin ; 2, lingual nerve ; 3,
ranine artery ; 4, fraenum linguae ; 5, orifice
of Wharton's duct ; 6, ranine vein, seen
through the mucous membrane ; 7, mucous
membrane covering sublingual gland.

vessels and nerves. The tongue has a
free rounded border at its anterior
extremity or tip, and at the sides as far
back as the last molar tooth, where the
border gradually disappears.

Mucous membrane. On the
under surface of the tongue the
mucous membrane is smooth and thin,
and in the middle line is raised into a
prominent vertical fold, the f/renum
lingua. In front of the frasnum the
ranine vein can be distinctly seen on
each side through the mucous mem-
brane, and close to it lies the rauine
artery. Further out a slight fold of
the mucous membrane, plica fimlriata,
with its free edge notched (see fig. G),

passes from near the tip backwards and outwards. This fold is better marked in
the foetus and child than in the adult ; and, according to Gegenbaur, it is a vestige

Fig. 6. UNDER SURFACE OF THE TONGUE OF A NEW-BORN
CHILD. (From Gegenbaur. )

of the under-tongue of the lemurs. From the
under surface of the tongue the mucous mem-
brane is reflected towards the inner aspect of
the lower jaw, forming the sublingual portion
of the floor of the mouth. The deep groove
between the tongue and the alveolar process
of the jaw may be termed the alveolo-lingual
sulcus. On each side of the lower and anterior

part of the frgenum linguas there is a distinct papilla, at the apex of which is the
orifice of the duct of the submaxillary gland (fig. 5. 5). From this point outwards
and backwards for about an inch-and-a-half the mucous membrane is raised into a
ridge by the sublingual gland. On this ridge are the openings of small ducts from
the sublingual gland (fig. 5, 7).




E .-




Plica stillin-
gualis
Plica fim-
Iriata



M. genio-

ylussns



THE TONGUE. 5

The dorsal surface of the tongue, from its mode of development and the structure
of its mucous membrane, presents a natural division into an anterior and a posterior
portion. These two portions are frequently separated in the adult "Dy a median
recess, the foramen ccecum, and a shallow groove (sukus terminal-is, His) passing
from this outwards and forwards on each side. 1 The anterior portion, forming about
two-thirds of the upper or dorsal surface, has its mucous membrane thin, closely
adherent to the muscular tissue below, and provided with numerous small eminences
named papillse. These are also found upon the tip and borders, where, however,
they gradually become smaller, and towards its under surface they disappear. The
mucous membrane on the posterior third of the tongue differs considerably from that
covering its anterior two-thirds. It is thicker, smoother, and less adherent, and in




Fig. 7. PAPILLARY SURFACE OF THE TONGUE, WITH THE FAUCES AND TONSILS. (From Sappey. )

1, 2, circumvallate papillae ; behind 2, the foramen caecum ; 3, fungiform papillae ; 4, filiform and
conical papillae : 5, transverse and oblique ranges ; 6, mucous glands and lymphoid follicles at the bas
of the tongue and in the fauces ; 7, tonsils ; 8, tip of the epiglottis ; 9, median glosso-epiglottic fold 01
frsenum epiglottidis.

place of papillas, is studded with numerous mucous glands and lymphoid follicles.
The latter are often called the lingual tonsils. Three folds of the mucous mem-
brane, one median and two lateral, named the glosso-epiglottic folds, pass backward
from the base of the tongue to the epiglottis. Between these folds are the two
glosso-epiglottic fossae or sinuses. Further forward the mucous membrane is joined
on. each side by the anterior palatine arch, behind which it is continuous with the
mucous membrane covering the tonsils. Except in the neighbourhood of the
circumvallate papillae the papillary surface of the tongue is devoid of glands, but
they occur abundantly at the base, sides, and under surface of the organ, and are
in structure similar to those which occur elsewhere in the mouth (fig. 3).



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