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FAAL BICARA

Dr. SRI TJAHAJAWATI,drg.Mkes.AIFM.

Spriestersbach,D.C.
Bradley,R.M.

1.Introduction to Anatomy and Physiology


identify and describe the anatomical position
identify and describe the planes of reference
identify ad describe tissue and organ systems
of the human body
identify and describe the systems of language
and speech
identify the common medical prefixes and
suffixes

Normal vocal cord

1.

2, 3

Process

Column of air P moves upward


towards
vocal folds in "closed" position; by
coordinated action of the
diaphragm,
abdominal muscles, chest
muscles,
& P opens bottom of
Column
of air
vibrating
Rib cage. layers of vocal folds;
body of vocal folds stays in place.

Column of air pressure continues


to move upward, now towards the
top of vocal folds, and opens the
top.
6-10 The low pressure created behind
the fast-moving air column
causes the bottom to close,
followed by the top.
Closure of the vocal folds cuts
10
off the air column and releases a
pulse of air. New vibratory cycle
repeat 1-10

4,5

2. Orientation and Embryological Development

identify and state the purpose of the three germ layers


from which all cell tissue is derived
identify from which germ layer the structure of the
auditory and speech mechanism develop
identify syndromes associated with embryonic
developmental disorders
state the embryological developmental stages of the
auditory and speech mechanism

3. The Breathing Mechanism

define breathing and describe the physics of breathing


and spoken language
define and describe the anatomy and physiology of the
trachea, lungs, diaphragm, and pleurae
identify and describe the functions of the spinal column,
the rib cage, the pectoral girdle, and the pelvic girdle
identify the musculature and describe the function of the
musculature for the breathing mechanism
describe the functions of the muscles of respiration
spoken language
identify and describe the various pressures and volumes
of spoken language and breathing

4. Structures of Phonation

describe the biological and non-biological


functions of the larynx
identify the structures of the larynx
describe the mechanisms and functions of the
laryngeal structures

- identify and describe the intrinsic and


extrinsic musculature of the larynx

5. The Articulators

identify and describe the bones of the cranium


and facial skeleton
identify and describe the function of the sinuses
describe the function of the vocal tract cavities
identify the articulators and describe their
functions
identify and describe the anatomy and
physiology of the articulators

7. Anatomy and Physiology of the Auditory


Mechanism

state the function of the auditory mechanism


state the function of the outer ear: pinna and external
auditory meatus
identify and label the divisions of the peripheral hearing
mechanism
identify and label the anatomy of the outer ear
define: epithelium, auricle, cerumen, meatus, pinna state
the functions of the middle ear and its structures:
tympanic membrane, ossicles, muscles, Eustachian tube
and mastoid air cells

state the function of the intra-aural reflexes and diagram the pathway
through which they are elicited
describe the state the purposes of the area-ratio and lever hypothesis
identify and label the structures of the middle ear
define: tympanic membrane, annulus, intra-aural reflex, mastoid,
tegmen, epi-, nasopharynx, mucous membrane, fundus, pars
flaccida, pars tensa, umbo, cilia, round window, oval window,
ossicle, facial nerve, trigeminal nerve, antrum
state the functions of the inner ear and its structures: semicircular
canals, saccule, utricle, and cochlea
label and identify the structure of the vestibular mechanism
label and identify the structures of the auditory mechanism of the
inner ear
name and describe the theories of hearing
define: ampulla, basilar membrane, cochlea, organ of Corti,
endolymph, perilymph, helicotrema, labyrinth, saccule, scala,
semicircular canals, stria vascularis, tectorial membrane, transduce,
utricle, vestibule, hair cells, Reissner's membrane

8. The Nervous System

identify the gross anatomy of the peripheral and


central nervous system
identify the anatomy and function of the CNS
and PNS
describe the functional neuroanatomy for speech,
language and hearing

Introduction - Speech vs. Language


Speech is the motor act of articulation, producing
sound, whereas language is the knowledge/use of a
symbol system to communicate.1 Thus, language
function, governed by the cerebral cortex, requires an
integration of visual and auditory (afferent/receptive)
input with motor (efferent/expressive) output. It is
centered in the left hemisphere in essentially all righthanded individuals and 85% of left-handers.

The frontal, parietal, and temporal lobes are all


involved: The receptive (afferent) function
operates in Wernicke's Area, at the parietal and
temporal cortex. The expressive (efferent) function
lies in Broca's Area, located in the frontal lobe.
Language and its associated functions of memory
and learning require many interconnections. The
term association areas is given to the regions
where these interconnections occur

Anatomy of the Vocal Tract/ Physiology of Speech


Phonetics
Phonetics, specifically articulatory phonetics, is the
study of sound production from the anatomical point
of view. Some linguists also study the acoustical
properties of sound, i.e. the physics of sound. Still
others consider how sound is perceived by the hearer,
i.e. auditory phonetics. In all cases, it is important for
you to know the basic anatomy of the vocal tract.

Sounds in speech are produced by airstreams - either by


exhaling or inhaling ("ingressive"). The presence or absence
of obstructions in the course of the airstream -the manner and place of articluation -- modifies the nature of
the sound produced.
Most speech sounds originate by passing a stream of air from
the lungs (exhalation) through one or more speech resonators.
The principal resonators are:
the pharyngeal cavity (Air passes the pharynx (which has the
epiglottis that prevents food from entering the trachea).The
upper part of the trachea contains the larynx. The vocal cords (
seen below) are two bands of tissue that extend across the
opening of the larynx);
the oral cavity (tongue, hard and soft palettes, uvula);
the labial cavity (area between the teeth and lips);
the nasal cavity.
A small number of sounds can be generated by modifying air
pressure inside and outside a resonator, without involving the
lungs (e.g. producing clicks).

Above the Larynx


The area above the larynx consists of three main
areas: the pharynx, the nasal cavity, and the oral
cavity. The pharynx consists of the area above the
larynx and below the uvula. The oral cavity is the
area from the back of the throat to the mouth. The
major parts of the oral cavity that are used in speech
production are the uvula, the velum, the tongue, the
hard palate, the alveolar ridge, the teeth, and the lips.
The uvula is that fleshy blob that hangs down in the
back of the throat. The velum is the soft palate, and
the alveolar ridge is a mass of hard cartilage behind
the teeth.

The manner of articulation depends on a number of


factors:
whether the vocal cords vibrate (
voiced vs. voiceless);
whether the airstream obstruction occurs above the
epiglottis (consonant vs. vowel);
whether the airstream passes through the nasal
cavity in addition to the oral cavity (nasal vs. oral);
whether the airstream passes through the middle of
the oral cavity or along the side(s).

The place of articulation is the point where obstruction occurs.


Typically, it is the point on the palate where the placement of
the tongue blocks the airstream. This can be:
the lips (labials and bilabials),
the teeth (dentals),
the lips and teeth (labio-dentals; the tongue is not directly
involved here),
the alveolar ridge (behind the front teeth),
the hard palate,
the soft palate,
the uvula,
the pharynx,
the glottis (the opening between the vocal folds).

Speech Development and Milestones 1, 3


Normal speech progresses through stages of cooing,
babbling, echolalia, jargon, words and word combinations,
and sentence formation. A basic knowledge of speech
milestones helps to detect dificulties at an early age. Early
detection is essential to determining appropriate
interventions.
birth - 3 months
4 months to 6 months
6 months to 1st birthday
age 1 to 18 months
18 months to 2nd birthday
age 2 to 3rd birthday
age 3 to 4th birthday
age 4 to 5th birthday

Bicara adl salah satu sistem komunikasi yg


mrpk. pernyataan buah pikiran dan pengertian
dg menggunakan lambang atau simbol akustik.
Bicara mrpk. Suatu sistem psikofisiologis yang
menggunakan berbagai bagian tubuh dan
bagian pikiran untuk mengkomunikasikan
suatu informasi yang diperoleh sebelumnya.

Proses fisik yang mendasari bicara adalah :


Organ respirasi yang mengalirkan udara yang
diperlukan untuk sumber kekuatan dalam
mencetuskan suara.
Organ fonasi yang memproduksi suara
Organ resonansi yang memperluas dan
memperkaya suara
Organ artikulasi yang membentuk suara menjadi
kata-kata yang berarti

Proses psikis adalah integrasi nerologik yang


meliputi:
Persepsi sensorik
Proses pembentukan simbol dan pernyataan
keseluruhan
Persarafan akhir yang mempersiapkan impuls
motorik yg membangkitkan seluruh sistem
supaya dapat berbicara

Struktur fungsional organ pengucapan:


1) Organ respirasi: trakea, bronkhus, paru-paru
2) Organ fonasi: larink dengan otot intrinsik dan
ekstrinsiknya, serta pita suara yang mrpk bagian
terpenting laring.
- Voiceless: pita suara membuka penuh waktu
inspirasi, pita suara saling menjauh sehingga udara
bebas lewat diantaranya.
- Voiced: pita suara bergetar ke arah lateral, udara
mendorong pita suara saling menjauh, aliran udara
lewat dengan cepat yang menarik kembali pita
suara untuk saling mendekat, proses ini terjadi
berulang sehingga terjadi getaran pita suara.

3) Organ resonansi: rongga faring, rongga mulut,


rongga hidung dan sinus paranasalis.
4) Organ artikulasi: bibir, lidah, pipi, gigi,
mandibula.

Vokal dan Konsonan


Vokal: dibentuk oleh aliran udara yang relatif
bebas tanpa adanya desakan pada pita suara
Konsonan: Udara yang keluar setelah melewati
pita suara mendapat hambatan pada organ
artikulasi, sebagian atau seluruhnya.
5) Organ saraf: melibatkan SSP, SST dan SSO

Mekanisme Nerologik Pengucapan


Rangsang (organ reseptor
umum/khusus)

Saraf otak/saraf spinal/SSO

SSP area sensorik

SSP area motorik

SST

Efektor menghasilkan aktivitas


bicara

Reseptor sensorik: organ reseptor umum


(eksteroseptif, interoseptif, proprioseptif) dan
organ reseptor khusus (penglihatan, pendengaran,
penghidu, pengecap) menerima rangsang
Saraf aferen: saraf otak S I S XII dan saraf
spinal: menghantarkan impuls saraf ke pusat
pemrosesan di SSP
SSP: area Broca (area motorik bicara), area auditif
(area Wernicke), pusat ideomotor (pusat refleks
dalam memilih kata dan kalimat)
Saraf eferen dari SSP ke SST : menyampaikan
sinyal saraf ke efektor untuk melakukan aktivitas
bicara.

Kelainan Fungsi Bicara


1. Gangguan artikulasi: disatria (kesalahan
mengucapkan kata-kata), dislalia (mengucapkan
kata tidak sempurna, huruf /r/
2. Gangguan suara bicara: disfonia (parau, serak)
3. Gangguan perkembangan bahasa: disfasia
4. Gangguan membaca : disleksia
5. Gangguan kemampuan menulis: disgrafia
6. Gangguan irama bicara: stammering, gagap