FAAL BICARA

ERVIN RIZALI,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

                                              

          

http://www.innerbody.com/image/dige01.html

Normal vocal cord

ProcessProcess 1.

2, 3 Column of Column of air pressure opens air pressure opens bottom of vibrating layers of vocal bottom of vibrating layers of vocal foldsfolds; body of vocal folds stays in ; body of vocal folds stays in place.place.

Column of Column of air pressure moves air pressure moves upwardupward

towards towards vocal folds in "closed" vocal folds in "closed" positionposition;;

bycoordinated action of the bycoordinated action of the diaphragm,diaphragm,

abdominal muscles, chest abdominal muscles, chest muscles, &muscles, &

Rib cage.Rib cage.

4,5

6-10

10

Column of Column of air pressure continues air pressure continues to move upwardto move upward, now , now towards the towards the top of vocal foldstop of vocal folds, and , and opens the opens the toptop..

TheThe low pressure created low pressure created behind behind the fast-moving air column the fast-moving air column causes the causes the bottom to close, bottom to close, followed by the topfollowed by the top..Closure of the vocal folds Closure of the vocal folds cuts cuts off the air column and releases a off the air column and releases a pulse of air. New vibratory cycle pulse of air. New vibratory cycle – – repeat repeat 1-101-10

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 right-handed 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.. 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-paru2) 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