Nura Eky

Bagian Fisiologi
FK UNISSULA
2018

FISIOLOGI LARING & FONASI

 Learning Objectives

 Larynx Structure

 Modeling Phonation

 Larynx in Speech
Struktur Laring

 Terdiri atas:
 Kartilago
 Jaringan ikat (ligamen, membran)
 Musculus
 5-7 cm ; Batas atas : ujung epiglotis, batas
bawah : tepi bawah kartilago cricoid
Kartilago

Tak berpasangan dan ditengah

 Epiglotis
 Tiroid
 Cricoid
Termasuk tulang hyoid
Yang berpasangan
 Aritenoid
 Kartilago aksesori : cuneiformis dan
corniculata
Ligamen & Membran

 Ekstrinsik
 Membran tirohyoid
 Membran cricotiroid
(median dan lateral)
 Intrinsik
 Membran quadrangular
 Conus elasticus
 Ligamen : vocalis
dan vestibulars
Musculus

 Ekstrinsik
 Suprahyoid
 Infrahyoid
 Intrinsik
Musculus Suprahyoid
 Musculus Aksi Innervasi
Mylohyoid Menarik hyoid ke n.Alveolar inferior
depan (cab. N. mandibula)
Geniohyoid Menarik hyoid ke Serabut Ansa cervikal I
depan
Stylohyoid Mengangkat hyoid Cab. N. facialis (VII)
saat menelan
Digastricus Menarik hyoid ke Ca.mandibular N. V
ant/post (ant)
Cab.digastrik N.VII
(post)
Stylofaringeus Mengangkat laring N . IX
Palatofaringeus Menarik miring ke Pleksus faringeal N.X
depan laring
Salfingofaringeus Mengangkat laring Pleksus faringeal N.X
Musculus Infrahyoid
Musculus Aksi Innervasi
Tyrohyoid Elevasi laring Ansa cervicalis
Sternohyoid Mendepresi laring (pleksus cervicalis
C1-C3)
Sternothyroid Mendepresi laring
Musculus Intrinsik
Musculus Aksi Inervasi
Cricotyroid Tensor laring n. Laringeus
Adduksi plica vocalis superior
cab.eksternal
Cricoaritenoid Adduksi plica vokalis n. Rekuren
lateral laringeus
Cricoaritenoid Abduksi plica vocalis n. Rekuren
posterior (“safety laringeus
muscle”)
Aritenoid Adduksi plica vokalis n. Rekuren
laringeus
Tyroaritenoid Adduksi plica vokalis n. Rekuren
Relaxor laring laringeus
Fungsi Laring

FUNGSI
PROTEKSI

FUNGSI
RESPIRASI
 Fungi Fonasi
 Laring sebagai vibrator (penggetar)
 Elemen : pita suara (vocal cord)
Vokalisasi

 Proses bicara  diatur oleh :

 Area spesifik korteks serebri  Wernicke and Broca
area
 Pusat pengatur pernafasan di otak
 Struktur artikulasi dan resonansi di rongga mulut dan
hidung

 Berbicara diatur oleh 2 fungsi mekanis :

 Fonasi  di Laring
 Artikulasi dan resonansi  struktur rongga mulut,
bibir, lidah, palatum mole  karakter suara seseorang
 Keras / Lemah Bunyi

Tinggi / Rendah Nada

Wernicke and Broca area

 When we speak :
1. We formulate what we are going to say in
Wernicke’s area
2. Then transmits our plan of speech to Broca’s
area
3.  the plan then is carried out via the motor
cortex
 Wernicke and Broca area

2. Area khusus memproses teks (tulisan)

https://www.youtube.com/watch?v=2iHDF5twkcE
Broca’s area

 Left frontal lobe

 Major function : speech production
 Composition : containing motor neuron
involved in control of speech
 It controls motor function involved with
speech production  membentuk artikulasi
bahasa
Aphasia Broca

 Aphasia : gangguan bicara karena kerusakan

pada otak
 Pasien dg afasia broca (expresif), tau apa yg
ingin dikatakan, tp sulit sekali kata-kata itu
dikeluarkan, walaupun mereka bisa
berkomunikasi dg sukses
 Berkata pelan dg kalimat pendek dg struktur
sederhana (grammar)
 Gejala lain: gangguan dalam mengulang kata-
kata, kesulitan membentuk kalimat dg grammar
komplek dan komprehensif baik secara oral
maupun tulisan.
Wernicke’s area

 Location : Left temporal lobe

 Major function : Important for the
comprehension of speech sounds and
considered to be the language
comprehension centre (pusat pemahaman).
Wernicke’s aphasia

 Speak normal grammar and rate but not make

sense
 Sentences without true meaning
 Tend to talk excessively
 So their is typically fluent but empty content 
word salad

 Difficulty understanding language

 Can not understand spoken words by other or
read written words
  impairment of language comprehension
Fonasi
Laring  vibrator
Elemen yang bergetar  plica vocalis (glotis)
 Suara diproduksi ketika fenomena aerodynamic
yang menyebabkan plika vokalis bergetar secara
cepat akibat vibratory cycles/siklus glotis
dengan kecepatan sekitar:
 110 cycles per second or Hz (men) = lower pitch
 180 to 220 cycles per second (women) = medium
pitch
 300 cycles per second (children) = higher pitch
 higher voice (tinggi nada) : increase in frequency of
vocal fold vibration
 louder voice (keras bunyi) : increase in amplitude of
vocal fold vibration
 Vibrasi glotis

 Terjadi akibat interaksi antara Aerodynamic

force dan aksi muscular plica vocalis (muscular
force)  Aero Dynamic Myo Elastic Theory

TEKANAN SUB Kontrol adekuat dari Bernoulli

GLOTIS musculus laring 
adduksi sebagian /
Effect
adduksi penuh plica
vocalis

SUARA
 BERNOULLI EFFECT
 Bila laju/kecepatan aliran fluida (cairan
maupun gas) bertambah besar, maka
tekanan fluida di tempat itu menjadi lebih
kecil dan sebaliknya, turun/naiknya tekanan
tegak lurus dengan arah aliran
Skema Bernoulli Effect. panah : pergerakan tekanan. Ketika udara
bergerak melewati saluran sempit, tekanan didalam menurun dan
tekanan diluar meningkat sehingga menarik sisi tersebut kedalam.
 Siklus Glotis
/Vibratory cycle
 The vocal folds alternately trap
and release air; each trap/release
is one cycle of vibration. This
cycle is often referred to as the
glottic cycle, and it is divided into
phases: opening phase, open
phase, closing phase, closed
phase
 During the closed phase, the air
pressure builds up below the vocal
folds. When the glottis opens, the
air explodes through the vocal
folds, and that's the beginning of
the sound wave. The strength of
that explosion determines the
loudness of the sound coming
directly from the larynx.
When the vocal folds are:
 1. open: air passes cleanly through (= voiceless
sound/berbisik)
 2. closed: air does not pass through (= no sound)
 3. lightly brought together: vocal folds vibrate in passing
air(= voiced sound)
 Sliding motion  memanjangkan/
Rocking motion  abduksi / adduksi Memendekan plica vocalis
Pitch

 Fundamental frequency (average: baby 500Hz, children 250-

400Hz ;men 125Hz ; women 200Hz) is primarily affected by

applying more or less longitudinal tension to

the VF using:
 Cricothyroids
 Tension in the vocalis muscle
OR
 Adjustments in vertical tension – depressing or
elevating the Larynx via suprahyiod and infrahyoid
muscles
Some Patology of Larynx