FISIOLOGI

KOMUNIKASI
 KOMUNIKASI
Aspek komunikasi :
Pendengaran (hearing)
Bicara (speech)
Bahasa (language)
Bicara struktur anatomi & fisiologi
Dalam berbahasa dipergunakan cara :
Verbal : bahasa tutur atau tulis
Non verbal : gestural/postural -> gerakan
tubuh & wajah
Bahasa kognisi dan integritas
 BAHASA
Sistem yang kompleks dan dinamis
dari simbol-simbol konvensional yang
dipergunakan dalam berbagai cara
untuk berpikir dan berkomunikasi

American Speech-Language Hearing

Associations Committee in Language
(ASHA, 1993
 BAHASA

Sebuah sistem, terdiri atas tanda-tanda yang

menurut peraturan-peraturan konvensional
(=sudah ditetapkan sebelumnya) dapat
dikombinasikan satu sama lain hingga menjadi
uraian-uraian mengandung arti yang
digunakan orang untuk saling menjelaskan diri

Winkler Prins, 1982

 Bahasa verbal Lima parameter :
1. Fonologi (bunyi)
2. Semantik (arti kata)
3. Morfologi (pembentukan kata)
4. Sintaksis (pembentukan kalimat)
5. Pragmatik (penggunaan bahasa dlm konteks)
Perbedaan hemisfer kiri dan kanan
 ANATOMI DAN FISIOLOGI
BERBAHASA
Stimulus auditif sistem
auditif area auditif primer
(di gyrus Hisch,pada kedua
lobus temporalis) 2 jalur .
I hemisfer yang dominan :
ke area asosiatif auditif
(bag.postor lobus temporalis
supor ).
II hemisfer yang non-
dominan : mll corpus
callosum area asosiatif
auditif di hemisfer yang
dominan.
 Dari asosiatif auditif (area
Wernicke) area
pengenalan /identifikasi
kata (bag.infor lobus parietal
hemisfer dominan)
kembali ke atau melalui
area wernicke mll
serabut asosiasi area
enkoding motor (area
broca) area motorik
suplementer (bag.medial
gyrus frontal superior)
area motor primer
 Stimulus visual sbg impuls
visual di pusat visual primer (lobus
oksipital kedua hemisfer) area
asosiasi visual (pengenalan &
identifikasi simbol bahasa) 2
jalur.

I dari area asosiasi visual yang

dominan area identifikasi kata
(area wernicke) area broca
area motorik primer.

II dr area asosiasi visual non

dominan menyilang mll corpus
callosum ke hemisfer yang
dominan area identifikasi kata
(area wernicke) area broca
area motorik primer.
 The major language centers of the
brain
The major language centers of the brain.
The motor and sensory areas are
presented as landmarks. Interconnecting
functional pathways are indicated by
letters:
A) The connection between Wernicke's
and Broca's areas, mediating expression
of language utterances in speech;
B) The connection between Broca's area
and the primary motor area;
C) Connection between primary auditory
perception and Wernicke's area;
D) Connection between vision and
Wernicke's area, mediating reading
ability;
E) Connection between somatosensory
perception (tactile, pain, cold/hot, position
sense) and Wernicke's area, this would
mediate language comprehension by
tracing letters on the skin or reading
braille.
 Human communication
Components of communication is
Encoding
Transmittal
Reception
Decoding
Involves the exchange of information and
ideas through various processes commonly
referred to as speech, language, cognition,
and hearing
Multidimensional group of processes used
to share thoughts, ideas, and emotions
 Speech is the system that produces
individual sounds, which, when placed
together, develop meaningful messages.
Cognition refers to the mental processes
by which one recognizes, manipulates,
and exchanges information to better
understand and make sense of the world
Hearing is the ability to detect and assign
meaning to sounds.
Circle Of Communication
 Speech production

Speech production requires multiple

physiological systems working together to
create an intelligible message
Five systems comprising speech
production include
respiration,
phonation,
resonation,
articulation, and
hearing.
 Respiration
Chemical and mechanical
Chemical respiration is concerned with
the exchange of oxygen and carbon
dioxide to and from the blood
Mechanical respiration (or ventilation) is
concerned with the tidal movement of air
in and out of the lungs will be the
primary focus For speech production
Subglottic Area
 To produce sound, an energy source is
needed to initiate the process the
respiratory system, causing air pressure
variations that result in airflow out of the
respiratory tract and into the vocal tract.
Speech production occurs upon
exhalation.
During speech production, the time for
inhalation is often reduced while the
exhalation time is increased
 Phonation
occurs when air is expelled
from the lungs through the
glottis
As air passes through this
area, a lower pressure
gradient occurs within the
larynx
When this drop
oscillating vibration
engine of the voicing
mechanism
Vocal fold motion occurs in
a wavelike fashion with
lateral undulations as well
as superior and inferior
movements
 Airflow is modulated and is the main
source of voiced sounds
A normal voice is best described as the
product of a controlled exhalation of air,
steady maintenance of subglottic air
pressures, and delicately balanced vocal
folds movement
 Resonation
Raw vocal tone is
modified and amplified
by resonance within
the pharyngeal, oral,
and nasal cavities,
Following transit
through the larynx, the
air is modulated by
changing the tension of
the pharyngeal walls
Raising or depressing
the larynx
modifying the position
of the jaw, tongue, and
lips
occluding or lowering
the soft palate
 Valving of the velopharyngeal region
requires the closure of the nasal cavity
from the oral cavity for production of all
sounds other than the /m/, /n/, and /ng/
sounds.
retraction and elevation of the soft
palate/velum, anterior movement of the
posterior pharyngeal wall, and inward
movement of the lateral pharyngeal walls
 Articulation
Coordinated actions of the tongue, lips,
jaw, and soft palate regulate the air
stream and produce the meaningful
sounds of speech called phonemes.
These structures, often referred to as
articulators, relax, compress, or
momentarily stop the air stream in varied
ways to produce specific vowels or
consonants.
 Neural Control
Motor control for respiration, phonation,
resonation, and articulation requires
complex neural networking, regulation, and
monitoring of muscle activity of both the
central nervous system and the peripheral
nervous system
the extrapyramidal nervous system also
plays a role.
Speech involves simultaneous activity in
various regions of the brain that are largely
spread over the cortical and subcortical
areas
 LANGUAGE
There are many lines of evidence to
support the concept that the left
hemisphere plays a crucial role in language
processing
Brocas area, as causing language
production problems, whereas damage to
the first temporal convolution, Wernickes
area, is associated with language
comprehension
Contributions from the right hemisphere
have been noted to give input regarding
prosody and comprehension of complex
syntax
 basal ganglia and thalamus have been
identified as having roles in language
function
 Klasifikasi Bunyi Bicara
Dibagi menjadi : Bunyi Huruf Bunyi Huruf
Konsonan Vokal

Tergantung masing-masing bahasa

Cara Pengucapan Daerah Artikulasi
Bilabial Labiodental Dental Alveolar Palatal Velar Glottal
Stop VL p (pit) t (tick) k (kit)
(button)
V b (bit) d (dig) (shoe) g (get)
Frikatif VL f (fit) (thin) s (sit) (measure) h (hit)

V v (vat) (them) z (zip)

Afrikatif VL t (chair)

V d (jew)
Nasal V m (mit) n (not) (sing)
Liquids V l (lip) r (rat)
glides V w (win) Y (yet)
 Bunyi Huruf Dimensi I

Vokal
Depan Tengah Belakang
Tinggi i (feet) u (moon)
I (sit) U (book)
O (boat)
Menenga e (bake) (mother) (law)
h (set) (hurt)
(sofa)
(put)
Rendah (man) a (father)

Dimensi II

Dimensi III
 Pemeriksaan

A. Kelancaran Berbahasa (FLUENT)

Merupakan refleksi dari efisiensi
menemukan kata-kata
Cara : - pasien menyebut nama hewan
dalam waktu 60 detik.
Skor normal : dapat menyebut 18 20 nama hewan
selama 60 detik.
pasien menyebut kata dengan huruf tertentu.
 Pemeriksaan
B. Pemahaman (KOMPREHENSI) bahasa
lisan
Cara :
- Konversasi mengajak pasien bercakap-
cakap
- Suruhan
- Pilihan (Ya/Tidak)
- Menunjuk
 Pemeriksaan

C. Mengulang (REPETISI)
Cara : p. Disuruh mengulang apa yang
diucapkan oleh pemeriksa.
D. Menamai (NAMING)
Cara : Terangkan kepada pasien bahwa ia
akan disuruh menyebutkan nama
beberapa objek,juga warna dan bagian dari
objek tersebut.
Kadang, p.afasia masih mampu menamai
objek dengan sirkumlokusi atau parafasia.
 Pemeriksaan

E. Membaca dan Menulis (READING and

WRITTING)
Dinilai setelah evaluasi bahasa lisan.
F. Penggunaan Tangan (Kidal atau
Kandal)
Ditentukan otak mana yang
dominan,dengan melihat penggunaan
tangan.
G. Berbicara spontan
Mengajak p.berbicara spontan atau
bercerita
 Pemeriksaan
Bila mendengarkan pasien berbicara
spontan atau bercerita,perhatikan :
Apakah bicara pelo/cadel/tertegun-
tegun/disprosodik?
Apakah ada afasia, kesalahan sintaks,
parafasia ?
TERIMA KASIH