Patient Summary: A 68-year-old male was admitted following a…

Patient Summary: A 68-year-old male was admitted following a unilateral stroke affecting the left medullary region. He reports difficulty controlling certain speech sounds, particularly those requiring precise tongue tip placement. His oral-motor examination reveals subtle tongue asymmetry and inconsistent precision when producing sounds that involve the tongue tip. Lip, jaw, and velopharyngeal function are intact. Patient Statement:“When I speak quickly, some sounds don’t come out clearly, and my tongue seems to drift to one side.” On Examination: Mild deviation of the tongue to the left on protrusion Reduced tongue tip elevation and lateral movement toward the left Inconsistent production of alveolar consonants (/t, d, n, l/) Jaw, lips, and velum function normal No evidence of velopharyngeal dysfunction Definitions: Contralateral: Refers to the opposite side of the body relative to a lesion or anatomical structure. Medulla (medullary region): Part of the brainstem containing cranial nerve nuclei; lesions here can affect tongue motor control. Multiple-Choice Question: Which is the most likely explanation for this patient’s tongue deviation and imprecise alveolar consonants following a medullary (UMN) stroke?