Glossary Brachial Plexus Injury Terms

The Brachial Plexus Center at Cincinnati Children’s Hospital Medical Center provides this glossary to help you understand words you may hear during your child’s evaluation and treatment.

Movement of the limbs away from the body, such as lifting the arm out to the side.

Movement of the limbs toward the body, such as bringing the arm close to the body from the side.

Toward the front.

A wasting away or decrease in the size of a cell, tissue, organ or body part. Atrophy occurs when muscles are not used due to lack of nerve function.

Tearing away. The nerve root being torn out of the spinal cord is the most severe type of nerve injury. An eyelid droop suggests a very severe avulsion of the lower brachial plexus, known as Horner’s syndrome.

The underarm area.

A muscle with two heads or origins. This muscle is used to flex the elbow.

Having two sides or pertaining to both sides.

Relating to the arm.

Brachial plexus
A network of lower cervical and upper dorsal spinal nerves that control movement of the arm, forearm and hand.

Brachial plexus injury
Also known as Erb’s palsy (upper trunk injury), Klumpke’s palsy (lower trunk injury), Erb-Duchenne palsy, obstetrical brachial plexus palsy (OBPI), trauma-based brachial plexus injury (TBPI) and neonatal brachial plexus injury.

Breech delivery
Birth or delivery of the fetus that takes place when the infant’s buttocks or feet come out first.

Pertaining to the neck or to the neck of any structure.

Cervical plexus
A network of nerve fibers originating in the upper four cervical spinal cord segments.

Also called the collarbone, the clavicle joins with the shoulder on one end and the sternum on the other.

A permanent shortening (as of muscle tendons or scar tissue that produces deformity or distortion).

A bruise or injury that does not puncture the skin.

A large triangular muscle that covers the shoulder joint. This muscle is used to raise the arm.

The thin muscle below the lungs and heart that separates the chest from the abdomen.

Farthest from any point of reference. A part of the body farthest away from the center of the body.

Describing the back or upper surface of a body part.

A difficult labor or delivery.

EMG (electromyogram)
A test where a small needle is inserted into muscle to record electrical activity inside the muscle.

Erb’s palsy
A type of brachial plexus injury that often presents with the child’s arm straight and wrist fully bent (waiter’s tip). The child may have good hand function but not full movement of the arm. Nerves C5, C6 and sometimes C7 are involved.

The movement of two elements of any jointed body part are directed away from each other (straightened).

A muscle that extends or straightens a body part, such as a finger or an arm.

Muscle contractions that appear as uncontrollable muscle twitching or tics. They usually indicate a neurological disorder and may be common with a brachial plexus injury.

Fibrous tissue
Although most connective tissue has fibrillar elements, the term usually refers to tissue laid down at a wound site, forming a scar.

Weak, lacking firmness, muscle tone and resilience.

Moving a joint inward to bring it closer to the body (bend).

A muscle that bends or flexes any body part, such as the arm or hand.

Gestational age
Fetal age of a newborn, calculated from conception until birth.
Horner’s syndrome
A nerve condition that includes a drooping eyelid (ptosis), constricted pupil, sunken eyeball (enophthalmos) and lack of sweating on one side of the face. Horner’s syndrome is caused by a lesion in the cervical sympathetic nerve trunk in the neck.

The nervous excitation necessary for the maintenance of the life and functions of the various organs including muscles.

Situated between the ribs.

Klumpke’s palsy
A rare injury of the lower brachial plexus (usually following breech delivery where the arm is above the baby’s head), where the child’s hand muscles and finger flexors are paralyzed.
Complete dislocation of a joint. (Subluxation is partial dislocation of a joint.)

The side of the body or body part that is nearer to the middle or center of the body.

A muscle, nerve or center that effects or produces movement.

MRI (magnetic resonance imaging) scan
An MRI uses a powerful magnet, radio waves and a computer to acquire pictures of the inside of your child’s body. MRI can be used to take small section pictures of just about any body part. Tour the MRI at Outpatient Mason.

Multidisciplinary team
A team of medical professionals that work together to support the patient. A multidisciplinary team for brachial plexus injuries would include a rehabilitation physician, orthopaedic surgeon, plastic surgeon and therapists.

Pertaining both to muscles and skin.

Narakas Classification
In 1986, A.O. Narakas (Algimantas Otonas Narakas, 1927-1993) published a classification system of neonatal brachial plexus palsy based on the clinical course of children during the first eight weeks of life.

Surgical removal or part of a neuroma.

A benign tumor composed of nerve cells, or scar tissue that forms when there is nerve damage.

Neuroma excision
When a neuroma is large, it must be removed. The nerve is then reattached either with end-to-end techniques or with nerve grafts.

Nerve grafting
When the gap between nerve ends is so large that it is not possible to have a tension-free repair using the end-to-end techniques or with nerve grafts.

This is used generally in those cases where there is an avulsion. Donor nerves are used for the repair. The parts of the roots still attached to the spinal cord can be used as donors for avulsed nerves.

The nerve has been stretched and damaged but not torn.

Occupational therapist
A healthcare professional who provides services designed to restore self-care, work and leisure skills to patients who have specific performance incapacities or deficits that reduce their abilities to cope with the tasks of everyday living.

Orthopaedic surgeon
A medically qualified doctor who specializes in surgery of the bones.

Paget Schroetter Syndrome
A specific type of Thoracic Outlet Syndrome (TOS) that occurs when the vein is compressed between the first rib, collarbone, and scalene muscles resulting in blood clot(s) in the subclavian vein in the subclavian vein

To affect or strike with paralysis or palsy.

Neither spontaneous nor active, not produced by active efforts.

Pectoralis muscles
Muscular tissues attached to the front of the chest wall and extending to the upper arms. These are located under the breast.

Peripheral nerves
The nerves outside of the brain and spinal cord, including the automatic, cranial and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons.

Peripheral neuropathy
Injury to the nerves that supply sensation to the arms and legs.

Phrenic nerves
The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm.

A physician specializing in rehabilitation medicine. Physiatrists help restore optimal function to people with injuries to the muscles, bones, tissues and nervous system.

Physical therapist
A trained rehabilitation professional who promotes optimal health function and independence by teaching exercises and other physical activities to aid in rehabilitation and maximize physical ability with less pain.

Plastic and reconstructive surgeon
A medically qualified specialist who specializes in surgery of the face, head, neck and nerve repairs.

A network or tangle. Plexus is a general term for a network of lymphatic vessels, nerves or veins.

Situated in back or in the back part of or affecting the back or dorsal surface of the body.

Closest from any point of reference. A part of the body closet to the center of the body.

Range of motion (ROM)
The range through which a joint can be moved, usually its range of flexion and extension. Active range of motion (AROM) is the active movement of the muscle. Passive range of motion (PROM) is the motion range of a joint through manual assistance.

Torn nerve or tissue.

An action or process that happens by internal impulse or energy. A spontaneous action occurs without force.

Subscapularis muscle action
Rotates medially. Subscapularis muscle action helps in adduction, abduction, flexion and extension.

Lying on the back.

Able to feel or sense things by touch.

Teres minor muscle
Upper dorsal axillary border of scapula. The teres minor muscle is used to rotate your child’s arm laterally and adduct it.

Pertaining to or affecting the chest.

Thoracic Outlet Syndrome (TOS)
Thoracic Outlet Syndrome includes disorders impacting the nerves and / or blood vessels when compressed between the first rib, collarbone and scalene muscles.

A contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head.

Traumatic Brachial Plexus Injury (TBPI)
Traumatic brachial plexus injuries that may occur due to motor vehicle accidents, bike accidents, all-terrain vehicle (ATV) accidents, sports, etc.

Trapezius muscle action
Rotates scapula to raise point of shoulder. It abducts the scapula: the upper part raises the scapula, the lower part lowers and pulls the scapula down. The upper part also draws the head to the same side and turns face to opposite site. The two sides together draw the head back.

Triceps muscle action
Extends and adducts the forearm.