1. It is immunization day at the health center. The first patient is a 2-month old well female infant who is scheduled for the following vaccinations: pneumococcal conjugate vaccine (PCV), pentavalent vaccine (Penta) and oral polio vaccine. PCV and Penta are given via intramuscular route. Where are the sites of injection? What muscle is targeted in the injection? Write down its origin, insertion and action. How do you locate this area?
- Injection site: Anterolateral thigh
- Muscle: Vastus lateralis
- Origin: Greater trochanter and linea aspera of femur
- Insertion: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
- Action: Extends leg at knee joint
- How to locate: Divide upper thigh into three parts horizontally. In the middle section, injection must go into the outer top portion.
2. The baby’s 65-year-old grandfather also came to the center because influenza vaccine is being offered to senior citizens. The flu vaccine is given intramuscularly. Which muscle is the preferred site for IM injection in this case? Write down its origin, insertion and action. How do you locate this area?
- Muscle: Deltoid
- Origin: Acromial extremity of clavicle (anterior fibers), acromion of scapula (lateral fibers), and spine of scapula (posterior fibers)
- Insertion: Deltoid tuberosity of humerus
- Action: Lateral fibers abduct arm at shoulder joint; anterior fibers flex and medially rotate arm at shoulder joint; posterior fibers extend and laterally rotate arm at shoulder joint
- How to locate: Feel the bone (acromion process) located at the top of upper arm. The correct area to give the injection is two finger widths below the acromion process. At the bottom of the two fingers will be an upside-down triangle. Give the injection in the center of the triangle.