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?
PCV
Injection site: Outer left upper thigh
Muscle targeted: Vastus lateralis
PENTA
Injection site: Outer right upper thigh
Muscle targeted: Vastus lateralis
Vastus lateralis
Origin: Greater trochanter and linea aspera of femur
Insertion: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament.
Action: All four heads extend leg at knee joint; rectus femoris muscle acting alone also flexes thigh at hip joint
How to locate the area: The middle third of the muscle
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?
INFLUENZA VACCINE
Injection site: Upper arm
Muscle targeted: Deltoid
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 jointAll four heads extend leg at knee joint; rectus femoris muscle acting alone also flexes thigh at hip joint
How to locate the area: In locating this area, lay three fingers across the deltoid muscle and below the acromion process.
References:
Doyle, G. R., & McCutcheon, J. A. (2015, November 23). 7.4 intramuscular injections. Clinical Procedures for Safer Patient Care. Retrieved September 23, 2022, from https://opentextbc.ca/clinicalskills/chapter/6-8-iv-push-medications-and-saline-lock-flush/
Tortora, G. J., & Derrickson, B. H. (2018). Principles of anatomy and physiology. John Wiley & Sons.