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?
Target Site of Injection: Anterolateral thigh
Target Muscle: Vastus lateralis
- Origin: Upper inter-trochanteric line, base of greater trochanter, lateral linea aspera, lateral supracondylar ridge and lateral intermuscular septum
- Insertion: Lateral quadriceps tendon which attached onto the tibial tubercle
- Action: extend the lower leg and allow the body to rise up from a squatting position
How to locate:
- The top border of the vastus lateralis muscle can be found a hand width below the groin.
- The bottom border of the vastus lateralis muscle can be found a hand with above the knee.
- The side borders are from the mid anterior thigh to the mid lateral thigh.
- The injection site is in the middle of all of these borders.
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?
Target Site of Injection: Upper arm
Target 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:
- The injection site is above the level of the armpit and approximately 2–3 fingerbreadths below the acromion process.
References:
Nabil Ebraheim. (2013, October 3). Deltoid Intramuscular injection - Everything You Need To Know - Dr. Nabil Ebraheim [Video]. YouTube. Retrieved September 23, 2022, from https://www.youtube.com/watch?v=Dzdf2YfOuQw
Nabil Ebraheim. (2018, June 22). Vastus Lateralis Intramuscular Injection - Everything You Need To Know - Dr. Nabil Ebraheim [Video]. YouTube. Retrieved September 23, 2022, from https://www.youtube.com/watch?v=XFog6uSwbuw
Tortora GJ & Derrickson B. (2014). Chapter 11 Muscular System. Principles of Anatomy and Physiology. John Wiley & Sons, Inc. 14 edition. Pp 327-446.