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?
The site of injection for the pneumococcal vaccine and pentavalent vaccine is in the anterolateral thigh and outer right upper thigh, respectively. Both target the vastus lateralis muscle.
Origin: Greater trochanter and linea aspera of femur
Insertion: Patella via quadriceps tendon; tibial tuberosity via patellar ligament
Action: Extend leg at knee joint
How to locate this area: outer middle third of vastus lateralis
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?
The site of injection for the influenza vaccine is in the upper arm, which prefers the deltoid muscle.
Origin: Acromial extremity of clavicle (anterior fibers), acromion of scapula (lateral fibers), spine of scapula (posterior fibers)
Insertion: Deltoid tuberosity of humerus
Action: Abduct arm at shoulder joint (lateral fibers), flex and medially rotate arm at shoulder joint (anterior fibers), extend and laterally rotate arm at shoulder joint (posterior fibers)
How to locate this area: middle of the deltoid muscle; feel the bony prominence to find the acromion process
References:
Doyle, G. R., & McCutcheon, J. A. (2015). 7.4 Intramuscular Injections. Opentextbc.ca. https://opentextbc.ca/clinicalskills/chapter/6-8-iv-push-medications-and-saline-lock-flush/#:~:text=To%20locate%20the%20landmark%20for
Tortora, G. & Derrickson, B.(2012). Principles of anatomy and physiology. John Wiley & Sons