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?
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Site of injection: Anterolateral thigh
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Muscle targeted: Vastus lateralis muscle
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Origin: Intertrochanteric line, greater trochanter, linea aspera of femur
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Insertion: Tibial tuberosity (via patellar ligament), patella
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Action: Knee extension
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How to locate: Locate the bulkiest part of the vastus lateralis (the junction of the upper and middle thirds 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?
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Site of injection: Middle of deltoid
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Muscle targeted: Deltoid
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Origin: Lateral ⅓ of clavicle (clavicular); acromion (acromial); spine of scapula (spinal)
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Insertion: Deltoid tuberosity of humerus
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Action: Flexion and internal rotation of arm; abduction of arm; extension and external rotation of arm
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How to locate: Find acromion process by palpating the bony prominence; injection site is in the middle of the deltoid (2.5-5 cm below acromion process)