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?
Intramuscular injections are administered into the muscle through the skin and subcutaneous tissue. The recommended site is based on age. For infants 11 months of age and younger, the recommended site of injection is in the anterolateral thigh.
Targeted muscle: Vastus lateralis
• Origin: Upper aspect of the intertrochanteric line, base of the greater trochanter and onto its anterior surface, from the proximal portion of the lateral lip of the linea aspera, lateral supracondylar ridge and the lateral intermuscular septum.
• Insertion: Into the lateral side of the quadriceps tendon, joining with rectus femoris and the other vasti muscles, enveloping the patella, then by the patellar ligament into the tibial tuberosity.
• Action: Extension of the leg at the knee.
To determine the injection site, using anatomical landmarks is a must. The muscle is located on the anterior lateral aspect of the thigh. The middle third of the muscl is used for injections-above the lateral condyle and below the greater trochanter. Inject the vaccine into the middle and thickest part of the muscle. Insert the needle at a 90-degree angle and inject all the vaccine in the muscle tissue.
Injection site of the targeted 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?
Intramuscular injections are administered into the muscle through the skin and subcutaneous tissue. The recommended site is based on age. For adults 19 years of age and older, the recommended site of injection is in the upper arm.
Targeted muscle: Deltoid muscle
• Origin: Anterior border of the lateral third of the clavicle
• Insertion: The deltoid tuberosity on the lateral surface of the proximal humeral shaft
• Action: Flexion and internal rotation of the arm at the shoulder
To determine the injection site, using anatomical landmarks is a must. The deltoid muscle is a large, rounded, triangular shape. Find the acromion process, which is the bony point at the end of the shoulder. The injection site will be approximately 2 inches below the bone and above the axillary fold/armpit. Inject the vaccine into the middle and thickest part of the muscle. Insert the needle at a 90-degree angle and inject all of the vaccine in the muscle tissue.
Injection site of the targeted muscle
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References:
- Centers for Disease Control and Prevention. (2022). Vaccine Administration Route and Site. Retrieved from CDC: https://www.cdc.gov/vaccines/hcp/admin/administer-vaccines.html
- Martin, D. (2013, November 13). Deltoid Origin, Insertion, Action, Innervation. Retrieved from The Wellness Digest: https://thewellnessdigest.com/deltoid-anatomy-origin-insertion-action-innervation/
- Martin, D. (2013, October 07). Vastus Lateralis: Origin, Insertion, Action, Innervation. Retrieved from The Wellness Digest: https://thewellnessdigest.com/vastus-lateralis-anatomy-origin-insertion-action-innervation/