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?
- Considering the age, said vaccinations can be injected in vastus lateralis muscle found in the anterolateral thigh, PCV on the right thigh while Penta on the left thigh.
Origin: superior intertrochanteric line, greater trochanter, superior lateral linea aspera, lateral gluteal tuberosity of femur
Insertion: lateral side of quadriceps femoris tendon, tibial tuberosity via patellar ligament
Action: for knee extension
How to locate? Find first the greater trochanter of the femur. Then, make an imaginary box on the upper leg, then find the groin. One hand’s width below the groin becomes the upper border of the box. Find the top of the knee. One hand’s width above the top of the knee becomes the lower border of the box, which is now your injection site.
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 preferred site for IM injection, in this case, the flu vaccine, is on the deltoid muscle of the arm. Its origin is in the anterior superior surface of the lateral third of the clavicle; acromion; spine of the scapula. The insertion is in the deltoid tuberosity of the humerus. Its action is for arm movement (abduction, flexion, and extension), and stabilization. You can locate the deltoid muscle by finding the acromion process, then use an imaginary inverted triangle. Using the inverted triangle, you can target the injection in the middle one-third of the triangle below the acromion process.