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?
Sight of injection – Anterolateral thigh: Right thigh (PCV) | Left thigh (Penta)
Muscle targeted – Vastus lateralis muscle
Origin – The greater trochanter and linea aspera of the femur
Insertion – In the patella via quadriceps tendon and then tibial tuberosity through the patellar ligament
Action – Leg extension at the knee joint to ensure that the infant’s leg is completely exposed
How to locate – Divide the thigh into three sections and locate both the greater trochanter of the femur (upper thirds) and the patella (lower thirds), the vastus lateralis would be in the middle of the two sites.
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?
Sight of injection – Upper arm: Usually on the arm of the non-dominant hand
Muscle targeted – Deltoid muscle
Origin – The acromial extremity of the clavicle, the acromion of the scapula, and the spine of the scapula
Insertion – Deltoid tuberosity of the humerus
Action – Acromial extremity of the clavicle: Flexion and internal rotation of the arm | Acromion of the scapula: Abduction of the arm | Spine of the scapula: Extension and external rotation of the arm
How to locate – Find the upper (Acromion or shoulder tip) and lower (Deltoid tuberosity) anatomical landmarks. An imaginary inverted triangle shall be drawn in between the acromion and deltoid tuberosity. The deltoid muscle is located at the middle of the imaginary triangle.