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 injection site for a 2-month-old infant would be the anterolateral thigh and the vastus lateralis is the muscle targeted in the injection. Its origin is the linea aspera of femur. Its insertion is the patella via quadriceps tendon and then tibial tuberosity via patellar ligament while its action is extending leg at knee joint. To locate this area, you can divide the upper thigh into three equal parts horizontally then the middle of the three parts is where the vastus lateralis is. With that, the vaccine must be injected into the outer top portion of the section.
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 intramuscular injection in this case is the deltoid muscle. Its origin is the acromial extremity of the clavicle (anterior fibers), the acromion of the scapula (lateral fibers), and the spine of the scapula (posterior fibers), while its insertion is the intertubercular sulcus of the humerus. Its action is that it extends, adducts, and medially rotates the arm at the shoulder joint draws the arm inferiorly and posteriorly, and elevates the vertebral column and torso. To locate the area, an imaginary inverted triangle may be used between the acromion and deltoid tuberosity. In this way, the injection site lies in the middle one-third of the triangle or in the center of the deltoid muscle.