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?
Since both PCV and Penta would be administered intramuscularly, the anterolateral region of the thigh of children below 2 years old. Thus, these two vaccines both target the vastus lateralis muscle. The following are the details for the origin, insertion, and action of this muscle:
- Origin — Intertrochanteric line; greater trochanter; gluteal tuberosity; linea aspera of femur
- Insertion — Patella; tibial tuberosity
- Action — Extension of leg at knee joint
To locate the injection site of the vastus lateralis, it is recommended to inject about halfway between the greater trochanter and the lateral femoral condyle.
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?
When giving a flu vaccine intramuscularly to people over the age of 2, the site of injection should usually be in the region of the upper and outer arm. Here, the deltoid muscle is being specifically targeted. The following are the details for the origin, insertion, and action of this muscle:
- Origin — Clavicle; acromion; spine of scapula
- Insertion — Deltoid tuberosity of humerus
- Action — flexion and internal rotation of the arm; abduction of the arm beyond the initial 15 degrees; extension and external rotation of the arm.
In the middle of the deltoid muscle is usually where the vaccine is injected. To locate a landmark of the deltoid, it is recommended to find the acromion process by palpating its bony prominence.