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?
Site of injection: Vastus lateralis muscle
Origin: Greater trochanter and linear aspera of femur
Insertion: Patella through quadriceps tendon and tibial tuberosity via patellar ligament
Action: Lower leg and knee joint extension
How to locate: Locate the greater trochanter of femur, make imaginary box on upper leg, one hand width below the groin, hand above knee, use side border of mid-anterior thigh then inject
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?
Site of injection: Deltoid muscle
Origin: Acromial extremity of clavicle, acromion of scapula, spine of scapula
Insertion: Deltoid tuberosity of humerus
Action: Abduction of arm, medial rotation of arm, lateral rotation of arm at shoulder joint
How to locate: Palpate the bony prominence of acromion process at lower arm, find middle of deltoid muscle approximately 1-2 inches below acromion process