1. 2-month old well female infant
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Where are the sites of injection?
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Anterolateral part of the thigh
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What muscle is targeted in the injection? Write down its origin, insertion and action.
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Vastus lateralis muscle
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Origin: Greater trochanter, upper lateral surface of linea aspera (femur)
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Insertion
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Tibial tuberosity through the patellar ligament
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Via the patella through the quadriceps tendon
Action: leg extension at the knee joint
How do you locate this area?
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Divide the area between the great trochanter and lateral femoral condyle (above the knee joint) into thirds. Locate the middle of the middle third. Move outwards from the center, lateral to the midpoint.
2. 65-year-old grandfather
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Which muscle is the preferred site for IM injection in this case? Write down its origin, insertion and action.
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Deltoid muscle
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Origin: lateral ⅓ of the clavicle, acromion, spine of the scapula
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Insertion: Deltoid tuberosity on the lateral side of the humerus
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Action: arm abduction at the shoulder joint
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How do you locate this area?
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Palpate the outer edge of the scapula, locating the acromion process. Form an imaginary triangle and measure 3-5 cm below the acromion.
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References:
Biondi, N. L. (2023, August 8). Anatomy, bony pelvis and lower limb: vastus lateralis muscle. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK532309/#:~:text=The%20fibers%20of%20this%20muscle,tuberosity%20via%20the%20patellar%20tendon.
Clinical guidelines (Nursing) : Intramuscular injections. (n.d.). https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intramuscular_Injections/
Deltoid. (n.d.). Physiopedia. https://www.physio-pedia.com/Deltoid
Figure. Anatomical markers used to identify the vastus lateralis injection site on the anterolateral thigh. (2018, June 12). The Australian Immunisation Handbook. https://immunisationhandbook.health.gov.au/resources/figures/figure-anatomical-markers-used-to-identify-the-vastus-lateralis-injection-site-on-the-anterolateral-thigh#:~:text=The%20injection%20site%20is%20halfway,halfway%20between%20these%20two%20levels.
Pirie, E. (2023, September 8). Deltoid muscle. Kenhub. https://www.kenhub.com/en/library/anatomy/the-deltoid-muscle
Professional, C. C. M. (n.d.). Deltoid muscles. Cleveland Clinic. https://my.clevelandclinic.org/health/body/21875-deltoid-muscles#:~:text=Deltoid%20muscle%20functions%20include%3A,backward%2C%20behind%20your%20body).
Vasković, J., MD. (2023, July 13). Quadriceps femoris muscle. Kenhub. https://www.kenhub.com/en/library/anatomy/the-quadriceps-femoris-muscle
Vastus lateralis. (n.d.). Physiopedia. https://www.physio-pedia.com/Vastus_Lateralis