ACTIVITY 3
1. The site of injection is:
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Anterolateral Thigh (since it is the ideal location for IM injection in infants younger than 12 months)
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Targeted Muscle: Vastus Lateralis
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Origin: Greater trochanter and linea aspera of femur.
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Insertion: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament.
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Action: All four heads extend leg at knee joint; rectus femoris muscle acting alone also flexes thigh at hip joint.
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How do you locate this area: To landmark the vastus lateralis, position the patient lying down or being held by a parent. Palpate the muscle below the greater trochanter and above the lateral femoral condyle (knee joint). Divide the muscle into thirds and administer the injection into the middle third of the muscle, in the outer anterolateral aspect, lateral to the midpoint of the thigh.
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2. The site of injection is:
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Upper Arm/Deltoid Muscle (because it is the recommended location for adults and older while the vastus lateralis muscle in the anterolateral thigh may be utilized if the deltoid site is inaccessible)
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Targeted Muscle: Deltoid Muscle
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Origin: Acromial extremity of clavicle (anterior fibers), acromion of scapula (lateral fibers), and spine of scapula (posterior fibers).
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Insertion: Deltoid tuberosity of humerus
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Action: Arm abduction, which means raising your arm out to the side of your body. Lateral fibers abduct arm at shoulder joint; anterior fibers flex and medially rotate arm at shoulder joint; posterior fibers extend and laterally rotate arm at shoulder joint.
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How do you locate this area: To locate the landmark for the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony prominence. The injection site is in the middle of the deltoid muscle, about 2.5 to 5 cm (1 to 2 inches) below the acromion process. To locate this area, lay three fingers across the deltoid muscle and below the acromion process. The injection site is generally three finger widths below, in the middle of the muscle.
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References:
Tortora, G. J., & Derrickson, B. H. (2017). Principles of Anatomy and Physiology. (15th Ed.). John Wiley & Sons Inc.
Centers for Disease Control and Prevention. (2020, November 16). Seasonal Influenza Vaccine Dosage & Administration. https://www.cdc.gov/flu/about/qa/vaxadmin.htm
Cafasso, J. (2023, April 21). What Are Intramuscular Injections? https://www.healthline.com/health/intramuscular-injection#injection-sites
Patel, Pesino et al. (2023, July 25). Anatomy, Head and Neck; Frontalis Muscle. https://www.ncbi.nlm.nih.gov/books/NBK557752/#:~:text=The%20occipital%20part%20of%20the,skin%20of%20the%20eyebrows%20upward.
BCcampus Open Publishing – Open Textbooks Adapted and Created by BC Faculty. (2015, November 23). 7.4 intramuscular injections – Clinical procedures for safer patient care. https://opentextbc.ca/clinicalskills/chapter/6-8-iv-push-medications-and-saline-lock-flush/