Activity 3 - Answer the following questions
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?
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In administering, PCV or pneumococcal conjugate vaccine and Penta or pentavalent vaccine to infant patients, use the vastus lateralis muscle in the anterolateral thigh. Administering PCV injections should be on the right thigh while Penta injections should be administered on the left thigh. The oral polio vaccine, from the word itself, is administered orally in doses by drops in the mouth.
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The vastus lateralis muscle in the anterolateral thigh are under the quadriceps femoris muscle group. The origin, insertion and action of the muscle are as follows:
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Origin: Upper intertrochanteric line, base of greater trochanter, lateral linea aspera, lateral supracondylar ridge and lateral intermuscular septum
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Insertion: Quadriceps tendon:
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Action: straightening of the knee
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In locating the area of injection on the vastus lateralis muscle, the patient can be positioned by being placed in a supine position while we locate the location. The patient's guardian may also carry the patient as an option. The injection site is roughly midway between the greater trochanter and the lateral femoral condyle, which are landmarks or points halfway down the vastus.
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?
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The preferred site for IM injections in this specific case is in the deltoid muscle located in the upper arm. Its origin, insertion and action are as follows:
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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: abducts arm at shoulder joint; posterior fibers extend and laterally rotate; anterior fibers flex and the arm rotates medially at shoulder joint.
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The patient should be sitting down and their arm bare and visible (shoulder to the top of the elbow). The deltoid muscle is a rounded triangle shape. You should be able to find the acromion by palpating the bony prominence and then trace and imaginary inverted triangle below the shoulder.
The Royal Children’s hospital melbourne. The Royal Children’s Hospital Melbourne. (n.d.). https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intramuscular_Injections/#:~:text=The%20deltoid%20muscle%20is%20a,inverted%20triangle%20below%20the%20shoulder.
Centers for Disease Control and Prevention. (n.d.). Administering pneumococcal vaccine: For providers. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/vpd/pneumo/hcp/administering-vaccine.html#:~:text=Administer%20pneumococcal%20conjugate%20vaccines%20(PCV15,adults%2C%20use%20the%20deltoid%20muscle.
Vastus Lateralis. Loyola University Medical Education Network. (n.d.). https://www.meddean.luc.edu/lumen/meded/grossanatomy/dissector/mml/vasl.htm
Tortora, G. J., & Derrickson, B. H. (2017). Tortora’s Principles of Anatomy & Physiology. Wiley.