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?
- Sites of injection: Anterolateral thigh
- Muscles targeted: Vastus lateralis
- Origin: Greater trochanter and linea aspera of femur
- Insertion: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
- Action: All four heads extend leg at knee joint; rectus femoris muscle flexes thigh at hip joint
- Locating the area: Palpate the muscle below the greater trochanter and above the lateral femoral condyle also known as knee joint.
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?
- Sites of injection: Upper arm
- Muscles targeted: Deltoid
- Origin: Acromial extremity of clavicle, acromion of scapula, and spine of scapula
- Insertion: Deltoid tuberosity of humerus
- Action: 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
- Locating the area: Find the acromion process, the bony prominence at the shoulder, and measure approximately 2 inches below it, just above the armpit.