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?
For a 2-month-old infant, an intramuscular injection, in this case PCV and Penta vaccine, is usually done at the muscle in the anterolateral part of the thigh. The muscle to be targeted is the Vastus lateralis, which is part of the group of muscles called the quadriceps.
The information of the muscle is as follows:
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 the leg at the knee joint; the rectus femoris muscle acting alone also flexes the thigh at the hip joint.
To locate the site for injection:
1. Divide the area into thirds from the greater trochanter to the lateral femoral condyle
2. Locate the center of the middle part and palpate the outer anterolateral aspect lateral to the midpoint of the thigh
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?
For adults, the flu vaccine is given intramuscularly through the deltoid muscle located in the proximal part of the upper limbs.
The information of the muscle is as follows:
Origin: Acromial extremity of clavicle (anterior fibers), acromion of scapula (lateral fibers), and spine of scapula (posterior fibers).
Insertion: Deltoid tuberosity of the humerus.
Action: Lateral fibers abduct the arm at the shoulder joint; anterior fibers flex and medially rotate the arm at the shoulder joint; posterior fibers extend and laterally rotate the arm at the shoulder joint.
To locate the site for injection, it is the thickest part of the deltoid muscle—about 2 inches or 5 centimeters below the acromion process.