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?
Site of Injection: Anterolateral Thigh
Target Muscle: Vastus Lateralis (for both PCV and Penta)
Origin: Intertrochanteric line and linea aspera of femur
Insertion: Tibial Tuberosity
Action: Extends Tibia, Knee extension
Locating the area:
- Palpate from a hand’s breadth above the knee to a hand’s breadth below the greater trochanter.
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The middle third of the muscle is the landmark for injection, spanning from the thigh's midline to its outer side.
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?
Site of Injection: Upper arm
Target Muscle: Deltoid
Origin:
Anterior head: Clavicle
Lateral head: Acromion of scapula
Posterior head: Spine of scapula
Insertion: Deltoid tuberosity of humerus
Action:
Anterior head: Flexes and internally rotates arm
Lateral head: Abducts arm
Posterior head: Extends and laterally rotates arm
Locating the area:
- Identify the acromion process; the injection site is 1-2 inches below it.