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Anatomy

Lower Limb

Question 68 of 180

A patient presents to ED for treatment having been informed by the GUM clinic that he has tested positive for gonorrhoea. You administer intramuscular ceftriaxone. Intramuscular injections in the buttocks should always be given in which of the following areas:

Answer:

The sciatic nerve passes through the lower medial quadrant. Intramuscular injections in the buttocks should always be given in the upper lateral quadrant of the gluteal region to avoid damage to the sciatic nerve and major vessels in the region.

Gluteal Quadrants

Anatomy / Lower Limb / Hip Joint and Gluteal Region

Last Updated: 6th February 2019

The gluteal region can be divided into quadrants by 2 lines: one line descending vertically from the highest point of the iliac crest, the other line passing horizontally through the first line midway between the highest point of the iliac crest and the ischial tuberosity. The sciatic nerve passes through the lower inner quadrant.

Intramuscular injections in the buttocks should always be given in the upper outer quadrant of the gluteal region to avoid damage to the sciatic nerve.

Safe Injection Site: Upper Outer Quadrant. (Image by British Columbia Institute of Technology (BCIT) [CC BY 4.0 (https://creativecommons.org/licenses/by/4.0)], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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