To open a child's ear canal, you should?

• A. Hold the lower ear, pulling down and backward
• B. Hold the upper ear, pulling up and back
• C. Twist the ear
• D. Massage the pinna

Answer: (A)

Opening the ear canal for an exam works by straightening the external ear canal so the otoscope can see the eardrum. In a young child, the canal angles upward, so gently pulling the earlobe downward and backward straightens it enough to view the tympanic membrane clearly. This is the appropriate technique for children under about three years old.

Pulling the upper part of the ear would be reserved for older children and adults, not for young kids. Twisting the ear or massaging the pinna won’t effectively align the canal and can cause discomfort. Use a gentle, steady motion and stop if there’s resistance.