During an otoscopic examination on an infant, in which direction is the pinna pulled?
a. Up and back
b. Up and forward
c. Down and back
d. Down and forward
ANS: C
In infants and toddlers, the ear canal is curved upward. To visualize the ear canal, it is necessary to pull the pinna down and back to the 6 to 9 o'clock range to straighten the canal. In children older than age 3 years and adults, the canal curves downward and forward. The pinna is pulled up and back to the 10 o'clock position. Up and forward and down and forward are positions that do not facilitate visualization of the ear canal.
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