When examining the ear with an otoscope, what does the tympanic membrane normally look like?

• A. Red and bulging
• B. Pearly gray and concave
• C. Yellow and dull
• D. Opaque white

Answer: (B)

The main idea is what a healthy tympanic membrane looks like when you inspect it with an otoscope. In a normal ear, the membrane appears pearly gray, translucent, and slightly concave. The pearly gray color comes from its thin, intact surface and the light that can pass through to reveal the underlying structures, like the malleus. The slight inward curve (concavity) is due to the tension of the membrane and the middle-ear space behind it being properly aerated. You may also notice a light reflex forming a small cone as you shine the otoscope.

If the membrane were red and bulging, that would point toward acute inflammation or infection with swelling pushing outward. If it looked yellow and dull, that suggests fluid behind the membrane or thickening from an effusion. If it were opaque white, that could indicate scarring or other chronic changes.