Submandibular salivary gland(palpation)

The palpation of the submandibular gland involves:

• position: the submandibular gland lies beneath the horizontal ramus of the mandible on the mylohyoid muscle, two or three centimetres in front of the anterior border of the sternomastoid muscle; it should not be confused with enlarged upper cervical lymph nodes which are deep to the sternomastoid muscle. It feels rubbery.
• relations: by bimanual palpation. The lump is felt between the gloved index finger of one hand inside the mouth, and the fingers of the other hand on the outer surface of the mouth and lump. It should be possible to appreciate that the lump is outside the structures that form the floor of the mouth. It should not be fixed to the mucosa of the floor of the mouth or to the tongue.
• the floor of the mouth: this displays the orifices of the submandibular ducts on their small papillae on either side of the frenulum of the tongue. If a stone is impacted at the end of the duct, its grey-yellow colour may be visible through the duct orifice.