Palpate the parotid (Figure 19) and submandibular (Figure 20) salivary glands using a bilateral technique. Normally these glands should not be palpable. Induration and pain could be signs of infection, blockage, immune system disorder or a neoplastic process. In addition, non-tender parotid enlargement may occur with alcoholism, diabetes, Sjögren’s syndrome, eating disorders, HIV infection and various malignant/non-malignant states involving the salivary glands.
Figure 19. Palpation of the parotid gland.
Figure 20. Palpation of the submandibular glands.