Fallopian Tube

Fallopian Tube


INTRODUCTION: 

  • The fallopian tube represents the cranial end of the Müllerian duct(paramesonephric ducts), with their cranial ends remaining open connecting the duct with the coelomic (peritoneal) cavity and the caudal end communicating with the uterine cornua.
  • The fallopian tube measures 4 inch (10 cm) or more in length and approximately 8 mm in diameter, but the diameter diminishes nearthe cornu of the uterus to 1 mm.
  • The fertilised ovum takes 3-4 days to travel through the fallopian tube and reaches the uterine cavity by the 7th day from ovulation.
  • Lie in the upper part of the broad ligaments
  • Tubal ostium is the point where the tubal canal meets the peritoneal cavity
  • Covered with peritoneum except along a thin area inferiorly, forming the two layers of the broad ligament.

ANATOMICAL PARTS:

The fallopian tube is divided anatomically into four parts:

The interstitial portion

  • Traverses the myometrium to open into the endometrial cavity
  • Shortest(18 mm) & narrowest(1mm)
  • Finest cannula can be passed into it during falloscopy examination
  • Circular fibres are well developed

Isthmus:

  • One-third of the total length
  • Longitudinal and circular muscle fibres.
  • Acts as a functional/anatomical sphincter.
  • Most common site for female tubal sterilization 

Ampulla:

  • Lateral, widest and longest part of the tube and comprises roughly two-thirds of the tube.
  • Mucosa is arborescent with many complex folds
  • Fertilization occurs here

Fimbriated extremity or infundibulum:

  • The abdominal ostium opens into the peritoneal cavity.
  • Fimbriae are motile & Prehensile
  • Ovarian fimbria larger and longer
  • Embraces the ovary at ovulation,
  •  Picks upthe ovum and carries it to the ampullary portion

MICROANATOMY:

The fallopian tubes have three layers:

The serous layer:

  • Consist of Mesothelium of the peritoneum

The muscular layer:

  • Outer longitudinal and inner circular fibres.

Mucous membrane:

  • Thrown into folds or plicae
  • Each plica consists of stroma which is covered by epithelium.
  • The epithelium of the mucous membrane consists of three types of cells:
  • Ciliated columnar or cubical: Propel a fluid current towards the uterus and plays some part in the transport of the inert ovum
  • Goblet-shaped cell: Lubricant and nutritive to ovum
  • Peg cells(rod-shaped)

 

VESSEL AND NERVE SUPPLIES:

  • The arterial supply to the uterine tubes is via the uterine and ovarian arteries. Venous drainage is via the uterine and ovarian veins. 
  • Lymphatic drainage is via the iliac, sacral and aortic lymph nodes.
  • The uterine tubes receive both sympathetic and parasympathetic innervation via nerve fibres from the ovarian and uterine (pelvic) plexuses. Sensory afferent fibres run from T11- L1.
 PATENCY TEST:

Tests Performed for Tubal patency are : 

  1. Hysterosalpingography (HSG): Screening test.
  2. Laparoscopic chromotubation: Best test
  3. Sonosalpingography (Sion Test)
  4. Hysteroscopy
  5. Transcervical Falloscopy
  6. Ampullary and Fimbrial Salpingoscopy
Exam Question
 
  • Narrowest part of Fallopian Tube is Interstitial portion
  • Parts of fallopian tube from ovary to uterus are Infundibulum – Ampula – Isthmus – Intramural
  • The length of fallopian tube is  10 – 12 cm
  • Longest part of the fallopian tube is Ampulla
  • Fallopian tube patency is checked by Hysterosalpingography, Laparoscopy & Hysteroscopy
  • ‘Peg cells’ are seen in fallopian tube
  • Most common site for female tubal sterilization is isthmus
  • The fertilised ovum takes 3-4 days to travel through the fallopian tube and reaches the uterine cavity by the 7th day from ovulation.
  • Tubal ostium is the point where the tubal canal meets the peritoneal cavity
  • MUllerian ducts develops in females into the Fallopian tubes
  • Isthmus acts as a functional/anatomical sphincter.
  • Maximum number of mucosal folds are found in ampulla
  • Fertilization takes place in ampulla
Don’t Forget to Solve all the previous Year Question asked on Fallopian Tube

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