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Fallopian tube

1900

The oviducts transport sperm and eggs and transfer fertilized eggs to the uterine cavity.

Emerges from each side of the uterus and extend to approximate the ovaries.

Measures about 8-10 cm in length.

Attached to the ovary by a small ligament.

Consists of an intramural portion of the tube passing from the uterine cavity via the uterine muscle.

The isthmic segment of the tube is a narrow area of the tube as it emerges form the uterus.

The ampullary portion of the tube is wider and more tortuous, and is the longest segment of the tube.

The infundibular aspect of the tube is bell shaped.

The fimbrial end of the tube exhibits the mucus membrane lining facing the ovary.

The fimbrial end is rich in cilia that can sweep the egg into the tube when released from the ovary.

Millions of cilia line the fimbria and interior of the fallopian tubes.

The inner layer of the oviduct is lined with endothelium, the endosalpinx.

Captures eggs released from the ovary in the fimbriated end, providing a conduit for an egg and sperm to meet for fertilization.

May be a passageway for endometrial cells and infectious agents to gain access to the pertoneal cavity.

The middle layer is made of muscles, the myosalpinx.

The outer layer, the serosa, is covered with epithelial cells.

The endosalpinx has folds, particularly in the ampullary and infundibular segments increasing surface area.

The myosalpinx has an inner circular layer and outer longitudinal layer.

In the interstitial, intramural segment, a third layer of muscle is present.

The serosa of the fallopian tube envelopes the muscle and provides a lubricating fluid to prevent friction of surrounding organs.

Among its function included: capturing the egg upon release from the ovary and moves the egg towards the uterus, assists movement of sperm toward the egg and nourishes the egg after fertilization until its transfer to the uterus.

Musculature of the tube propels the sperm and egg toward each other via peristaltic contractions.

Fertilization normally occurs in the ampullary area of the fallopian tube.

The tubes inner endothelial lining is covered with cilia which beat in coordinated waves and capture the fertilized egg by the fimbrial and transport it towards the uterus.

The endothelium secretes nutrient rich material that sustains the egg after fertilization and during the earliest phases of embryologic development.

Inside the tube the egg and the sperm meet with fertilization of the egg.

If an egg is not fertilized within 24-36 hours it deteriorates and will be removed by the immune system.

Distal fallopian blockage is most commonly due to pelvic inflammatory disease and salpingitis.

Agents associated with pelvic inflammatory disease and distal fallopian tube obstruction most commonly include C. trachomatis or N. gonorrhoeae, but can be due to mycoplasma, ureaplasma, anaerobic and coliform species and myobacterial infections.

Tubal scarring can occur with adhesions, endometriosis, and bacterial peritonitis.

The distal fallopian tube may be the site of origin of high grade serous ovarian cancer.

The fallopian tube has an outer muscular layer and an inner mucosal layer with ciliated columnar cells, secretary cells, and intercalated cells.

The fimbriated end of the fallopian tube has an open communication with the peritoneum and is similar to the epithelium of the ovary.

The fimbriated end of the fallopian tube has been implicated in many adenocarcinomas thought previously to have a arisen in the ovary.

The prophylactic removal of apparently normal tubes and ovaries from women would BRCA1 or BRCA2 mutations show that the fimbriated end of the fallopian tube harbors serous carcinoma in 2 to 7% of specimens.

Inflammatory diseases of the most important benign tubal disorders.

Infections can ascend from the lower genital tract to the fallopian tube and reach the peritoneal cavity, leading to pelvic inflammatory disease.

Fallopian tube infections typically become chronic and cause permanent tubal occlusion and enlargement of the fallopian to the starting the reproductive pelvic architecture and cause infertility.

Tubal infertility caused by bilateral hydrosalpinx is managed by in vitro fertilization rather than restoring tubal function.

Hydrosalpinx adversely affects in vitro fertilization outcomes by reducing the implantation rate and increases the risk of miscarriage.

1-2% of live births are complicated by ectopic pregnancy, and at least 93% of such pregnancies are located in the fallopian tube.

Prophylactic bilateral salpingectomy at the time of hysterectomy or tubal ligation for women at risk for ovarian carcinoma is recommended, as it reduces the risk of the latter.

Excisional tubal sterilization is associated with risk reduction for ovarian epithelial cancer by 64%

Increasingly common that prophylactic bilateral salpiningectomy

is being combined with hysterectomy

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