The uterine tubes are a pair of ducts which carry ova from the ovaries to the uterine cavity. Every tube is all about 10 cm long and is located in the upper free margin of the broad ligaments of the uterus.
- 1 External Features
- 2 Structure of The Uterine Tube
- 3 Arterial Supply
- 4 Venous Drainage
- 5 Lymphatic Drainage
- 6 Nerve Supply
- 7 Clinical Significance
Every tube presents 2 endings and 4 parts.
It opens into the lateral angle of the uterine cavity. The uterine opening (ostium) is 1 millimeter in diameter.
Lateral (Fimbriated) Ending
It interacts with all the peritoneal cavity close to the ovaryby piercing the posterior layer of the broad ligament.
- It arch downward and inward partially to encircle the ovary.
- The abdominal ostium is 3 millimeters in diameter and its margin possesses atypical small fingerlike processes termed fimbriae, thus it’s also referred to as fimbriated end.
From lateral to medial end, the fallopian tube is split intofour parts: infundibulum, ampulla, isthmus, and intramural.
Infundibulum (1 Cm Long)
- It’s the funnel-shaped lateral-most part which projects past the broad ligament of uterus.
- It overlies the ovary and presents an abdominal ostium.
- The circumference of the funnel is prolonged by changing number of unusual processes termed fimbriae. 1 fimbria longer and more deeply grooved compared to the others is closely applied to the tubal extremity of the ovary and is referred to as an ovarian fimbria. The ovarian fimbria functions as a detector to time the release of ovum. Just before the discharge of ovum fimbriae begin sweeping the surface of ovary and ease the entry of ovum into the fallopian tube.
Ampulla (5 Cm Long)
- It’s the broadest and longest part of the pipe and creates quite more than 1-half of the whole tube.
- It’s thin walled and tortuous.
- It’s the site of fertilization of ovum.
Isthmus (25-3 Cm)
- It’s the narrowest part and is located just lateral to the uterus.
- It’s round and cord-like because of thick muscular wall.
Intramural (Interstitial) Part (1 Cm Long)
It’s the section of uterine tube that traverses the uterine wall in the junction of fundus and body. It is located inside the wall of the uterus, thus the name intramural.
Structure of The Uterine Tube
From outside inward, the uterine tube contains 3 layers: serous, muscular, and mucous.
- The serous coating is originated from the peritoneum.
- The muscular layer is composed of smooth muscle that is ordered into inner circular and outer longitudinal layers.
- The mucous coating contains lining epithelium and underlying lamina propria.
The mucous membrane lining the tube presents about 6 primary longitudinal folds which in turn give rise to a number of secondary and tertiary folds. Consequently the lumen of the tube becomes highly atypical. This arrangement helps to supply nourishment to the zygote from all sides.
The lining epithelium is simple, ciliated columnar. It is composed of 2 types of cells: ciliated columnar cells and non-ciliated secretary cells. The secretion of secretary cells gives nutrients to the fertilized ovum. The cilia of ciliated cells beat toward the uterine cavity and assist in the transportation of the fertilized ovum.
The fallopian tube is provided by 2 arteries: ovarian and uterine arteries. Typically the medial 2-third of the tube is provided by the uterine artery and lateral 1-third by the ovarian artery.
The veins correspond to arteries, thereby venous blood is drained by the ovarian and uterine veins.
The lymph vessels follow the veins and drain into internal iliac lymph nodes, pre-aortic and para-aortic lymph nodes.
- The tubes are provided by both sympathetic and parasympathetic fibres. The sympathetic fibres are originated from ovarian and superior hypogastric plexuses. The preganglionic sympathetic fibres are originated from the T11 L2 spinal sections. The preganglionic parasympathetic fibres to the lateral part of the tube are originated from the vagus nerve and to the medial part from the pelvic splanchnic nerves (S2, S3, S4 spinal sections).
The inflammation of the uterine tube (or salpinx) is referred to as salpingitis (salpinx: trumpet-like). It’s the commonest cause of tubal block resulting in secondary sterility in female. Recently, the prevalence of tubal block has grown in modern females likely since they miss morning bath as a way to report on duty in time and waste time in makeup. Tubal infection typically happens because of upward spread of infection from vagina and uterus. The patency of tubal block is analyzed by these evaluations:
- Insufflation evaluation (or Rubin’s evaluation); Air is shoved into the uterus, and if tube is obvious, the air leaks into the peritoneal cavity. The leakage of air creates hissing or bubbling sound which can be heard by a stethoscope over the iliac fossa.
- Hysterosalpingography; It’s a radiological technique where a radiopaque substance (example, Lipiodol) is injected into the uterus by a suitable canula. It summarizes the uterine cavity and uterine tubes, and if tubes are evident, the contrast medium spills into the peritoneal cavity.
It’s commonest in the uterine tube (tubal gestation) and is typically related to intraperitoneal hemorrhage, among the reasons for acute abdominal crisis in women of childbearing age. The hemorrhage happens because of rupture of the tube caused by enlarging conceptus.
It’s a procedure for the female sterilization. In this process, every fallopian tube is ligated at 2 points and the section of tube between the ligatures is resected. This prevents the assembly of male and female gametes, thus no fertilization. This is the perfect approach of family planning in female.