Fallopian Tube: Structure, Embryology, and Clinical Significance

A Fallopian tube is a pair of long and narrow ducts in the female human abdominal wall that transfer male sperm cells to the egg. It provides a suitable environment for fertilization, and transports the egg from the ovary.

• Each fallopian tube is 10–13 cm long and 0.5–1.2 cm in diameter.
• The tube's channel is coated by a mucous membrane layer with many folds and small cone-shaped tissue projections.

• They are located close to the ovaries at the top border of the wide ligament that extends laterally from the uterus and opens into the abdominal cavity.

Also Read: Human Reproductive System

Key Terms: natomical Structure, Blood Supply, Embryology, Uterus, Ovaries, Fallopian tube, Eggs, Sperms, Fertilization, Tissue, ligament

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Structure of Fallopian Tube 

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The four anatomical regions of the fallopian tube are the uterine, isthmus, ampulla, and infundibulum. The uterine ostium and a brief portion closest to the uterine horn are located most medially in the uterine region. The uterine portion is next to the isthmus. The ampulla, which is located to the side of the isthmus, is the most common location of fertilization. 

• The infundibulum, which is located farthest from the uterus, terminates in an abdominal ostium that opens into the peritoneal cavity and fimbriae, which collect the discharged oocyte throughout each menstrual cycle.
• The fimbria ovaries are fimbriae that connect the infundibulum to the adjacent ovary.
• The fallopian tubes serve as a pathway for the ovum or gamete from the ovary to the uterus and provide a region for fertilization.

Also Read: Phases of Menstrual Cycle and Menstrual Hormones

Anatomical Structure of Fallopian Tube

The fallopian tube is divided into four sections (from lateral to medial). Fimbriae are ciliated finger-like projections that catch the ovum from the ovary's surface.

• Fimbriae are attached to the infundibulum, which is a funnel-shaped aperture near the ovary.
• The ampulla is the broadest part of the uterine tubes.
• Fertilization is generally done in this area.
• The isthmus connects the ampulla to the uterine cavity and is a thin part of the uterine tubes.

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Blood Supply and Lymphatics 

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Anastomoses between the ovarian and tubal branches of the ovarian artery and ascending branches of the uterine artery provide vascular feed to the fallopian tube. The ovarian arteries branch off the abdominal aorta on each side, inferior to the renal arteries' origin. The ascending branches of the uterine arteries branch out from the internal iliac arteries and proceed superiorly to the uterine horns, while the descending branches travel inferiorly to the superior vagina.

• In the same way that the arterial supply travels to the tubal branches of the uterine and ovarian veins.
• The drainage from the right ovarian vein goes to the inferior vena cava (IVC), while the drainage from the left ovarian vein goes to the left renal vein.
• The internal iliac veins flow into the IVC and the uterine veins into the internal iliac veins.
• The fallopian tubes have a similar lymph drainage system as the ovaries.
• The fallopian tubes send lymph to the para-aortic (lumbar) lymph nodes as well as the pelvic lymph nodes.

Also Read: Female Reproductive System

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Embryology of Fallopian Tube 

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The paramesonephric or Müllerian ducts give rise to the fallopian tubes. The mesoderm, the middle layer of one of the embryo's three basic germ layers, gives rise to these ducts. The ectoderm and endoderm are the other two layers.

• The tubes are formed by elongating and coiling the superior vertical and middle horizontal features of the duct to generate fully developed fallopian tubes.
• The uterus and superior vagina are formed when the paramesonephric ducts merge in the midline.

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Clinical Significance of Fallopian Tube 

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Several gynecologic illnesses involve the fallopian tubes, necessitating the operations indicated before. Ectopic pregnancies most commonly occur in the ampulla, which can be treated medically or surgically with a salpingostomy (tube opening) or salpingectomy (tube removal) (tube excision and removal). Malignancies of the ovary, fallopian tube, or uterus, as well as benign diseases such as hydrosalpinx and tubo-ovarian abscess, may necessitate fallopian tube removal.

• In the context of ovarian cancer, the fallopian tubes have special relevance.
• The most common kind of ovarian cancer, high-grade serous ovarian cancer (HGSOC)
• It is frequently detected at an advanced stage, resulting in a dismal prognosis.
• According to new research, most occurrences of HGSOC begin in the fallopian tubes years before ovarian cancer manifests.

Also Read: Sexually Transmitted Diseases

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Surgical Considerations of Fallopian Tube 

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Surgical considerations of the fallopian tube are- 

• Salpingo-oophorectomy: the elimination of the ovaries and fallopian tube
• Salpingectomy: the excision of the fallopian tube 
• Salpingostomy: a surgical cut into the fallopian tube to provide an aperture 
• Tubal ligation: female surgical sterilization by occlusion, withdrawal, or ligation of fallopian tubes.

Also Read: Fertilization

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Things to Remember

• The mucous membrane contains cells with fine hair-like structures and projections called cilia. 
• The cilia's swinging movements and the fallopian tube's wall's repetitive muscular movements work together to move the egg or sperm.
• Pelvic infection, endometriosis, and congenital anomalies can all cause problems in fallopian tube structure and function.
• The lymphatic drainage system of the ovaries and fallopian tubes is similar.
• Both the pelvic lymph nodes and the para-aortic (lumbar) lymph nodes get lymph from the fallopian tubes.
• Fallopian tube irregularities or injuries can influence a woman's fertility.
• Sperm are often unable to reach the egg if the tubes are obstructed or damaged.

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