anatomy and physiology

IntroductionFallopian tubes are the another structure of internal organ of the female reproductive system. It also known as uterine tube. The lumen of each tube communicates with the peritoneal and prond to pelvic infection.

Macroscopic Structures

• Fallopian tube are two tubes lined with ciliated epithelia.

• Each tube extend from the cornua of the uterus, travels towards the side wall of the pelvic, then turns downwards and backwards before reaching it.

• Lenght averages 11 -12cm each tube

Divided into four segments• isthmus - 2.5mm in length. It is medially bordered by the intramural portion

of the tube that connects to the endometrical cavity and laterally by the ampullary part of the tube

• Ampulla - 5mm lenght. It is an intermediate dilated portion.The most common site of human fertilization.

• Imfundibulum - 6mm.This is the terminal and distal of the tube. T urns backwards and downwards and ends in finger like projection known as fimbriae.

• Fimbrae - It a finger of tissue around the proximal of fallopian tube. During ovulation the blood vessels become engorged and give the fimbrae increased power to sweep ovum

Part of Fallopian Tube

Microscopic Structure

• Composed of 3 layers in the wall the mucosa (ciliated epithelium)connective tissue, and peritoneum

• Ciliated epithelium (mucosa) -forms the lining of the tube. -As the result of ovarian hormone for its

embedding in the uterus.

• Connective tissue - muscle is arranged in two layers :

1)An inner layer of involuntary circular muscle fiber.

2)An outer layer of involutary longitudinal fibres which continues into the body of the uterus.

• Peritoneum - hangs over the tubes but is absent on their inferior surface.

3 major layer of the fallopian tube seen undermicroscopic :• Endosalpinx(the inner endothelial layer)has

many fold, particularly in the ampullary and infundibular region.

• Mysolpinx ( the middle muscular layer)or muscularis, has consist of two muscle layer, an inner circular and an outer longitudinal layer.

• Serosa the outer membranous layer or epithelium. The serosa is a smooth membrane that envelopes the tubal muscle and secret a lubricating fluid to prevent friction againts other internal organ.

Changes of the Fallopian Tube During Pregnancy

• During puberty, develop from the size and give place for fertilization.

• .During pregnancy, tubal epithelium remains low. There is considerable variation in postmenopausal changes in the tubal epithelium - Hypertrophy of the tubes

Changes of the Fallopian Tube During Pregnancy

• Becomes more vascular• As uterus grows and enlarge, fallopian tube

also lifted out of pelvis.• During puerperium, the fallopian tube returns

to pregravid status after 6/52 postpartum

Constribution Of Fallopian Tube To Reproductive System

1)Fertilization• The ovum travels to the ampulla in the tube,

where typically the sperm are met and fertilization occurs in fallopian tube.

• zygote travels towards the uterus aided by activity of tubal cilia and activity of the tubal muscle. After about 5 days the new embryo enters the uterine cavity and implants about a day after.

• After about 5 days the new embryo enters the uterine cavity and implants about a day after.

• Occasionally the embryo implants into the fallopian tube instead of the uterus, creating an ectopic pregnancy commonly known as a tubal pregnancy

Fertilization and implantation in fallopian tube

2) Ectopic Pregnancy• The fallopian tubes may cause the fertilized egg to

implant in one of the fallopian tubes rather than in the uterus. The fetus would then begin to develop in the tube, where there is no room for it to keep growing. This is called an ectopic pregnancy.

• An untreated ectopic pregnancy could cause the fallopian tube to burst suddenly, which might lead to life-threatening bleeding.

Image Ectopic Pregnancy

3)Pelvic inflammantory disease (PID)• Infection of the reproductive organs of

women. This may cause infection the fallopian tubes. The two most commonly involved bacteria that cause PID are Chlamydia trachomatis and Neisseria gonorrhoeae, that cause the sexually transmitted diseases,chlamydia and gonorrhea.

Organ Affected With Pelvic Inflammatory Disease

4)Tubal Ligation (BTL) And Resection of a portion of the fallopian tube is the most frequent method of blocking the tubes. This involves tying a segment of tube and removing it. There are variations of this technique.

i)Tied the fallopian tubes

ii)Cut the fallopian tubes

iii)final result

Conclussion

• Fallopian tube is one of the critical organ in the fertilization process.Ovum and sperm will be fertilized at the ampula area and then early embryonic will be transferred directly to the endometrium wall of uterus and become fetus.This is the starting point of pregnancy.

• Fertilization will not occur if there is any abnormality at the tube such as blockage,tumors,tubal cancer and infection of tubal cilia.This can damage the tube or narrows its diameter and increases the chance of an ectopic pregnancy(a pregnancy develop in the tube or another abnormal location outside the uterus).

• Therefore,it is critical for midwife to aware and understand anatomy and its function as the basic knowledge in midwifery