fallopian tube problems 7 july17

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Fallopian Tube Problems
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Description

• The human oviduct, also known as the fallopian
  tube, is an essential component of the normal
  reproductive process. The tube, which connects
  the peritoneal space to the endometrial cavity,
  captures the egg after ovulation and transports
  the sperm from the uterus to the fertilization
  site in the ampulla (the middle portion of the
  tube). The ampulla serves as the physiologic site
  for final gamete maturation, fertilization, and
  early embryonic development. This article reviews
  the morphologic, physiologic, functional, and
  pathologic aspects of the human oviduct.
• See Medscapes Womens Sexual Health Resource
  Center.

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• Embryology
• Early in the embryologic life, 2 sets of paired
  genital ducts exist the wolffian ducts
  (mesonephric duct) and the müllerian ducts
  (paramesonephric duct). At about 6 weeks'
  gestation, the wolffian ducts regress in females
  because testosterone and müllerian inhibiting
  substance (MIS) are not secreted in the absence
  of testis. The müllerian ducts develop into the
  female genital tract in a cephalocaudal fashion.
  The more cephalad ends of the paired
  paramesonephric ducts are opened to the
  peritoneal cavity and develop into the fallopian
  tubes, while the more caudal portion fuses in the
  lower midline to form the uterovaginal
  primordium, which later develops into the
  epithelium and glands of the uterus and
  cervix. 1
• If one müllerian duct fails to develop (usually
  associated with lack of development of the
  mesonephric system on the same side), a
  unicornuate uterus results, which consists of one
  uterine horn with only one fallopian tube.
  Complete failure of the müllerian system results
  in the absence of the fallopian tubes, the
  uterus, the cervix, and most of the vagina
  (Rokitansky-Küster-Hauser syndrome). Also
  see Mullerian Duct Anomalies.
• Remnants of the paramesonephric or mesonephric
  ducts may persist in the female as paratubal
  cysts or hydatid cysts of Morgagni.

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• The infundibulum, from the Latin word meaning
  funnel, is the funnel-shaped most distal end of
  the tube and is in close relation to the ovary.
  The peritoneal ostium lies at the base of the
  infundibulum and is surrounded by 20-30 irregular
  fingerlike projections (fimbriae), which spread
  over the surface of the ovary, and a single large
  fimbria (the fimbria ovarica), which is attached
  to the ovary. The fimbriae trap the ovulated ovum
  and sweep it through the tubal ostium into the
  ampulla. 4 The infundibulum is surrounded by a
  thin longitudinal muscular layer.
• The ampulla is about 4-6 cm in length and is the
  longest region of the tube, comprising about half
  its length. It is also the widest region, about 6
  mm in inner diameter, and the most tortuous
  region. Its luminal diameter is wider at its
  distal end than its proximal end. It is
  relatively thin walled and surrounded by 2 smooth
  muscle layers, an inner longitudinal layer and an
  outer circular layer. Fertilization occurs in
  this region.
• The isthmus is short, about 2.5-4 cm, and begins
  as the tube exits the uterus. Its lumen is
  narrow, about 1-2 mm in diameter, and the
  muscular wall is thick and well developed,
  consisting of 3 well-defined layers an inner
  longitudinal layer, an outer longitudinal layer,
  and a middle circular layer. 5, 6
• The interstitial or intramural segment is 1-2 cm
  long and constitutes the uterine-tubal junction.
  This section extends through the wall of the
  uterus and the ostium opens within the uterine
  cavity.

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