SEMINAR IN GROSS

AMATOMY
THE FALLOPIAN TUBE
PRESENTED BY
ADETUTU MARY AYOMIKUN
BMS/19/20/0069
TABLE OF CONTENT
 INTROUDCTION
 FUNCTION

 EMBRYOLOGY

 SURFACE ANATOMY

 HISTOLOGY

 NEUROVASCULATURE

 APPLICATION TO KNOWLEDGE

 CLINICAL RELEVANCE

 REFERENCES
INTRODUCTION
 The fallopian tubes are bilateral conduits
between the ovaries and the uterus in the
female pelvis. They function as channels
for oocyte transport and fertilization. Given
this role, the fallopian tubes are a common
etiology of infertility as well as the target of
purposeful surgical sterilization. They can
also be sites of ascending infection or
neoplasms.
 INTRODUCTION
 2 tortuous tubes (10 cm in length) with less than 1mm
diameter, it lie in the free upper part of the broad ligament.
 They blend medially with the cornu of the uterus
 Laterally their free outer end curves backwards towards the
ovary.
 Their lumen communicates between the uterine and the
peritoneal cavities.
 Fimbriae – finger-like projections at the distal end that receive
the oocyte
 Cilia inside the uterine tube slowly move the oocyte towards
the uterus (takes 3–4 days)
 Fertilization occurs inside the uterine tube
 NOTE: Does not physically attach to the ovary
Tubal functions
 Ovum Pick Up, at the time of ovulation, by their free fimbrial end,
 Transport Of The Ova through the tubal lumen, by their peristaltic
and ciliary movements, and
 Production Of Secretions necessary for capacitation of the sperm
and nutrition of the ova during their journey, by their lining cells.

 Provide a site for fertilization

 Attaches to the uterus
 Supported by the broad ligament
EMBRYOLOGY
 The paramesonephric ducts, otherwise known
as the Mullerian ducts, form in female embryos
at around week five or six due to the absence of
anti-mullerian hormone (AMH). With estrogen
stimulation, the cranial ends of these ducts
eventually form the fallopian tubes. Caudally, the
paramesonephric ducts fuse in the midline and
ultimately form the uterus and superior vagina.
Most cranially, a remnant of the
paramesonephric duct may persist as a vestigial
structure called the vesicular appendage or the
hydatid cyst of Morgagni.
SURFACE ANATOMY
 4 parts
 1. Interstitial part (1
cm): pierces the
uterine wall, very
narrow, no
peritoneal covering,
no outer longitudinal
muscles.
 2. Isthmus (2 cm): straight, narrow, thick walled portion lateral to
uterus.
 3. Ampulla (5 cm): the widest, tortuous, thin walled outer part.
 4. Infundibulum (2 cm): trumpet shaped outer end opens into
the peritoneal cavity by the tubal ostium.
 The ostuim is surrounded by fimbriae, one of which is long
and directed towards the ovary (fimbria ovarica).
SURFACE ANATOMY
 Fallopian tubes, otherwise called oviducts or
uterine tubes, are hollow seromuscular
organs that originate at the uterine horns,
extend laterally within the superior edge of the
mesosalpinx of the broad ligament, and
terminate near the ipsilateral ovary.

Most medially, the uterine part includes the uterine

ostium and a short segment nearest to the uterine
horn.
IMAGE SHOWING THE SURFACE ANATOMY OF THE FALLOPIAN
TUBE
SURFACE ANATOMY
 The isthmus is adjacent to the uterine part. Lateral to
the isthmus is the ampulla, the most common site of
fertilization.
 Most distal from the uterus, the infundibulum ends at
an abdominal ostium opening up into the peritoneal
cavity and fimbriae, which catch the released oocyte
during each menstrual cycle.
 One fimbria, named the fimbria ovarica, serves to
connect the infundibulum to the ovary nearby.
 In addition to providing a space for fertilization to occur,
the fallopian tubes function as a passageway for the
ovum or gamete from the ovary to the uterus
Anatomical Relations
 Bounded
 above by loops of intestine
 below by the broad ligament and
its contents.
 medially they blends with cornu of
the uterus while
 laterally they are bounded by the
lateral pelvic wall.
 The ovaries lie posterior and
inferior to the Fallopian tubes at
each side.
Histology of the Fallopian tubes
 Mucosa (endosalpnix): Arranged
into 4-5 main longitudinal ridges
that give rise to subsidiary folds
or plicae. It is lined by columnar
partially ciliated epithelium.
 Muscle layer: Outer longitudinal
and inner circular involuntary
smooth muscles. It is thick at the
isthmus and thin at the ampulla.
 Serosa (peritoneal covering): The
extrauterine part is covered by
peritoneum in the upper margin
of the broad ligament.
Blood Supply & Lymphatic Drainage
 Arterial supply:
 branches from both the uterine artery, and the ovarian
artery.
 Venous drainage:
 Right ovarian vein drains directly into the IVC
 Left ovarian vein drains into the left renal vein.
 Lymphatic drainage:
 para-aortic LNs directly via ovarian lymphatics.
 Nerve supply
 sympathetic and parasympathetic fibres
 Applied anatomy
 Tubal pain is referred to the tubal points (On the lower
abdominal wall 1/2 an inch above the midinguinal
points).
APPLICATION TO KNOWLEDGE
 There have been rare reported cases of fallopian
tube diverticula, agenesis, and duplication.
Diverticula or duplications increase the risk of
tubal pathologies such as hydrosalpinx or
torsion, as well as ectopic pregnancies.
 Tubal abnormalities leading to occlusion or tubal
agenesis may contribute to infertility.
Diethylstilbestrol (DES) exposure in utero, in
particular, has been linked to abnormal
development of the fallopian tube (Briceag et al.,
2015)
CLINICAL RELEVANCE
 The ampulla is the most common site of ectopic pregnancies,
which are either treated medically or removed surgically with a
salpingostomy (creating an opening in the tube) or salpingectomy
(tube excision and removal).
 Removal of the fallopian tubes may be necessary for malignancies involving
the ovary, fallopian tube, or uterus, as well as benign conditions, including
hydrosalpinx and tubo-ovarian abscess.

 Fallopian tubes have a unique significance in the context of ovarian

cancer. High grade serous ovarian cancer (HGSOC), the most
common type of ovarian cancer, is often diagnosed at an advanced stage,
leading to poor prognosis. Recent evidence has shown that most cases of
HGSOC originate in the fallopian tubes years before the presentation of
ovarian cancer (Labidi-Galy et al., 2017).

 A tubal ligation is an option for patients desiring permanent sterilization

 REFERENCES
 Ajithkumar TV, Minimole AL, John MM, Ashokkumar OS. Primary fallopian tube carcinoma. Obstet Gynecol Surv. 2005
Apr;60(4):247-52. [PubMed]
 Briceag I, Costache A, Purcarea VL, Cergan R, Dumitru M, Briceag I, Sajin M, Ispas AT. Fallopian tubes--literature review of
anatomy and etiology in female infertility. J Med Life. 2015 Apr-Jun;8(2):129-31. [PMC free article] [PubMed]
 Dawood MY. Laparoscopic surgery of the fallopian tubes and ovaries. Semin Laparosc Surg. 1999 Jun;6(2):58-67. [PubMed]
 Eddy CA, Pauerstein CJ. Anatomy and physiology of the fallopian tube. Clin Obstet Gynecol. 1980 Dec;23(4):1177-
93. [PubMed]
 Ezzati M, Djahanbakhch O, Arian S, Carr BR. Tubal transport of gametes and embryos: a review of physiology and
pathophysiology. J Assist Reprod Genet. 2014 Oct;31(10):1337-47. [PMC free article] [PubMed]
 Gandhi KR, Siddiqui AU, Wabale RN, Daimi SR. The accessory fallopian tube: A rare anomaly. J Hum Reprod Sci. 2012
Sep;5(3):293-4. [PMC free article] [PubMed]
 Khalaf Y. ABC of subfertility. Tubal subfertility. BMJ. 2003 Sep 13;327(7415):610-3.
 Labidi-Galy SI, Papp E, Hallberg D, Niknafs N, Adleff V, Noe M, Bhattacharya R, Novak M, Jones S, Phallen J, Hruban CA,
Hirsch MS, Lin DI, Schwartz L, Maire CL, Tille JC, Bowden M, Ayhan A, Wood LD, Scharpf RB, Kurman R, Wang TL, Shih
IM, Karchin R, Drapkin R, Velculescu VE. High grade serous ovarian carcinomas originate in the fallopian tube. Nat
Commun. 2017 Oct 23;8(1):1093. [PMC free article] [PubMed]
 Marino S, Canela CD, Nama N. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Sep 5, 2022. Tubal
Sterilization. [PubMed]
 Sajjad Y. Development of the genital ducts and external genitalia in the early human embryo. J Obstet Gynaecol Res. 2010
Oct;36(5):929-37. [PubMed]
 Thurmond AS, Machan LS, Maubon AJ, Rouanet JP, Hovsepian DM, Moore A, Zagoria RJ, Dickey KW, Bass JC. A review of
selective salpingography and fallopian tube catheterization. Radiographics. 2000 Nov-Dec;20(6):1759-68. [PubMed]
 Venturella R, Morelli M, Zullo F. The Fallopian Tube in the 21st Century: When, Why, and How to Consider
Removal. Oncologist. 2015 Nov;20(11):1227-9. [PMC free article] [PubMed]