FALLOPIAN TUBES AND
OVARIES
BY:
KSHITIZ SONI
20180179
INTRODUCTION-

The fallopian tubes, also known
as oviducts, uterine tubes,
or salpinges (singular salpinx)
are uterine appendages, lined from
inside with ciliated simple columnar
epithelium, leading from
the ovaries of female mammals into
the uterus, via the uterotubal junction.
They enable the passage of egg
cells from the ovaries to the uterus. In
non-mammalian vertebrates, the
equivalent structures are just
called oviducts.
STRUCTURE:
Its different segments are
(lateral near
the ovaries to medial near
the uterus): the infundibulum with
its associated fimbriaenear the
ovary, the ampullary region that
represents the major portion of the
lateral tube, the isthmus the visible
medial third segment which is the
narrower part of the tube that links
to the uterus, and the interstitial
(also known as intramural) part that
transverses the uterine
musculature. The ostium is the
point where the tubal canal meets
the peritoneal cavity, while the
uterine opening of the fallopian
tube is the entrance into the uterine
cavity, the uterotubal junction.
MICROANATOMY
A cross-section of a fallopian tube
shows four distinct layers, from outer
to inner: serosa, subserosa, lamina
propria and innermost mucosal. The
serosa is derived from
visceral peritoneum. Subserosa is
composed of loose adventitious tissue,
blood vessels, lymphatics, an outer
longitudinal and inner circular smooth
muscle coats. This layer is responsible
for the peristaltic action of the
fallopian tubes. Lamina propria is a
vascular connective tissue.
The inner layer is a single layer of simple columnar epithelium. The columnar
cells have microscopic hair-like filaments (cilia) predominately throughout the
tube, but are most numerous in the infundibulum and
ampulla. Estrogen increases the production of cilia on these cells. Between the
ciliated cells are peg cells, which contain apical granules and produce the
tubular fluid. This fluid contains nutrients for spermatozoa, oocytes,
and zygotes. The secretions also promote capacitation of the sperm by
removing glycoproteins and other molecules from the plasma membrane of the
sperm. Progesterone increases the number of peg cells, while estrogen
increases their height and secretory activity. Tubal fluid flows against the
action of the cilia, that is toward the fimbrial end.
FERTILISATION
The tube allows passage of the egg from the ovary to the uterus. When
an oocyte is developing in an ovary, it is encapsulated in a spherical
collection of cells known as an ovarian follicle. Just prior to ovulation
the primary oocyte completes meiosis I to form the first polar body
and a secondary oocyte which is arrested in metaphase of meiosis II.
This secondary oocyte is then ovulated. The follicle and the ovary's
wall rupture, allowing the secondary oocyte to escape. The secondary
oocyte is caught by the fimbriated end and travels to the ampulla of
the uterine tube where typically the sperm are met
and fertilization occurs; meiosis II is promptly completed. The
fertilized ovum, now a zygote, travels towards the uterus aided by
activity of tubal cilia and activity of the tubal muscle. The early embryo
requires critical development in the fallopian tube. After about five
days the new embryo enters the uterine cavity and on about the sixth
day implants on the wall of the uterus.
The release of an oocyte does not alternate between the two ovaries
and seems to be random. After removal of an ovary, the remaining one
produces an egg every month.
Occasionally the embryo implants into the fallopian tube instead of
the uterus, creating an ectopic pregnancy, commonly known as a
"tubal pregnancy".
Clinical significance



Patency testing
While a full testing of tubal functions in patients
with infertility is not possible, testing of tubal
patency is important as tubal obstruction is a
major cause of infertility.
A hysterosalpingogram, laparoscopy and dye,
or HyCoSy (hysterocontrast sonography) will
demonstrate that tubes are open. Tubal
insufflation is a standard procedure for testing
patency. During surgery the condition of the
tubes may be inspected and a dye such
as methylene blue can be injected into the uterus
and shown to pass through the tubes when
the cervix is occluded. As tubal disease is often
related to Chlamydia infection, testing
for Chlamydia antibodies has become a cost
-effective screening device for tubal pathology.

Inflammation

Main article: Salpingitis

Salpingitis is inflammation of the fallopian
tubes and may be found alone, or be a
component of pelvic inflammatory
disease (PID). A thickening of the fallopian
tube at its narrow portion, due to
inflammation, is known as salpingitis
isthmica nodosa.
Like PID and endometriosis, it may lead
to fallopian tube obstruction. Fallopian tube
obstruction is associated
with infertility and ectopic pregnancy.

Cancer

Main article: Fallopian tube cancer

Fallopian tube cancer, which typically
arises from the epithelial lining of the
fallopian tube, has historically been
considered to be a very rare
malignancy. Recent evidence suggests
it probably represents a significant
portion of what has been classified
as ovarian cancer in the past.[5] While
tubal cancers may be misdiagnosed as
ovarian cancer, it is of little
consequence as the treatment of both
ovarian and fallopian tube cancer is
similar.
SURGERY:
 The surgical removal of a fallopian
tube is called a salpingectomy. To
remove both tubes is a bilateral
salpingectomy. An operation that
combines the removal of a fallopian
tube with removal of at least one
ovary is a salpingo-oophorectomy.
An operation to remove a fallopian
tube obstruction is called
a tuboplasty.


The ovary is an organ found in the female
reproductive system that produces an ovum.
When released, this travels down the fallopian
tube into the uterus, where it may become
fertilized by a sperm. There is an ovary
(from Latin ovarium, meaning 'egg, nut') found
on the left and right sides of the body. The
ovaries also secrete hormones that play a role in
the menstrual cycle and fertility. The ovary
progresses through many stages beginning in
the prenatal period through menopause. It is also
an endocrine gland because of the various
hormones that it secretes.




The ovaries are considered the female gonads.[2] Each ovary is
whitish in color and located alongside the lateral wall of
the uterus in a region called the ovarian fossa. The ovarian fossa
is the region that is bounded by the external iliac arteryand in
front of the ureter and the internal iliac artery. This area is about
4 cm x 3 cm x 2 cm in size.[3][4] The ovaries are surrounded by a
capsule, and have an outer cortex and an inner medulla.
Usually, ovulation occurs in one of the two ovaries releasing an
egg each menstrual cycle; however, if there was a case where one
ovary was absent or dysfunctional then the other ovary would
continue providing eggs to be released without any changes in
cycle length or frequency.
The side of the ovary closest to the fallopian tube is connected to
it by infundibulopelvic ligament,[3] and the other side points
downwards attached to the uterus via the ovarian ligament.
Other structures and tissues of the ovaries include the hilum.


The ovaries lie within the peritoneal cavity, on
either side of the uterus, to which they are
attached via a fibrous cord called the ovarian
ligament. The ovaries are uncovered in
the peritoneal cavity but are tethered to the body
wall via the suspensory ligament of the
ovary which is a posterior extension of the broad
ligament of the uterus. The part of the broad
ligament of the uterus that covers the ovary is
known as the mesovarium.[4]
The ovarian pedicle is made up part of
the fallopian tube, mesovarium, ovarian
ligament, and ovarian blood vessels.

The surface of the ovaries is covered with membrane consisting of a
lining of simple cuboidal-to-columnar shaped mesothelium.

The outermost layer is called the germinal epithelium.


The outer layer is the ovarian cortex, consisting of ovarian
follicles and stroma in between them. Included in the follicles are
the cumulus oophorus, membrana granulosa (and the granulosa
cells inside it), corona radiata, zona pellucida, and primary oocyte. Theca
of follicle, antrum and liquor folliculi are also contained in the follicle.
Also in the cortex is the corpus luteum derived from the follicles. The
innermost layer is the ovarian medulla.[7] It can be hard to distinguish
between the cortex and medulla, but follicles are usually not found in
the medulla.
Follicular cells flat epithelial cells that originate from surface epithelium
covering the ovary, are surrounded by Granulosa cells - that have
changed from flat to cuboidal and proliferated to produce a stratified
epithelium
At puberty, the ovary
begins to secrete
increasing levels of
hormones. Secondary
sex characteristics
begin to develop in
response to the
hormones. The
ability to produce
eggs and reproduce
develops. The ovary
changes structure
and function
beginning at puberty.


The ovaries are the site of production and periodical release
of egg cells, the female gametes. In the ovaries, the
developing egg cells (or oocytes) mature in the fluidfilled follicles. Typically, only one oocyte develops at a time,
but others can also mature simultaneously. Follicles are
composed of different types and number of cells according
to the stage of their maturation, and their size is indicative
of the stage of oocyte development.
When the oocyte finishes its maturation in the ovary, a surge
of luteinizing hormone secreted by the pituitary
gland stimulates the release of the oocyte through the
rupture of the follicle, a process called ovulation. The follicle
remains functional and reorganizes into a corpus luteum,
which secretes progesterone in order to prepare
the uterus for an eventual implantation of the embryo.

At maturity, ovaries
secrete estrogen, testosterone, inhibin,
and progesterone. In women, fifty percent of
testosterone is produced by the ovaries
and adrenal glands and released directly into the
blood stream.[16] Estrogen is responsible for the
appearance of secondary sex characteristics for
females at puberty and for the maturation and
maintenance of the reproductive organs in their
mature functional state. Progesterone prepares
the uterus for pregnancy, and the mammary
glands for lactation. Progesterone functions with
estrogen by promoting menstrual cycle changes
in the endometrium
THANK
YOU
KSHITIZ SONI
20180179