FRS - Uterine Tubes

Question 1

What are the functions of the uterine tubes?

Answer 1

Transfer and transport ovum from the ovary to the uterus.

This is done by ciliated columnar epithelial cells and peg cells. They waft the ovum towards the uterus and supply it with nutrients.

There is also a smooth muscle layer that assists with transportation of the ovum and sperm. Peristalsis is most action when there is high levels of estrogen.

Question 2

Anatomical structure?

Answer 2

The tubes can be subdivided into four regions, from distal to medial:

1) Fimbriae - finger-like projections that capture the ovum from the surface of the ovary.
2) Infundibulum - funnel-shaped opening near the ovary to which fimbriae are attached.
3) Ampulla - widest section of the uterine tubes. Fertilisation occurs here.
4) Isthmus - narrowest sections of the tubes connecting the ampulla to the uterine tubes.

Question 3

Vascular supply and lymphatics?

Answer 3

Arterial supply - uterine and ovarian arteries.

Venous drainage - uterine and ovarian veins.

Lymphatic drainage - iliac, sacral, and aortic lymph nodes.

Question 4

Innervation?

Answer 4

Sympathetic and parasympathetic innervation arises from ovarian and uterine plexuses.

Sensory afferent fibres run from T11-L1.

Question 5

Clinical relevance: salpingitis

Answer 5

Inflammation of the uterine tubes that is caused by bacterial infection. It can cause adhesions of the mucosa which can block the lumen of the uterine tubes. This can result in infertility or ectopic pregnancy.

Question 6

Clinical relevance: ectopic pregnancy

Answer 6

If the uterine tubes are partially-occluded, sperm may enter but the ovum may not be able to leave.

The ovum can then be implanted into the uterine tubes. This is known as an ectopic pregnancy.

This is a medical emergency. If not diagnosed earlier, this can result in a haemorrhage of the affected tube.

Question 7

Clinical relevance: ligation of the uterine tubes