Fallopian tubes
Synonyms
Tuba uterina, salpinx
English: oviduct, tube
Figure fallopian tube
- Fallopian tubes -
Tuba uterina - Fallopian tubes -
Isthmus tubae uterinae - Large part of the fallopian tube -
Ampulla tubae uterinae - Folds of the fallopian tube lining -
Plicae tubariae - Fallopian tube fringed funnel -
Infundibulum tubae uterinae - Uterine cavity -
Cavitas uteri - Cervix - Ostium uteri
- Ovary - Ovary
- Uterine tip -
Fundus uteri - Mucous membrane -
Tunica mucosa tubae - Muscle wall
(inside ring layer) -
Tunica muscularis - Muscle wall
(outside longitudinal layer) -
Tunica muscularis - Peritoneum cover -
Tunica serosa - Vein of the muscle wall
- Artery of the muscle wall
You can find an overview of all Dr-Gumpert images at: medical illustrations
anatomy
The fallopian tube is one of the female sexual organs and is created in pairs. One fallopian tube is about on average 10 to 15 cm long. You can think of it as a hose, so to speak, that carries the Ovary with the uterus connects and thereby a matured Egg cell, which can be fertilized in the course of the fallopian tube, enables safe transport.
At the ovary, the fallopian tube begins with a funnel, which then turns into a ampoule (Ampulla tubae uterinae) expanded. The ampoule has the largest diameter of the fallopian tube and is approximately 2/3 of the total length. In this area, the mucous membrane of the fallopian tube is heavily folded. Then the inner diameter narrows by a distance of about 2 to 3 cm, just before the fallopian tube opens into the uterus. This place is called "isthmus“, The opening area is only 2 mm here. The adjoining part is the shortest of the fallopian tube and runs in the wall of the uterus, where the fallopian tube ultimately also enters.
Together with the ovary, the fallopian tube is often referred to as "Adnexa" summarized.
histology
In the fallopian tube can three wall layers distinguish: on the very outside is the Tunica serosa. She's a layer off connective tissuewho hold the fallopian tube with the wide mother band (the uterus) so that it is not lying around "loosely" in the body.
The one lies further inside Tunica muscularis, the muscle layer of the fallopian tube. This consists of an outer longitudinal muscle and an inner circular muscle layer smooth muscle cellsthat ensure that the fallopian tube is capable of a wave-like movement that is used to transport the egg cell.
That lies entirely within Tunica mucosa (Endosalpinx), the mucous membrane. Here you will find longitudinal folds, which are more pronounced the further you are from the uterus away. The mucous membrane contains the cells that are of great importance for the correct functioning of the fallopian tube. For one, it contains Epithelial cellsthat carry cilia (ciliated epithelium), i.e. structures that look like tiny hairs. These cilia beat from the ovary towards the uterus, helping to direct the egg in the right direction. In addition, there are cells here that release a certain secretion that is neutral to acidic. These cells adapt their activity to which part of the cycle the woman is currently and whether one pregnancy present or not.
Function of the fallopian tubes
Every month the woman in the Ovary several ova approach. As a rule, however, only one egg cell completely completes this maturation process (this final stage is known as Graaf's follicle). One end of the fallopian tube practically comes to rest over the ovary. This ending is a funnel (Infundibulum) with "fringes" (Fimbriae) one to two cm in length. Some of these fringes are directly related to the ovary.
Shortly before an egg “jumps”, you can notice rhythmic movements in the fimbriae, which helps the funnel of the fallopian tube to slip over the ovary in the right place to accommodate the jumping egg. Once this process has taken place, the contractions (Contractions) the muscular layer and the ciliated cells of the mucous membrane ensure that the egg cell is transported through the fallopian tube to the uterus. This hike through the fallopian tube usually takes about 3 to 5 days. Doesn't take place during this time fertilization, the egg eventually reaches the uterus and is eventually excreted from the body.
When a Sperm cell however, when the egg reaches the 6 to 12 hours it is fertile, fertilization takes place. This usually happens in the area of ampoule. This then means that the egg begins to divide in the fallopian tube.In most cases, it has reached either the 12- or 16-cell stage before it finally lodges in the lining of the uterus and continues to mature there.
About from 40th year of life natural remodeling processes of the fallopian tube wall begin, which are completed when the menopause is reached, i.e. when the woman no longer ovulates or menstruates and therefore can no longer become pregnant. So they are without any disease value, as the body simply adjusts itself to the fact that it no longer has to carry a pregnancy to term. The ciliated epithelium loses height and the cells excrete less secretion.
Diseases
There are several diseases that affect the fallopian tubes. Not infrequently it can go through vagina, cervix or uterus rising bacteria causing inflammation of one or both fallopian tubes (Salpingitis) come. Sufferers often have Abdominal painsome of which may be aggravated during intercourse or urination. Depending on how severe the inflammation is, there are also general signs of inflammation such as fatigue or fever, or vaginal discharge (Genital fluorine). This inflammation usually lets itself through Antibiotics get a good handle on it. Sometimes, however, there are complications that should not be underestimated. In some patients the inflammation continues to rise, which eventually leads to involvement from the Ovaries (Adnexitis) or des Peritoneum (Peritonitis), two clinical pictures that are associated with considerably more severe symptoms.
It can also happen that the ciliated epithelium is damaged and / or adhesions or scarring occur within the fallopian tubes. In the worst case scenario, these processes can lead to a infertility as the sperm and / or the egg can no longer be transported properly. At unfulfilled desire to have children It is therefore always essential to check the permeability of the fallopian tubes as part of a diagnosis.
The principle is based on the sterilization benefit the woman. With this as "Tubal ligation"Procedure, the fallopian tubes are simply" tied off ". The advantage of this permanent form of contraception is that it can be reversed at any time with a new operation.
Another complication of fallopian tube sticking, but not the only cause, is one Ectopic pregnancy (extrauterine pregnancy). Here the fertilized egg incorrectly does not implant itself in the uterus, but rather in the mucous membrane of the fallopian tube. Here, however, the conditions for the embryo to grow are not given, as there is not enough space on the one hand and not enough nutrients on the other. For this reason, the embryo normally detaches itself from the mucous membrane relatively early, which often goes completely unnoticed by the woman. Sometimes, however, this discharge also leads to scarring, which can then be the reason for infertility. In rarer cases, however, the embryo initially continues to develop in the fallopian tube for a while. If this is not noticed, the fallopian tube may burst or tear at some point due to the lack of space (Fallopian tube rupture) come. This complication is an absolute emergency, as it can be massive from the fallopian tube Hemorrhage can get into the abdomen. Sufferers complain of sudden violent behavior Abdominal pain and can even turn into a life-threatening one State of shock expired.
Fallopian tube adhesions
Fallopian tube adhesions to care in about 20% for infertility of women in Germany. Usually the fallopian tubes stick together from inflammation conditions. Often that sticks together upper open end of the fallopian tube, where the Fimbriae ("Fringes" of the fallopian tube) of the fallopian tubes. These are usually ascending infections from the vaginal tract. Often there is also damage to the ciliated epithelium of the fallopian tube, even with inflammation. It can even happen that the Inflammation here a cavity filled with pus forms.
The inflammations usually come through bacterial infections come about, gluing can through Chlamydial bacteria, Anaerobes, gram-negative bacteria, Neisseria gonorrhea (also called gonorrhea) and in very rare cases of tuberculosis arise. Often there is one ascending fallopian tube infection through the Scabbard. The most common for inflammation are the Enterococci and E. coli intestinal bacteria responsible. But chlamydia is also involved in 40% of the cases. The infections run in the process often without symptoms, only small bleeding suggests it. Other typical symptoms such as Pain and fever added.
In patients with IUDs, the risk of ascending infections is further increased. In addition, the likelihood increases with frequent sexual intercourse.
You can find more information on our website Fallopian tubes glued.
Ectopic pregnancy
The Ectopic pregnancy is with 98% the most common pregnancy outside the uterus, the uterus. The risk of an ectopic pregnancy is approx at 1-2%. Patients with ectopic pregnancy usually lose their child and it will also be for them in the future harder to get pregnant. After a previous ectopic pregnancy that is Risk of another ectopic pregnancy increased by 15-20%.
Cause of ectopic pregnancy
By Inflammation of the fallopian tubes or through the so-called Endometriosis can the fallopian tubes narrower or even impermeable be. Endometriosis is Uterine lining, which in this case occurs in the fallopian tubes and causes irritation here. especially the Fallopian tube adhesions inflammation plays the most common role here.
There is also Inflammation of the abdomen (such as with Appendicitis), which can lead to adhesions and thus to Impermeability of the fallopian tubes can contribute. It can also occur during operations in the region Adhesions or kinks come.
Another cause can be Tumors of the fallopian tubes, but also benign Tumorshow to be the fibroids of the uterus. The fibroids press on the fallopian tubes from the outside and narrow them. In addition come hormonal fluctuations and conditions that can cause an ectopic pregnancy. Hormonal fluctuations increase especially with age.
You can also Spirals, Tube sterilization, use of mini-pills favor an ectopic pregnancy.
course
The course of ectopic pregnancy is different and depends on the Localization of ectopic pregnancy.
- Resorption of ectopic pregnancy through the surrounding tissue
- Fallopian tube rupture: In the case of the fallopian tube rupture, the fallopian tube pregnancy was previously in the constriction (isthmus) of the fallopian tube. The pregnancy continues to grow until it becomes one Rupture of the fallopian tubes comes. This can lead to extremely heavy bleeding with danger to life come! It is the second most common course of an ectopic pregnancy.
- Fallopian tube abortion: Fallopian tube abortion usually occurs in an ectopic pregnancy in the back part (ampoule) the fallopian tubes. The ectopic pregnancy usually gets into the cavity of the ampoule and so gets there in the abdomen. About half is now absorbed. The other part takes care of Abdominal complications. It is the most common course of an ectopic pregnancy. The symptoms of a fallopian tube abortion are similar to those of a fallopian tube inflammation, mostly lying Pain in the lower abdomen in front.
- Termination of pregnancy: This course is by far the rarest.
localization
Most often, an ectopic pregnancy occurs with 65% in the ampoule on, followed by the Isthmus with 25% and in 10% there are other locations.
therapy
Should the ectopic pregnancy at an early stage are discovered, one is usually enough Treatment with the chemotherapy drug Methotrexate out. In cases of late discovery, then mostly must but operated on become. The emergency operation has meanwhile become very rare due to the good diagnostics.
