Fallopian tubes

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Schematic representation of the internal female sex organs with womb ( uterus ), cervix ( cervical ), fallopian tubes, ovaries (ovarian), and vagina .

The fallopian tube (also oviduct ; Latin tuba uterina , tuba fallopii ; ancient Greek σαλπίγξ salpinx ) is a paired part of the sexual organs in female vertebrates, which starts as a tube or duct on both sides of the uterus and ends near the respective ovary . In mammals, after ovulation, it enables the transport of the mature oocyte or egg cell from the ovary to the uterus. Takes place in the fallopian tube in the presence of sperm , the fertilization of the egg. The human ovaries and fallopian tubes are often grouped under the term adnexa in anatomy .

embryology

The development of the fallopian tube is made from the upper part of the Müller gangs .

anatomy

Histological cross-section of a human fallopian tube in the middle of the cycle: (1) lumen, (2) high prismatic ciliated epithelium with kinocilia, (3) gland cells, (4) tunica muscularis, (5) arteriole

In humans, the fallopian tubes are about 10-15 cm long tubes that are attached to the broad ligament of the mother ( ligamentum latum uteri ) by a hanging strap ( mesosalpinx ) . The end of fallopian tube close located on the ovary consists of a funnel ( infundibulum fallopian tube ) with 20 to 30, 1 to 2 cm long fringes ( fimbriae tubae therefore also "fimbria") from which the adherent to the ovary as ovaricae fimbriae designated become. The infundibulum expands into the ampulla tubae uterinae . At 7 cm, this is also the longest section. This is followed by a 2 to 3 cm long bottleneck called the isthmus tubae uterinae. The pars uterina tubae uterinae (“part of the womb”) is the part that pierces the wall of the uterus. It is only 0.1 to 1 mm wide and opens into the uterine cavity with the ostium uterinum .

Fine tissue structure

The mesosalpinx as a serous peritoneal coating forms the upper edge of the ligamentum latum uteri . The muscle layer ( myosalpinx ) is responsible for the contractile movements of the fallopian tubes and is made up of an outer longitudinal layer and an inner circular layer of smooth muscles .

The mucous membrane ( endosalpinx or tunica mucosa ) is the innermost layer and has longitudinal folds. The single-layer, highly prismatic ciliated epithelium mainly contains secretory cells and epithelial cells bearing ciliated cells, which are distributed in different proportions in the course of the fallopian tube and depending on the stage of the sexual cycle .

history

The first mention of the fallopian tube is ascribed to Herophilos of Chalcedon , a Greek doctor who lived around 300 BC. Taught in Alexandria. Further descriptions followed, but it was not until Gabriele Falloppio (1523–1562) expanded the anatomical knowledge of the fallopian tube to such an extent that it still bears his name in many countries today (including Latin tuba Fallopii , English Fallopian tube ). Old names for the fallopian tube included egg duct, mother's trumpet, cornu (uteri), cornu matricis, humerus, keraía, latera, cornual ligament, oviductus, ovarian tube, vas seminale, vas spermaticum, vena tenuissima and via medulla.

function

If a follicle (an egg cell together with the surrounding granulosa cells ) has matured into Graaf’s follicle , the mucosal fringes (fimbriae) at the transition from the ovary to the fallopian tube fimbriae show rhythmic movements. At the same time, the fallopian tube moves up and down through muscle contraction until the ovary comes to rest over the mature follicle through chemotactic influences. The egg cell is transported through the fallopian tube after it has been expelled from Graaf's follicle, on the one hand again by muscle contractions of the fallopian tube and on the other hand by a flow of fluid in the direction of the fallopian tube. The cilia (cilia) of the epithelial cells lining the fallopian tubes determine the direction of the fluids and thus also the egg cell . They beat rhythmically towards the uterus.

It takes up to 5 days to transport the egg into the uterus. However, since the human egg cell can only be fertilized for 6 to 12 hours, this also means that it must be fertilized by a sperm cell in the fallopian tube ampoule . In order to increase the probability of conception, the transport of the sperm cells towards the ampoule is also supported by the fallopian tube by means of muscular contractions.

At the time of ovulation, the egg, the first meiotic division just completed and begins the second meiotic division (→ meiosis ). In the fallopian tube, those cumulus cells that were expelled from the follicle together with the oocyte now detach . From the fertilized egg cell, the zygote , a multicellular structure arises during the transport through the fallopian tube through furrows . The uterine cavity is usually reached in the 12 to 16-cell stage, with the 16-cell stage of the zygote being called the morula due to its mulberry-shaped shape .

menopause

From the age of 40 there are morphological and ultrastructural changes in the fallopian tube epithelium, although these changes in the sense of a dissociated epithelial tissue reaction do not occur simultaneously. Among other things, from the beginning of the premenopause the secretory performance of the epithelial cells and the number of ciliated cells decrease, and the epithelium loses height; Processes that are most pronounced in the postmenopause .

sterilization

Tying off the fallopian tubes ( tubal ligature ) is a form of sterilization for women . Sterilization can also be brought about by clipping (metal clip, mostly made of titanium), coagulation, cutting through the fallopian tube or a combination of the methods mentioned. After this procedure, the egg cells can no longer get into the uterus, but rather die in the fallopian tube and are resorbed there. These methods used for permanent contraception can only be reversed to a limited extent by attempting refertilization .

Diseases and dysfunction

  • Continuity of the tube

In almost half of all cases, an unfulfilled desire to have children is caused by the sterility of the woman. Almost a third of these cases are due to the closure of one or both fallopian tubes, usually as a result of an inflammation of the fallopian tube ( salpingitis ). Checking the patency of the fallopian tubes is of primary importance in the context of sterility diagnostics and can be carried out using hystero-contrast salpingography or chromopertubation .

  • Ectopic pregnancy

In probably 1 out of 150 cases - precise information is difficult to give here, since around 50% of the fertilized egg cells are presumably lost as early miscarriages in the first few days - the zygote, now referred to as a blastocyst , does not nest in the uterus, but outside of the same: an ectopic pregnancy occurs , which is located in the fallopian tube in 99% of cases (see ectopic pregnancy ). The latter can not due to lack of nutrient supply and inadequate space allowances held be. The embryo and placenta usually detach themselves from the fallopian tube wall. This discharge does not have to cause problems, but can also lead to scarring of the fallopian tube and thus be the cause of later infertility . If the embryo develops in the fallopian tube over a long period of time, a serious complication is a fallopian tube rupture with hematosalpinx . A delayed or prevented Eipassage in the fallopian tube is the most common cause of ectopic pregnancy, where previous infections , especially in users of a spiral , usually this are responsible.

  • An inflammation of the fallopian tube, which can salpingitis, isolated or in the context of abdominal inflammation occur. With isthmica nodosa salpingitis inflammation- related bag-like widening of the tube at the transition into the uterus, which can lead to tube displacement .
  • With tube carcinoma is a very rare malignant is formation of the fallopian tube called.
  • A surgical removal of the fallopian tube is called salpingectomy , removal of the tube with the corresponding ovary is a salpingo - ovariectomy referred. A relocation of the fallopian tube is surgically treated with a tube plastic .

Web links

Wiktionary: fallopian tubes  - explanations of meanings, word origins, synonyms, translations
Wiktionary: Ovidukt  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. a b c d e f g h Ulrike Bommas-Ebert, Philipp Teubner, Rainer Voß: Short textbook anatomy and embryology . 3. Edition. Thieme, Stuttgart 2001, ISBN 978-3-13-135533-1 , p. 338 .
  2. a b Ellen Schulze: Ultrastructural changes in the lamina epithelialis of the human tuba uterina in pre- and postmenopause in comparison with younger ages. Dissertation, Institute for Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, 2001 ( full text as PDF file, 15 MB ).
  3. ^ Albert Lehner: Ovary and fallopian tubes. Anatomy studies in antiquity and modern times - therapy concepts in the 19th and 20th centuries. In: Würzburger medical historical reports 9, 1991, pp. 17–35.
  4. Albert Lehner: Ovary and fallopian tubes: anatomy studies in antiquity and modern times. Therapy concepts in the 19th and 20th centuries. In: Würzburg medical history reports. Volume 9, 1991, pp. 17-35, here (cited): p. 17.