fallopian tubes
Summary
The fallopian tubes (uterine tubes/oviducts) are paired muscular ducts connecting the ovaries to the uterus, serving as the site of fertilization. They are lined by ciliated columnar epithelium that helps transport the ovum toward the uterus. They are a common site for ectopic pregnancy and can be affected by infection (salpingitis) leading to infertility.
Detail
Embryologically, the fallopian tubes derive from the paramesonephric (Müllerian) ducts. Each tube is divided into four segments: the infundibulum (with fimbriae that capture the oocyte from the ovary), ampulla (widest portion and most common site of fertilization), isthmus (narrow segment connecting to the uterus), and the intramural/interstitial portion (passes through the uterine wall). The tubal wall contains smooth muscle for peristalsis, and the mucosa has ciliated and secretory (peg) cells; ciliary beating and muscular contractions propel the oocyte/embryo toward the uterus.
Clinical significance: Pelvic inflammatory disease (commonly due to Chlamydia trachomatis or Neisseria gonorrhoeae) causes salpingitis, which can lead to tubal scarring, adhesions, and increased risk of infertility and ectopic pregnancy (most commonly implanting in the ampulla). Ectopic pregnancy presents with amenorrhea, abdominal pain, and vaginal bleeding, and can rupture causing life-threatening hemorrhage—a gynecologic emergency. Tubal ligation is a common method of permanent contraception. Hydrosalpinx (fluid-filled dilated tube) can result from chronic infection or obstruction and may impair fertility. The tubes are also implicated in the pathogenesis of high-grade serous ovarian carcinoma, with evidence suggesting many arise from the fimbriated end of the fallopian tube (serous tubal intraepithelial carcinoma, STIC lesions).
Sources
- BRS Gross Anatomy
- First Aid for the USMLE Step 1
- Langman's Medical Embryology
- Robbins Basic Pathology
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