Uterine Tube-Uterine TubeFunction-Blood Supply-The Uterine Tube as a Conduit for Infection-Pelvic Inflammatory Disease-Ectopic Pregnancy- Tubal Ligation-

Uterine Tube

The two uterine tubes are each about 4 in. (10 cm) long and lie in the upper border of the broad ligament . Each connects the peritoneal cavity in the region of the ovary with the cavity of the uterus. The uterine tube is divided into four parts:

1. The infundibulum is the funnel-shaped lateral end that projects beyond the broad ligament and overlies the ovary. The free edge of the funnel has several fingerlike processes, known as fimbriae, which are draped over the ovary .

2. The ampulla is the widest part of the tube.

3. The isthmus is the narrowest part of the tube and lies just lateral to the uterus .

4. The intramural part is the segment that pierces the uterine wall .

Function

The uterine tube receives the ovum from the ovary and provides a site where fertilization of the ovum can take place (usually in the ampulla). It provides nourishment for the fertilized ovum and transports it to the cavity of the uterus. The tube serves as a conduit along which the spermatozoa travel to reach the ovum.

Blood Supply

Arteries

The uterine artery from the internal iliac artery and the ovarian artery from the abdominal aorta .

Veins

The veins correspond to the arteries.

Lymph Drainage

The internal iliac and para-aortic nodes.

Nerve Supply

Sympathetic and parasympathetic nerves from the inferior hypogastric plexuses

The Uterine Tube as a Conduit for Infection

The uterine tube lies in the upper free border of the broad ligament and is a direct route of communication from the vulva through the vagina and uterine cavity to the peritoneal cavity.

Pelvic Inflammatory Disease

The pathogenic organism(s) enter the body through sexual contact and ascend through the uterus and enter the uterine tubes. Salpingitis may follow, with leakage of pus into the peritoneal cavity, causing pelvic peritonitis. A pelvic abscess usually follows, or the infection spreads farther, causing general peritonitis.

Ectopic Pregnancy

Implantation and growth of a fertilized ovum may occur outside the uterine cavity in the wall of the uterine tube. This is a variety of ectopic pregnancy. There being no decidua formation in the tube, the eroding action of the trophoblast quickly destroys the wall of the tube. Tubal abortion or rupture of the tube, with the effusion of a large quantity of blood into the peritoneal cavity, is the common result.

The blood pours down into the rectouterine pouch (pouch of Douglas) or into the uterovesical pouch. The blood may quickly ascend into the general peritoneal cavity, giving rise to severe abdominal pain, tenderness, and guarding. Irritation of the subdiaphragmatic peritoneum (supplied by phrenic nerves C3, 4, and 5) may give rise to referred pain to the shoulder skin (supraclavicular nerves C3 and 4).

Tubal Ligation
Ligation and division of the uterine tubes is a method of obtaining permanent birth control and is usually restricted to women who already have children. The ova that are discharged from the ovarian follicles degenerate in the tube proximal to the obstruction. If, later, the woman wishes to have an additional child, restoration of the continuity of the uterine tubes can be attempted, and, in about 20% of women, fertilization occurs.