NEB Exam Q: ctd: UTERUS | ANATOMY

ANATOMY OF UTERUS , SUPPORTS OF GENITAL ORGANS​

Supports of Vagina:

1. Upper part by the lower components of the transverse cervical ligaments of Mackenrodt or cardinal ligament
2. Lower vaginal part by the:

a) Fibres of the levator ani muscle
b) Urogenital diaphragm
c) Perineal muscles

3. Anterior vaginal wall by pubocervical fascia
4. Posterior vaginal wall by perineal body and rectovaginal fascia

The Fallopian Tube:

The fallopian tubes are two tortuous ducts which extend from the ovaries to the cornua of the uterus, one on each side.
Fallopian tubes are also called Uterine tubes or Oviduct.

Anatomy of Fallopian tube:
Length: 10 cm.

Situation: Each lies in the free upper border of the broad ligament of the uterus.

Extension: Its lumen communicates with the uterine cavity at its inner end and with the peritoneal cavity outer end.

Parts: Four parts:

1. Interstitial or intramural part: 1-2 cm in length and is the part which traverses the uterine wall. It gets no peritoneal coat.
2. Isthmus: Straight and narrow portion adjacent to the uterus and measures 2-3 cm in length.
3. Ampulla: Wider thin walled and tortuous outer portion, approx. 5 cm in length. It leads to the infundibulum.
4. Infundibulum: Trumpet shaped outer end of the tube with and opening into the peritoneal cavity (abdominal ostium). The ostium is surrounded by fimbriae, which moves freely and are devoid of broad ligament and pick up ovum when release from ovary.

Structure of Fallopian tube:

1. Serous layer: Derived from peritoneum.
2. Muscular layer: Outer longitudinal and inner circular layer of involuntary muscle.
3. Submucous layer: Delicate connective tissue which separates the muscle zone from the mucosa lining of the lumen (Endosalpinx).
4. Mucosa: Lined by ciliated columnar epithelium. Mucous membrane is thrown into complicated folds which fill up the lumen of the tube.

Blood supply of Fallopian tube:

Arterial supply: Medial 2/3rd by Uterine artery and lateral 1/3rd by Ovarian artery.

Venous drainage: Drains into the pampiniform plexus of the ovary and into the uterine veins.

Lymphatic drainage of Fallopian tube: Into aortic and para-aortic lymph nodes.

Nerve Supply of Fallopian tube:

Sympathetic from ovarian and superior hypogastric plexus and parasympathetic from vagus.

Development of Oviduct:

Mucosa: From cranial vertical and middle horizontal part of the para-mesonephric duct.

Muscle and serous coat: From surrounding mesenchyma.

Functions of Fallopian Tube:

• Transport of sperm and ovum.
• Site of fertilization.
• Helps in development, survival and transport of zygote

Some pathological conditions of Fallopian tube:

A. Infection: Salpingitis
B. Neoplasm

• Benign: Fibroma, Leiomyoma, Haemangioma, Adenomatoid tumour, Polyp
• Malignant: Primarily Choriocarcinoma, Sarcoma, Carcinoma and secondary from ovary, uterus or large intestine.