Fallopian Tube Anatomy and Vascularization

Fallopian Tube (Uterine Tube) Parts

• Extends from the superior end of the uterus to the lateral pelvic wall
• Enclosed within the mesosalpinx portion of the broad ligament
• Has four parts: infundibulum, ampulla, isthmus, uterine part (intramural segment)
• The infundibulum is trumpet-shaped with fimbriae to collect ovulated eggs
• The ampulla is the widest part, where fertilization normally happens
• The isthmus is the narrowed portion before the uterus
• The uterine part is the shortest, embedded in the uterine wall

Fallopian Tube Vascularization

• Arterial supply:
  • Tubal branch of the uterine artery (from the internal iliac artery)
  • Tubal branch of the ovarian artery (from the abdominal aorta)
  • These two arteries anastomose along the uterine tube
• Venous drainage:
  • Follows the arterial system
  • Venous plexuses become confluent in the subserosal layer

Lymphatic Drainage

• Drains along the upper edge of the broad ligament
• Drains to the para-aortic (lumbar) lymph nodes

Innervation

• Sympathetic fibers originate from the thoracic and lumbar sympathetic chain
• Parasympathetic fibers derive from the pelvic splanchnic nerves (S2-S4) via the inferior hypogastric plexus
• Sensory (afferent) fibers travel with sympathetic fibers to T10-L2

Pelvic Canal Spaces

• Divided into supradiaphragmatic and subdiaphragmatic spaces
• The supradiaphragmatic space contains pelvic organs like the bladder, uterus, and rectum
• The subdiaphragmatic space is filled with adipose and connective tissue, connecting to the perineum's cutaneous fat lining

Peritoneal Spaces in Females

• Vesicouterine pouch is located between bladder and uterus
• Rectouterine pouch (Pouch of Douglas) is located between rectum and uterus, lowest fluid collection site

Peritoneal Spaces in Males

• Rectovesical pouch is located between bladder and rectum

Perineal Spaces

• Deep perineal space above perineal membrane include the internal pudendal vessels, dorsal nerve, urethral sphincter, deep transverse perineal muscle, Cowper's glands, vestibular glands
• Superficial perineal space below perineal membrane include erectile tissues, ischiocavernosus, bulbospongiosus, Bartholin's glands

Ischioanal Fossa

• Boundaries: perineal skin (below), obturator fascia (side), sacrococcygeal ligament (behind)
• Contains: fat, vessels, external anal sphincter

Structure of the Uterus

• Pear-shaped organ with three layers: perimetrium (outer), myometrium (muscular), and endometrium (inner lining)
• Position: midline between the bladder and rectum, typically in anteversion and anteflexion
• Function: supports implantation, fetal development, and childbirth; regulates the menstrual cycle

Uterus Vascularization

• Arterial supply: uterine artery as a branch of internal iliac
• Venous drainage: via uterine venous plexus to the internal iliac vein

Uterus Innervation

• Sympathetic innervation from inferior hypogastric plexus
• Parasympathetic innervation from pelvic splanchnic nerves (S2-S4)

Uterus Anatomy

• Thick-walled muscular organ in between bladder and the rectum
• Consists of a body and a cervix
• Inferiorly joins the vagina
• uterine tubes project laterally from the uterus

Main Parts

• Fundus: Is the top of the uterus, above the entry point of the uterine tubes
• Body : Is the usual site for implantation of the blastocyst
• Cervix: The lower part of the uterus linking it with the vagina

Ligaments of the Uterus

• Includes the Broad ligament, round ligament, ovarian ligament, cardinal ligament, uterosacral ligament
• Broad ligament consists of a double layer of peritoneum
• Connects the lateral pelvic wall to the uterus
• Divided into three parts: mesometrium, mesosalpinx, mesovarium

Arterial Supply to Uterus

• The uterine artery (branch of the internal iliac artery) travels along the broad ligament to the cervix
• Crosses over the ureter and extends upwards towards the vaginal fornix

Supportive Structures

• Transverse cervical (Cardinal) ligament connects pelvic walls to the cervix for strong lateral support
• Pubovesical ligament runs from the pubic bone, around the bladder, to the cervix
• Uterosacral ligament extends from the sacrum to the cervix, providing posterior support

Uterus Support System

• Pelvic floor muscles support uterus inferiorly
• Pelvic diaphragm muscles: levator ani & coccygeus muscle function
• Vagina: passive support structure to help maintain uterine position

Broad Ligament and Round Ligament of Uterus

• Broad ligament is a double-layered peritoneal fold extending from the uterus to the lateral pelvic wall
• Mesometrium supports the uterus
• Mesosalpinx supports the fallopian tube
• Mesovarium supports the ovary
• Round ligament extends from the uterine horns through the inguinal canal to the labia majora, helping maintain anteversion

Lymphatic Drainage of the Uterus

• The lymphatic drainage follows distinct pathways based on uterine region
• Cervical drainage is into the external iliac and internal iliac lymph nodes, plus some to the sacral lymph nodes
• Body plus fundus drainage mainly goes to the external iliac lymph nodes, some to the lumbar lymph nodes
• Round ligament drainage goes to superficial inguinal lymph nodes

Ovaries Structure

• Small, almond-shaped paired organs
• Located on either side of the uterus
• Composed of cortex and medulla
• Cortex has developing ovarian follicles such as primary, Graafian, and corpus luteum
• Medulla has blood vessels, lymphatics, and nerves

Location & Relations

• Intraperitoneal near the lateral pelvic wall in the ovarian fossa
• Ovaries develop high on the posterior abdominal wall and descend before birth

Ovary Functions

• Oogenesis: Production of oocytes
• Secretes the Estrogen and progesterone hormones that regulate the menstrual cycle and secondary sexual characteristics

Ovary Vascularization

• Blood supply comes from the ovarian artery (branch of the abdominal aorta at the L3 level)
• Right ovarian vein drains into the inferior vena cava (IVC)
• Left ovarian vein drains into the left renal vein

Ovary Innervation

• Autonomic innervation includes sympathetic (thoracic and lumbar fibers) and parasympathetic (vagus nerve) components
• Pain fibers from the ovary travel with sympathetic fibers to the T10-L1 spinal levels

Suspensory Elements of the Ovary structure

• Suspensory ligament of the ovary holds the superior pole of the ovary and carrying blood vessels plus nerves
• Proper ligament of the ovary connects inferior ovary to uterus
• Mesovarium attach short peritoneal fold to ovary to broad ligament

External Female Genitalia (Vulva)

• Includes: mons pubis, labia majora & minora, clitoris, vestibule
• Vascularization: internal and external pudendal arteries supply blood, veins drain into the internal pudendal vein

Innervation

• Sensory comes from the pudendal nerve (S2-S4)
• Autonomic innervation: parasympathetic (S2-S4) for lubrication, sympathetic for clitoral erection

External Male Genitalia

• Includes penis and scrotum
• Penis is made of corpora cavernosa and corpus spongiosum
• Scrotum holds the testes and regulates temperature

Male Genitalia Vascularization

• Internal pudendal artery branches into dorsal, deep, bulbourethral arteries
• Veins: drain the dorsal vein of the penis into the internal pudendal vein

Male Genitalia Innervation

• Sensory and motor come from the pudendal nerve (S2-S4)
• Autonomic: Parasympathetic (S2-S4) causes an erection
• Sympathetic (T11-L2) causes ejaculation

Inferior Hypogastric Pelxus

• Location: on both sides of rectum, bladder, and reproductive organs
• Formed by fusion of hypogastric nerves from superior hypogastric plexus and pelvic splanchnic nerves (parasympathetic from S2-S4)
• Made of of sympathetic (T10-L2) and parasympathetic (S2-S4) fibers

Secondary Plexus from Hypogastric Plexus

• Rectal plexus supplies the rectum
• Uterovaginal plexus innervates the uterus and vagina in females
• Prostatic plexus innervates the prostate and seminal vesicles in males
• Vesical plexus controls bladder and urethra

Elements of the Urogenital Diaphragm

• A muscular structure in the deep perineal pouch
• Includes the external urethral sphincter
  • Deep transverse perineal muscle provides structural support to the perineum
  • Compressor urethrae muscle assists with closing the urethra in females
  • Sphincter urethrovaginalis helps close both urethra and vagina in females

Urogenital Diaphragm Innervation

• All muscles are innervated by perineal branches of the pudendal nerve (S2-S4) for voluntary contraction and relaxation
• Autonomic fibers come from the inferior hypogastric plexus

Pelvic Diaphragm Elements

Muscular floor of the pelvic cavity made of:

• levator ani: pubococcygeus, iliococcygeus, and puborectalis
• coccygeus extends from ischial spine to sacrum
• Function: supports pelvic organs, controls continence

Pelvic Diaphragm Innercation

• Levator ani: direct branches from S4 plus inferior rectal branch of the pudendal nerve (S2-S4)
• Coccygeus: branches from anterior rami of S3-S4

Urinary Bladder

• In pelvic cavity, posterior to pubic symphysis
• Parts: apex, base, trigone, detrusor muscl

Bladder Vascularization

• Arterial supply: superior vesical artery from umbilical artery and inferior vesical artery from internal iliac artery
• Venous drainage: vesical venous plexus drains into the internal iliac vein

Male Uretha Composition and Location

• 15-20 cm long with four parts
• Preprostatic urethra: located within the bladder wall, controlling urine flow
• Prostatic urethra: passes through the prostate gland, receiving ejaculatory ducts
• Membranous urethra passes through the urogenital diaphragm that is the narrowest part
• Spongy urethra: longest section, located within the corpus spongiosum, opening at the external urethral orifice on the glans penis

Course Positions

• Starts from the bladder, passing through the prostate
• Bends forward after the urogenital diaphragm and backward within the penis for example during erection
• Bend between root and body of the penis disappears

Structure, Composition, and Direction of Female Urethra

• Short and about 4 cm long with straight structure
• Pass inferiorly through the pelvic floor into the perineum
• Opens in the vestibule, in between the labia minora, just anterior to the vaginal opening
• Mucosal layer: It is made for urethral gland lubrication
• Muscular layer: is a smooth muscle forming the internal urethral sphincter (involuntary
• External urethral sphincter is formed by striated muscle from the urogenital diaphragm (voluntary

Rectal structure

• At Vertebral Level S3 the Rectum is a continuation of the sigmoid colon
• It follows the sacral curve
• It is pulled forward by the puborectalis muscle (perineal flexure).

Rectal Location

• The rectum lies anterior to the sacrum and coccyx, covered by peritoneum
• Related structures include the bladder, seminal vesicles, and prostate which are related to the rectum in males
• The posterior vaginal wall & the uterus are related to in the rectum in females

Rectum Layers

• Arterial supply: Superior rectal artery comes from inferior mesenteric artery
• Middle rectal artery comes from the internal iliac artery
• Inferior rectal artery comes from the internal pudendal artery
• Sympathetic: From lumbar splanchnic nerves (L1-L2) via the inferior hypogastric plexus
• Parasympathetic: From pelvic splanchnic nerves (S2-S4), promoting defacation
• Somatic Control: Inferior rectal nerve controls the external anal sphincter with branch from pudendal nerver

Pelvis Vascularization

• Comes mainly from the internal iliac artery that divides into anterior plus posterior trunks
• Posterior Trunk contains the iliolumbar artery & Lateral sacral artery
  • Superior gluteal artery that supplies gluteal lateral pelvic wall
  • Sacral region that supplies gluteal muscles
• Anterior Trunk
  • Gives superior vesical artery for the bladder from the Unmilical artery; and Inferior vsicale in males that supplies the prostate
  • Supplies uterus, uterine tubes from Uterine artery (females) plus external genitial organs
• Inferior gluteal artery
  • Provides muscles of obturator artery & the gluteal region

Internal Iliac Vein Drain

• The Internal iliac vein gathers blood from the pelvic organs, then merges with the external iliac vein, to create the vein with common name inferior Vena Cava
• Then it becomes the portal & systemic circulation through which they create vessels by their Uterine and Prostatic

Boundaries

- By Inferior Pelvic Diaphragm

The contents are allowed by ischioanal

Seminal Vesicle Structure

• Each seminal vesicle is a Coiled, tube like & Encapsulated gland
• Contains many pocket-like outgrowths, which increase its surface of secretion
• The structure is where the smooth muscles are contained

Seminal Vesicle Functions and Locations

• Situated between the Bladder area plus Rectum on which its higher gland of Prostrate gets produces by seminal fluid
• Its 70% which helps lies posterior to Bladder and lateral to of vas deference with Ampulla

Spermatic cords in relation to the vas deference components

• Transports sperm from epididymis to ejaculatory duct with the help of Arteries and Plexus of veins
• Pampiniform structure helps regulate and control temperature

Testis Structure

• Covered by the tunica albuginea and there's where formation into lobules occur
• The sperm is formed in the semiferous tubules
• Sperm transport in a row:
  • Formed in rete testis → epididymis (efferent ductules

Testis Positioning

• They descent Through posterior abdominal wall
• Then go Through inguinal canal → before brith it descents to scrotum
• The veins support the transportation with vessels being connected to epididymis

Prostate Gland

• About 3 cm long
• 4 cm wide with both lateral lobes
• It is what is enclosed to the venous from venous capsule
• The area lies to the Symphysis on where the levator is

Prostate Function

• In sperm the motility and viability the prostatic fluid secrets an enzymes
• Produce which liquefy semen (prostate-specific antigen)

Inner and outer layers around the muscle

• The vessels that communicate are the vertebral plexus
• Innervation are Smooth
• Muscle and contracts

Peritoneum Cavity, Pelvis, and Organs

• It forms folds for reflection and it does not cover all organs
• The uterus for example

Branch & Lymph Supply

• Glutean artery lateral & Gluteal muscle
• Posterior Trunk - Contains the walls of structures
• It gets supplies to obturator artery from the lower region
• The internal pudendal vessels, the genitilia that help with supplies vessel

Overview of the fallopian tube's anatomy, including its four parts: infundibulum, ampulla, isthmus, and uterine part. Details the arterial supply from the uterine and ovarian arteries, as well as venous and lymphatic drainage pathways. Focuses on the tube's structure and blood supply.