Age Related Changes of Morphology, Length And Luminal Diameter of Human Fallopian Tube

Transcription

1 IOSR Journal of Denal and Medical Sciences (IOSR-JDMS) e-issn: , p-issn: Volume 16, Issue 7 Ver. III (July. 2017), PP Age Relaed Changes of Morphology, Lengh And Luminal Diameer of Human Fallopian Tube * Jayasri Devi 1, Tribeni Medhi 2, Feroz Hussain 3 1 Professor & Head, Deparmen of Anaomy, Fakhruddin Ali Ahmed Medical College, Barpea, Assam 2 Assisan Professor, Deparmen of Anaomy, Fakhruddin Ali Ahmed Medical College, Barpea, Assam 3 Demonsraor, Deparmen of Anaomy, Fakhruddin Ali Ahmed Medical College, Barpea, Assam Corresponding auhor: *Jayasri Devi Absrac: Inroducion And Objecives: Fallopian ubes are he imporan par of female reproducive rac wih long flexuous srucures, beginning wih he ovarian end each ube is divisible ino four segmens viz. infundibulum, ampulla, ishmus and inramural. Due o increasing rae of ubal block and inferiliy, fallopian ubes are gaining imporance and have become a subjec of research in presen days. The aim of he sudy is o ascerain any differences of morphology, lengh and luminal diameer of he fallopian ube in differen age groups and he research work could be uilized for invesigaion and reamen of diseases and inferiliy. Maerial and mehods: Ten specimens of each group i.e., prereproducive, reproducive & posmenopausal were colleced from fresh unembalmed human cadavers received in he deparmen of Anaomy and Forensic Medicine FAA Medical College, Barpea, Assam, afer compleing all legal formaliies. Lengh of he fallopian ubes were measured by sandard mehod as well graphical mehod before hisological processing. The slides were prepared using sandard laboraory procedure (H&E sain). Under low power objecive, luminal diameers were measured by using micromery slides. Resuls: Sudy revealed ha fallopian ubes of he prereproducive group shows less numbers of convoluion han he oher wo groups. Among he groups average lengh of lef and righ fallopian ube were recorded shores (7.4 cm and 7.2 cm) in prereproducive group han he reproducive (10.1 cm and 10.0 cm) and posmenopausal (10.0 cm and 9.9 cm) group. Luminal diameer of boh he ubes among he groups, narrowes diameer were recorded in he ishmus and wides in he ampullary segmen. Sudy showed regarding luminal diameer of boh he ubes in he same segmen, narrowes in he reproducive group (ishmus-0.24 mm) and wides in posmenopausal group (ishmus0.27 mm). Conclusion: From he sudy i can be concluded ha: 1. Among he hree groups average lengh of he fallopian ube is shores in prereproducive group. 2. In all he groups he luminal diameer was recorded narrowes in he ishmus. 3. In inergroup comparison of luminal diameer of inramural and ishmus segmen of boh he ubes, narrowes diameer recorded in reproducive group. 4. In ampullary segmen highes luminal diameer recorded in reproducive group. Keywords: Prereproducive, reproducive, posmenopausal, luminal diameer, inferiliy I. Inroducion Fallopian ubes (oviducs or uerine ubes) are long paired flexuous reproducive organ exending bilaerally from he uerus in he upper margin of he broad ligamen of he uerus. The ube ranspors ova, spermaozoa, zygoes, he pre-implanaion morulae and blasocys o he uerus. I has major role during reproducive period, bu i remains as if vesigial organ before pubery and afer menopause. Each ube is divisible ino four segmens from laeral o medial viz. infundibulum, ampulla, ishmus and inramural or inersiial [1]. The infundibulum is funnel shaped and is formed of a number of processes, he fimbriae. Nex o he infundibulum, ampulla is he long expanded par which is he normal sie of ferilizaion [2,3] and erminaes in a relaively shor firm segmen, he ishmus. The inramural par or pars uerine is he medial mos par of he uerine ube which is embedded in he wall of he uerus. In hird cenury B.C., Based on he anaomical observaions of Herophilus, he Alexandrian anaomis, Rufus he Greek anaomis and physician firs described he human oviduc as anennae or ocopus like arms exending as prolongaion from each side of he uerus [4]. Bu ill sixeenh cenury he exisence and anaomical relaions of he oviducs were no clear. Gabriele Fallopius in his publicaion of Observaiones Anaomicae [5] illusraed he oviducs in a beer way, and he erm fallopian derived from his name. By he mid-nineeenh cenury, knowledge of he oviduc was relaively complee bu conemporary knowledge of he oviduc derives in grea par from wenieh cenury due o advances in echnology and applicaion regarding morphological and hisological findings. The reproducion is direcly correlaed o he funcioning of he differen pars of he reproducive sysem in co-ordinaion wih he oher sysems of he body. In he presen era DOI: / Page

2 due o he increasing rae of inferiliy, he reproducive organs and heir funcions gaining imporance and have become he subjec of research. Sudies on biomery of fallopian ube in respec o differen age groups have been repored by differen workers [3,6,7]. The Presen sudy was carried ou o observe any differences of morphology, lengh, and luminal diameer of human fallopian ube and heir inerrelaionship wih respec o differen age groups and he research work could be uilized for invesigaion and managemen of inferiliy and posmenopausal diseases. II. Maerials And Mehods Specimens were colleced from fresh unembalmed human cadavers received wihin six hours of deah in he deparmen of Anaomy and Forensic Medicine, FAA Medical College, Barpea, Assam, following all legal formaliies and excluding obvious pahological changes. Each specimen is complee wih uerus and boh he fallopian ubes(fig. 2). The specimens of he fallopian ubes were divided ino hree groups according o he differen ages as shown below: Groups Group-I (Prereproducive) Group-II (Reproducive) Group-III (Posmenopausal) Ages Number of specimens (Years) 0 o o & above 10 Ten specimens (20 ubes) were colleced from each group and each ube was complee wih inramural, ishmus, ampulla and infundibulum segmen. Morphological measuremens were aken before fixing he specimens. To measure he lengh of he ube firs a flexible sof coon hread was placed along he curve of he ube saring from he fimbriaed end o he morphological ueroubal juncion (Fig.2). Then he lengh of he hread was measured in cenimeers (Fig. 4). Anoher graphical mehod [8] was employed in which he ube was placed on a graph paper (Fig.1) and a poin was marked where fimbriaed end lies and oher poin was aken a morphological ueroubal juncion. The oal number of squares (1small square = 0.1cm) crossed by he ube were couned and he lengh was calculaed. Bu he inramural par lies inside he uerine issue and i was difficul o measure is lengh by previous wo mehods. According o several workers [7,9] he average lengh of he inramural par is 1.0cm. Thus his 1.0 cm. was added o he measured lengh of each fallopian ube o calculae he complee lengh. The number of convoluions of fallopian ubes were also recorded. For hisological sudies four segmens of he ubes were idenified and from each segmen approximaely 3 o 5mm pieces were made and fixed in 10% formol saline and labeled separaely. The fixed issues were processed for embedding in paraffin and secioned a 5 m hickness. Secions were sained wih rouine Haemaoxylin and Eosin mehod [10]. Sained slides were sudied under low power objecives, luminal diameers were measured wih he help of an Spencer ocular lens and objecive micromeer scale. Calculaion of micromery scale: 15 divisions of ocular micromeer = 5 divisions of objecive micromeer. Therefore, 1 division of ocular scale 5/15 divisions of objecive micromeer. As 1 division of objecive micromeer = 0.01mm Hence, 5/15 divisions = 5/ mm = 0.003mm = 3.33 m (10-3 = 1micron) Therefore, 1 division of ocular micromeer scale = 3.33 m Saisical Analysis: The lengh and luminal diameers were analyzed by sandard saisical mehods [11]. The daa were analyzed o calculae he Mean ± SE and es was applied o find ou he saisical differences beween he mean values. III. Resuls And Observaions In presen sudy he resuls and observaions were grouped in hree headings as follows: 1.Morphology, 2. Lengh and 3. Luminal diameer. Morphology: As fallopian ube is a flexuous organ i shows some convoluions. The number of convoluions were more in prereproducive and reproducive ages (Fig.1,2) while i was observed less in posmenopausal cases (Fig.3). In all he groups differen segmens of he fallopian ubes were easily idenified by heir relaive DOI: / Page

3 diameers. In all he ubes infundibulum was funnel shaped and prominen fimbriae surrounded is opening. Uerine ubes were enclosed in a perioneal fold derived from broad ligamen and mesosalpinx were presen in all he hree groups, (Fig.1,2,3). Lengh: The average lengh of lef and righ fallopian ubes were recorded as in Group I-7.4 cm and 7.2 cm, Group II cm and 10.0 cm and Group III-10.0 cm and 9.9 cm, respecively (Table 1,2,3). In all he groups i was recorded ha lef ube was lile longer han he righ ube bu saisically hey were a par (Table 4). Inergroup variaion of he lengh of he lef and righ fallopian ube of prereproducive, reproducive and posmenopausal groups has been shown wih he help of bar diagram (Table 5,6, Fig. 7,8). Bar diagram showed ha he lengh of he boh lef and righ fallopian ubes of prereproducive group was shores (7.4 cm and 7.2cm) han he reproducive (10.1 cm and 10.0 cm) and posmenopausal groups (10.0 cm and 9.9 cm). However, here was lile difference beween he lengh of he ubes in Group II and Group III bu nonsignifican (Table 4,5,6). Luminal Diameer: In all he groups, he luminal diameer of he fallopian ubes were recorded a hree differen segmens saring from medial o laeral, inramural or inersiial (D 1 ), ishmus (D 2 ) and ampulla (D 3 ). Prereproducive group exhibied average luminal diameer of lef and righ uerine ube a D 1, D 2 and D 3 as 1.0 mm and 0.9 mm, 0.34 mm and 0.28 mm and 5.9 mm and 5.89 mm respecively (Table 1). In reproducive group, average luminal diameer of lef and righ oviduc was recorded a D 1, D 2 and D 3 as 0.61 mm 0.26 mm and 6.5 mm, and 0.57 mm, 0.24 mm and 6.4 mm respecively (Table 2). Average luminal diameer of lef and righ uerine ube was recorded a D 1, D 2 and D 3 as 1.87 mm, 0.33 mm and 6.30 mm and 1.84 mm, 0.27 mm and 6.2 mm respecively in posmenopausal group (Table 3). In all he groups i was noed ha he luminal diameer of boh he ubes were narrowes in he ishmus segmen and wides in he ampullary segmen (Table 4,5,6) and also represened by bar diagram (Fig. 7,8). Inergroup comparison showed ha luminal diameer of boh he ubes in he same segmen found o be narrowes in Group II (reproducive) and wides in Group III (posmenopausal) which has been represened by bar diagram (Table 5,6, Fig. 7,8). Table 1: Lengh (cm) and luminal diameer (mm) of fallopian ube in prereproducive age (Group I) Number of Specimen Lengh (cm) Inramural Ishmus Ampulla Lef Righ Lef Righ Lef Righ Lef Righ Average Table 2: Lengh (cm) and luminal diameer (mm) of fallopian ube in reproducive age (Group II) Number Lengh of Specimen (cm) Inramural Ishmus Ampulla Lef Righ Lef Righ Lef Righ Lef Righ Average DOI: / Page

4 Table 3: Lengh (cm) and luminal diameer (mm) of fallopian ube in posmenopausal age (Group III) Number Lengh (cm) of Specimen Inramural Ishmus Ampulla Lef Righ Lef Righ Lef Righ Lef Righ Average DOI: / Page

5 Table 4: Mean values for lengh and luminal diameer of fallopian ube in differen age groups Parameers Group-I Group-II Group-III Lef Lengh of fallopian ube Righ (cm) SE ± Value of NS NS NS Luminal diameer a inramural par (D 1) (mm) Luminal diameer a ishmus (D 2) (mm) Luminal diameer a ampulla (D 3) (mm) Group-I : Prereproducive Group-II : Reproducive Group-III : Posmenopausal Lef Righ SE ± Value of NS NS NS Lef Righ SE ± Value of NS NS NS Lef Righ SE ± Value of NS NS NS NS Non significan Table 5 : Average lengh (cm) and luminal diameer (mm) of lef fallopian ube in differen age groups Age group Lengh (cm) Inramural (D 1) Ishmus (D 2) Ampulla (D 3) Prereproducive (Group I) Reproducive (Group II) Posmenopausal (Group I) DOI: / Page

6 Fig.7. Bar diagram showing inergroup variaion in lengh and luminal diameer of lef fallopian ube Table 6 : Average Lengh (cm) and luminal diameer (mm) of righ fallopian age ube in differen groups Age group Lengh (cm) Inramural (D 1 ) Ishmus (D 2 ) Ampulla (D 3 ) Prereproducive (Group I) Reproducive (Group II) Posmenopausal (Group III) Fig.8 : Bar diagram showing inergroup variaion in lengh and luminal diameer of righ fallopian ube DOI: / Page

7 IV. Discussion Resuls and observaions obained in he presen sudy revealed several poins of ineres having marked imporance in pracical life which may help in invesigaion and managemen of inferiliy cases. Morphology: As well known fallopian ube is a flexuous organ, in he presen sudy i was found ha number of convoluions were more in reproducive age group han he prereproducive and posmenopausal groups which migh be due o srong muscular aciviy required o propel he ovum and zygoe o he uerine caviy as has been saed by previous research worker [6,19]. In all he ubes infundibulum was funnel shaped and prominen fimbriae surrounded is opening. In all he hree groups, uerine ubes were enclosed in a perioneal fold derived from broad ligamen [7] and mesosalpinx were presen (Fig.1,2,3). These findings also corroborae wih he findings of oher workers [9,12]. Lengh: The average lengh of uerine ubes obained in he prereproduive age group (7.4cm and 7.2 cm) was shorer (Fig.7 & 8) han he reproducive and posmenopausal groups. The average lengh recorded in reproducive (10.1 cm and 10.0cm) and posmenopausal (10.0 and 9.9 cm) groups (Table 5 & 6 and Fig.7 & 8) were similar wih ha recorded by several workers [13,14]. The reason for shorer lengh of uerine ube in prereproducve group migh be explained in he ligh of ha he ube is sill in he process of growh and while, in oher wo groups he growh process has already been compleed. In all he groups i was recorded ha lef fallopian ube was lile longer han he righ one hough here was no significan difference (Table 4) which could possibly due o he fac ha he lef ube migh ge lile more space during growh and developmen han he righ one.luminal diameer: In all he groups i was noed ha he luminal diameer of boh he ubes were narrowes in he ishmus segmen and wides in he ampullary segmen (Table 5,6 & Fig. 4,5) and has been confirmed by some workers [13,18] and could be possibly due o variaion of hickness of musculaure. Average luminal diameer recorded in he inramural segmen of prereproducive and reproducive group (Table. 4) were wihin he range of he mos of he invesigaors [16,17,18]. Inergroup comparison showed ha luminal diameer of boh he ubes in he same segmen found o be narrowes in reproducive and wides in posmenopausal which is suggesive of srong muscular aciviy in reproducive age as has been confirmed by some invesigaors [18,19,20]. V. Conclusion From he sudy he following findings were summarized: 1. Fallopian ubes of reproducive group were more convolued han he prereproducve and posmenopausal group. 2. Among he hree groups average lengh of he fallopian ube is shores in prereproducive group ( cm) han he reproducive ( cm) and posmenopausal ( cm) group. In all he groups lef uerine ube was found o be longer han he righ ube. 3. In all he groups he luminal diameer was recorded narrowes in he ishmus (prereproducve mm, reproducive mm and posmenopausal mm). Inergroup comparison of oviducal luminal diameer in he same segmen (ishmus) narrowes diameer was recorded in reproducive group ( mm) and wides in posmenopausal group ( mm). As inferiliy is one of he major subjec of research and ubal block being a common cause, he presen sudy on fallopian ube in relaion o differen ages may open scopes for invesigaion and reamen of inferiliy cases as well as posmenopausal diseases. References [1]. Gunasegaran J. P. Texbook of Hisology Alas and Pracical Guide. 3 rd Ed. (Reed Elsevier Pv. Ld. 2016). P-325 [2]. Sadler. T.W. Langman s Medical Embryology. 12 h. Ed. (Lippinco Williams & Wilkins, 2012). P-32 [3]. Singh, I. In : Texbook of Human Hisology Wih Colour Alas and Pracical Guide. 7 h Ed. (Jaypee, 2014). Chaper. 20. P-353. [4]. Bodemer, C. W. Hisory of he Mammalian Oviduc. In : The Mammalian oviduc Hafez. E. S. E. and Blandau, R.. J,,(eds) (The Universiy of Chicago Press, 1969). Pp [5]. Fallopius, G. Observaiones anaomicae. In : The Mammalian oviduc. Hafez, E.S.E. and Blandau, R.J (eds). Venice. (The Universiy of Chicago Press, 1561). pp [6]. Baniser, L.H. and Dyson, M.. Reproducive Sysem. In : Gray s Anaomy. 38 h Ed. (Churchill Livingsone,1995). Pp [7]. Dafary, S.N., Chakravari, S. Reproducive Anaomy. In : Holland & Brews Manual of Obserics. 3 rd Ed, P-5. [8]. Kolesnikov, V. The Roo Sysem of Frui Plan. (Mir Publisher, Moscow 1971). Mira, S. Anaomy. (1982). Vol I. pp [9]. Carleon, H.M. Hisological echnique. 3 rd Ed. (1957). Pp [10]. Gupa, S. P. Saisical Mehods. 13 h. Ed. (Sulan Chand and Sons. New Delhi, 1980). pp. A [11]. Sisson, S. and Grossman, J. D. Ruminan Urogenial Sysem. In : The Anaomy of DomesicAnimals. Vol-I. Gey, I. R. (eds). (W. B. Saunders Co., Philadelphia, London, Torono, 1975). Ch. 31. Par I,946 and Par II, 953. [12]. Dua, D. C. In : Tex Book of Gynaecology. 2 nd Ed. (1994). Pp [13]. Anderson, J. R. and Genadry, R. In : Novak s Gynaecology. 12 h Ed. Berek, J. S., Adashi, E. Y. and Hillard. P. A. (eds) (Williums & Wilkins, 1996). pp [14]. Dua, A. K. In: Funcional Hisology. The Female reproducive Sysem. (2015). P-272 DOI: / Page

8 [15]. Rubin, I. C. Observaions on he inramural and ishmic porion of he fallopian ubes wih special reference o he so-called Ishmospasm. Sur. Gynec. & Obs., : [16]. Tindal, V.R. Jeffcoa s Principles of Gynaecology. 5 h Ed. (Buerworh-Heineman (ed). 1994). pp [17]. Dawn, C S. Tex Book of Gynaecology and Conracepion. 12 h Ed. (Dawn Books, Calcua, 1995). pp [18]. Novak, E. R. and Woodraff, J. D. In: Novak s Gynaecologyand Obserics Pahology wih clinical and Endocrine Relaion h Ed.Pp [19]. Lisa, J. R., Gioia, J. D. and Rubin, I. C. Observaions on he inersiial porion of he fallopian ube Sur. Gynec, & obs. 99 : [20] Lisa, J. R., Gioia, J. D. and Rubin, I. C. Observaions on he inersiial porion of he fallopian ube Sur. Gynec, & obs. 99 : * Jayasri Devi. "Age Relaed Changes of Morphology, Lengh And Luminal Diameer of Human Fallopian Tube." IOSR Journal of Denal and Medical Sciences (IOSR-JDMS) 16.7 (2017): DOI: / Page