Fallopian Tube 401 



it is sufficiently empty and flaccid, it is drawn out of the wound. The 

 pedicle is then transfixed, and, its spermatic vessels being securely tied 

 with the broad ligament, the cyst is then cut off. The other ovary 

 must be inspected ; if enlarged, it also should be removed. The sponges 

 and forceps are then carefully counted, and the wound is closed by 

 sutures which enclose the parietal peritoneum as well as skin. 



THE FALLOPIAN TUBE 



The Fallopian tube, 4 in., lies in the highest part of the free border 

 of the broad ligament ; it leads from the serous coat of the ovary into 

 the cornu of the uterus, with which it communicates by a minute orifice. 

 The ovarian end is trumpet-shaped and fringed, one of the fringes 

 serving to connect it with the ovary, as shown on p. 390. 



Structure. Its external coat is of peritoneum, and is derived from 

 the broad ligament. Then comes a muscular layer of longitudinal 

 and circular fibres ; and lastly the mucous lining, which is continuous 

 with the peritoneum at one end, and with the lining of the uterus at 

 the other. The epithelium is columnar ciliated. Through the tube 

 micro-organisms, septic matter, and vaginal douches may find their 

 way from the uterus into the peritoneal cavity. 



The Fallopian tube depends for its supplies upon the vessels and 

 nerves of the ovary and uterus. 



The functions of the ciliated epithelium are to sweep the ovum 

 into the uterus and to hinder the ascent of spermatozoa. When in- 

 flammation, possibly of gonorrhceal origin, has stripped the tube of 

 the epithelium, the descent of the ovum is retarded and the ascent 

 of spermatozoa little hindered, extra-uterine pregnancy being then 

 specially apt to occur. As a result of the original infection, on exami- 

 nation of patients who have died from the effects of tubal pregnancy, 

 old peritoneal adhesions are often met with. Such women have 

 commonly been sterile, because ' their procreative machinery was out 

 of gear.' (Lawson Tait.) 



Rupture of the pregnant tube may occur into the peritoneal 

 cavity a dangerous casualty or between the layers of the broad 

 ligament. 



Though the tube has normally a lumen only the size of a bristle, 

 it may become greatly dilated and may be converted into a mucous 

 or purulent cyst hydro-salpinx or pyo-salpinx (o-aXyrty^, tube). The 

 elongated tumour of a dilated tube may be recognised by the finger 

 in the vagina. If allowed to remain, pain continues and great risk of 

 suppurative peritonitis, from the bursting of the tumour, is incurred. 

 The symptoms and treatment of pyo-salpinx have been clearly described 

 by Lawson Tait. 



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