NBME Answers : realmedicmd's page

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+1 visit this page (nbme23#49)

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I incorrectly chose vasodilation. Found out that it’s actually vasoconstriction (vasodilation is parasympathetic):

Autonomic nerve fibers are also crucially involved in the regulation of vascular effects in the skin. Sympathetic nerve fibers release norepinephrine and/or NPY to innervate arterioles, arteriovenous anastomoses, and venous sinusoids which results in vasoconstriction, whereas parasympathetic nerves mediate vasodilatation through activation of venous sinusoides by the release of ACh and VIP/peptide histidine methionine.

https://physiology.org/doi/full/10.1152/physrev.00026.2005

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Why is it that the intercostal vein provides the most direct pathway for metastatic breast cancer cells to spread to vertebral column? I thought it was internal thoracic (mammary) and I couldn’t find much searching online, besides wikipedia saying that internal thoracic vein drains the breast.

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gainsgutsglory Intercostal vein → Azygos → Batson vertebral plexus → infection of inner vertebral body +35

realmedicmd The internal thoracic drains into the subclavian, intercostal drains into the azygos system which is a more direct path to the vertebral drainage. +1