Medical school education is expansive. Some doctors will look back and scoff at the minutiae: how much did we really need to know about Tay-Sachs disease or c-ANCA/p-ANCA? Nevertheless, here are nine things that I had no clue were medical phenomena prior to medical school. (Obviously there are a ton of things I learned in medical school, but these below points are really amusing).
There’s an organ called the thymus.
Did you know this? I sure did not. There is an organ in kids that sits behind their sternums that “involutes” over time (basically shrinks and disappears into a fatty tissue). It actually plays an important part in the production and maturation of the immune cells called T-lymphocytes. There’s a disease, called Complete DiGeorge Syndrome, that may occur if a child is born without a thymus.
The testes descend.
I did not take human anatomy or embryology in undergrad. If I did, this would not be on the list. Embryologically, the testes originate in the abdomen and are supposed to travel through a cylinder-of-sorts called the inguinal canal into the scrotum. In some babies, the testes have yet to descend, which is something that needs to be monitored and investigated by a physician. Failure to have testes descend can result in infertility, and more seriously, testicular cancer.
The eFAST exam
Allow me to venture off into the world of Emergency Medicine. I was surprised I did not know this because I was an EMT back in the day. Anyways, when a person reports to the ER after traumatic injury where hemorrhaging is suspected, the ER doctor will pull out an ultrasound machine. Previously, I thought they would send the patient for a CT. Four areas need to be scanned because they are potential spaces for fluid collection. These areas include the pericardium (a sac surrounding your heart), the “hepatorenal recess, also known as Morrison’s pouch, the right paracolic gutter, the hepato-diaphragmatic area, and the caudal edge of the left liver lobe.” This is called the eFAST exam because it stands for “Focused Assessment with Sonography for Trauma (FAST) exam” but also because the test should be initiated rather quickly.
Gallstones do not necessarily mean there is an infection of the gallbladder.
I thought gallstones and gallbladder infection were synonymous. Gallstones can exist on their own and do not necessarily require surgical intervention. However, gallstones can impact the cystic duct (a tube leading out of the gallbladder), causing gallbladder infection, also known as cholecystitis. A gallstone can even travel more downstream in these tubes, blocking the common bile duct (which drains bile from the gallbladder and the liver).
Some people have an extra muscle in their forearms.
Yeah dude…
The Palmaris longus. In 30% of the population, an extra thin muscle exists on the front of the forearm. Its primary action is to help flex the wrist. The Palmaris longus muscle, if it exists in you chaotic beings, is interposed between the Flexor Carpi Ulnaris and the Flexor Carpi Radialis muscles.
IUDs are not just a convenience—but a gold standard.
Prior to medical school, my XY-chromosome-self assumed intrauterine devices were birth control alternatives for women who did not want to take a pill every day. Little did I know, IUDs are almost 100% effective for birth control, making it the most effective amongst birth controls (I suppose abstinence is up there too).
Phentermine/Topiramate
I previously thought of weight loss pills in the same vein as placebo sham teas, but then I got to my primary care rotations in third year and some patients had tried the weight-loss combination medication called phentermine/topiramate (with mixed reviews). Pubchem states phentermine’s mechanism of action involves “hypothalamic release of norepinephrine, a neurotransmitter involved in stress responses (fight-or-flight reactions), and reduces hunger sensation. Phentermine also causes the release of epinephrine or adrenaline outside of the brain, resulting in breakdown of stored fat.” Topiramate “augments appetite suppression and satiety enhancement.”
Although adverse reactions can be plentiful, based on clinical data, 70% of patients on this combination drug did lose 5-10% of their body weight over 56 weeks.
Spinal Tracts
So...listen. I knew there was a spine. Have some faith in your man. I knew that a severed spine could kill someone. I just didn’t know about the content of the spinal cord. There are different tracts of the spine. Some tracts descend down from the brain. Others ascend towards the brain. Some are sensory. Some are motor. These tracts “decussate” (cross over to the other side of the body) in different places. Also, you know the whole fight-or-flight response thing? Sympathetic nervous system vs. parasympathetic nervous system? Was I the only one who thought that this was purely hormonal based? There are actual sympathetic and parasympathetic nerve fibers. Pretty cool, right?
Ascaris lumbricoides life cycle
If you wanted nightmare fuel, you’re about to get it. There is a species of nematodes called Ascaris. In tropical climates, especially in areas of inadequate sanitation, the Ascaris eggs may be ingested from poop-lathered water and foods. The eggs hatch into larvae, enter the blood and MOVE TO THE LUNGS. Naturally, you cough this stuff up and swallow it, giving these buggers a second shot at the GI tract, where they now fully develop into reproductive-aged adult worms that you can poop out its progeny and contaminate your environment. It’s the ciiiiiiirclllllee of liiiifffeeee.
At the time of publishing this post, I am a fourth year medical student. This is not medical advice nor an endorsement.
At HRTMedical ( https://hrtmedical.net/ ) we boast unique and thorough approach which supposes using the cutting-edge treatment methods and technologies to help you safely reach perfect results under the control of experts.