Rostral ventrolateral medulla spinal cord via reticulospinal tract. Physostigmine, a choline-esterase inhibitor, elevates endogenous levels of acetylcholine and causes a rise in blood pressure by stimulation of the RVLM. Orexinergic neurons from the lateral hypothalamus output in the RVLM. Rostral ventrolateral medulla The rostral ventrolateral medulla (RVLM), also known as the pressor area of the medulla, is a brain region that is responsible for basal and reflex control of sympathetic activity associated with cardiovascular function. Abnormally elevated sympathetic activity in the RVLM is associated with various cardiovascular diseases, such as heart failure and hypertension. The RVLM is notably involved in the baroreflex. It
Lateral hypothalamus substructures, including the rostral ventromedial medulla, rostral ventrolateral medulla, nucleus ambiguus, solitary nucleus, spinal trigeminal nucleus, pontine micturition center, ventral respiratory group, and pontine respiratory group), area postrema, and dorsal nucleus of vagus nerve. Cannabinoid receptor 1 (CB1) is colocalized on orexinergic projection neurons in the lateral hypothalamus and many output structures, where the CB1 and orexin receptor 1 (OX1) receptors physically and functionally join together to form the CB1–OX1 receptor heterodimer. There is substantial anatomical and functional overlap and systemic cross-talk between the endocannabinoid system and orexin system within the central nervous system. Through the diverse outputs of the