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 Lateral hypothalamus The lateral hypothalamus, also called the lateral hypothalamic area, contains the primary orexinergic nucleus within the hypothalamus that widely projects throughout the nervous system; this system of neurons mediates an array of cognitive and physical processes, such as promoting feeding behavior and arousal, reducing pain perception, and regulating body temperature, digestive functions, and blood pressure, among many others. Clinically significant disorders that involve dysfunctions of the orexinergic projection system include narcolepsy, motility disorders or functional gastrointestinal disorders involving visceral hypersensitivity (e.g., irritable bowel syndrome), and eating disorders. The neurotransmitter glutamate and the endocannabinoids (e.g., anandamide) and the orexin