Meredith’s underside jawbone line on both sides exhibited several small localized bruise marks which appeared consistent with extreme finger pressure in those areas. At least five separate localized bruise marks were noted to the chin line. Trauma bruising was also evident just below the base of the left ear.
The most serious wounds were to Meredith Kercher’s throat region. Three horizontal cut marks were noted to her right throat area below her right ear. These markings had a similar orientation, suggesting they occurred at or near the same time. One appeared to show inward stabbing. Heavy bruising was associated with these stab and cut wounds.
Three slanted vertical cut marks were noted under her mid to left center chin area. The slanting was from lower left to upper right. These markings had a similar orientation, suggesting they occurred at or near the same time.
The most notable of these markings was a gaping wound about three inches long. It was a deep wound that involved uneven tearing of tissue after the initial penetration.
Notable bruise markings were noted to both elbow regions. Some bruising was also noted to the mid section of the right forearm. Light knife tip contact wounds were found to the hands.
Pathologist Lalli also noted bruising to the hips and some to the right leg, none of which were readily detectable from the available photos of those regions.
An area of trauma was noted to the rear scalp by the pathologists. From the crime scene photos, numerous loose long hairs were observed on the floor and a large plug of hair was observed in the blood where Meredith’s head had rested. These indicated strong pulling or yanking trauma to the hair and scalp.
Some of the crime scene photos suggest limited use of the right arm after the mortal wound. This infers possible trauma to the right shoulder rotator cuff region that may have rendered the right arm incapacitated after the mortal wound.
Analysis of injury infliction
The bruises on Meredith's elbows suggest strong handgrips during the struggle. Bruises on the legs and hips were probably caused by contact with furniture.
The killer also pulled Meredith's hair violently to gain control or position her body.
The finger bruises to the jaw line may have occurred in multiple stages, although probably in rapid succession.
The initial throat stabbing wounds were likely the horizontal wounds to the right throat area leading to significant external bleeding that continued until death. The blood flow coming from this wound was likely reduced at times by hand pressure at the site. Meredith was likely able to get her right hand to her throat area after the initial stab wounds were inflicted, and it came into contact with the blade tip a couple of instances.
The final stabbing wounds were likely the series of slanted vertical wounds under the chin. The mortal gaping stab wound led to heavy bleeding into the esophagus as well as externally.
The knife inflicting the mortal wound was likely thrust with considerable force into the throat to the full depth of the blade. The killer then pulled the knife upward with maximum force increasing the length of the gaping wound. The last one fourth of the wound involved tearing brought about by an extreme upward force being applied by the killer.
To inflict the mortal wound, the killer needed to be solidly positioned and in full control of Meredith’s head. The likely position would be behind and above the victim, using one hand to hold her head backwards in firm contact with the killer’s lower midsection while using the other hand to inflict the mortal wound.
The mortal wound immediately led to copious outward blood loss, while a considerable amount also bled inward into the esophagus. Some of the blood that entered the esophagus was inhaled and expelled through the mouth and nose as aspirated blood drops. Some of the blood expelled through the mouth had a darker and heavier appearance.
Pathologists have concluded that Meredith died from suffocation, but the blood loss was also enough to cause death. Pathologists indicate that Meredith only had about 10 minutes to live after the mortal wound was inflicted. During that period, she would only have been fully conscious for a couple of minutes.
All told, the horrible injuries to Meredith Kercher were fully consistent with an assault by a strong man who swiftly overpowered her.