>>>>> PLEASE, this will be a long post, so if you quote from it in your responses,
only cut the part you want to address and not the entire post. <<<<<
Since the autopsy photos were made public, there have been several marks that troubled me. One is the round mark just below JonBenet’s right ear. The two small marks on her back which Smit tried to tie to a stun-gun also interest me, but I can’t account for them either.
But the one I thought I might be able to start with is the triangular mark on JB’s left side of the neck. As DeeDee249 has pointed out previously, it is very similar to a mark that shows up in some other photos of victims who died as a result of some type of ligature strangulation. This being the case, that this particular type of mark is somewhat common in strangulation victims, I would think that pathologists would have a name for it. But if they do, I haven’t yet found it. But what I have found out is that there Is possibly a simple explanation for it, but it requires a little anatomical knowledge (which I did not have before starting).
Since I don’t have a medical background, I didn’t understand what all of these marks were, so I didn’t give them a great deal of attention. But I can read and I’m determined to find out what each of these mean. I invite anyone to participate in this discussion, regardless of their slant toward ultimate guilt, because I don’t see it as pointing to “who did it” as much as simply “what caused it”. I especially hope that anyone with a medical background, or access to someone who does, will add to this so we can understand what it means, and whether or not my conclusion is correct.
Here is what was written in the AR by Dr. Meyer:
“The area of abrasion and petechial hemorrhage of the skin of the anterior neck includes on the lower left neck, just to the left of the midline, a roughly triangular, parchment-like rust colored abrasion which measures 1.5 inches in length with a maximum width of 0.75 inches. This roughly triangular shaped abrasion is obliquely oriented with the apex superior and lateral.”
The information that follows is based on about a dozen or so different sources. I made notes as I read and have digested and compiled it (not to mention a lot of copying and pasting) with what I found. (IOW: Don’t think that I use words like this in ordinary conversation.)
First of all, we all probably think of an abrasion as something caused by a rubbing action which causes some type of visible damage to skin. But if a medical person sees some type of damage and doesn’t know the cause, he might refer to the area as an abrasion because of its definition in dermatology. In other words, he is not addressing its cause, but rather its appearance.
When we (maybe I should say “I”, as a lay person) think of a cut, a bruise, or an abrasion, we (or, I) think subjectively to the cause of each. When a pathologist uses these terms, he/she is thinking objectively to the appearance until he/she establishes the cause.
“In dermatology, an abrasion is a wound caused by superficial damage to the skin, no deeper than the epidermis. It is less severe than a laceration, and bleeding, if present, is minimal.”
Now we need to understand a few terms that will be used here. It may seem simplistic, but let’s start with an understanding of the words petchiae, purpura, and ecchymoses. All of these are commonly referred to in lay terms as types of bruises (or contusions), and each is more correctly defined by the length of its diameter as either a petechia (< 3 mm), purpura (3 mm to 1 cm), or ecchymosis (1 to 3 cm). While there are different causes of these, including some types of diseases or medical conditions, and they may be present in different areas of the body, they are all manifest as a darker discoloration of the surface of the skin, and they are more pronounced and visible on a lighter-skinned person.
Since none of the autopsy photos available to us show the area with the scale close enough to see for ourselves, we have to use the only measurements given in the AR as 1.5” by 0.75” (3.8cm by 1.9cm). If you look at the photos showing this area, you see that at what Dr. Meyer refers to as the apex of the triangular area (actually it is more cone shaped because it is rounded at the base), the darkness of the discoloration begins to fade away and is not as pronounced as it is in the center of the rounded area (or the base of the triangle), and it ends at the ligature furrow. Because of its size, let’s look at what an ecchymosis is and what causes it.
An ecchymosis is a skin discoloration due to hemorrhage (bleeding) under the skin. A small hemorrhagic spot in the skin or a mucous membrane, larger than a petechia, forming a nonelevated, rounded, or irregular purplish patch, caused by the passage of blood (extravasation) from ruptured blood vessels into the interstitial subcutaneous tissue as a result of trauma to the underlying blood vessels.
An ecchymosis should not to be confused with a hematoma which is a pocket or localized collection of blood usually in liquid form within the tissue. This distinguishes it from an ecchymosis, which is the spread of blood under the skin in a thin layer. Nor should an ecchymosis be confused with internal bleeding which is generally considered to be a spreading of blood within the abdomen or skull, not within muscle tissue.
Ecchymoses (or bruises) are actually made of little pools of blood, so the blood in one place may flow toward the ground, and the bruise may appear in another location. Bruising present in a different location than the actual site of impact is called ectopic bruising and occurs when the tissue at the site of injury is loose, allowing blood to travel under the skin to another location due to gravity or other forces.
A bruise forms from seepage of blood in an internal wound. The blood gradually decomposes, changing color from red to blue as hemoglobin loses its oxygen, and then to yellow as the hemoglobin is reabsorbed. Bruises change colors over time in a predictable pattern, so that it is possible to estimate when an injury occurred by the color of the bruise. Initially, a bruise will be reddish, the color of the blood under the skin. After one to two days, the red blood cells begin to break down, and the bruise will darken to a blue or purplish color. This color fades to green at about day six. Around the eighth or ninth day, the skin over the bruised area will have a brown or yellowish appearance, and it will gradually fade back to its normal color.
After an injury, the color changes that occur are due to the breakdown of hemoglobin from within escaped red blood cells in the extracellular space. More specifically, the striking colors of a bruise are caused by the phagocytosis and sequential degradation of hemoglobin to biliverdin to bilirubin to hemosiderin, with hemoglobin itself producing a red-blue color, biliverdin producing a green color, bilirubin producing a yellow color, and hemosiderin producing a golden-brown color. As these products are cleared from the area, the bruise disappears. Oftentimes the underlying tissue damage has been repaired long before the process is complete.
(end of aggregate quotes)
So, with all of this newly found knowledge (for me at least), let’s consider that the area in question is from the subcutaneous pooling of blood (seems like DeeDee may have told us this before) caused by the trauma to the neck. Then the question becomes why or how did it form in this triangular or cone-shaped pattern?
To answer that, take a look at what the surface of the neck looks like in relation to what is underneath the skin. Here are two illustrations from Gray’s Anatomy on Wikipedia:
Here is the subsurface musculature:
There are four distinct frontal (anterior) triangular areas that are formed and shown in the shaded areas here:
These are better shown in the following illustration (taken from the site http://home.comcast.net/~wnor/lesson5.htm):
Excluding the purple posterior triangle, the four anterior triangles are submental (smen), submandibular or digastric (sm), muscular-visceral (mus), and carotid (car).
The area we are most interested in is the carotid triangle shown here:
If you place your thumb and fingers around your own neck and apply a little pressure, you can feel the area this is referring to. You’ll notice also by feeling around a bit that this triangular area has no muscles or structures close to the surface, and it represents somewhat of a voided area in this respect.
I believe that the reddish triangular (or cone-shaped) area shown in the autopsy photos and described in the autopsy report is caused by the rupture of a blood vessel, or a number of small capillaries, in the area of the base of the triangle (or cone). As these capillaries bled outward from the center of the traumatized area along the subcutaneous layer, the blood would be slightly restricted within the carotid triangle, an eventually work its way upward as it begins to trail off toward the apex and end at where the ligature furrow is.
3a. 3. "The Triangles of the Neck":
3b. 2. "The Veins of the Neck":
"Anatomy of the human neck":