A British student killed in Italy was attacked by more than one person, a medical examiner testified Saturday in the trial of American suspect Amanda Knox and her former boyfriend in Perugia, Italy.

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PERUGIA, Italy — A British student killed in Italy was attacked by more than one person, a medical examiner testified Saturday in the trial of American suspect Amanda Knox and her former boyfriend.

A second witness said bruises found on the victim’s body were not compatible with consensual sex.

Knox, of Seattle, has said she is innocent of charges of murder and sexual violence in the 2007 death of Meredith Kercher.

During Saturday’s testimony, she kept her head down as graphic images from Kercher’s autopsy were shown in court, according to prosecutor Giuliano Mignini. Raffaele Sollecito, who also denies wrongdoing, glanced at the images sporadically, Mignini said.

A third suspect, Ivory Coast national Rudy Hermann Guede, was found guilty of identical charges last year and was sentenced to 30 years in prison. He also took the stand Saturday, but refused to answer questions, as was his right under Italian law, since he has been convicted.

Prosecution witness Vincenza Liviero, a medical examiner, testified behind closed doors to comply with a request from Kercher’s family to preserve the victim’s memory.

“It was an action carried out by more than two hands, and there was sexual violence,” Liviero told reporters at the end of the hearing.

“There were so many wounds, caused by a knife and caused by hands,” Kercher’s lawyer Francesco Maresca said. “The only way they could have been from one person is if that person had three or four hands.”

Gynecologist and prosecution consultant Mauro Marchionni also testified that the bruises on Kercher’s body suggested nonconsensual sex, Maresca said.

Knox, 21, was on an exchange program in Perugia and sharing an apartment with Kercher, a 21-year-old student from Leeds University in England, when the Briton was found stabbed to death in the house on Nov. 2, 2007.

Prosecutors allege Kercher was killed during what began as a sex game, with Sollecito holding her by the shoulders from behind while Knox touched her with the point of a knife. Prosecutors say Guede tried to sexually assault Kercher and then Knox fatally stabbed her in the throat.

Sollecito has maintained he was in his own apartment in Perugia and does not remember if Knox spent part or all of the night of the murder with him. Knox initially told investigators she was in the house when Kercher was killed and covered her ears against the victim’s screams. Later, Knox said she wasn’t in the house.