Their bodies told a horrific story.

At 2 years old, Leo Krim was too young to defend himself when his nanny dragged a knife across his neck, slicing a jugular vein and striking his spinal cord. His wounds suggested that he could have been cut from behind.

But the injuries his sister, Lucia Krim, 6, sustained suggested she fought back. She was stabbed 22 times in the neck and six times in the torso. There were also cuts on her hands and arms, a medical examiner testified on Monday in State Supreme Court in Manhattan in the trial of the nanny, Yoselyn Ortega.

The siblings’ mother, Marina Krim, found the children dead and bloodied five and a half years ago in the family’s Upper West Side apartment, the nanny stabbing herself in the neck in a suicide attempt.

Charged with first-degree murder, Ms. Ortega has pleaded not guilty by reason of insanity. But while the case is likely to turn on evidence about the defendant’s mental health, the early days of the prosecution’s case have laid out some of the killings’ most wrenching and graphic aspects.

Yoselyn Ortega has pleaded not guilty by reason of insanity in the stabbing deaths of two children in her care. Prosecutors decided not to show the jury the autopsy photos.Credit…Pool photo by Jefferson Siegel

“There’s no doubt she did it,” he said. “More often than not district attorneys tend not to use autopsy photos unless to advance the case in a meaningful way.”

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