Medical Terms & Keyed Notes Annotating The Associated Anatomical Diagram, Re: Vincent W. Foster Autopsy Data

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Medical Terms & Keyed Notes Annotating The Associated Anatomical Diagram, Re: Vincent W. Foster Autopsy Data

© Hugh Sprunt, March 1999; All Rights Reserved

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Definitions Used

Source: Webster's Medical Desk Dictionary (Merriam-Webster, 1986; 790 pages)

Pharynx: The part of the alimentary canal situated between the cavity of the mouth and the esophagus and in man being a musculomembranous tube about four and a half inches long that is continuous above with the mouth and nasal passages, communicates through the eustachian tubes with the ears, and extends downward past the opening into the larynx to the lower border of the cricoid cartilage where it is continuous with the esophagus.

Posterior: Situated behind: as a: situated at or toward the hinder end of the body : Caudal. b: Dorsal – used of human anatomy in which the upright posture makes dorsal and caudal identical.

Nasopharynx: The upper part of the pharynx continuous with the nasal passages. [Separately, a medical text states, "The nasopharynx lies superior to the soft palate and opens into each nasal cavity through the right and left posterior nasal apertures."]

Oropharynx: The part of the pharynx that is below the soft palate and above the epiglottis and is continuous with the mouth. [A medical text: "The oropharynx is situated inferior to the soft palate and posterior to the root of the tongue. . . The oropharynx reaches from the soft palate to the upper border of the epiglottis. . . Posteriorly, it is level with the second cervical vertebral body and the upper part of the third."]

Laryngopharynx: The lower part of the pharynx lying behind or adjacent to the larynx.

Soft Palate: The membranous and muscular fold suspended from the posterior margin of the hard palate and partially separating the mouth cavity from the pharynx.

Hard Palate: The bony anterior part of the palate forming the roof of the mouth.

Uvula: The pendent fleshy lobe in the middle of the posterior border of the soft palate.

Defect: A lack or deficiency of something necessary for adequacy in form or function <a hearing defect >.

Numbered Points on the Anatomical Diagram

[In an effort to communicate clearly and unambiguously and to avoid misunderstanding, the keyed notes below were intentionally written in a somewhat redundant manner.]

Point 1 This point is the location of the first "entrance wound" per the Foster autopsy report and was located on the anatomical diagram in three corroborating ways.

First, the autopsy doctor reported that the first "entrance wound" was located in the "posterior oropharynx," which is where Point 1 is located (in the middle of the vertical range of the posterior oropharynx).

Second, the autopsy doctor also reported that the first "entrance wound" was located 7.5" vertically downward from the crown of Foster's head, which distance lies only 2.5 mm vertically below Point 1 (scaled to the size of the hard copy of the anatomical diagram).

According to my calculations, the original color anatomical diagram represents a head whose linear dimensions are ~50% - the actual percent came out to be 50.4% - of the linear dimensions of Foster's head; the 2.5 mm distance on the diagram is therefore the equivalent of about one-fifth inch on Foster’s head.

Third, I measured the location of Point 1 (a 7.5" vertical drop from the top of Foster's head) on an actual human skull that I borrowed from a doctor friend (the measurements on this skull being properly scaled to Foster's head and allowing about one fifth inch when measuring downward on the borrowed skull for the lack of hair and scalp on the borrowed skull – about one fourth inch on Foster's head – that was, of course present when the autopsy doctor made his measurement).

I not only ended up with a point located in the posterior oropharynx, but a point almost in the middle of the vertical range of the oropharynx (actually, 2.5 mm below the midpoint at the scale of the anatomical diagram).

To be conservative, Point 1 is located in the exact middle of the vertical range of the oropharynx (as nearly as I could measure it) rather than at the location, 2.5 mm below, of my "best estimate" based on the "7.5 inch" measurement by the autopsy doctor.

The line (I used a small bamboo skewer) joining the opening between the upper and lower two front (closed) teeth pairs on the skull and the point 7.5" (scaled to the size of my borrowed skull which was a fraction of a percent more than 80% of the linear dimensions of Foster's head) vertically below the crown of Foster's head dropped very slightly – a sixth of an inch or so, about 4 mm – from the opening between the teeth to the 7.5" point (6.0" on the borrowed skull; 7.5" X 0.80 = 6.0").

This result (the slight downward tilt from front to back) would have been some justification for placing Point (1) on the diagram about a fifth inch lower on Foster's posterior oropharynx (a tenth of an inch on the diagram itself or about 2.5 mm), but I did not do so because I wanted to be conservative – even though the autopsy doctor's 7.5" measurement would (and did) produce a point that low, I didn't push it, in part because his phrase "posterior oropharynx" was not qualified by an adjective like "upper" or "lower" or "middle."

The distance between Point 1 and Point 8 on Foster's head is 7.5". Strict calculation (50.4% X 7.5") would make this distance ~3.8" on my hard copy of the diagram. The actual distance on my hard copy of the diagram is 3.7" – again, part of my effort to locate Point 1 in a "conservative" manner (one-tenth in on the diagram being 2.5 mm).

That is, Point 1 is located in the posterior oropharynx on my copy of the anatomical diagram about 2.5 mm higher than it should be. As indicated, I thought this was the conservative approach and I saw a benefit in being able to say that Point 1 was located at the midpoint of the vertical range of the oropharynx (based on the definition I use which is given above).

Point 2 This point is located on a horizontal line passing through Point 1. Since Point 1 is ~7.5" (on Foster's head) vertically below the top of Foster's head, that means that Point 2 is also ~7.5" below the top of Foster's head. This places it on the neck in the position shown.

Although the cervical vertebra and the Atlas are not shown on this diagram, I believe that this location corresponds to a point on the neck just to the rear of the second cervical vertebra and the upper part of the third (see the definition of oropharynx above).

Note: while the position of Point 1 is "fixed" on the diagram (See above), Point 2's location is an estimate based on the assumption that the bullet that left the barrel and produced the first "entrance wound" (autopsy doctor's language) in the "posterior oropharynx" was traveling horizontally.

Thus, Point 2 could be somewhat higher or lower than shown. It would, of course, be about one-tenth of an inch lower – on the anatomical diagram – if a horizontal line were drawn through the location of my measured "best estimate" for the entrance wound (2.5 mm on the diagram below Point 1).

However, as I think can be seen from the diagram as amplified by these notes, Point 2 and Point 3 (which are the "same" point officially – namely at the Point 3 location) are, relatively speaking, a long way apart on Foster’s head.

Presumably, though, if the observation made at the funeral home is correct (see my piece "Gross Anatomy"), the location of Point 2 on the neck should correspond to the base of the hairline on Foster's head and, should be in the "neck" as shown (as opposed to the "head"), that is, if you give credence to the language in the Narrative Summary of the Medical Examiner's field report from his examination of body at Fort Marcy Park the evening of the death since the (unaltered) Narrative Summary states that the wound was "mouth to neck" not "mouth to head."

Point 3 This is the location of the exit wound specified by the autopsy doctor in that it is 3.0" below the top of Foster's head.

This converts to a distance of 1.51 inches on my hard copy of the autopsy diagram 3.0 X 50.4%) as shown (Line 3-9). Presumably, this is the distance to roughly the center of what the autopsy doctor described as a 1" by 1.25" exit wound.

Point 4 As a cross-check on the location of Point 3, I measured the distance from the top of Foster's head on the autopsy diagram to a horizontal line joining the tops of the ears of the figures on the autopsy diagram (Body Diagram - Head).

As you can see from the autopsy diagram, the exit wound lies just above a horizontal line joining the tops of the ears. If the anatomical diagram on which I placed my lines and points is consistent with the Body Diagram - Head of the autopsy report, then the equivalent point on the anatomical diagram should fall slightly below the center of the exit wound on the anatomical diagram.

I "scaled" the two heads (the anatomical diagram with my lines and points and the Body Diagram - Head in the autopsy report) so that I could plot the equivalent point on the anatomical diagram. As you can see, it falls just below Point 3 (as it should). This makes me more confident that the location of Point 3 on the anatomical diagram is correct.

Point 5 This point was determined in the following manner. I measured the distance on my own head (using a compass and being careful with the point) from the midpoint at the base of my nostrils to the top of my upper lip (mouth closed). I made the equivalent measurement on the anatomical diagram.

I then measured the distance between the same two points on my head, but with my jaw as wide as I could open it by straining. I then solved for the length of he equivalent distance (jaw wide open) for the head in the anatomical diagram and got Point 10.

The reason I did this is that some folks have said, hey, you will get good line-up with the line of the gun barrel, the posterior oropharynx, the rest of the official wound track and the location of the official 1" by 1.25" exit wound on the back of the head if Foster's mouth had been as wide open as possible and the gun laid flat against the lower jaw and tongue and fired at this upward angle.

We do not, however, get good alignment when we look at Line 10-3. This is because Point 5 lies along Line 10-3 and Point 5 is located in the posterior nasopharynx, not the posterior oropharynx as the autopsy doctor stated. This distance between Points 1 and 5 on a head the size of Foster's is 0.9" and Point 5 is materially above the border (using the definitions above) between the oropharynx and the nasopharynx.

Even if we believe that the autopsy doctor "really meant" nasopharynx when he wrote/typed "oropharynx" (twice) and that when he wrote/typed 7.5" (twice) he "really meant," say, 6.0", the location of Point 5 does not square with what he wrote. However, we need to account for the vertical extent of the barrel of the gun, which brings us to Point 6.

Point 6 This point well up on the posterior wall of the nasopharynx was located by allowing (in the vicinity of the uvula of the soft palate – the end of the barrel must have been somewhere near that location officially) for the effect of the diameter of the barrel of the official death weapon, an Army Colt Special .38 Revolver with a 4" long barrel.

That is, Line 7-6-3 is the "same" as Line 10-5-3 (jaw in each case as wide open as possible) but making an allowance for the diameter of the gun barrel at the assumed point for the end of the gun barrel (roughly 3.5" of the 4" gun barrel in the mouth) which takes us (for the purposes of this demonstration only) to the vicinity of the uvula. Lines 10-5-3 and 7-6-3 are not parallel only because I thought it appropriate to allow for the diameter of the gun barrel in the mouth at the end of the gun barrel.

The result, if we are assuming that Foster's mouth is as open as can be and the gun is laid along the tongue and if we allow for the diameter of the gun barrel, Line 7-6-3, like Line 10-5-3 (only more so) does not "line-up" in two senses:

A) The first "entrance wound" in each case is not in the "posterior oropharynx" as the autopsy doctor wrote; instead it is well into (especially when we allow for the barrel diameter) the nasopharynx, and

B) the measured distance from the top of the head is not the 7.5" given us by the autopsy doctor, but 6.4" in the case of Point 5 and 5.9-6.0" for the more realistically located (allowance for gun barrel diameter) Point 6.

Point 7 See the description of the location of Point 6 which explains the location of Point 7 on the anatomical diagram.

Point 8 This is the location of the "top" or "crown" of Foster's head for the purposes of measuring the 7.5" vertical drop on Foster's head as written by the autopsy doctor. Although perhaps it is not clear on the anatomical diagram (it shows up on my color copy, but not on a black and white photocopy of my color copy), it appears to me that the anatomical diagram (unlike my borrowed skull where I did decrease the 7.5" measurement to allow for the thickness of Foster's scalp and hair; see above) shows some thickness above the upper bone of the skull for scalp/hair (just as it shows the flesh of the lips, etc.).

So, when measuring the 7.5" drop in the report of the autopsy doctor for purposes of putting Point 1 on the anatomical diagram, I did not decrease the 7.5" measurement for the thickness of hair and scalp (though, of course, I did "scale" the distance onto my hard copy of the anatomical diagram by the 50.4% factor discussed above).

Point 9 Same "altitude" as Point 8, but drawn vertically over the rear of the head of the anatomical diagram to allow the 3.0" vertical drop to the 1" by 1.25" exit wound described by the autopsy doctor.

Point 10 The location of the top of the upper lip of the anatomical diagram if the anatomical diagram's jaw is opened as much as possible. See above under the discussion of Point 5 for how this point was located on the anatomical diagram.

Summary

In closing these Keyed Notes, we finally reach the "buried lead." Line 1-4 shows the trajectory of the bullet (that is, no additional adjustment needed for the diameter of the gun barrel) using the location the autopsy doctor described for the first "entrance wound" ("posterior oropharynx, 7.5" below the top of Foster's head) and the "exit wound" (3.0" vertical drop from the top of Foster's head along the vertical mid-line of the head).

Assuming the bullet was not deflected materially between the time it was fired and the time it exited the skull (and there is no indication in the autopsy report that the wound track had to be "bent," by bullet deflection or otherwise, in order for the "good alignment" to exist, as the autopsy doctor described the alignment to the Starr OIC) the line of the barrel of the gun would have had to have been along Line 1-3.

The problem? There are at least two.

As you can tell from the discussion of the locations of Line 10-5-3 and Line 7-6-3, the barrel of the gun must have laid along the "southwestern" extension of Line 1-4.

However, as we have seen above, Foster's jaw (whether he opened it or someone opened it for him after he was dead) could not have been physically open enough to accommodate the Line 1-3 trajectory for the bullet without dislocating his jaw well before the jaw was sufficiently opened.

Furthermore, the line that connects Point 1 and Point 3 does not even show the gun barrel as being inside Foster's mouth when the shot was fired

It is my hypothesis that the autopsy report is internally inconsistent at least to this extent (that is, there may be other internal inconsistencies as well).

As I have said in other places, this particular inconsistency, to my mind, would be reconciled (would vanish) provided you believe that when the autopsy doctor wrote/typed (twice) "posterior oropharynx" he really meant to write/type (twice) "posterior nasopharynx" AND when he wrote/typed (twice) "7.5 inches," he really meant to write/type (twice) "6.0 inches."

In particular, those who believe that Line 7-6-3 approximates the wound track that the autopsy doctor really meant to describe (namely those who ignore the fact that he placed the first "entrance wound" in the "posterior oropharynx" and focus on the "defect" that he, in effect, said fragmented some of the soft palate – referring, I believe, to the portion of the soft palate that is the uvula) must ask themselves why Point 6 is in the posterior nasopharynx and ask themselves why the autopsy doctor wrote 7.5" when he meant to write 6.0".

I am not prepared at this point to make that concession, especially in light of related points mentioned in my piece, "Gross Anatomy," such as the "mouth to neck" language of the Narrative Summary of the Medical Examiner's field report, the witness at the funeral home who stated (apparently in all innocence) that there was an exit wound in the back of Foster's neck at the base of his hairline, etc., etc.

Notes on Methodology

I have referred to the borrowed human skull I used as being, within less than a percent of error, 80% (in each dimension) of the size of Foster's head. How the heck did I figure that out? I made an assumption that I thought was reasonable.

I got "from" Foster's head "to" my borrowed skull via an intermediate step: using my own head. I thought it was reasonable to approximate the size of Foster's head by scaling upward from my own head. The ratio I used was the ratio of our heights (6" 4.5" for Foster and, standing tall, 5' 11" for me).

This is obviously an approximation, but based on looking at photos of Foster and me (comparing the head to the rest of the body), I believe that scaling the heads using our heights was reasonable.

That is, I think that Foster and I are both more or less "big headed" people (for our respective heights) and that, in particular he is not a "small headed" person and I am not a "big headed" person (no snickering, please). In short, I assumed out heads were reasonably geometrically similar in shape and cross section except that Foster’s head was bigger in proportion to the ratio of our heights.

Once I "scaled" Foster's head to my head, I then used various dimensions on my head and the equivalent dimensions on my skull to determine a series of ratios.

All those ratios were very close to each other, giving me confidence that the method to get from "my head" to "my borrowed skull" was a reasonable one. All these very similar amounts, when averaged, came out to a fraction of a percent over 80%.

I am sure the method I described above introduced some errors, but I believe they were very modest, especially when compared to the modest errors introduced by the autopsy measurements themselves.

That is, even if you believe that the autopsy doctor measured to the nearest one-eighth inch in making all his measurements (because, say, he recorded one dimension of the exit wound to the nearest one-quarter inch, and that precision should be controlling rather than rather than his measurements of distances between two different parts of the body (rather than across an exit wound) which he reported to the half-inch, the estimating errors I introduced would be relatively small.

I also made all measurements to the nearest millimeter (on the anatomical diagram, one the skull, on the autopsy's Body Diagram - Head, etc.) except for a very few measurements (on my head and on the borrowed skull) which I measured to the nearest sixteenth of an inch (using a flexible measuring tape used for sewing).

An example of a measurement (and I repeated each measurement three or four times to get an average and to check on reproducibility) made with the sewing tape was the measurement of the distance around my head and around my borrowed skull in the nearly horizontal plane that included the furthest rearward extension of my head (the occipital protuberance) and the very top of my nose just below the eyebrows.

Subsequent Independent Corroboration of Wound Location

The point on the accompanying anatomical diagram that plots the location thereon of my "best estimate" of the point on the posterior oropharynx 7.5" below the top of Foster’s head (3.8" on the hard copy of the accompanying anatomical diagram) – namely the point on the diagram that is 2.5 mm vertically below Point 1 (see discussion above) – was subsequently independently corroborated by J. C. Huntington.

J. C. Huntington "scaled" a face-front photo of Vince Foster and located the "7.5 inch point" by using the FBI Lab Report in the official record (Tab 1 of the Fiske Report, dated May 9, 1994, at Page 12). Information in that report indicated that the distance between the pupils of Foster’s eyes (based on the 71 and 73 mm PDs from two pair of Foster’s prescription eyeglasses) was approximately 72 mm.

Mr. Huntington's work is at his website.

This email address is being protected from spambots. You need JavaScript enabled to view it.  is a CPA and Attorney in Dublin, California. Investigating the Foster case has been an avocation of his since the July 20, 1993, death. His ~380-page report on the death is available for just the cost of copying and shipping from various print shops around the US (Try 301-937-6500).

He serves on the legal team of Foster federal grand jury witness Patrick Knowlton (Attorney-of-Record, John H. Clarke, Washington DC, 202-332-3030). Mr. Sprunt also has been a guest on some 200 radio and television programs concerning the Foster death, including appearances on CBN, A&E, MSNBC, C-SPAN, and NET (now America's Voice). His work has been utilized by the authors of two books on the Foster death published in late 1997, Chris Ruddy's The Strange Death of Vincent Foster and Ambrose Evans-Pritchard's The Secret Life of Bill Clinton.

Mr. Sprunt was interviewed at length in 1996 by the Starr OIC in Washington. His Foster work also put him on the cover of The New York Times Magazine's February 23, 1997 issue.