Donald Smith, 61, is charged with kidnapping, raping and murdering the girl, and faces a possible death sentence if convicted.

Smith allegedly lured her family to Walmart in June 2013 with promises to buy a McDonald's meal and new clothing, then left with the girl. Security video showed her skipping out the door behind him. Cherish was never seen alive again.

During 45 minutes of testimony on Tuesday, which left jurors in tears and had them covering their eyes, Dr Rao listed the dozens of injuries Cherish had sustained during her final moments, including bruises and cuts on her knees and thighs.

The medical examiner said the child's female anatomy was 'totally distorted' from the trauma of the rape, as First Coast News reporter Anne Schindler live-tweeted.

She estimated that it took the eight-year-old 3-5 minutes to die. As she was being strangled, her right eye began bleeding.