Quinten Massys' Grotesque Old Woman , 1510-1520, was obviously created with a degree of  disegno interno . Anatomy: skull, eye sockets, nostrils, chin, cheekbones, collarbone, and fingers are depicted. Biologically correct? Yes, especially the hands.

 

Proportion: the skull is too long and egg-shaped. Eyes are too small, nose too short, breasts large(?). Biologically correct? Hands - yes, skull, length of nose and distance between nostrils and lips (like a chimpanzee) - no. Mass: there are many hills and valleys which are accurately shaded in high and low value. The eye sockets are sunken inward, the breasts flow over the top of her dress, and the knuckles and tendons in the hands show their bumpiness. In this example, the artist combined disegno esterno with disegno interno. Some parts are deliberately distorted or abstracted. If Massys could so beautifully represent the details of the hands, why didn't he continue that degree of accuracy and naturalism throughout the painting?
 

There is a symbolic message. Attached to a print created from the painting, Massys condemned older women who do not dress age-appropriately. He is ridiculing this older woman who still wears her hair and exposes her breasts as she had at least thirty years earlier.