Is THIS just a simple shape/object with an image as a “texture” fill?

[Thomas Sobiech]

So, this is apparently an Illustrator file…
As a relative newbie, I’m strying to figure out how this was accomplished (the skull detail.)
A “live trace” for something like that would generate THOUSANDS of paths/anchors, and not look nearly this good. Is it just a simple shape/object in the shape of the skull outline, with an image as a “texture?”