A 31-year-old man had shrapnel wound in the neck. O/E, it was noticed that when he blew his nose or sneezed, the skin above the right clavicleftbulged upward. The upward bulging of skin could be explained by

The suprapleural membrane, also known as Sibson fascia is a strong fascial connective tissue layer above the superior thoracic inlet on each side, placed on top of the tips of the lungs. It's damage may cause bulge out appearance. Ref ganong's review of medical physiology 25e