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This term is used when a red-neck or skid is on a motorized vehicle and crashes it to the point of being thrown off the machine.
"I was goin third gear wide open when that badger popped in front'a me, tried goin 'round the critter and ended TITS UP IN THE RHUBARB!"
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Drunk to the point of being unable to stand up.
She drank the entire bottle of vodka. We found her tits up in the rhubarb.