An exaggeration stemming from the term 'Fuck me sideways...' and adding the verbal irony of the words 'screw' and 'nail' as references to sex. Used as an exclamation in response of surprise, anger, etc.
"You what?! Well screw me sideways with a nail gun..."
"Screw me sideways with a nail gun... I got another ticket..."
"Screw me sideways with a nail gun! That freaking hurt!"
The process of fucking your cousin (with your dad) in a shed, with a blindfold on your dick and riding a tractor upside down and singing Yankee Doodle dandy. Your cousin has to be tied sideways to the wall, or it is illegal.
A request made upon the exchange of two camels for eight goats.... this is primarily an exchange made between two incompetent individuals and involves Mia Khalifa at some point in the exchange. This is of economic and political value to citizens of three middle eastern countries; Yemen, Oman, and Jordan -> the dead sea may be enacted to drown the camels
*Says Jesus to his Disciples* I'm running low on Camels, can you butt fuck me sideways?!?